pecanpies

I think you might be putting the cart before the horse a little unless there's more information you haven't included in your question. Have you taken a practice test yet? How did you score? What were your weakest areas? How long have you been a practicing RN, and what kind of unit are you on/what kind of patients do you see? In my case, I started by taking a practice exam. I just barely received a passing score. My weakest area was Cardiovascular, in large part because my hospital does not do open hearts, and we rarely see a Swan. We also have a dedicated CCU, so the heart patients we do get typically go there. Since Cardiovascular is 20% of the exam, I knew I would need to dedicate a lot of time to studying, especially in this area. Based on the results of my practice exam, I developed a study plan that focused on my weakest areas. I spent about eight weeks studying, and I did practice questions every day. In the last couple of weeks, I took three more full-length practice exams. It worked for me - I just passed yesterday! Good luck to you.

I bought a cheap stainless steel band solely for work. It was about $35 at a local jewelry store. If it gets damaged or lost, no big deal - I'm only out $35. I have a beautiful wedding ring (in my opinion!) and band that I don't want damaged or lost through the one of the many hazards of nursing.

Sorry the counseling center was so unhelpful. =( That's frustrating. At least you gave it a shot! I spent a ton of time studying in the library when I was in school, both the first time around and when I went back for my BSN. When I was in school the first time (and living on campus with no car), the library was a 10 minute walk from my dorm room. When I went back for my BSN, the library was about 10 minutes away from the commuter parking lot. I walked to and from the library in rain, sleet, snow, you name it. Twenty minutes was a small price to pay for a quiet, calm study environment. Since you asked, I think you should give the library a try. At the school where I got my BSN, our library had about 10 "quiet rooms" - small rooms off one of the main levels with a door and a small desk. Those were REALLY quiet - and no distractions! There was nothing on the walls, no clocks, etc. They were the perfect place for someone (like me) who is very easily distracted by any level of noise or conversation. Maybe your library has something similar?

I am not a counselor, psychiatrist, therapist, etc. and even if I were, that would in no way qualify me to offer any sort of diagnosis or advice over the internet. That being said...I sense a lot of anxiety in your post. You obsess about very normal everyday noises (shuffling papers, opening drawers, etc.) and it clearly is a source of intense stress for you. You obsess about the quality of your sleep, to the point where sleep is actually becoming more difficult. From what you have written, I get the feeling that you are experiencing the sense that the world is against you - you lost your old roommate, didn't get the single room, don't have a car, etc. You're focusing entirely on the negatives in your life, to the point that it is now affecting your sleep and health. You don't want to go to the library because it takes 10 minutes to walk there, but how much time have you spent worrying about this? I bet it's more than 10 minutes. Does your school have a counseling center for students? It might be helpful to talk some of this out, in person, with someone there. I am in no way suggesting that there is something "wrong" with you. We all go through stressful times in life and sometimes, the stress becomes too much. Do NOT let this hinder your path to becoming a nurse. A counselor can give you some strategies and coping mechanisms for dealing with this stress. If you don't have a counseling center, do you have health insurance? Many health insurance plans offer a limited number of counseling sessions via telephone, for free. It's worth looking in to. Good luck to you, and remember - this will pass! You can get through this.

At our hospital, they train new hires in the AIDET method of communication. It's simple, easy to remember, and though it might sound cheesy or false, actually has helped me communicate better with patients & families, especially when I'm stressed out. Here are the basics: A: Acknowledge the patient and the problem/concern. Make eye contact and SMILE! "I see your IV pump is beeping - I'm sorry about that! I know it can be annoying." I: Introduce yourself. "My name is {Jane} and I'm another nurse on this unit." D: Duration - let the patient know how long something will take (this might not always be relevant/needed). "I'll be back with a new bag of IV fluids in ten minutes." E: Explanation - give the patient a straightforward explanation of any test or procedure you're performing (again, may not always be relevant). T: Thank. "Thanks for your patience while I go get your nurse/get a new bag of IV fluids/etc." If you stick to these steps, you won't forget to make eye contact, smile, introduce yourself, etc. because it's part of a process you repeat again and again. It is SO easy to appear rushed and rude when you're stressed out or have another, more urgent situation to address. You have to remember that each person typically considers his/her own needs most important. The person with the beeping IV pole doesn't know or care that you have another patient whose sats are dropping for no reason, or whose BP is bottoming out. They're annoyed, and they want the beeping stopped - now. To them, that's what's most urgent. With eye contact, a warm smile, an introduction, and a brief explanation, you make each person feel as if their concerns are important - because they ARE important, at least to that person, no matter how minor they may be in comparison.

I do wish our unit had a family kitchen area - I've seen these in other hospitals and they are a huge time saver. Instead of the nurse making multiple trips for drinks, snacks, cups of ice, etc., family members can do it themselves. I have no problem grabbing someone a cup of ice or a drink, but it's fairly low on the priority list, especially if I've got meds administer, dressing changes to perform, or patients to turn. I'm sure many people would rather take 2 minutes to go get their own Sprite than wait 20+ minutes for me to finally have a chance to do it.

I'm posting this this because I need advice on how NOT to let this happen again, and also because I want other new grads who might've made mistakes like me to know they're no alone!I'm a new grad in a trauma ICU. I started June 15. Yesterday was my first day taking 2 patients all by myself, with no one looking over my shoulder or supervising. We were short that day, had several very needy patients, some family drama, and a patient who was rapidly going downhill who ended up passing right at shift change. My patient load was relatively easy, though. In the morning, I got an order to take one of my patients to CT. At my hospital, once the order's put in, CT calls when they're ready for you. Well, CT never called, and the day just started getting crazier and crazier. Like I said, my patient load wasn't bad, but other nurses needed my help and I stayed very busy. All of a sudden, I catch my breath and look up - and it's 5:30. Guess who hasn't gone to CT? Yep. Right after I realize this, the phone rings. It's the doctor, who (rightfully) chews me out for not getting my CT done. I proceed to grovel, apologizing and saying it was totally my fault for dropping the ball and it will not happen again. Ugh.Well, CT couldn't take me until 6, and by then respiratory was about to start shift change, so I wasn't able to go to CT until after I'd given report during my own shift change. I took that patient to CT myself around 7:30 because I did not want to dump my mistake on night shift. I'm off today, feeling like an idiot an hoping this mistake won't result in a write-up - or worse - as it well could. Experienced nurses, I'd love your feedback on how to keep this from happening again. I have seen the organization sheets that have been posted here before and use something similar at work. It wasn't enough - or I wasn't using my tools to the extent that I need to. This was my first big screw-up and my biggest concern is making sure this mistake, or one similar, never happens again!

Your nurse practice act is here: http://www.doh.state.fl.us/mqa/nursing/info_practiceAct.pdf Based on what pages 93-95 say, I would not carry out that order. It states on page 95 that for an LPN to administer anything through a central line, you must have special training. At least, that is my interpretation. Definitely call your BON, but use the practice act to back up your refusal in the meantime.

Could you give a few examples, please? If there are some specific posts that have upset you, that's one thing. If not, this feels like yet another instance of someone beating a dead horse. This topic has been absolutely worn out on AN.

I'm a new grad nurse who just started on a 10-bed critical care unit one month ago (my first actual day on the unit was June 13). My preceptor is fair, patient, and level-headed. She's also tough and doesn't let anything slide - and I'm incredibly glad for it. I do something stupid almost every day that am I there: things like spraying myself with tube feeds; having to re-check something because I forgot to write it down; walking to the Pyxis twice in 15 minutes because I didn't pull all my 8am meds at once - typical new grad mistakes that happen when it's chaotic on the unit and you let yourself get flustered. There are definitely times when my preceptor points out these errors and I feel dumb, but I'm happy that she does so. It's not my goal to just slide by. It's my goal to be an excellent nurse. There are nurses on my unit who barely even acknowledge me and I'm sure don't know my name, and I'm OK with that. I'm in a position where I need to earn their respect, and I'm certainly not there yet. I intentionally applied for a challenging position. I KNEW there would be days I'd feel like an absolute idiot (turns out, it's most days!). I'm glad that no one's cutting me any slack because it's making me a better nurse, one mistake at a time. I'm sure there are new grads out there who expected (or thought they deserved) an easy ride, but that attitude isn't universal.

Apply to University! They hire lots of new grads - including me and about 8 of my friends!

I'd definitely ask at orientation. I'm sure you're not the first to run into this!

You should never do anything outside your scope of practice or anything you do not feel safe doing. If that's what you mean by "refuse," then yes - you can refuse. If you're asked to do something that you don't feel safe or comfortable doing, what I would do rather than just refuse is to explain you don't feel comfortable and ask for help. You could ask for a demonstration, or ask them to walk you through the procedure as you do it. The downside to this is that many nurses, when asked for help, will just do the task themselves rather than assisting you to do it. Keep that in mind and be an advocate for yourself - explain that you really want to perform the skill or task, but would like them to watch you/walk you through it/guide you/etc. If you're asked to do something outside your scope of practice, you should always politely refuse regardless of whether or not you feel competent. For example, as a second semester nursing student, I was asked to call a doctor. That's not an appropriate request to make of a nursing student. Even though I consider myself capable of making a phone call and was familiar with SBAR, I politely explained that I was not allowed to speak with the doctor over the phone and apologized for being unable to help them. They were annoyed, but I did what I had to do to protect myself.

It's intense. The program is split into six 8-week sessions. The first four sessions run from the second week in May to the middle of December; in that 6-month span, the longest break you get is 4 days at Thanksgiving. It's absolutely grueling, especially towards the end of that stretch. If you can make it to Christmas break, though, you'll be fine - I don't think we lost anyone after that point, or if we did, it was only a couple. The program is definitely hard - our 40% dropout/failure rate speaks to that. Many people failed out, but some chose to leave because the program was too intense. A couple dropped into the traditional 4-year program or the 2-year "slow" accelerated program. I think not working is a good idea. There were definitely people who worked a few shifts a month as techs/CAs/etc., but not many. They had also already been in those jobs for awhile so they weren't taking on a new job in addition to school. If you've never worked as a tech or CA, I would recommend it. I did not and I wish I had. There are so many little things you pick up just working in the hospital environment that I had to learn in clinicals (and am still learning during my orientation now!). I will say this - if you are planning to stay in the Louisville area, having a BSN from Bellarmine will make you very marketable. I had 3 interviews by early March of this year and a job offer by the end of March in the specialty that I wanted. Many people had jobs before graduation or within a month of graduating. Being an accel grad alone is enough to get you an interview at several of the hospitals here. Good luck! Feel free to send me a PM if you want, too.

At my hospital we wait 60 days from the 3rd Hep B shot (or booster) to draw Hep B titers. I don't know about varicella - sorry! Most people getting varicella titers drawn that I know of have never had the vaccine, so we've never had to think about any kind of timing.