K.P.A.

Your patient is floridly psychotic with extremely delayed responses. He's got the word salad, flight of ideas, tangential, etc. He was dropped off by someone who doesn't want him around. He's paranoid and responding aggressively. He looks sick! NOW: do your H&P. You have a paranoid patient who looks like a body builder. 300lb of muscle. He does NOT want to take his involuntary medications. You do not have time to do the paperwork associated with holding him down to administer. Can you get the medication in him. Can you tell the difference between compulsive polydipsia and a diabetic going acidotic? Can you train minimum wage staff in patient care? Can you build them into a proactive team? Can you tell the difference between a 'heart attack' or 'seizure' in a drug seeking patient who has been fooling ERs for 20 years and the real thing? Without the benefit of history? Psych takes some skill...

It's the rare day that we have "core coverage" = 1:8 for techs, 1:18 for RN, 1:24 for LPN, 1:3 for line of sight, 1:1 and 2:1 for :-) Numbers are lower for night, weekend, and holiday shifts. As far as I know there is no state standard.

You'll have a much better shot at getting into an accelerated program with strong pre-req progress on your application. My plan B was public health classes while waiting for a nursing school slot. With A's in pre-req classes, I didn't have to wait and never got into plan B but am still considering public health if I don't get into a DNP program next fall. FWIW, I'm well over age 50 and this is career # 5 or 6.

I recommend rounding as soon as possible after coming on shift so you know what you'll be dealing with. Ask patients how they are feeling and if they need anything. I suspect there is some sort of patient assessment flow sheet you need to complete on each shift and this gives you the information to start it. Know your patient concerns and can get them taken care of early in the shift. Part of therapy is providing structure. Let the patients know that you have some other work to do and will be doing rounds again, give them a specific time, and stick to it. You're modeling. Next, do your chart checks. You don't want someone missing evening meds because an order was missed. You will also want to note any lab orders so you can let the 11-7 shift know which patients will be going to the lab and will be NPO. Give your tech(s) as much autonomy as you can. This takes a while if you are new. Structure your staff activities but also give them as much autonomy as you can. Don't get discouraged. It will take many months to develop an efficient and enjoyable structure for your shift. You eventually want as much of your shift as possible to be therapeutic, and pro-active, without turning yourself into an autocrat. As for staying late to finish work. Prioritize your work so that you complete everything that can't be done by the next shift. Hand the rest off in report.

When asked to work my off Sunday mornings I ask for the next Friday off in exchange. Management would rather pay someone else overtime on Sunday than try to fill my Friday slot ;-)

from the EMTs: "nutted up" = decompensated usually with a groan: Cluster B or Axis II

I wear scrubs.

I get called so many things I don't bother keeping track ;-)

I've recently graduated and am pushing 60. Nursing is not difficult. The real challenge is working with women.

You're young. Go work in the refinery for a while. You can always return to nursing.

I'm twice your age, already had a BS, and just completed an accelerated program and boards. Curriculum for accelerated and traditional programs is the same. The main advantage of traditional is that it will give you time to work as a tech and you can learn a lot by doing this. For an older guy like me, 18 months made a lot more sense than 36. (four semesters in a row vs six semesters with summer breaks).

Hell. Done. Pinned.

0) patient feels good, I feel good...kind of addicting 1) the captive audience 2) fun playing with guts 3) female nurses share A&P knowledge 4) work schedule

If that poop had any more yeast in it, the flies would all be drunk.

What about NOT dating, just casual sex? Student? Instructor? I've got a psych project :-)

Have any of you dated or considered dating your instructors?

The only two times I've been asked to step aside during clinical... 1. Muslim woman, because her husband was going to be there soon. She was OK with a male nurse. 2. Little old lady...said she was too old to have a young man looking at her(embarrassed). I've been asked to step into the room. Male doctors do not want to be alone with female patients when examining genitals.

Yes, but it's blocking their way...not yours.

Do not read into the question. Go with what you are given. Weigh my advice carefully...I'm just beginning my final semester :-) 5,4,2,1,3 Based on information given and "safety first". 5. Diabetic is the most likely to die in the shortest period of time. 4. HTN pt may die but if he doesn't stroke...it's gonna take longer. 2. NV is common, seldom fatal, and most people have experienced it. 1. Meds usually fall in a 1-2 hr window, depending on facility. 3. Aggressive pt...it may prove uncomfortable for the pt but in context it's an issue for security until there is enough time to focus on him.

No interest in sports here... Bikes, cars, fishing, hunting, computers, math, physics, women, dogs, airplanes, farming, working out, ...there's plenty to talk about aside from sports. Women like to talk about fishing, motorbikes, etc. too...

I switched(nth career) for purely selfish reasons... The captive audience, lack of cubicles, preponderance of female co-workers, amazing variety of odors (perhaps I was a dog in a previous incarnation), but mostly the feeling I get when I can make someone else feel better are my reasons for aspiring to enter the profession or trade(if I get stuck in a union shop).

Nursing school academic adviser or entry screening person can tell you. I'm a strong advocate of finishing what you start and say...before making a radical change, finish what you started. FWIW, I flunked calculus and then got an A in it. Unlike algebra, geometry, and trig, the Calculus requires a lot of mental adjustment. It's less like puzzle solving and more like learning a new way to think.

If that's your spring schedule...suggest you try to find someplace to take the nutrition in fall. It's easy but time consuming and you'll appreciate NOT having it in the spring. If you're good with analytical thinking, A&P 2 is easier than A&P I. If you memorize well, A&P I is easier than A&P 2. If you're good a both...don't sweat it. I couldn't do it...but one of my classmates has 7 children. Another has a full time job. They have no social life but are doing fine with school and clinical.

You'll never finish if you don't start...

Hold for everyone...but if it's been a while and a young guy is passing through, I'll pass the torch For women...open their doors, tend to their coat, bag, and chair, wait until they are seated, tell them they look good (make a point of noticing hair changes, etc), and listen. -KPA