Career2_BSN

I'm doing my preceptorship in Hospice (my 1st choice). Up until now, all of my clinical experience has been in a hospital and I've gotten pretty comfortable with assessments, charting, med passes, etc in the hospital setting. The last two weeks of my med/surg rotation (before preceptorship), I was taking my nurses full loads and they were answering occasional call lights but I did most of the work. I felt like a nurse, like "I can do this". Now, I find myself using all paper (no computers), the paper charts (3" thick or more) are at the office while we're out in the field, I feel unorganized with all of this paper shuffling and kind of lost without the patient's history readily at my fingertips. I didn't realize how convenient it was to see all of the previous charting so you can say "yea, his condition is the same" or "no, it's definitely changed" or "I see they gave him XYZ and that could be the cause of his problem". How nice it was to have lab values and now we're relying solely on symptoms. Each time we walk out of a patient's home, I share my assessment and thoughts with my preceptor. She usually agrees with me, but then she brings up things she noticed about the patient (things I didn't pick up on) and I feel totally inadequate. For example, one patient had a sudden change of LOC along with a fever. We all thought infection, likely UTI since that's common. The preceptor asked me what I thought of his breathing. I told her breaths were shallow, on the slower side, and listening to the lungs, there didn't seem to be a lot of gas exchange. She agreed and thought that perhaps he was also having some CO2 toxicity and instructed the family to put his CPAP on until he showed signs of improvement. As soon as she said it, I'm thinking, "duh, why didn't I think of that? We had a lecture on that." There have been other smaller things, but this was the biggie that I felt like, I wouldn't have been what the pt needed at that time. Going into our preceptorship rotations, our instructors cautioned us to set realistic expectations for ourselves. They reminded us, we are students and won't know everything. But, I can't help wanting so desperately to be everything my patients need and knowing I'm failing. I just don't know enough. Anyone else feel like they just aren't enough? Any experienced nurses who remember having these feelings and grew past it? Do these feelings resurface anytime you move to a new dept or nursing function?

My mouth just dropped.

I can't answer your question personally, but my nursing instructors all swear by the ATI and Saunder's practice tests. Previous students agree. We have to take ATI tests throughout the entire program and the Dean swears that's why the school's NCLEX passing rate is so high (~96% each year). According to them, the ATI tests are written by the same people who write the NCLEX. The ATI website updates their exams to match the NCLEX exam. The Saunder's review, while in paper form, is still supposed to be excellent review as well. Since we take so many NCLEX-style tests, we get more comfortable with the exam - not only the question content, but also the format. This is supposed to help with anxiety but I'm sure I'll be popping Immodium before the test regardless.

That's because people haven't learned how to use the nifty little tool called the Search Box up in the top right-hand corner of the screen. It's amazing how much information one can find with just a little bit of homework. But no, they need to be center-of-attention and have someone answer their post directly. OK, that sounded totally snarky when proof-reading, but it's true.

You didn't owe them an apology for taking a well-deserved break and they clearly didn't want to hear one....they just wanted to vent. Because of many encounters such as this, I apologize less frequently now. My response instead is "I'm here now. How may I help you?" Granted, if I messed up on something and am truly sorry, I apologize very quickly. But this was an obligatory apology. Not necessary.

Yes, yes, yes!!!

Wow, Ruby! My jaw dropped further and further with each story!

lpn2B2016 - I think this one made all of us sob and look forward to starting school. Congratulations on starting in January!!! I start my RN this August so we should be graduating around the same time. I read this article several months ago and yet it enters my mind often.

Congratulations!!!

I've only attended 1 orientation meeting so far in my program (there are a total of 8 orientation meetings this Spring and then school officially starts this Fall). The Nursing Dean informed us we will have lecture tests and then we will have ATI tests. ATI tests take questions directly from the NCLEX. The reason they give you NCLEX questions is so you are already familiar with them when you sit for the official NCLEX and you're more likely to pass when it counts. Our program has a 95%+ pass rate every semester. We have to pay $500 for ATI access (for the 2 year program). There are pre-tests, review material, and then final tests in each area of study. The tests are set up in the same format as the NCLEX so we are essentially preparing for this for 2 years. While you may have been ill-informed initially, adding NCLEX questions to your tests actually benefits you in the long run. Buy the Lipincott book and start studying. Perhaps speak with those who did well and ask them their study strategies so you can do the same.

As wonderful as the VA opportunity sounds, it seems family is definitely your priority and the way you've painted it in just a few paragraphs, the strain on the family might be strong enough to warrant walking away from the VA (for now). We like to take our kids on an annual week-long road-trip with our tent trailer. This past summer, we skipped that because I elected to take a weekend CNA course. It was 13 weekends - full days - and spanned the entire summer. I worked my 40 hr/week day job Mon-Fri and attended the course all day Sat and Sun. Every other week, I took Thurs and Fri off to be my "weekend". During one of those "weekends", I had wisdom teeth pulled so I didn't enjoy those 2 days. Through this, I learned a very valuable lesson. I NEED time with my family as well as time for me. Whether I'm crafting or reading or vegging out in front of the TV, time to decompress is therapeutic and necessary. My initial thought was to work full time and go to school full time so we could avoid racking up school loans. I now realize, school loans can be repaid. My sanity and the happiness of my family is worth paying an extra bill after graduation. I will likely work part time but I know we will be okay if I quit work altogether to focus on school and family. You sound like a very driven individual and no one can tell you what to do, but after learning my lesson last summer, I would personally stay home, work the CNA job, and enjoy the down time with your family. Network like he** in your CNA job so perhaps other doors will open up for you during the next year of school. Get your PCT certs to allow for even more networking. Look around your area for inexpensive things to do with the family. One of my kids' favorites things to do is go to our local frozen yogurt place. We'll each get a serving and then go hang out at the local park/playground. For that afternoon, frozen yogurt is our dinner. I, too, love photography and my kids are my favorite subjects so I have camera in-hand for many outings, especially these. We also live near beaches so we'll pack a picnic and head out for a day or we'll go on a local hike. In our area, museums are free one day a month (they rotate, a handful free each Tuesday). I'll check out which are free and we'll attend those that day. Pitch a tent in your own backyard or sleep under the stars. Your kids want your time, not your money. During school, time is tough to come by. This summer could potentially be therapeutic for the whole family and allow you to strengthen the bond again to get you through next year. What ever you decide.....best of luck to you!!!

I looked into the Poway and Grossmont ROP programs as well and they didn't fit my schedule. I took the weekend CNA program through California Medical College and they were very good. Excellent curriculum, phenomenal instructors. The facility we did our clinicals at was a nice facility despite the fact that it was located in Lemon Grove. The program was pricey - $2250 if you paid everything on time - but they offer a payment plan if you need to make monthly payments. You have to put $1k down and then monthly payments of $250 after that. They accept all major credit cards and all materials (books, 2 uniforms, a pen light, gait belt, bandage scissors, a nice stethoscope and a bp cuff) are all included. They've had a 100% pass rate for several years and they plan to keep that status. They bring in one of the official testers to review with you for a couple of days so you go in there pretty confident that you'll pass. My class had a LOT of people who were on the path to nursing school so they were accustomed to studying and were serious about their aspirations. We also had a small handful who would likely remain in the CNA role indefinitely. I'm glad there are those who wish to stay in this role indefinitely because we certainly need them but I found myself in the former group. I'm glad I went through this program.

Hi Dukesmama - I, too, was accepted into SD City's program. Maybe we'll run into each other in tomorrow's class. I applied to Southwestern, City, Mira Costa, Palomar and Grossmont. I was accepted into Southwestern and Mira Costa and turned them both down since City is closer. I should hear from Palomar this week or next. Won't hear from Grossmont until next month. Grossmont is closest to me so it's my 1st choice strictly for logistical purposes. But I'm thrilled to be in City's program. My stats getting in were... 3.7 Science GPA 3.6 overall GPA TEAS 85% CNA 3 semesters of Spanish, had to work during pre-reqs, hubby is a vet, kids have disabilities (claimed family hardship) I calculate that to be roughly 73 points which seem low to me, but it was good enough to get accepted into 3 of the 5 programs I applied to.....still waiting to find out about the other 2.

ewww.....

O..M..G.. A $5 bottle of Rid, used twice, a week apart, works wonders. As a parent with 3 kids, all in public school, we get Pink Eye and Lice notices at least once a year. You know what I do with them?? Throw them in the trash. I got lice once when I was in high school. My cousin had had it and after shampooing her hair, I let her sleep in my bed. We were using Nix and come to find out, the strand of lice she/we had was immune to Nix. It would make them very sick but not kill them. Took us a few washings and a severe hair cut (waist-length to shoulder-length) to get rid of the problem but it was NOT the end of the world. Kids have had pink eye, too.....also, not the end of the world.