SNLou84

Hi everyone. So I am a nursing student taking patient education and we were given the following scenario - Basically there is an 18 year old male who has HIV, he admits to the nurse that he is intimate with his girlfriend but that she does not know he has HIV. He states that she would leave him if he told her. I have heard many news stories about people being arrested for not disclosing their HIV status. I put this as my response - that I would educate him about the risks and the risk he is putting his partner in. I would also talk to someone who is above me who also knows the patients situation and find out if the police should be involved. Before I put my response, I even looked online and found many different cases in which this occurred in the newspaper. The only thing I am unsure about is if this would be violating HIPPA to involve the police. Yet, if the police weren't involved, and he continued to have sex with more and more people, wouldn't he be spreading HIV and putting more and more people at risk? That to me seems completely immoral. But my instructor said going to the police would make for an awkward situation, so then I started feeling like my response was not correct. Any insight would be greatly appreciated! Thanks!

I dont think cucu got upset by your comment at all....her response was not even rude.

Dafreak, I do tend to ramble when I am emotional or feel strong about an issue...lol. It is hard to say exactly what you mean when typing. It is a lot easier through words. :) As for the last minute thing - it was not last minute. This care plan had a set day, set time for it to be turned in as a hard copy. So we were all turning it in at 7 am on our clinical floor. As for finding a babysitter - that honestly would have been impossible. I have three set people to watch my son. My whole entire family was at the wake & so there was nobody available to watch him. It was very late notice for me when I found out so I never would have been able to find someone during the hours of 1 am to 6 am. This was more of an emergency type of situation but even so if you don't have the funds available to you (child care is expensive) and you don't have additional people to help, then there is nothing that can be done about it and it's on you as a mom to take responsibility. All my friends work, my boyfriend had work, my family was at the wake, and my son's Godmother lives in Ireland so I really did not have a soul to watch him. Normally my mom would have but she had the wake and as I stated before, she does enough for me and I cannot ask her to not go to the wake just so I can go to clinical for the day when we are able to make up clinical if needed. Which missing clinical is not a problem as long as I make it up. I am going an additional day, normally a day that I would be off to make it up. There was once a girl sick in pre-conference with a runny nose/etc... and she was sent home and made it up another day. So they are pretty okay with that as long as it is a reasonable excuse and isn't a lie. I would never lie or miss clinical just to miss as obviously that is how we learn. The other instructor, the one who did stick up for me, talked to me and told me that my care plan was very good & that my review was good enough to PASS so I DID PASS. Luckily I worked really hard and put a lot of time into that care plan and finished early enough to where I turned in the care plan for review pretty much completed....so that definitely worked out in my favor. I am just happy with passing and I only felt the need to go to someone else if I didn't pass because I just did too much work to not receive at least somewhat of a grade. But in the end, it did work out. My one instructor was pretty nice about it and now I know next time to call no matter what hour as that is way better communication than an email. The head instructor, well, she still is rude to students and many of the girls aren't really fond of her because of how she talks down to us but I am just going to deal with it as best as I can and hopefully make it through this. :) Thanks to everyone who responded. I know it is hard to understand the situation through an email because it's hard to get the true story across. However, I believe that family is important and if we didn't care and one of them passed away during nursing school and we didn't give them time in our lives - you know how guilty we would feel when it was all said and done and we didn't have another second with that person? At least, that is how I feel. I love my family & to me, they come first. Yes, nursing school is important but I could never live with myself if I didn't make time for the ones I love. I already sacrifice more than enough for nursing school. I devote every day to it. I study every single weekend. I get good grades and have made it through everything so far. So my aunt's death is a time I feel should be given to my family, not nursing school. I think so many of us worry about school, school, school, and trying to measure up and we often put aside our family and God. I think nursing schools should let students have time with their family here and there - even just a day. I feel I rarely get the time to relax. Today has been the first day in a LONG time and it is long overdue.

Hi everyone.....so right now I am a nursing student and i am not very happy with my school right now. A lot of students aren't. We pay so much money and the school is so disorganized, the teachers are rude, and I find myself dreading every day I have to go. I miss my old school. I wish i never left at times. Here is my dilemma....please tell me what you think and if you would feel the same way I do or what you feel I should do. Recently I just had my first care plan due. I finished it a week before it was due. I worked so hard on it and I know I would have received an A on it. Well, my teacher told us that she wanted us to turn it in as a hard copy to her at the start of clinical on the Thursday it was due. That Thursday, at about 1 in the morning I found out my aunt had passed away a couple days prior and that her wake was going to be later that day. I was late in knowing about it because I had not been home for a couple days since I was studying at my Godmother's for two exams and doing a research project- that's where I go when I need peace and quiet for exams. So I came home Wednesday night - more like Thursday morning because it was 1 am - and found out that the wake was that morning (Thursday). I have a son (toddler age) that normally my mother or my boyfriend watches for me when I have clinical. However, my boyfriend had work and because of the death in my family, my mom and dad and my entire family had to go to the wake. Both my parents work on Thursday so this meant they had to go early as possible and they planned to stay until they had to leave for work. Therefore, I had to stay home with my son. If i had a choice, I would have gone to the wake but my son is very little and I just wasn't comfortable with him going to a wake yet at his age. So, when I found this out at 1 am......I emailed my teacher right away and I let her know. I had her house number but I didn't feel comfortable calling her house at 1 in the morning when on her paper it says the time to call her house is between 6 and 6:30 am. So I emailed her and told her the situation. Then, I thought to myself that I should just email the care plan just in case since i wouldn't be able to make it in. i just got a new MAC so I was still a little new to using it and because it was our first care plan....of course I had issues. We were allowed to send our care plan in for review since it was our first one and I did the week prior. I did it in the format that the instructor has us download and everything seemed fine and I saved it. I sent it to my teacher and when I received it back from her, she said it wasn't in the correct format and that it needed to be but that she could tell I did a lot of hard work and that it was really good. I opened the document back up, and like she said, it was no longer in the correct format. It no longer had the box format and the lines, etc... So to make her happy, I copied and pasted everything back into the original format and printed it out when I had completed the care plan so that way my hard copy was at least in the right format. So back to the wake/not being able to go to clinical dilemma.....so at 1 in the morning, i sat there trying to figure out how to make it work and stay in the format. I even tried sending it to my yahoo email and tried pulling it up on my HP computer, only to have it cut off words, make the paragraphs long but not wide, and half of a page was not showing up but if I clicked by it, some of the words would come back up but as soon as I clicked away or printed it out, it didn't show up again. I tried four times sending it to my email in different ways and nothing would work. Therefore, I decided to forget it because my hard copy was in the correct layout and I didn't want to send an online copy that was all messed up and have her grade that one instead. Mind you, this whole time I was never thinking I HAD to send an online copy because our instructor wanted it as hard copy. I checked my email throughout the day and right before bed and never received nothing from her. The next morning, I saw her email saying that she never got my care plan and that because I did not turn it in on the due date that most likely I will not be graded from the final care plan and that she will see if she can use the care plan I turned in for review - a care plan that did not have the reference page complete, did not have the AMETHOD complete, did not have the surgery step by step complete. We have to receive a 79 on the care plan or else it is considered failed and if you fail a care plan, it says in the syllabus that means you fail the class. I am hoping I am reading this wrong because I think this is insane!! The very next day I turned in the hard copy of my care plan. My instructor knew I did not make up this excuse, she knew I had to have had my care plan done because I was one of the few that turned it in for review and didn't save it for the day before it was due. On Monday, the head instructor talked to me (this is who I am unhappy with) and told me they would not be accepting my hard copy of my care plan. I told her that I had a death in my family, my aunt, and I did not have any choice but to miss. i told her I didn't even get to go to the wake because I had no one to watch my son. I have never had anyone treat me as rude as this woman did. She basically implied I should have found a babysitter....because right... finding one at 1 am is so easy!! And with my whole family being at the wake, there wasn't anyone to watch him. My mom does a lot for me and the least I could do was let her and my father go to a wake for someone very close to us. This instructor then had the nerve to say, "And what was your aunt's name?" As if I was lying! I told her my aunt's first name and she's like, "and last name?". I couldn't believe it. She had me in tears when i walked back in the classroom. My whole family is just shocked by the insensitivity of her behavior....the school says they stand for compassion and respect, but where was that when she was talking to me?? To leave me in tears and because my aunt died i may possibly be kicked out of nursing school??? I am so upset right now. I told her that I was never told to send it through email, that my instructor wanted a hard copy. I told her that I DID try to send it online just to make myself feel better and as proof it was done but I even said in the email to the instructor that I would try and email it if it worked but that I knew she knew I finished it because she saw my review and that was almost finished. I told the instructor that I tried to send it and it had parts missing then and the whole layout was lost with the boxes and lines. She told me I should have called some tech place. As i have come to find out, this tech place is for online classes for the school! The syllabus did not say A WORD about this tech place. I emailed the tech place to find out if in fact they deal with MAC/HP incompatibility problems but I'm thinking they deal with blackboard/computer problems, not what I am having a problem with. What I don't get is how rude and insensitive she was about my aunt passing away....and how she couldn't even be understanding for the FIRST care plan when OF COURSE people are going to have issues. I don't see how it is my fault that my computer is up to date and hers is 2003. I don't feel I should be punished for that. I wish I could have recorded the way she talked to me because it was just so low, as if I was nobody to her. Why do I pay all this money and here I am going to a religious university and yet, they aren't even understanding when a family member dies??? Yet somehow I was suppose to still turn in this care plan with the files not working and with not even knowing I 100% needed to turn it in online. I emailed my instructor twice and she had all day to write me back that day and did not. If she had told me to email my care plan, I would have just emailed it the way it was but I never received an email telling me to email it to her so how was i suppose to know that they would be THIS insensitive and act like my situation meant nothing. If you were me, would you go to someone higher about this? I truly feel my final care plan deserved to be accepted. I did not use an excuse because I didn't have it done.....I did not miss just to miss. I had no one else to watch my son and my family including myself was mourning for my aunt. I turned it in the very next morning, bright and early, and yet that was not good enough. The lady has my hard copy sitting in her hands and yet she is refusing to accept it. I honestly cannot believe this school...I am so sick of going here and dealing with such cold, heartless people. We get our care plans back this week & if I pass, I probably will just be the bigger person and let it be.....but if I don't pass when I know very well I should have and after knowing how some people did it the day before it was due and didn't do half the work I did....then yeah, I am going to have a problem because I am not letting this woman kick me out of the nursing program when I have a 4.0 GPA and have worked so hard to be where I am at right now. Thanks to everyone who listened to me vent and any advice posted. I truly do appreciate it. Then, I went to bed.....because I was on 2 hrs of sleep and knew I would be getting up pretty early with my son.

Thank you Daytonite, you are so nice! :)

If you don't mind me asking or if this isn't too personal, why were you dropped? I have never heard of any program doing that unless the student is below the GPA that they want and has failed more than one class or has received lots of C's. My school puts you on academic probation if your GPA falls under and you have the next semester to bring it up or else you are dropped. We are also only allowed to receive one C per semester and if we don't bring it up again, we are dropped. I am so sorry that this happened to you. What about joliet junior college? They have a nursing program. Not sure if it is online or not but maybe try calling them? I hope everything turns up for you!!

Hi everyone. I have a test this week. I received an A on my first test but a D on my second one. I am so scared I am not going to pass this class. For me, this class is the hardest one I have ever taken. My test is on Antimicrobial Therapy and Drugs that affect the heart, blood vessels, and blood. Both powerpoint packets have 33 pages each and have 6 little slides on each page so the material is LENGTHY! I feel so overwhelmed and I am not sure what is the important information as our teacher does not really break it down for us or give us a study guide like the other Pharm class gets. I am more worried about the heart packet - she discusses: drugs acting on the Regin-angiotensin-aldosterone system ace inhibitors (function/adverse effects/types/what to watch for/etc) ARB's calcium channel blockers and the diff drugs such as verapamil and nifedipine vasodilators drugs for hypertension primary, secondary hypertension, classes of antihyperintensive drugs Alpha1 receptor blockers (all the diff. types) beta adrenergic blockers drugs for heart failure ace inhibitors again diuretics beta blockers inotropic agents digoxin antidysrthmic drugs dysrhythmias class1 sodium channel blockers class 1b agents xylocaine class II beta blockers class III potassium channel blockers class IV calcium channel blockers adenosine adrenergic agonists prophylaxis of coronary heart disease drugs that lower LDL cholesterol levels cholesterol testing classes of lipoproteins lipid lowering drugs statin dosing HMG CoA Reductase inhibitor bile acid-binding resins nicotinic acid fibric acid derivatives zetia drugs for angina pectoris nitrates** routes of administration for it watch for beta blockers calcium channel blockers revascularization therapy prevention of MI & Death Anticoagulant, antiplatelet, and thrombolytic drugs heparin warfarin diff bw veins/arteries and what drugs thrombosis coumadin management of ST elevation myocardial infarction reperfusion therapy adjunct drug therapy complications of MI Non drug therapy of MI Drugs for Hemophilia drugs for def. anemias iron def. anemias iron preps vit b12 def. vit b12 preps cyanocobalamin folic acid anemia causes and consequences hematopoietic and thrombopoietic growth factors epoetin alfa leukopoietic growth factors thrombopoietic growth factor See what I mean....ITS INSANE. And there are about 10 little details and a couple slides information for each one. I am OVERWHELMED. And that is just the heart packet! So basically I was wondering from those who have taken this class, what are the really important topics I should focus on for the test? What topics really need to be known or are pretty general so I know what to study. Any information or help is appreciated!! Thanks!

In my first clinical rotation, without any warning whatsoever, i was given a C.diff patient. I was also given patients with MRSA too. They had told us about standard precautions but had never mentioned we would be thrown right on a floor with patients that had this. My very first day I had a patient who didn't have anything or so we thought and I had taken care of him all day until right before i left, his labs came back and he had MRSA. It was in his nares so luckily I think I'm okay. The C.diff patient I had was not even my patient but she needed to be fed so my instructor sent me to do it. I was not very happy about that at all considering I have OCD & I freak out over germs, etc...but I put on my gown, gloves, etc....and went and fed her. Then later on, I had to help move her to the toilet with one other girl. It just was not the best experience let me tell you but you get through it and wash your hands very well and then your done. What I didn't like is our instructors told us nothing about C.diff prior to going there. I think that isn't right at all. I think we should be informed A LOT better than we were. But don't worry, it's not as bad as you think. You do your job and as long as you wash your hands and wear the gown and gloves you will be fine. I didn't even wear a mask, my patient didn't have an odor at all. So I think it really depends on the patient.

Daytonite and TLC.....I just wanted to thank you both for caring and trying to help me. I really do appreciate it so much! Daytonite, you reminded me of a sheet I had on OREM from last semester. I am going to try and dig it up and hopefully I still have it. I know the basics for each one and some of the topics that go under each one, it's just the specifics which I am unclear about. Thank you again. If you have time and read the goal/expected outcome I listed and can tell me if that sounds okay, that would be wonderful! Thank you!!!!

We did receive a handout for the nursing diagnosis which uses the issue of constipation to explain each one. So it says NANDA: constipation related to prolonged immobility as manifested by decreased frequency of stools, lack of appetite, c/o headache and abdominal pain. For the NOC: it says BOWEL ELIMINATION. The goal is: The patient will return to a normal pattern of bowel elimination. The NOC Indicators/expected outcome says: The patient will drink 2000ml in each 24 hr period. My problem is I don't know how to apply this to Anxiety. My three issues are: Ineffective breathing pattern, Pain, and Anxiety. I understand the PES format and have mine finished but I am unsure how to make an Anxiety goal more specific. I put: GOAL: The patient's anxiety level will decrease. Expected Outcome: The patient will demonstrate some ability to reassure self upon discharge. Is this right? I wasn't really sure how to make a decreased level of anxiety specific without making it an intervention. Then in addition they want rationales supported by a journal article. And the problem with all this is they just gave us our care plan patient last Friday, so I have only had a week to do this in addition to doing a research project and studying for exams. Unfortunately they did not have us take a class on this. We did get a powerpoint packet on the nursing diagnosis but not a detailed one that really explains what we need. Our teacher handed us a guideline for nursing care plan which is an outline and states one sentence under each topic. For the nursing diagnosis, it states: A. select one problem and state a nursing diagnosis using the PES format. (I understand PES) Come up with 3 diagnoses for each care plan. B. Self-care agency - include clients expected outcomes and broad goals EX: fluid volume deficit - nursing diagnosis/ Goal: The client demonstrates evidence of adequate hydration. Each outcome must have a subject, verb, and indicate the action performed with measurable terms expected of the client. Include a time frame. C. Nurse agency - nursing actions 1. choose appropriate nursing system (THIS I UNDERSTAND) 2. state whether nursing actions are independent or dependent (THIS I UNDERSTAND) 3. Include rationale to justify nursing actions 4. use a journal article and highlight in NCP 5. identify the source and page number for each action and rationale

I have looked all over the board about care plans and I find everything BUT the one thing I am looking for. It seems most care plans involve Maslow but mine does not, it involves OREM. I really have no idea where blood pressure, temperature, and pulses go. Also, I really get the feeling that my teachers are doing way more with our care plan than the other ones I'm reading about which honestly upsets me because it's already hard enough without making it so detailed and lengthy! I am just over this whole thing already. Another thing is, for each nursing diagnosis, we have to have 3 goals and 3 interventions for each nursing diagnosis. With the goals, they want us to put the self care agency, expected outcomes, and broad goals. Then put a nurse agency/system and include whether the nursing actions are independent or interdependent and include rationales as well as A JOURNAL ARTICLE and highlight in the NCP (I dont understand this at all!) Then we have to evaluate and modify..... The problem is....my patient was from same day surgery and then was admitted so I never was able to see her discharge papers or find out what happened with her because by the time my shift was over, her records still weren't up on the computer. I am just so unbelievably frustrated. I have a good majority of the info but these two areas are torturing me! Please Help!!! (Thank you Daytonite for trying to help, I appreciate it....I looked through all the info but didn't see anything on OREM or the specificity of the goals with everything my instructor is asking for)

Thank you again! I honestly feel inducing her now is too soon (she said she just turned 40 weeks yesterday) but I don't know if the 40 week estimate is completely accurate. I think they are more of going by the fact the baby is 7lbs 9 oz. and they feel that is a full-term baby n therefore time to give birth. But thank you all for clearing up the "narrow bone" statement made by the doctor. I now completely understand what is meant by that and I think it is likely the doctor didn't know 100% if that was the case or not. Thanks again!!

To TIAKAY ON PAGE 3: I totally agree hun! Being a full-time nursing student and a mom is a lot harder than people realize because you basically feel like your putting your kids last. It's a horrible feeling. I think when some of the ones who are very rude about the kid thing have their own kids, they will definitely realize that it is really hard....emotionally as well. A girl who I thought was my friend throughout the program and who I knew her life and she knew mine, knew my son was very sick and I had been going to doctor appts, having tests done, etc...to find out what was going on with him. I asked her if she could pick up a packet for me for a class since I had to miss it which the teacher was totally understanding about and the girl actually got mad at me as if i was using her, for a packet mind you that SHE did not type, the teacher did! And this was someone I considered a good friend. She then had the nerve to go on and tell me "School comes first". Yes, school comes first in certain areas but when my son is seriously sick, HE COMES FIRST. Only a mom would understand that but I just couldn't believe the nerve of her. I actually had tears in my eyes afterwards because I couldn't believe someone could be that cruel and not understand at all. I do understand some people who don't have kids have a lot going on - working full time, sick parent, etc.... but this girl did not work, did not have any family issues, lived at home and was basically stress-free. I just couldn't believe the insensitivity. But then again, if you have never had a lot of stress in your life other than silly issues - you may never understand what it is like to be under real stress. When I was 18 and independent with no boyfriend and no children, I had no idea how minor my issues were. i would get upset over this and that and be so worried over the smallest things but at that time in my life, they seemed like a lot to deal with when really now, I realize they weren't at all.

I would love to be able to say "No wonder why people get such a bad impression of women and men call women ******* - the constant gossiping, talking behind each other's backs, getting mad when someone receives an A who deserves it, girls immediately calling you after the exam to interrogate you over the test questions and then argue with you if you did not put down the same answers as them.....and come to find out your answer is in fact the correct answer yet the interrogator originally said to you, "no, that is not it at all..I'm not even going to discuss your answer because it's wrong". UNREAL. Having to hear one particular girl badmouth everyone....students, teachers, her boyfriend, her friends, her mom, etc.... Everything this girl would say would be so negative and annoying. She never had anything positive to say and always acted like miss know it all who had been there and done that. She even had the nerve to tell our clinical instructor that she was bored and did nothing of importance during the rotation. Then, she would badmouth her one roommate to the rest of us yet drive home with her when the class was over. Also, to some of the teachers who when you ask them a question, they never respond with a real answer. Because NO we don't know everything, we are new nursing students and have A LOT to learn....and we want to be taught...we want to know why this answer is right and why this answer is wrong. Yet so many teachers fly through the material, with us barely being able to write down what they are saying, and the material isn't allowed to even enter our brains because our hands are scribbling away writing notes, leaving us with aching hands and fingers when the class is over. I just wish some of the teachers would slow down....i know they feel the need to fit every little piece of material in the lecture, but it doesn't always help with really learning the important material that ends up being on the test. AND taking timed quizzes UGH.....taking a 15 question quiz in 15 min is NOT easy...and doesn't allow us to really think through our answers or the questions. ESP when the questions aren't just multiple choice BUT ESSAY! I spend so much time rushing through in hopes that I answer all the questions in time that I can't focus on details or the CORRECT answer because my brain can only worry about the time and how much time I have left. I think this is a horrible way to learn & help us succeed. Thinking through the question and our answer leads to more success than rushing through it all. AHHH I feel much better! I know I vented about teachers too but I really needed to get that out!! Thanks!!!!!

The nursing students in my school are unbelievably competitive. In fact, some of the girls actually get mad if you do better than them, it's insane. (I understand getting mad in some instances but getting mad at someone for getting an A when they deserved it isn't right, ESP. if they studied more, etc and this is what a lot of the girls do at my school because they are all about getting one up on the other). But yes, we all will compare ourselves to our peers because it's impossible not to. I feel it's okay to question or get upset if in fact you study MORE and put more time into it than girls who go hang out with friends or go on vacation and barely put any time into school....because how can you not wonder why or how that is possible after putting that much work into it? One of the girls in my classes barely studies. She will start studying at 9pm the night before the test and yet she received a B on the last exam. I really don't understand it. I don't know if it's because she has nurses in her family and they help her or if she is just good at that subject but I have felt very discouraged about this class and knowing that I study more and get a lesser result doesn't help. I feel I study hard, I learn the material as best as I can, and it's just not enough for this class. For my clinical class, I have received higher grades so I know it's not my studying method....I really feel it must be the material. But good luck to you, I wish I could be of more help. I did look online and I plan to go buy a book other than my textbook and the name of it is - Prentice Hall Reviews & Rationales: Pharmacology (2nd Edition). It has received really good reviews & you can find it at Borders or on Amazon.com. I plan to go buy it tomorrow and hopefully it helps, I will let you know! :)