littley

Baptist is like a fortress...you can't get in ANY way! In all honesty, I've been to their ER twice this year and wasn't at all impressed; actually had an unpleasant experience both times so not sure why they are so picky. Moving on...there are two hospitals that I have seen that are currently accepting applications for new grads. One is Bethesda Memorial in Wellington, FL, and the other is Delray Medical Center. You can search their job openings in the career section and they will be listed under nursing. These hospitals are about an hour north of Baptist so its a bit of a drive but I don't think we can be too picky at first. If you live further north, they're even closer. Another option is North Shore Medical. I spoke to the recruiter there during a job fair I went to when I was job searching and she told me to apply because she tries to do what she can for new grads. Another tip...don't just apply online. Send your resume with a cover letter along with a copy of your license, any certifications, letter of recommendations, etc. Send a whole packet and address it to the hospital address to the attention of nursing recruitment. You'll be taking an extra step from just online applications like everyone else out there. Hope this helps!

Ummm...I never made this a big deal. I was taking suggestions. Invasive is someone performing a lady partsl exam on me for pre-employment. However, my health is my business PERIOD and is an invasion of my privacy. I agreed to it obviously and I have nothing to hide but like someone did mention, yes I was concerned that if out of the blue something came up that it would risk my job that I need very much because I have been unemployed for a year now. So for those that were supportive and understanding and gave their experiences, thank you; everything came back fine and I am in my orientation now. To those that attacked about making a "mountain out of a molehill" or insinuating this was blown out of proportion..."seriously", I hope that's not how you respond to your patient's worries and concerns.

They can screen me from top to bottom and obviously if I was a drug user then they need to know. I just worry that if (God forbid) something comes back abnormal (like low plates, low WBC, or anything else that requires much further workup), that I will lose the opportunity because I'm not a "healthy" employee. I'm a new grad and the opportunity I was offered comes around once in a lifetime. As far as i know and feel, I'm healthy...but still, being in the medical field you know that you can easily be surprised sometimes. I just have to wait but still, it rattles my nerves a bit cause you never really know.

hi to all!! i just wanted to take a few minutes and ask around. i went today for my pre-employment physical. i know that obviously drug testing and titers are drawn. however, when i'm about to be taken to the lab, i am told that i will also have a cbc done. i felt that was really invasive in regards to my health privacy. i think my health, as long as its not a communicable disease issue where my patients are at risk or i am at risk of catching it from my patients, is exactly that...my health. at that point, i really had no choice. its the job of my dreams and what am i going to say...no and there goes my employment. however, i did feel slightly violated. what if there is something? what if even though i am young and healthy, they find something very wrong and either a) they decide that someone sick is not someone they want to invest in and i lose the job i didn't even get to start and/or b) now the hospital is aware of my health issues? maybe i'm wrong but i just feel that it was unnecessary. what do you all think?

Hi Jadu1106...I am going to a job fair on Monday actually. I'm excited about that because they have a specific time slot for new grads. So fingers crossed! And hi PediLove2147! I have applied to all specialties, including home health. But even home health is getting picky. A lot of them are requiring all these classes (alzheimers, OSHA, etc.) just to apply and then who knows if after you spend the money on those courses they hire. But I haven't given up...I gotta keep trying. I'm going to register for a Critical Care Course for November and I guess just keep trying to make my resume look more inviting in the meantime. I know I'll find something...your suggestions just give me more ideas! Thanks again! :redpinkhe

Thank you so much BSN graduate...I will definitely check it out. I've been sending my applications generally but I have already started to mail them in to the Nursing Recruitment dept specifically of some hospitals. Thank you again and good luck with your new job!! Cherish it!!!

hi to all...i am writing because i am about wits end with the job searching. i worked so hard in school, i had impeccable grades, i had a great reputation as an excellent, intelligent student with all my professors both in lecture and in clinical. now after i passed my boards i am finding it impossible to find a job. i have sent out i don't know how many applications. i send at least 5-10 a day. i currently live in miami but i have sent applications everywhere from miami up to orlando. that's as far as i can really go in regards to relocating. i have sent personal letters with my resume to nursing recruitment at different hospitals. nothing. so my question is...does anyone have any suggestions? is anyone aware of hospitals that do hire new grads? i know of some that have the versant program but that would mean i have to wait til january to apply and if i do get accepted, i have to wait til march to work. i cannot afford that right now. i stopped working to go to school full time and can't continue to not work now. please send me your suggestions

Thanks so much!!! I still wanna see those results but it is definitely relieving to hear! :[anb]:

hi everyone! well, i took my nclex yesterday. i've always been a great student, studied my butt off, knew that saunders book from back to front, did i don't know how many kaplan questions....and left there feeling like i guessed on at least half of those questions. that test is difficult! i've had very, very difficult professors who's tests were absurdly difficult and who half the class failed (not me though) and now compared to nclex, those tests were a joke. anyways, the point of the thread is to know if there is anyone in florida who has tried to do the pearson trick and it worked. i have read a ton of threads on how it does but a lot of them are in cali. some i don't know where the person is from so i wanted some peace of mind by having someone from florida tell me it worked. it didn't let me re-register so i am a tiiiiiiny bit relieved. much love to all and good luck to those also awaiting their dreaded results. :heartbeat

Hi there my fellow nursing students. I am graduating in 3 weeks and needed input on what you think is the best prep material for the NCLEX. My school supplies us with this set of prep materials called ATI but I also want to use something else. An acquaintance of mine suggested Pearsonvue, which she used it and passed on the first try. Any first time passers out there please send me your suggestions, especially those that maybe had hard time with grades in nursing school but then were able to kick that NCLEX in the butt please. Congrats to those that have made it and thanks in advance for the help! :redpinkhe

Hi iridius...where did you find the info on the TNCC courses available in Miami? I will be graduating in a month and ER nursing is my passion so I also want the upper hand when it comes to applying. I know they recommend some experience to take the course but I'm confident that I can learn it. I'm already signed up for my ACLS cert in August and then want to do the TNCC after that. Don't think I'll be staying in Miami but still, the more you know hte better.

Hi, I just took a critical thinking exam where it is rumored that we will penalized for not putting the pt on contact precautions. The scenario did not have an order for contact precautions. The pt did have MRSA but per CDC guidelines on their site, contact precautions for MRSA apply for "SOME" patients. CDC doesn't state that it is mandatory for all patients. My question is, are contact precautions ordered by the MD or are we as nurses at liberty to put a patient on contact precautions? The quicker the replies the better because I need to be ready to argue this if in fact I was penalized. Thanks!

ok well, my professor buckled down for about 2 weeks, gave us feedback on only 2 careplans and has since then been back to her lax self again. so, within the next couple days i'll be posting up some scenarios with the careplan i came up with and would really appreciate some feedback. the purpose is not prioritizing but coming up with a dx and appropriate goals and interventions. this is not for a grade...these are practice scenarios so any type feedback can be taken. the scenario goes as follows: mr. ch is a 65 y/o admitted to the medical unit from a rehab center with severe abdominal pain (9). past med hx of open heart surgery 6 months ago and a cva 2 months after surgery with left sided weakness. on examination, abdomen is firm to touch with tenderness on palpation. mr ch complains of difficulty swallowing, is very selective with food choice ,and takes minimal oral fluids .mr. ch refuses to get out of bed and has not had a bowel movement for 4 days. dr orders include: plavix 75 mg po daily what would be assessed?: assess vital signs, assess the abdomen (ausculate, percuss, and palpate), assess rom, assess diet history and eating habits, asses usual patter of bowel elimination. nursing dx: constipation r/t immobility and insufficient fluid intake aeb subj: abd pain of 9 on a 10 scale, refuses to get out of bed, difficulty swallowing; obj: left sided weakness, minimal oral fluids, no bowel mvment for 4 days, firm abdomen, tenderness on palpation. short term goal: the patient will report a decrease in abdominal pain from constipation from a 9 to 0-3 within 2 hours. long term goal: the patient will have a bowel movement within the next 24 hours. interventions: 1. the nurse will assess the patient's usual defecation patterns and diet history. rationale: this will allow the nurse to become familiar with the patients bowel patterns and usual diet for more personalized plan of care 2. the nurse will assess the patient's bowel sounds. rationale: patient may be impacted since there has been no bowel movement within 4 days and abdominal pain is severe. hypoactive bowel sounds may indicate impactation. 3. the nurse will inform physician of any abnormal findings. rationale: will allow the physcian to review orders and change them if needed for patient's condition. 4.the nurse will show the patient how to use the call light and place it within reach. rationale: patient can call nurse as soon as urge to defecate presents for assistance and will provide patient safety due to hemiplegia. 5. the nurse will assist the patient in ambulating to the bathroom when urge presents and assist the patient with leaning forward at 90 degrees when defecating. rationale: flexion decreases the resistance to the movement of feces from the rectum. 6. the nurse will encourage the client to walk and change positions frequently. rationale: bed rest and decreased mobility lead to constipation. mobility increases peristalsis. 7. the nurse will administer plavix per dr orders. rationale: patient has a hx of cva so anti-coagulant therapy needs to be given as dr ordered. 8. the nurse will consult with the physician for a nutrition referral to provide patient with adequate fiber intake. rationale: 20g/day of fiber will increase bulk which cause stool to move through the colon faster. 9. the nurse will consult with the physician to recommend an order for an enema. rationale: patient has had no bowel movement for 4 days and has severe abdominal pain. enema will alleviate symptoms of constipation and alleviate pain without having to administer pain meds, which may cause worsening of constipation. 10. the nurse will provide patient with 1500-2000ml of fluids daily and encourage patient to drink it all. rationale: hydration will increase water in the intestines, aiding in the softening and passage of stool. adequate water intake is also essential with a high fiber diet. 11. the nurse will teach the patient the importance of adequate fiber and fluid intake and physical activity in maintaining a proper defecation pattern. rationale: an informed patient is more likely to follow through on treatment. 12. the nurse will teach the patient the risks of impactation and its consequences. rationale: same as above 13. the nurse will teach the patient how to avoid the vasalva maneuver and why. rationale: the maneuver can cause bradycardia and consequently maybe even death in cardiac patients. thanks in advance for feedback; its greatly appreciated!!!

I feel your pain. I get like that at the beginnig of every semester. My first semester was the worst. Its only natural to feel so stressed but you have to calm down because that stress will not only interfere with you body physically, it will also affect your mind and you need that to be 100% to learn. I work full time and am in nursing school and the one thing that helps me control my stress is a schedule. I have a schedule to study, where unless necessary, nothing can interrupt it. Whatever else i have to do or need to do has to be done at another time. Focus on one thing at time...nurses have to learn to prioritize so start practicing Tackle what's important first, read what's important first...if you have a test or assignment that's your priority. When you feel stressed practice deep breathing. Breathe from your belly and diaphragm, not your chest. When you breathe shallow you're off-setting the natural balance of O2 and CO2 in your blood and that isn't going to help. That's a sign to your body to be alarmed due to a stressor. Deep, slow breathing brings a balance back and allows you to re-focus. Remember, the way you see a problem is the problem so stay positive. Everything seems it can't be done until its done. Its not a lot but hope these pointers along with everyone else's suggestions help out. :nmbrn:

Thank you Daytonite! This is what I wish our professor would do. Again, this has basically been me teaching myself. I misunderstood the defining characteristic of altered visual stimuli. As i went over it again I realized it didn't apply in the way I had understood it did. I'm going to revise my care plan using your suggestions. Your help was greatly appreciated!

Ok, well, unfortunately my clinical professor is a little to lax for my taste. I'm all for not over-stressing us but I'm in school to learn and be challenged and its not happening. Its our first clinical this semester so its practice time for care plans. We've been there for about 5 weeks now and we have not had to turn in any care plan and thus have no feedback. So I've been practicing writing them out and honestly, have no idea if I'm on the right track.I'm basically teaching myself with the help of one other classmate that feels the same. This week the professor said for us to practice doing a careplan for the neurological system using our clinical patient. I know you're not going to have insight on all my pt's conditions but I don't really need the feedback on the dx. I need the feedback on the careplan I wrote based on the dx. Below is a copy of what I came up with. Please take a look at it, tell me what you think (honestly), and if I'm even on the right track here. I know you may be limited since you don't have info on my patient but I'm hoping I can still get some feedback. Thanks in advance for you help. NURSING DIAGNOSIS: Chronic confusion r/t Alzheimer's Disease SUPPORTIVE DATA (subjective & objective) Subj: Pt stated nurse did not uncover his food but nurse did ask and he told her he wasn't ready. He says maybe he forgot. Obj: Altered/disturbed personality (irritability) and altered response to visual stimuli due to blindness. SHORT TERM GOAL/OUTCOME The patient will remain free from falls and/or injuries by next week's clinical visit. EVALUATION OF SHORT TERM GOAL The patient will report no falls or injuries due to confusion or altered visual stimuli on next weekly clinical visit. DATE NURSING ACTIONS SCIENTIFIC RATIONALE EVALUATIONS MODIFICATION OF PLAN OF CARE The nurse will assess the degree of cognitive impair-ment using CAM This will provide a baseline for fur-ther evaluation The nurse will assist patient with memory activities. This will motivate the client to reinforce usefulness and maintain cognitive ability. The nurse will pro-vide safety mea-sures by mainting walkway and area free of clutter This will decrease his risk for falls and injuries due to his confusion and altered response to visual stimuli. The nurse will show the patient location of call light and make it easily accessible. Will provide safety for the patient; pt can easily and quickly call for assistance if needed due to confusion or altered vision; will reduce chance of pt wandering. The nurse will assist the patient for all activities that re-quire ambulation. Same as above. The nurse will approach the pt in a calm and slow man-ner and speak in a slower, lower voice. This will avoid startling the patient, will increase comprehension; both which can help prevent an irritated response. The nurse will moni-tor the patient's nu-tritional intake and assist with feeding if pt requests. Confused patient's may not be able to always remember to eat or the amount eaten; due altered visual stimuli, it may be difficult for pt to eat on his own. The nurse will evaluate diagnostic results of psycho-logic evaluation(s). Evaluating psychiatric diagnostic findings will allow the nurse to be better informed regarding the ex-tent of the pt's alzheimer's and/or confusion. The nurse will teach the patient simple exercises and activi-ties paced to his abilities that he can perform on his own. This will help the patient maintain mobility despite loss of vision and confusion even when nurse not available.

Thanks so much for your help! And thanks for not giving me a direct answer...I still wanted to figure it out on my own. Decreased cardiac output was one of my main choices. With her irregular heart rate, CAD, MI, and hypertension it made sense. Thanks again for your help.

okay, i've tried to avoid using this to help figure out a case scenario but i'm on my last hair here. our professor gave us a packet of scenarios to practice with. right now, its our first clinical semester. we're not focusing on prioritizing yet because we haven't done med-surg. the main focus is to gather data and formulate a dx and careplan. saying that, i am going to give you the case and then tell you what i'm having the issue with. the case is as follows: mrs. d is a 73 y/o recently widowed female with a hx of cad and mi 5 years ago. niddm for 7 years. is in fairly good health. mrs. d was brought into the er by her daugther who wasn't able to reach her by phone, went to her apartment, and found her on the floor lethargic, with no recollection of how she ended up on the floor. the pt was admitted with a dx of syncope. vitals signs: bp 148/94, p 93 and irregular, r 24, blood sugar 317. physical assessment shows no signs of injury or bruises, able to move all extremities on command with no pain. at present, mrs d is quiet, answers questions with short replies appropriately. she is withdrawn, states she wants to be left alone, and has been seen crying. appetite is poor, color is pale, and she cannot remember the last time she had a "decent meal" and "could care less". now, the easiest thing that jumps out at me with clustering info is hopelessness. one dx i came up with is hopelessnes r/t deteriorating physical condition aeb subjective: "could care less" and obj: decreased verbalization ,poor appetite, withdrawn, and lack of involvement in care as demonstrated by unstable glucose level. however, even though they don't want us to prioritize, i can't just overlook her unstable vital signs. my issue is that i think her hyperglycemia ties into all that however, i cannot find a nursing dx that allows me to establish that. for example, i though of ineffective cardiopulmonary tissue perfusion because of the tachypnea and arrythmia, etc. but i cannot find a r/t factor. i know that high blood sugar levels can cause hypovolemia (which is a r/t factor) however, the only symptom of hypovolemia that i have info to compare on is the bp, that its high. hypovolemia cause a decrease in bp. there were a few other dx's that it was the same thing...i could not find r/t factor that matched he situation. i can use the hopelessness and it won't be wrong but i want to learn in the process how tie signs, symptoms, diseases, and medical dx's altogether. i'm sure once i do med surg it'll be easier for me but in the meantime, i have pulled a dozen books and can't figure it out for this case. just want a little insight to start training my brain to think like a nurse.