Purlple

I had to give a report to the nurse who LOVES to tell other nurses LOUD enough for everyone around what they need to learn or what had they missed. She herself missed an order to feed a patient for the WHOLE day, missed the culture results, and didn't chart all her meds she gave but had to say few times loud enough for everyone around "You learned something new today!". (She decide to teach me how detailed my charting had to be.) I always appreciate the teaching but not in this manner of telling everyone on the station ( a front of docs, CNA's, and other nurses) that she taught me something new. When I (quietly!) told her about the order to feed patient that she missed and missed cultures results (I mentioned it as a matter of fact info) on patient she just said "Go on!" like I am waisting her time and it was nonuseful information to her. GRRRR...... Unbelievable... Is it always the case if the nurse is older she immediately thinks she is doing better job? Or what is it?...

I had to give a report to the nurse who LOVES to tell other nurses LOUD enough for everyone around what they need to learn or what had they missed. She herself missed an order to feed a patient for the WHOLE day, missed the culture results, and didn't chart all her meds she gave but had to say few times loud enough for everyone around "You learned something new today!". (She decide to teach me how detailed my charting had to be.) I always appreciate the teaching but not in this manner of telling everyone on the station ( a front of docs, CNA's, and other nurses) that she taught me something new. When I (quietly!) told her about the order to feed patient that she missed and missed cultures results (I mentioned it as a matter of fact info) on patient she just said "Go on!" like I am waisting her time and it was nonuseful information to her. GRRRR...... Unbelievable...

I think the collapsed lung will cause deviation or shifting of the heart on one side because it will be an empty place there. Also, the other lung will shift as well. It may cause all sort of cardiac, circulatory (think about deviated aorta) and pulmonary problems. I think an open fracture does not necessarily mean patient has damaged artery even so it's bleeding. This is only my guess.

That's true about NCLEX questions. A lot of them ambiguous and we have to try to read into what would they really mean to ask. Also, just a thought...I checked Glasgow 13 and it can be as "inappropriate words" that gives you that score. If I had only one space in ambulance I would not use it for 70 y.o. with "inappropriate words" (could not be an emergency) but for 42 y.o. with a one lung injury.

Congratulations! :)

the nclex may not tie up with your experience well or so i was taught in nclex prep class. you need to think of it as an "ideal situation". the question is ... only lpn or only uap (no rns) because this is a delegation type qs. it does not have another choice. another way of saying, you need to delegate each to either lpn or uap.

I just found out I passed. Yeah............!!!

I passed!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

At first I was thinking - 3 y.o. old autistic boy but than the rational for most priority questions is that you act on acute illness first and then the chronic one. The blood pressure systolic 150 put him in Hypertension level 1 and risk for stroke. SO, I wasn't sure.

Did you feel you did OK about the test when you finished it? I had only 75 and I am not sure... Someone told me I supposed to feel how I did but I have no idea. I don't know if this a good or bad sign (I mean have no confidence about if that was good or bad). From what I understand 75 questions have to be very clear good or very clear bad.

OOoopsss...

It was one answer question (not filling in space type). It was worded as "to send" to get medical help. I re-read every question before answering and tried to visualise it. So, all of them were assessed (no pulse, Glascow 13, etc) and it's up to you (or soft of...) which one to send first to get help. I can't wait to get my results. I had so many priority and delegation that I can't simply check with a text.

I got 3 (garlic, ecinasea, herbal teaching) questions. I knew only answer for garlic. As well, I got a question about Progressive Relaxation Technique and how it properly done. Hmmm??? I read later that it is a specific muscle relax. technique.

I chose #2. My rationale was that he has a fair chance to be OK after a treatment and airway ahead of broken leg (#3). (I wasn't thinking about any patient helping others.) 70 y.o. may be in shock or has a confusion. As well, perhaps he has some other chronic condition (he is not young...) that make him unappropriate or confused. I think Glaskow coma score 13 means the patient may be just inappropriate which is not that uncommon for 70 but I am not sure in it.

Which one would you send to get medical help first: 1. 70 y.o. man in Glaskov Coma level 13 2. Man with a possible collapsed one lung and exacerbations on the same side 3. Screaming teenager with broken leg (open fracture) 4. 4 y.o. boy pulseless, non-breathing, with dried blood

It makes me feel better others think alike.

if you are a nurse who did physical examination in a community. Who would need an immediate follow up : 42 y.o. man with a blood pressure 150/88 or 3 y.o. boy with no eye contact

What would you delegate to LPN or UAP: a. transport active TB person to radiology b. feed recent CVA person who is on thickened diet (risk for aspiration I guess)??

How long you can administer anesthesia? I didn't see any CRNAs in age of 60 or older. What type of job can they do when close to retirement?

Thanks for your responses. I posted my message before actually seing what the PACU is about. After I had some exposure to it I see what you mean.

I was helping with a care for one pt in her mid thirties. She was fine until her early 20th. Then she had a stroke and a brain damage due to oxygen deprivation. She is now has pancreatitis, paralysis of most part of her body, fibromyalgia, trach tube, GI tube (feeding). She get suctioned few times a day. You know how is suctioning makes pt feel. She is in severe pain because of her pancreatitis and/or fibrimyalgia. The most awful thing that she can't make a sound to ask for pain med but cries silently with her mouth open as if she is trys to scream and her face perspire and heart beating over 100. She can't push a button for help either. We didnt' know how much she could understand us. And we didn't know if she could see well because her eyes were not focused. This pt was admitted few times with for different reasons. She have relatives who visits her. She is full code!.. Why?..She crys everytime someone is approaching her for any reason. I think she is very anxious and scared. We are doing all that interventions and she just probably wants to die. When I saw her I thought about coming home and writing a proxy for myself.

I'm only a student. Me and my classmates noted that older nurses are much less sensitive to their patients' pain as compare to the newer nurses. We think this is difference in the nursing schooling. The professors drill in our heads in Nursing School to advocate for our patients to treat pain. We spent enourmous amount of hours only on pain assessment and management. What we see in practice, the older nurses ignore patients' pain complains as "He or she already got some" or "he is a drug addict" or "I just gave him". Well, it's obviously not working for him or her if it's 10/10 or 9/10. I had to tell the relatives of the patient to ask Doc about a pain med when she or he have the opportunity. At the same time I felt awful advising them to talk to the Doc when they see him 'cause it't mean pt will suffer for few hours. The nurse in a meantime was complaining on her day and wining patients. I wander if the nurses like that were the same all the time or the work in the hospital made them that way.

I'm on my last year of school and applied to ICU internship (with potential employment) within one large teaching hospital. There are more people applied than the number of open spots. So, I may not get it. In a meantime I have to pick my second choice. Eventually, I would like to work in ICU. What should I choose as my second choice for the internship: Emergency, PACU, MedSurg? or should I apply to very small ICU in a small non-teaching hospital? I had my clinicals in all these departments. The one thing I noticed that I liked my day if I worked in friendly nursing/doctors environment (any department). It could be the same dept but my day was totally different depending with whom I worked. I loved Emergency when I was working with awesome nurse. The next day I was working with a nurse who had "Leave me alone attitude" and my day was awful. I came home with a thought "may be emergency is not for me". I know I think about the whole specialty based on people I worked with that day and this is not right, but I'm aware of it. Ok... I'm going away from my main question. Any advises about the second choice for future ICU? Thank you

I'm on my last year of school and applied to ICU internship (with potential employment) within one large teaching hospital. There are more people applied than the number of open spots. So, I may not get it. In a meantime I have to pick my second choice. Eventually, I would like to work in ICU. What should I choose as my second choice for the internship: Emergency, PACU, MedSurg? or should I apply to very small ICU in a small non-teaching hospital? I had my clinicals in all these departments. The one thing I noticed that I liked my day if I worked in friendly nursing/doctors environment (any department). It could be the same dept but my day was totally different depending with whom I worked. I loved Emergency when I was working with awesome nurse. The next day I was working with a nurse who had "Leave me alone attitude" and my day was awful. I came home with a thought "may be emergency is not for me". I know I think about the whole specialty based on people I worked with that day and this is not right, but I'm aware of it. Ok... I'm going away from my main question. Any advises about the second choice for future ICU? Thank you