shananigansWI

I took my exam on Thursday, and got the good pop up! Am I the only person that doesn't want to pay for quick results? If I were really worried I might not have passed I'd be more inclined, but I feel pretty confident. I just feel like the whole testing industry is a bit of a racket, between all the prep programs and materials, fees and the like, I just don't want to give them $8 more. Maybe that just means I'm cheap.

I am currently working as a nursing assistant at a hospital affiliated with the university I am earning my BSN from. Many of the new grads that worked as SNAs (student nursing assistants) on this unit have been accepted as nurse residents and seem to continue seemlessly into beginning nurses on the floor. I've been encouraged to apply for the nurse resident program, which I think I will. Only thing causing me to hesitate at all is, I'm wondeing if the area I'm working in (surgical specialties gyn/urol/ent/plastics) is going to be too insular and narrow? I think it may be a good idea for the first year since it is a likely employment prospect, but I am not convinced I'm in love with surgical inpatient hospital nursing? Is it considered bad form to take the year of preceptor experience and run off to another employer?

It is technically not included in my school's curriculum (a recent and controversial change actually), and the nurses at the hospital where I did my first two clinicals seemed to pretty much rely on lab techs for blood draws and the IV team to start IVs, but I did see them draw from PICCs a few times. Today I went to orientation for my new clinical rotation and learned that the instructor will be giving us an optional IV start and blood draw lab, and we'll likely get to use these skills in clinical. She really doesn't have to do that since it's not part of our curriculum, but she thinks it's an important skill so she's taking the time to teach us. So excited about this clinical, I think I'm going to get a lot more hands on skills experience. I was kind of surprised my school didn't require a CNA course as a prereq. I took one and worked as a CNA for a few months before I started nursing school, so I was kind of annoyed that we had to spend time on those basic skills in clinical lab.

We get one day of OR observation during our first year, it's my turn next Tuesday. I think it will be an interesting experience, I've never been in an OR and we get to follow the patient to PACU.

I just heard about taking the LPN NCLEX after the first year of the RN program from another student recently. I don't know if it's very common or encouraged, probably not since this is the first I've heard of it, but if it's an option I think I'll do it. Not sure if I'll pursue LPN work before I graduate, but if nothing else it'll give me the experience of taking an NCLEX exam, which will hopefully help when it comes time to take the RN NCLEX. Couldn't find any info on this specifically on the web so I just emailed my state's Department of Safety and Professional Services to see what the deal is. I'll report back when I hear from them.

We have white scrub tops with the school logo and "school of nursing" embroidered on them, navy blue scrub pants, and white shoes with some color on them ok. I like the uniforms alright, except I had to get an XL top to fit over my bust and hips and it's comically large on me otherwise. If I were any kind of seamstress I would try to alter it. If we're on the unit doing clinical prep we can just wear business casual with our lab coats.

I'm in the beginning of the second semester of my program, and realizing I have no idea what I want to do. I feel like my experience is too limited and there are so many options, many of which I am still completely unaware. I guess I'm hoping to be lucky enough to come across an experience that grabs me and says "this is it!" Is that foolish?

We just had a librarian come and do an active learning session on research in one of my classes this afternoon. We covered how to search for things on PubMed and CINAHL. Our group made a PICO-style question to research and we'll be making a presentation after we do some assignments related to the topic. Since we're all in the same clinical on a hematology/oncology/SCT unit we decided on "When used as a complimentary therapy along with standard pharmacological interventions, does acupuncture decrease nausea and vomiting in chemotherapy patients more than pharmacological interventions alone?" I might suggest starting by looking to your nursing experience thus far and trying to form a question on a topic of interest to you, then let that question guide your research. In my experience, librarians are more than happy to help and can guide you to the information you're looking for in a fraction of the time it would take you to dig it up yourself. Good luck!

I have Nursing Central on my phone, which includes Davis's Drug Guide. I often use this in clinical and to look up any drugs I don't know as I come across them. It's also useful for reference information when writing up pharm study material. I read quite a few entries a day that way, it's pretty handy.

I'm finding pharm to be a challenge too, so much info and almost all of it new to me. I just took the second exam of the semester in my pharm class, got an 81. That was the class average, so I shouldn't be so disappointed I guess, but honestly I think that's the lowest grade I've gotten on an exam since I started taking my prereqs. I think I need to devote more time drilling, writing up study notes, flashcards, visual aids, etc. Learning common suffixes can help, but there's always a ton of drugs we have to just straight up memorize the name, class, indications, contraindication, interactions, mechanism of action, blah blah blah. I'm going to be so happy when pharm is over!

Mine could have gone better. There was another student assigned to this pt as well since her case was pretty complicated. Admitted with an anoxic brain injury (following an incident of food aspiration and vomiting), and had a neuro status change (speech unintelligible, increased anxiety) s/p 2 seizures she had in the hospital a couple nights before we were assigned to care for her. Pt was complete quadriplegic from a spinal cord lesion and had a demyelinating disease similar to MS. We got through taking vitals just fine and the CNA brought in some linens and supplies for a bed bath. When we got started with that, the CNA left (without saying anything) and there we were with a pt hooked up to an NG tube, PICC line, cardiac telemetry device, and foley. We found out when we rolled her that the motion and manipulation made her agitated and anxious and her O2 sat took a dive, not to mention we hadn't turned off the NG tube feeding and she could have aspirated with the head of the bed lowered (lesson learned!). Thankfully, at that point the skin nurse came in on her rounds and was able to give us some direction and get situation under control. We were probably 2 seconds from hitting the call light. So, basically I feel like we got thrown to the wolves on day 1. We're lucky the pt wasn't harmed, but seriously, there is no way we should have been left alone to deal with that by ourselves. The pt I am assigned to tomorrow was crying when I entered the room to introduce myself this afternoon during clinical prep. She was polite, shook my hand, and agreed to let me work with her tomorrow, but didn't want to talk about what was bothering her. *Fingers crossed* for a better clinical day. ETA: I guess our first clinical was technically the flu shot clinic for hospital employees. That pretty much rocked, I got to do about a dozen IM injections and placed TB skin tests for most of those people too. Nice blebs on all of them! Feeling much more confident about the whole poking people with needles thing after that.

Thanks everyone for sharing your "brains"! Our instructor wanted us to come up with our own format to use for clinical prep tomorrow, this thread has been a great place to mine ideas. I decided to keep it pretty simple and uncluttered, I'm sure I'll be tweaking it as I find out what I really need to know and we become responsible for more pt care. Attached here if you want to take a glance. Brain.pdf

Glad I found a thread on this topic! I just did my first flu shot clinic yesterday, and left pretty confused about the issue of air bubbles for IM injections. We were using pre-filled syringes. Our instructor demonstrated putting the needle on, then pushing the air out before administering the injection. Once I got to my station, the RN supervising me there told me after I gave the first shot that removing the air bubble from the syringe is unnecessary, and actually undesirable because you lose a few drops of the dose when you push the air out, and the air helps keep the vaccine in the muscle. After that I left the air bubble in. Another point of contention: Whether or not to pinch up the deltoid with your non-dominant hand while administering the injection. Our instructor demonstrated giving the injection while pinching the muscle up. I found this helpful for visualizing the muscle to find the proper place to inject, but I don't see why you would hold it in that position for the injection? One of the nurses told another student that you would only do that on very small people, and that you might actually miss the muscle doing that on a larger person. Makes sense to me.

Like everyone said, I think it will vary a lot depending on the program. While working on my first semester of prereqs I was considering the Accelerated Online Bachelor’s to BSN program at UW-Oshkosh. It's a one-year distance learning program with clinicals arranged within driving distance of your home. I decided to try for the traditional 2-year program UW-Madison for a variety of reasons. It's close to home (I can bike there), I got my BA there and know I like the school, I'll have the opportunity to continue part time work while in school if I choose (the accelerated program does not allow students to be employed during the one year program), there were two fewer prereq classes to complete, I think there's something to be said for physically being in the same place as your classmates and instructors, and 4 semesters at UW-Madison costs less than the one-year accelerated program. I was fortune enough to get into my first choice program on the first try, starting there in the fall. I did have the accelerated option in mind as a back up if I didn't get in, but I don't think I would have personally been as happy with it. I guess the most important thing is to look at your goals, do your research on schools and see what option makes the most sense for you. Good luck!

My organic/bio chem class had a semester long project doing assignments and writing a paper and presentation on one drug. When I was doing my research on lorazepam I came across the Mosby's Nursing Drug Reference guide at the library. I really like the format and references, I plan to get one when I start my program in the fall.