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  1. LovingLearning

    Most useful Pre-reqs

    In addition to those mentioned, I took Physics. Surprised myself and got an A...and it comes in handy. It's not directly RN school related, but I understand things better and techniques come more logically to me, because I understand the principles behind it (eg smaller lumen = higher pressure -> HTN/BP (and it's medications), needle choice, barrel choice, and so on). Sounds kinda dumb, but I'm glad I took it. I wish my second language was anything but sign language...spanish would've been good... Best- Lovin' Learning
  2. notes from first year on the floor at los angeles county rn school... things to tell your patients: ~if you have a whoopsy stomach at the sight of blood, don't lean over and watch me change the surgical dressing on your leg. that will lead to vomitus in the wound, and several other people in scrubs answering my call for help. it will also wind up with you in the or again getting irrigated to make sure everything that was in your stomach which is now on your leg is not in your wound. ~if you're a gang banger, got shot in a drive by (for the third time), please don't have your homies come into the hospital and scare other patients by their presence. and please, when i (the student nurse, at that) enforce the 2 at a time rule, don't threaten me with 'making sure' i get mine. and then don't get miffed when i don't run down to the cafeteria to get you a double bacon burger. and it really doesn't help to have an escort watching everything i do. *i* am not the bad guy here...and i don't need monitors. and no, they can't come into the med room to 'watch me get the good stuff.' ~when you're limited to bed rest because you've had hardware put in both your legs, and pt hasn't cleared you for movement and not given you any assistive devices (like that wheelchair you so greatly desire...), don't get your girlfriend to get a rolly-chair from the nurses' station, manage to get into it, use the toilet, and then get back in bed. and when asked, you didn't get that idea from me. ~and yes, when you urinate dark green colored, putrid smelling urine, you're probably not going home tonight. the dr will very likely think you've gotten an infection in your abdomenal gunshot wound, and bring you down for emergency surgery. tell your dad dark green urine is not normal, and he doesn't have to yell at me because he wasted a trip to take you home. i already know parking's terrible...i walk more than 1/2 a mile to work from my parking place in whatever weather is going on. have a towel, and relax a bit. it's probably going to be a long wait. and no, coffee on the floor is for the rns, so we can keep up with people's needs. ~and expect the nurse, and the student nurse, to chastise you when you're caught trying to shoot illegal drugs in to your already ravished body via the iv we put in so we could put medication in there. dude, where'd you get that stuff anyway? and yes, we really did have to call the police. ~when you've asked for yet another ice pack, and i have to make one out of a latex glove because you've used the two dozen we keep on the floor, don't be mad that it leaks. that's why i wrapped it in a towel in the first place...and yes, ice melts when you've got it under your head. ~and yes, i will ignore you wolf whistling at me to get my attention. and don't get embarrassed when, in front of your homies, i explain that using the call light will indeed work...and i know you know where it is, because you've used it before...quite a few times. if you're wolfwhistling, you're breathing...and sometimes, that's all i need to know. thanks for the learning opportunities: ~leaving the poop in the potty for me to look at. i really do need to chart what it looks like; i don't do this because it's fun. ~making sure i know you need your pain meds. other patients informing me of the screaming woman doesn't actually make my feet move faster, but it does make me laugh. ~keeping your eyes closed and holding your breath when i come in the room, just "to see" what i'll do, especially if i've just given you medication for that pain you were screaming about. i will come and thump your shoulder. be happy i stopped before i decided chest compressions were a good idea. and for that patient who listened to me, who helped me help him, who asked good questions about his illness, and who hugged me when i told him i was going off shift, thank you, thank you, thank you. because of you, i was able to leave the floor in a good mood. because it only takes one person saying 'hey, nurse, thanks...' to make our day. and just as a last note, spitting at me and calling me names doesn't really make me want to do anything extra for you, like bring you that burger you're demanding. it was a good idea, and it was a good dinner...sorry you smelled it on me when i came back in the room after lunch. other adventures which were outstanding: ~seeing how abusive parents explain to the po-po that you weren't actually boiling the baby, you were just "cleaning his ass with hot water." and being able to walk away before i beat the parents. ~watching a patient bleed out and die on tuesday, and calling a code blue on a patient on wednesday. ~doing post mortem care on a patient who, last week, was chitchatting about horrid hospital food. ~finding out as one inserts the syringe that the patient's family has already given him something 'for the pain'...and then discovering that the bottle reads "morphine to be administered sublingually"...and yanking the hypo out as fast as possible so he doesn't get any more. ~discovering that someone really can have a bp of 63/37, and be talking and asymptomatic...while you run into the hall and get help. ah, first year rn. what an adventure. for the first time since returning to school, i did not make dean's list. i passed, two as, one b, and a c...but there is always next semester to get back onto it. i'll do it, too. and when i came off the dean's list, my instructor asked me if i had a learning disability. no, but you may have a teaching disability...and yes, i did really say that...and walked off very, very quickly (she was too stunned by my comment to say anything that day, and prudently didn't ask me any more about why my grade was slipping in medsurg...during her lectures in particular...smart chick, she.) i've come to discover that 4 am coolness and dark is a good time to see a quiet, calm city but not a good time to discover that you're out of printer ink; that 3 pm and hot is a better time to find that damned ink; but that it's best to stock up on it in the first place. i've discovered that my local diner really didn't mind that we held study group on the porch, sometimes spreading out "sterile field" on the neighboring table and practicing foley insertions on paper drawings until midnight. i've learned that even a quick "i love you, dad" makes the difference in my father's day. i've learned that a quick hug for a colleague whose day just got horrendous because a patient let her have it, makes a difference. i've learned that buying the lunch for the person behind you in line makes a difference. i've learned that most kids will respond to you when you make faces and talk in character voices, even if you're doing something scary...and that a bandaid that *they* select will make a difference. i've learned having a license plate holder which says "i save lives; what do you do?" gets you out of tickets...and that really makes a difference (problem with the license plate holder, though, is that you actually come to the police's attention far more often than before). lol. i've learned that the nightmares do go away after a while, and that what bothered you two weeks ago can easily be trumped by what you discover today, and that getting a hug from a colleague - or a patient - will make a difference. i've learned that fine print and low light do not make the studying go more easily; nor does studying in bed. osmotic absorption from books is a myth, but will leave you with lines on your face when you sleep on the books all night...and those lines can't be covered by make-up. i've learned that cornering my instructor and asking for help is a very, very good thing. i've learned that instructors are people too, make mistakes, and have a lot more pressure on them than i first thought. i've learned that most learning happens on the floor, while struggling to put theory into practice; that things are supposed to go one way, but often go another...and being flexible is key. i've learned that assessment really does drive the train. and i've learned that some doctors really do appreciate your help, and rely on you to catch things and bring it to their attention...even when it's really hard to gather the courage to do so. but what i've learned most, through the trials and travails of rn school, is that i love this stuff. it's hard. it's trying. it's scary. it's very, very tough. and it's the best thing i've ever, ever done. nursing is the right choice for me. just thought i'd post this up for you guys. best- lovin' learning
  3. LovingLearning

    Swine flu raises fear of pandemic - Adults and Children

    In re: changing the level to 4...there are a whole lot of economic implications with level 4 and above; large companies have plans to deal with things like this, which include closing operations, and bringing people home, stopping shipping, et cetera. There are also a whole lot of trade implications, including stopping imports/exports, in some cases. I've even read where the stock market would close at higher levels. I suspect that the WHO is getting pressured to not change the levels just yet, d/t the enormous ramifications to the economic structure and financial health (or lack thereof) of this country (and the world at large). It is stunning, however, that the WHO has not acted independently, and done what should be done; follow their own guidelines and let the chips fall where they may. If, however, they do change the levels and institute guidelines which restrict import/export, I wonder about how that will affect interstate commerce; trucking, agriculture, and supply lines may be affected. And if that happens, that will be a serious challenge to day-to-day life for everyone. Just my thoughts this morning...it will be interesting to see how the politics of being ill will affect the health of a nation, both economically as well as physically. Best- Lovin' Learning
  4. LovingLearning

    Swine flu raises fear of pandemic - Adults and Children

    Ditto...Nebraska it is for me too. It is a great book. I'd rather it stay in fictional land, though. I've been doing a lot of reading about this today; it seems there is a lot of concern, and the CDC/WHO is not producing much reassurance. I live in EQ country, and have, for the last 20 years, kept a goodly supply of food for me and my critters (cats and horse) on hand. I think, however, that tomorrow, when I do my regular marketing, I will look into getting a bit more on hand than I usually do. I am pretty calm...but the stuff I'm hearing/reading isn't reassuring whatsoever. Best- Lovin' Learning
  5. LovingLearning

    Oh! The sacrifices we make just to get through nursing school

    What have I sacrificed for NS? My sanity. But I have to say, it's worth it. Being sane wasn't too much fun anyway, and I don't actually miss it **too** much. Best- Lovin' Learning
  6. LovingLearning

    Strange experience yesterday, feedback please...

    I just wanted to update the thread... Spring break, and that rotation has been successfully completed. I had my evals by my professor, and nowhere on the evaluation was any comment about this incident whatsoever. He did say that I took initiative, and that I was able to manage patients' needs effectively, but other than that, there wasn't even a hint that this occurred. YAYAYAY! Now, on to Peds and OB...only 9 weeks left for second semester, and I even managed to pull off a B in pharmacology! Thanks again for all the support...I appreciate it a lot. Best- Lovin' Learning
  7. LovingLearning

    Strange experience yesterday, feedback please...

    Thanks for the support, you guys...I appreciate it a lot. There has been zero issues regarding this event, literally NONE. Apparently, no complaints from staff, none from my instructor, and none from the patient, so I figure it's all good. As a matter of fact, I had a patient this week who was very, very ill...with no dx. When I was done with my day, my instructor (who'd helped me carry out Drs orders that were new, et cetera), told me I was a very good nurse, and was able to take excellent care of my patients. So I'm pretty satisfied with that, going into midterms and rotation shifting. Thanks again, everyone. I do appreciate the feedback and support. Best- Lovin' Learning
  8. LovingLearning

    please i need your prayers

    Hugs, love and prayers to you, as you start this new part of your life. You are not alone; God sees, knows, and holds each dream and tear in His hands. Your beloved is watching you through the holes in the floor of Heaven, and will not leave your side. In this time, remember that there is always a Plan, and that you are never alone. Best- Lovin' Learning
  9. LovingLearning

    My pt dies on me in clinicals... and.

    Just wondering how you're doing? Despite my fear that I was going to have nightmares, I haven't, at least not yet. I will say I'm taking a lot of good natured teasing from my colleagues, but that's to be expected. LOL. Hope you're handling it well. Best- Lovin' Learning
  10. LovingLearning

    I have a few questions I really need help with 3/6/09

    She's not going to help you because you need to learn how to break down a question...I'm learning that, too. 1. If a patient has pneumonia and becomes restless: vital signs are T 100F, P 110, RR 28, BP 130/72, what should you suspect? O.K., let's see. Pt has a fever, is tachycardic, resp are high, BP a little elevated. So what's going on? Look at your NANDA dx book, and look up the diagnoses. Match the symptoms to the characteristics, and you can narrow it down. Then, consider the airway, breathing, circulation issues; choose the one which deals with those both, and I'll bet it's the answer. 2. The usual dietary recommendations for a cardiac patient includes? Break this down, too. What is the biggest issue with cardiac patients? Which diet is best for them? In your medsurg book, look at cardiac diet, low sodium diet, low fat diet, and see which one appears best. Then, look at your nutrition section in your text, and determine which would be best for a cardiac patient. Between those two sections, you should be able to figure out the answer. 3. A nurse should be alert to complaints of decreased exercise tolerance and dyspnea in African American males because they are at risk for ? If you really can't figure out the answer, look at the recent billboards peppering most cities. This illness has a higher constituency of African Americans, and is on the rise. What do you nearly almost always find as a co-diagnoses on the Kardex? Another way to look at the question is to once again, hit the text. Which one of these illnesses causes both of those symptoms, and appears in the African American population more often? What the instructor is asking you to do is learn about the s/s of the illnesses, and learn your NANDA dxs, and then apply that to the questions. I'm going to give a wild guess and say that what she wants from you isn't guessing, but to start putting 2+2 together and coming up with 4. It's not easy, but if you break it down and do the research, and then apply the nursing process and critical thinking skills, you'll come up with a good answer, and be able to justify your choices (give a good rationale). Good luck! Best- Lovin' Learning
  11. LovingLearning

    Strange experience yesterday, feedback please...

    Hey back, All Star... Thanks a bunch. With this instructor, he is all about applying the nursing process, and doing what needs to get done - as long as we stay within the parameters of what the school has cleared us for, and as long as he knows we can do it. And in this particular situation, with the weirdness of the fire alarm, nurses locked off the floors, and whatnot, the charge nurse was who gave me the direction, and who guided me until my instructor was able to get back up. It'smyturn said: Yes, it was one heck of a day...LOL. But that's what happens sometimes; the day gets weird, and you have to go with what you have. And no, I didn't figure you meant I was going nuts...it's all good. I am a strong personality, and I do ride the line between aggressiveness and assertiveness. And like you, I go at it full force and effect, as the old song goes. In this instance, it was a strange combination of events; a staff RN who is the kind who, when a student gets assigned to her, groan...and a fire drill...and a missing instructor...and a SN who was stuck with the instructor, and a patient who I was covering for in pain and needing some help...and a charge nurse who trusts and knows me. Thanks for clarifying...I appreciate the time you took, and the feedback you gave. As it stands, I took my instructor aside yesterday, and asked again if there was any issue. He looked at me and said "why would there be any issues?" with a puzzled look on his face. LOL. It was just a weird day. Followed by a second weird day. But it's Friday now; I've learned a lot this week, and today is a day to just relax with the cat in my lap and a cup of coffee at my side...ah, Fridays! Best- Lovin' Learning
  12. LovingLearning

    Strange experience yesterday, feedback please...

    I hear you. Bear in mind I wasn't running down the hall screaming or anything. I was also a little startled when the charge nurse said "well, call the Dr. and let him know." But I hear you. Thanks for your input. Best- Lovin' Learning
  13. LovingLearning

    Strange experience yesterday, feedback please...

    Thanks, Nurse educator. I was concerned enough to go through the chart, check allergies (both chart and with the patient and her oldest daughter), take vitals and look at last labs, pull my med book and review this particular med's contraindications (it was vicodin), check tylenol intake for the last 24 hours, talk to the patient about her reactions, and also her daughter who were both familiar with the medication. It wasn't early in the shift, and I was guided by the charge nurse who was right there with me for the conversations with the Dr. Let me also add this: the pt had a chest tube placement with only motrin on the chart for analgesia s/p. The Dr. wrote an order for morphine (IV) for BTP along w/ the vicodin. Thanks for the compliment. :) Daytonite, I've written a response twice now to your comments, and chose to delete. What I've decided to say is simply thanks again for your feedback; everything is a learning experience. Best- Lovin' Learning
  14. LovingLearning

    Strange experience yesterday, feedback please...

    Daytonite said I don't know which rules I broke? I asked the staff rn twice to help the patient, and asked her what I should do to start the process. She declined to either give me instructions or to take care of the patient herself. I went up the chain of command in a situation I was unfamiliar with and I didn't let a patient suffer. The staff RN went home. My instructor let me into pyxis. I gave the pt the vicodin and she reported 2/10 in 30 minutes. I followed school protocol...patient care comes first. I followed the charge nurse's directions in getting ahold of the Dr in the absence of my instructor. I did as we are taught...interacted with the Dr as appropriate (very little, in fact). Since the fax was down, the NA took the oder (as usual) to the pharm. Pharm put it into pyxis. The patient got her meds. No one complained, or was even upset. My instructor wanted all the details just in case - as I would, if the roles were reversed. Leaders, to me, are those folks who step in and deal with a problem when it arises if no one else is doing it. Leaders set an example. Leaders go to their leaders when there's a situation they don't know how to handle. Leaders take responsibility and action when the situation calls for it. For me, being asked to take care of a very delicate situation yesterday by the same charge nurse from the day before spoke of her confidence and trust in my judgment...additionally, my staff RN asked me to come with her for emotional support during a procedure she was uncomfortable with. Apparently, with the charge nurse and the RN I was assigned to, they're comfortable with me. And my instructor didn't see fit to write me up, discipline me, or admonish me in any way other than what he did in the parking lot after hours. So I'm not sure which rules I broke. Best- Lovin' Learning
  15. LovingLearning

    Need encouragement and advice

    I don't think you should give up...you've got a lot going on right now, between the struggles with studying and with your father's health issues on top of it. Take the break, but don't give up... And I'll share my favorite "secret study tip": tape the lectures. Spend the money to get one of those really good digital ones, and tape the darn things. Listen to them while you're driving, while you're exercising, while you're cleaning the house...but listen to them. It gets in better that way somehow... And my favorite "stay sane at all costs tip" is to take ONE day a week - only ONE - and make it a book free, study free, stress free day. Sit on the sofa, and watch your toenails grow. Go to the mall and watch the people. Do anything other than struggle and stress. I guarantee you, you'll be more able to get the stuff you're studying to stay in there...and come back out when you need it, if you take the time to have YOU time. And I'm old, too...we can do it. We can so completely do it. Best- Lovin' Learning
  16. LovingLearning

    My pt dies on me in clinicals... and.

    Seeing as I had my first post mortem care tonight, and it was a very similar situation...all I can say is I'm right there with you (he wasn't my patient, though...). After we were done, I nearly passed out and then vomited. The RN with me told me it will get better with time, and that she'll make sure I get to do all PM care in the future so I can get used to it. Sigh. But it's really freaky when the body moves around on it's own like that. It's all normal and natural, but it's still pretty freaky. I'm right there with ya...I'm just hoping there're no nightmares. Best- Noni