KimN

I am very sorry that you are going through this, I can only imagine how heartbroken you must be. However, I think it is wise for you not to go to the BON .. it is the instructor's responsibility to pull an individual from a program if they feel there is unsafe practice occuring. I can tell you from experience in my program that some of the A students in class ARE NOT competent on the floor - and in fact it terrifies me that they will be practicing nurses one day. Book/grade smarts will allow you to pass the NCLEX... so who is there to advocate for future patients? It is the nursing instructors that are working with us now during school and seeing our patterns. As student nurses we should know best that isolated incidents require education .. a pattern is something that needs to be addressed. I in no way mean this as a personal attack against you because I honestly feel for you and am sorry to hear this. But on the flip side I do agree that your mistakes warranted further action. Think about how devastated you would be if anything did happen to any of these patients... or how you would feel if a nurse did these things if the patient were a family member. I think there is something to be said about your comment as working previously as a LNA. I saw that a lot of the students who made harmful mistakes during clinicals were actually those who had previous experience working with patients and nurses. Because they see others doing these things they tended to think it was OK practice even though they actually knew it was wrong. These students also tended to be the most likely to roll their eyes and scuff when corrected by an instructor or nurse (not implying you are this way btw). Anyway i'm sorry this happened and it seems that you are taking responsibility for your actions, but have to say that there is probably a larger issue to why the instructors chose to exit you from the program. I wish you luck and happiness with whatever you pursue in your future :)

After two weeks jam packed with midterms, lectures, seminar, CWE hours in the emergency department, and a group project - I am overjoyously happy to say that I have THE WHOLE AFTERNOON TO MYSELF! I came home and changed into my pajamas (at 1:00 in the afternoon btw) turned my phone on silent and just sat. In pure silence. It's beautiful really. This is actually what makes nursing school worth it ... these times that you can appreciate nothing at all. To all of you who are stressing over a test or assignment right now i'm sorry ... but I will be back with you tomorrow. So what am I to do with all of this time .. nap, read a book for pleasure, watch tv?? No, I am on AN talking about nursing. Something is obviously wrong with me! Anyway I am so excited that I have some "me" time that I had to share it with you all - afterall you guys understand what I am talking about more than anyone else! I hope you all are enjoying your day as well

What information have YOU come up with? If you provide what you have done so far then we can try and help you organize or clarify those thoughts/issues. Without any information from you we can't help much.

Well here is my two cents on the BP issue. Based on what is presented here we do not know what is normal for this patient. Yes it is unlikely that her BP is normally that high, however, we cannot assume that she is having increased CO when we really don't know if that is abnormal for her. Also, you can make a nursing diagnosis and interventions related to her pain - within these interventions you can address the BP briefly by stating that pain medication as ordered may decrease anxiety and may lower BP (or something along those lines so it satisfies instructor). Most likely your instructor just wants to see that you can connect increased heart rate and blood pressure to a response to pain. Good luck!

Seems unfair to throw it on you last minute but usually you have more than one opportunity to take it .. many schools allow two - do you know if your school will allow this? I'm sorry I am really not trying to sound insensitive but I think it's actually a really good thing. It is scary but think of the confidence it will give you about the NCLEX when you pass. My school requires us to take HESIs 6 times a year!!! Seriously it's crazy and we have to take a final cummulative one at the end of the year to pass. They basically sprung it on the class doing it a few years ago when it started. I gripe about it but I think it's good -- we should be able to pass these tests if we are going to be nurses afterwards .. I would want my nurse to have been able to pass at the end of school! But really all the luck in the world to you and you've been preparing for it all along!

Okay okay let's see if I can make any sense here from student to student. It seems that maybe prioritizion is the issue here? I know when I started nursing school I would be so stressed about these things that I would find myself pulling for amy diagnosis that would fit, that I didn't think about the actual components of the problem and what is the most pressing issue that I need to be aware of as a nurse. The goal for preeclampsia is to get momma as far along or as close to term as we can get her and prevent her from developing eclampsia (seizures). Eclampsia can cause significant fetal harm and possibly death because of insufficient oxygenation. So that is a safety issue that takes priority in this case. Yes, she has high blood pressure but are you sure that her problem is related to fluid deficit .. and if so what makes you think that? Are there medications and non-pharmacological treatments that can help reduce the risk of this woman having a seizure? And what about the fetus ... you've got two patients here so we need to be monitoring them both. So I think if you decided to bring the baby in and the risk for hypoxia related to (vasospasms/seizure/whatever) as evidenced by (signs of more severe preeclampsia .. headache, BP, DTRs, etc). Also, what if she has a seizure - what would have to happen then? ... hmm premature delivery ... C-section complications ... ?? And lets think about diabetes here too and how that can complicate preeclampsia as well as the baby when it's born. What signs will the baby have from having a diabetic mother .. what are the S/S of hypoglycemia in baby and momma. I know it's a ramble but I hope it helps. This stuff can be very fun and fulfilling if done thoroughly and thoughtfully. You'll be thankful one day when you see it in real life and think "I know about this!" :)

Also I completely agree with Biffbradford's comment. The hospital I am working in does post jobs on their website etc. but primarily uses internal nurses already working for their facility to fill them. Most of these nurses that fill the jobs are facing department cuts themselves and are basically moved. Legally they have to post them online, but they don't even consider external applications.

I have no advice that can help you with securing a hospital position, but I do have some insight on the new grad hiring thing. It seems that in my area many facilities are hiring straight from their own preceptored students from nursing school. For instance I am in the emergency department and have the oppportunity to preceptor there for a full year before I graduate. I've been told that if I continue to do well I will likely get an offer when I graduate because many of the newer nurses that do not have hospital experience generally don't make it past orientation. The thought I guess is that they already have seen what you can handle and don't have to "trial" it in a new hire that is unfamiliar - which also means less orienting time for them. I have heard this is becoming more common. It's a good thing for me, but I feel like it is NOT fair at all to those who are in your position. I worry about not getting that offer, or hired in the hospital at all after graduating and not having that experience on my resume a year from now. I'm sorry that you and so many others are experiencing this. I truly hope that your persistance and drive pays off for you ... only good things can come with time :)

I completely agree with the above poster. I used to be that first year student that complained about not doing catheters, etc. (although payback has been a you-know-what this term .. it's been catheters galore!) And although I do still think practicing skills is very important and helps with confidence, now that I am almost done I am more concerned about things like prioritization, full patient assessments, critical thinking on my own, and just complete patient care. I am more worried about making sure I am competent enough to provide safe and excellent care to my patients on my own. I really wish that we did have more opportunities in clinicals, but I think you will do great! :)

I am in my last year of nursing school and asked my program director about signing up for clinical work experience credits on top of my class and clinical schedule. There are about five of us doing it and working full time with nurses in various departments. I worked hard and got into the ED and by the time my last term comes up I should be able to completely handle my own down there and prove i've got what it takes. I have heard other new grads have gotten hired this way and have used this as basically my chance to shine and show em' what I got. It's exhausting on top of everything else but so worth it since I HAVE TO GET HIRED IN THE ED! You should see if your program will allow you to do something like this. Hate to say it but most the time you've got to know someone or have a chance to show them what you can handle to get hired on out of school. I know that it has been commented on several times, but I cannot advise you strongly enough against going into any ED and handing the director your resume. I would almost say that's enough not to get a call back ... it may show you dont understand the culture of the ED. If you've got the desire find a way.. I wish you lots of luck!!!

I don't know ... that sounds pretty. scary. I can just imagine the looks from other staff members you will receive when they see you writing patient information down for your own records and then leaving the facility with it. I'm also not sure that keeping the mother's initials would do much good helping you statistically. It seems like once you are working on the floor for a while you will have a mental statistic library! :)

Please don't ever believe you are dumb for having a rough patch in your program. This website is here for a reason, and there is a 'student' section for all of us, who just like you, are struggling at some point or another. You deserve to be where you are ... no nursing program is easy to get into and you earned your way in. I hate to say it, but to quote my instructors, "nursing school isn't hard, it's just hard to learn to adjust." Not to down play all of the work that goes into it, but the trick is learning to adapt to the style of nursing school... and once you get it down it gets so much easier I swear! I haven't met a single person who did not struggle at first. I urge you to make frequent visits to your instructors ... they will appreciate your eagerness to improve. I wish you all the luck in the world!!

Hey, as a senior nursing student I can tell you that there were people who made it into my program with less than excellent GPAs. The key is nursing specific pre-requisites ... in which case they pretty much needed to be perfect. I think you've got a good of a shot as anyone with your pre-req grades. Good luck!

Thanks for the responses! I don't think I did a very good job of wording my question. I was actually not intending it to sound like I was seeking advice about what I personally would do in that situation, but instead just trying to get some feedback on the research I was looking through. I definitely understand that a physician provides the orders ... I am a confused student, but I definitely know that ... PHEW! :) It was really meant more out of interest because I had never heard this before and was wondering if it's something that was common. Also, I was wondering about the claim of it being unsafe for pediatric patients and wanted to see if anyone had any feedback. Although it is not my job to dictate the orders, it is mine to know when it is not safe to carry them out. And in the end i'm still a student which means I think too much about everything & am fascinated by new information. :)

Hey guys, So I have been working on my case study for a pediatric patient that presents to the ED with DKA. As i'm doing my research I have been finding a lot of conflicting information about whether or not it is standard today to give an insulin bolus... a lot of resources are telling me that they are finding that the bolus is either not necessary or unsafe. Since I haven't been in a DKA situation myself I can't speak to what is currently practiced in my local hospital, although i'm assuming they do provide a bolus before starting a continuous drip. I will check their protocols in clinicals on Thursday though. Anyway, for the purpose of my assignment I am going to include the bolus as a treatment since that is what our current med/surg book says, but was just wondering... what do you guys think? Have you been in this situation and seen whether or not your facility gives an initial bolus? Thanks :)