CharleeJo.RN

I've worked in a pain clinic for a few years. We mostly do interventional treatment, but of course we prescribe as well. However, with the increase of abuse and diversion, we have all become so jaded, almost automatically assuming people are just drug seeking. I feel like we treat patients like criminals sometimes...random drug screens, pill counts, pharmacy check ups, huge contracts to sign, etc. etc... Obviously we have patients with legitimate pain who really do need opioids. But my question to you guys is, what do you suggest in terms of trying to "re-wire" the way we first perceive our patients? Any articles or anything like that you know of, that I can distribute to our doctors and nurses to help bring some of that negativity down? I just feel like we're doing a disservice to the field; but it's very difficult to work in pain management!

Definitely. I used Qbank for my PN exam and got minimum questions and passed. For my RN exam, I only did about a hundred practice questions out of Saunders, got minimum questions and passed. As long as you understand the question, understand the rationales to the answers, know your infection control precautions and medication suffixes, I'm sure you will do just fine.

no one can tell you what drugs they were tested on, that's in violation of the confidentiality policy you have to sign. the biggest help you could get on it - study medication suffixes and know what drugs those relate to. then, even if you have no clue what that drug is or never heard of it, if you know the suffix you can determine what the drug is for and then you can figure out what you need to watch for in the patient, how to tell if its effective, etc. worked for me on the PN and RN, i didn't even study specific drugs, just suffixes. for example, -olol is a beta blocker so its for hypertension (think of metoprolol), -vir is antiviral typically for HIV/AIDS (think of Norvir), -azole is proton pump inhibitor so it reduces gastric acid (think of omeprazole). so i'd associate a suffix with a common med to make me remember what its for more easily.

memorize infection control mnemonics (MRS WEE, SPIDERMAN, VCHIPS) and medication suffixes. for a disease, don't worry about the whole biological process - just know what it is, common symptoms, and common complications (thats how you determine "which patient to see first"). always go by ABCs for prioritization. when you do study Q's, always read the rationale regardless of whether you get it right or wrong, and make sure you understand what the question is asking. if you don't know the answer to something, eliminate what you know the answer isn't and you should be able to get close to what the correct one is. have faith and try not to stress.

For NCLEX-PN, i studied my butt off. did lots of practice questions daily, studied infection control precautions, medication suffixes, and reviewed content. it was overkill, i thought. i eventually threw out the content review and just looked up stuff as i went through practice Q's to refresh my memory. i had an hour drive to the testing center, so i had recorded myself reading out medication suffixes and infection control mnemonics and listened to that on my way up. i took the test (about two months after graduation), got minimum questions, felt it was actually pretty easy a test, and found out i passed (and yes the pvt worked for me:) the only book/cd i studied was Kaplan. i did not do any hurst reviews. For NCLEX-RN, i just took that yesterday. i have been out of school for over a year but have been getting really good clinical experience. anyways, i waited until 2 days before my ATT expired (ya, i know) to take the test. i paid $50 for saunders comp review 5th edition, and didnt even use the book - just did assessment and practice Q's on cd. in total, i only did 120 practice q's. again, i studied infection control mnemonics and medication suffixes. total study time for the rn, maybe at best 3-4 hours. i just didn't put much time into it. but again, i got minimum 75 questions, felt it was pretty easy as well (just like PN exam only with some RN-specific content) and the pvt says i passed but i have to wait another day to know for sure. you just have to realize that if you got through school and did well, you DO KNOW the content. you just have to focus and allow yourself to pull on that knowledge you already have and be able to apply it. even the questions i didn't know the answer to - i felt pretty confident in my answer, because atleast i knew what the answer WASN'T. it's a matter of deduction - eliminate what you know isn't correct and you're left with what is. plus knowing the infection control guidelines and med suffixes made a huge difference. just say a lot of prayers, try not to freak yourself out with stress and you should do just fine. good luck :)

Thanks, I feel much better :)

Hey guys, I've been out of school for a year now and am just starting my studying for the NCLEX-RN. I purchased Saunders Comprehensive Review for the NCLEX-RN Examination, 5th edition. Here's my question: I've been studying off my old notes and going over those lab values, but I've already found a discrepancy between those and what is in the study book. For instance, they list the range for HCO3 to be 22-27; in school, it was always 22-26. Could someone be so kind as to list lab value ranges as they know the NCLEX considers them to be? I would be so upset if I got a question wrong because I was a point or two off of what the test considers a normal range! Or anyone know where I can get this info? Thank you so much!!

Hey, I agree with mc3. I've never had so much ridiculousness working with men as I have with women. I'd take a male coworker over a female coworker any day of the week. Makes my life easier.

You know, you're probably right about the making BFF's comment. My soon-to-be-husband (in 2 days!) and I just moved here, and we don't know anyone, and our social life needs a boost. That's my problem! I'm such a people pleaser too - I always want everyone to like me. Maybe I will just ask her though. Thanks.

I agree with xtxrn. Hating someone takes way too much energy - they aren't worth it. Just keep a smile on your face, do what you have to do, and get on with your life.

Oh lord, I've dealt with that at quite a few places. My last job I was at for over a year, and was happier than anyone in the world the day I quit because I was moving. It was wonderful! There were maybe 5 people (out of 60+) that I didn't dislike. So many of them were horrible, spiteful, insubordinate, disrespectful, gossiping biotches. So how did I deal with it? I just went to work, did my job, minded my own business, didn't participate in gossip (if someone were saying something, I might listen, but NEVER gave any comments). They probably thought I was anti-social, but I frankly didn't care about their pettiness or being social with people I didn't care for anyway. My boss felt i was a great nurse and those that mattered respected and appreciated me. If i needed to delegate something, I did - if I needed help, I'd ask someone who was helpful - and at the end of the day, I'd vent to my family, fiancee' and friends. Work is work, and I left it there at the end of the day. :)

I've worked at large LTC facilities before (4 of them) and have dealt with many, many, MANY catty and double-faced women. I learned through those experiences not to trust coworkers, not to talk to them about anything personal, and to keep all opinions & thoughts to myself. However, I am now working in a much smaller facility (the nursing staff I work with is less than 20 girls) and they all consider themselves family, and are friends outside of work. I was really excited to be in this type of environment and really enjoy the job and the people I work with. Everyone is so nice, non-******, and unbelievably pretty much ZERO gossip. Crazy! But - there is one girl who seems to not care for me, and is the only one who doesn't always say "hi" to me when I do to her and acts, most of the time, like I'm insignificant. I don't know if it's just because I'm the new girl and they are all so tight-knit, so that's just how she is with new ones? Or if it's something about me specifically. Normally, I wouldn't really care - especially if it was a bigger facility, because I just always kept to myself, got my work done, and got the hell outta there. But it's much different here. So how do you deal with this kind of situation? Should I extend the same behavior to her or keep on doing what I'm doing and hope she comes around? Should I just stay out of her way? I'm always asking the girls if they need help or if there's anything I can do for them, maybe I'm just being annoying? WOW this post makes me sound really lame! haha But I'd appreciate any feedback. For whatever reason it's just been bugging me. Thanks

Many potential employers do background checks and may do a credit check. A credit check includes a list of past employers, although not every place you've ever worked will probably show up - but if you were somewhere for that long, it probably would. Then you'd have to explain why you left it out. I've been in the same situation as you, and I put the former employer on my resume. Actually, when my employer terminated me, she said "you don't even have to tell people you were fired. We can't release that information, so you can tell them it just wasn't a right fit for you here." That's exactly what I did, too. And I haven't had any issues - I've had nursing jobs since then, and I work at an amazing - and extremely picky - facility now. It's best to be as honest as you can without setting yourself up for failure. :)

Believe me - it DOES get better. A million times better! I've worked as an LPN for about 2 years now and just graduated with my ADN, and it's amazing where I'm at now compared to where I was as a brand-new nurse. I never thought I'd get to this point, professionally or emotionally. I'm only 3 weeks into a new job in an entirely new and specialized field, so coming to this place was kind of like being a new grad again - I didn't know jack about this field and basically had to start from scratch. I still spend evenings researching procedures and meds we use. However, the difference between now and then is my confidence. Back then, I had ZERO confidence, and due to everyone beating me down (coworkers, supervisors) I was convinced I'd never amount to anything resembling a decent nurse. I was fired from my first nursing job - basically for poor judgment - and that was one of the lowest points in my life. I'm talking major depression, seclusion, just all around misery. Felt like such a failure, fool, all those things. I did very well in school, but in the real world, I just couldn't cut it. But I was wrong. After being fired, I decided to spend a few months before pursuing another nursing job. I went back to my old non-nursing position per diem to make some money, and with the rest of my time I did a few things - spent a lot of time dealing with what happened, working through my own feelings of failure and unworthiness, then building myself back up. I studied skills I knew I lacked in, reviewed basics and common diseases/meds, and then looked for another nursing job. I learned from my mistakes at the last place and somehow I did very well at this new job. I was able to get organized, utilize resources, seek help when needed and not be ashamed to ask for it, and prioritize so I could deliver the best patient care with what time I had. Now I'm even better at being a nurse and actually get commended for my skills, confidence, and patient interaction. I love where I work and I know I am good at what I do. What I'm trying to say is - don't worry, you'll get there. It just takes a lot of time, patience, and practice. Continue to work on things that you need to work on, seek help, and ask others for tips - how do you stay organized? how you do prioritize? how do you keep track of all the little things that come up? I used to keep a notebook with me and every thing that came up I'd write down, so I wouldn't forget, and I could prioritize what needed to be done and mark it off as I finished it. I'd gather supplies ahead of time and do as much as I could with one patient while I was with them - which meant I had to get all my info before starting rounds, so I could anticipate what needed to be done and do it as I went along. Just take your time, you're not expected to be fast yet. What's important is that you're safe and doing things correctly. With time, you'll get better and faster. Just keep faith in yourself and continue to build on your skills. Good luck.

Yes, they are all right. The bottom line is - ALWAYS - cover *your* ass. That means you ask questions to clarify anything ambiguous or not seeming right, and doing things the correct & safe way until you've reached that point in your career where you know the safe way to sidestep things. I've been in similar situations too, as I'm a fairly new nurse and recently finished with my ADN. You just have to always go by your comfort level and if you know that something is being done that isn't "by the book" then DON'T do it. It will be your butt, not anyone else's, if something goes wrong or someone catches wind of it. And everybody else will be satisfied with your role as the scapegoat, so long as they are safe and sound. Good luck to you and don't let yourself be jaded by other people's misery. Some people truly don't belong in the nursing profession. Just do what's right, safe, and ethical - your patients can only benefit from it.