JGarner37

I did a BSN program. On an average week, we would be assigned 300-400 pages. I would consider myself lucky if I only had to read 250 in a week. I had one pharm test that covered 60+ chapters. That was pretty impossible, so my study group and I split up the reading and each typed up outlines for each chapter. For some classes it was extremely beneficial to complete the questions on the CD or website that was linked tothe book. Other classes I had, the professor created their own questions based on what our assigned reading was and literally take it from an area in the chapter we were less likely to read. It really varies from professor to professor on where they get their test questions. I know it's a lot of reading in nursing school, but basically you have to do it. Remember this is temporary. Did I read 99% of the assigned reading? No. I probably did 90% or more of the assigned reading though and it has served me well. I still reference my text books though. I'll come home from work and look up a diagnosis or an unusual lab that was ordered. Good luck!

1) I always admire veins, especially at the gym. Body builders always have freaking fantastic veins. I also touch my boyfriends veins when we're holding hands or at the movies. I also put my fingers in his 5th intercostal space to feel his heart beating. 2) When I sign receipts, I have to make a conscious effort not to sign my name, RN. 3) the other day I knocked on the door to the empty med room, lol 4) I also use a lot of the computer commands from our program at work on my home computer... which obviously doesn't work.

I always doubled up in nursing school, wearing a heavy tampon and heavy pad. In nursing school, during clinicals it's a little easier to get a break than when you're on your own. For those with really heavy periods, that can't find a great way to control this - another option would be to take birth control for 3 months in a row. This decreases your periods to 4/year rather than 12/yr. Of course talk to your doctor first ladies.

I did faint in my pedi ICU rotation. It had been like 8 hours since I had anything to eat and was drawing blood hourly from the pt's A-line for serial ABG's. I had drawn the blood several other times that day, so it wasn't the blood. I drew the blood, handed the syringe to the RT waiting at the bedside, started flushing the line and then passed out. Luckily I didn't take the line with me. I was mortified! The pt's mom, two nurses, the RT, a flight nurse and the physician were all at the bedside. The nurses then paged my nursing instructor and she quickly came up there. I was even more mortified when she later casually mentioned it to my classmates! Luckily it hasn't happened since. Just because you passed out doesn't mean you wont make a great nurse!

Thanks for the encouragement!!

I know the CNA's are always busy, but they get upset when I call them. I should probably just be a little more assertive. Heatwave, that sounds like the epitomy of my unit! I have the charge nurse for help. I work Fri,Sat, Sunday though, which means that our unit director isn't there and the charge nurse has to round on all 30+ pt's. Some charge nurses are more patient and willing to help than others. How long did it take for things to get better? Hopefully soon!!

Hi fellow nurses . I graduated in August and got my license in September. I started an internship on tele at the end of September. My internship was 4 months and I had a preceptor the entire time. I am now on my own and have 4-5 patients. I am having serious issues with time management and am looking for help. I work late every shift. I get to work, get report, assess my pt's, look at labs, stock my cart (while waiting for vital signs to be put in) and start passing meds. We are frequently short with CNA's because of sitter cases, so when pt's ask for things that could be delegated, I feel like I can't call the CNA because sometimes it is 1 CNA (2 at most) for 32 patients. After meds, I try to start charting, doing the care plan, etc. and can rarely get through more than one patient at a time because of interruptions or patient status change. I also have to do chart checks, rhythm strips twice per shift and I & O sheets. I'm not really sure what I'm doing wrong, or what I need to do to improve my time management. I am feeling so overwhelmed and discouraged. Any advice would be appreciated and considered!

I did totally dread my med surg clinical. Maybe I'll just head straight into a specialty. Thanks for responding , good luck to you too!!

I graduated with my BSN this month and will be sitting for boards on 9/11. I have started looking for jobs and am seeking advice from you guys! I have heard that every GN should work for at least a year on telemetry/med surg. On the other hand, I have heard that tele/med surg is just a place to acquire bad habits. I'm interested in doing L & D, NICU or pedi oncology. Should I do a year on tele/med surg or go directly into my specialty?? All insight is appreciated. Thanks in advance

The pay seems a little low. However, my sister did several of her clinicals there and personally knows nurses that work there. She loves Baylor downtown and hopes to start her career there. From what I understand, it is a nurse driven hospital and the low pay may be worth an enjoyable place to work.

what are the insurance companies in texas that issue nursing malpractice policies? the only one that i have found is bill beatty insurance. does anyone know of any others? thanks!

If I was doing this care plan, these are some of the things I would think about. These are just thoughts. I don't know if they are NOC or NANDA (or whatever your school requires) though. Acute pain r/t recent surgery (placement of G-tube) AEB things like altered vital signs, facial grimacing, etc. Impaired mobility r/t CP Impaired skin integrity r/t prolonged immobility For psychosocial, maybe you could use knowledge deficit r/t new placement of G-tube AEB mom states "will I give meds through this tube"... etc. I guess you could do fear r/t ... AEB baby screams every time I approach the crib. Those are the first that come to thought. Think ABC's first. Does she have impaired circulation? Look in your book on CP & a lot of books will have a section w/ the nursing process for the specific dx. Good luck.

If it is fully compensated, the pH will have returned to a normal limit (7.35-7.45) but the other values will be abnormal. For example: pH: 7.43 PaCO2: 48 HCO3: 36 1) assess the pH. It is normal but >7.40 so it is on the high side of neutral (since it is above 7.40), indicating alkalosis (for this purpose) ↑ 2) Assess the PaCO2: it is high ↑ 3) Assess the HCO3: It is high ↑ 4) follow ROME (respiratory opposite, metabolic equal). Look at your arrows. Since the arrows are going the same direction (equal), we know it is metabolic. Dx: Fully compensated metabolic alkalosis ____ Partial compensation is only partially compensated because the pH is not back into normal range yet, but the body is working to get it there. In partially compensated, the pH is still outside of the range, & the both of the other values will be off (which indicates partial compensation) because in a regular imbalance, the pH will be off & only one of the other values will be off. In partially compensated, again all 3 are off. Ex: pH: 7.33 paCO2: 62 HCO3: 35 Step 1: assess the pH. It is low ↓ (indicating acidosis) step 2: assess the PaCO2: it is high ↑ step 3: Assess the HCO3: it is high ↑ step 4: look at your arrows & follow ROME. We know it is respiratory because the arrows are opposite (pH v. others). We know that it is partially compensated d/t all of the values being off & we know it is acidosis d/t the low pH. Dx: Partially comensated respiratory acidosis. Normally I don't rsepond to these things.. but, I used to have a really hard time w/ this stuff & am hoping I can simplify this. Again, you HAVE to know your values. If you don't know your values, you cannot interpret an ABG. If you still don't get it after reading this & have some time before an exam, buy Fluid & electrolytes made incredibly easy. When I started nursing school, I would guess on these questions because I didn't even know where to start. Now, several semesters after I read the book (now taking critical care) - I still understand it. It helped me a lot. The other thing is once you figure out the steps, practice! If you need clarification on this, let me know. Good luck!

http://www.nhlbi.nih.gov/health/dci/Diseases/hhw/hhw_electrical.html This is a little clip of the electrical conduction of the heart & how it relates to the ECG.

I have also had trouble w/ interpreting EKG's & am still working on that. The first thing I can tell you for ABG's is know your values. When given a problem, first look at the pH. Is it acidosis or alkalosis Then look at the PCO2: is it high or low Then look at the HCO3: is it high or low I draw arrows next to the each factor (whether high or low) & then compare my arrows. Follow ROME (Respiratory Opposite Metabolic Equal) meaning in respiratory (acidosis or alkalosis) the pH arrow will be in the opposite direction of the PCO2. If it is metabolic (acidosis or alkalosis), the pH arrow will be the same direction as the HCO3. If either is partially compensated the other value will be off. If it is fully compensated, the pH will be normal and the others will be off. But, even though the pH is within normal limits, you can still tell if it's acidosis or alkalosis. If it's higher than 7.4 (7.41+), it's alkalosis, if it's lower than 7.4, it's acidosis. Then follow the previous steps. http://www.skillstat.com/Flash/ECGSim531.html http://www.nhlbi.nih.gov/health/dci/diseases/hhw/hhw_electrical.html Good luck!