Sugar-Phosphate

Hello fellow nurses and student nurses, I am at the point in my nursing school education where I need to choose a preceptorship for my last semester. I need some guidance. My school, unfortunately, offers less guidance in this area. A little about me. I am enthusiastic and love pretty much every nursing area I have worked in. My passion however is pediatrics and long term, I am planning to work in a childrens emergency. Unfortunately, I do not see myself getting there in the next 5 years, as it is in the big city, and I need to pay off some debt before I move to a bigger city to accumulate more debt. I was recently hired as an employed student nurse in a surgical department, a rotation I have enjoyed. The short term 5 year plan, is to work in the City I live or in the next city, which is 20 minutes away. The hospital I am employed at for the summer is 20 minutes away. I have 3 options I have chosen. We often get either our first or second option chosen, and rarely our third if one and two don't pan out. Please note, some of these are so rediculously superficial and should not be a factor My options are as follows with pros and cons them: Local Surgical department Pros: City I live, Chances of hire post preceptorship are good, I have worked 2 rotations in school in this department specifically, low commuting time. Another area to get my foot in the door. great co-workers Cons: no starbucks (yes this is a factor lol), smaller, older unit (lots of ortho, less variety), smells (again from older unit). Has been over a year since I have been on this unit, and with have to re-integrate myself. Less interested in this hospital when I graduate. Next City Surgical department Pros: I will have recent experience in this department after hire, already familiar with unit working dynamics --> decreased learning curve, integration in department already present, familiar with doctors, protocols and local numbers. Has a starbucks. I would like to work in this hospital when I graduate, newer hospital and more holistic approach to care. Cons: what if I hate working in this unit this summer, then I need to work there for 46 shifts as a preceptor student, risks of role confusion from working student (limited scope) to a preceptor student (widened scope), It would limit my chances of a hire somewhere else. (all my eggs in one basket so to speak) Pediatrics Next City Hospital (same as surgical unit above) Pros: my passion, I fit the best in this rotation, I would love to work here upon graduation, then move to a larger childrens hospital later, great for work experience and long term career goals. Great working atmosphere. Has starbucks. Cons: it has been 3 years since this rotation, and learning curve is steep (everything from assessments to work-place relationships). I wonder if I was passionate about this area because my instructor was so incredible (is it truly my passion or was I idealistic). As a student we were limited in skills when working with children and I am intimidated with my knowledge and skills for this area (another reason to choose surgical - get my skills cemented before this area). Lastly, getting a job here is risky, and I may be closing off a door for another area. Any insight? -Sugar_Phosphate

So, I am almost at the end of nursing school and really need assistance on oxygen therapy. This seems like it should be one of the easiest topics, and yet my school just skims over the topic. So, perhaps you experts can help me understand this topic. Nothing online seems to really explain this! Ok, so this is what I do know When a pt presents with hypoxia, SpO2 When a person breaths oxygen with a normal RR, they inhale approximately 21% of atmospheric oxygen, which is normally enough to provide adequate oxygenation in the blood. As a persons oxygenation decreases d/t some other mechanism, there is often a decrease is blood-oxygen saturation and often some compensatory mechanism (HR and/or RR changes). I am also noting when can see respiratory depression as well. It is shown through evidenced based practice that oxygen therapy is only for hypoxia and not SOB. 1L of oxygen via NP provides approximately 24% oxygen: so does this mean it is 3 percent above atmospheric pressure, and only providing a small amount of supplementation? When using NP at 6L/min it = 44% so this is over double the amount of oxygen a person gets at atmospheric. right? Ok, so now we have shown my confusion about this, I am even more confused about high flow vs low flow oxygen. When does the flow rate become high flow oxygen? 15L/min? 10L/min? OR does high flow and low flow just mean method of delivery and the ability of oxygen to mix with atmospheric air? I read that as it mixes with atmospheric air, the amount of oxygen delivered, is lower than the air/L/min. So then, is high flow simply a method of re-breathing to ensure a person gets a higher concentration of oxygen via their method of delivery (i.e. the venturi mask). Wow what a ramble, I hope this made sense! I am so confused lol Ok so to sum up the ramble, my questions are as follows: 1. what does the % per L/min actually mean? how much oxygen is a person getting and how much does this increase the saturation in their blood. For example does 2L/min increase a 90% O2 saturation 2%? 2. What is the difference between high flow and low flow oxygen? is it just a reference to the type of mask/method of delivery used? Looking forward to your guidance! :) -Sugar-Phosphate

Hi, I had gastric bypass a year ago. I am a nuraing student right now, but can really attest to its effectiveness, managing shifts and complications. Please feel free to message me. I have lost 160 pounds total so far, 50 prep and 110 post op since halloween 2013. Reasons for surgery: I was not going to be and hypocrite and give dietary advice if I was severely overweight. It would destroy the rapport I developed with my patients. I am young, and needed tot are control over my life. Complications: cholecystitis leading to emergency cholecystectomy, acute pancreatitis, vitamin deficiency, iron deficiency, drug intolerances, and a very sensitive stomach. How it impacts my life: I need to choose my food very wisely. I do not eat pastas, breads, potatoes. I do eat quinoa and cous cous d/t it's high protein content My biggest worry for you is ketosis. Many doctors in the us focus on extremely low carbohydrates, below 20g per day. When I was that low, I was not able to practice safely and could not administer medications d/t that inability to critically think. So this is something to be very aware of! I usually get about 100 carbs per day, 60-90g protein, and maybe 1000 calories. This is a great surgery despite its changes. Feel free to message me, as I said, I have lots to say on the subject :)

I also want to add that a watch is important in giving iv direct medications!

Our school has a 60% passing grade. But to get in, you need at least 80-90% average.

From the information you have provided, everything you have on her is circumstantial. Although she was found with your property, you did not see her take it yourself, therefor I am not sure your police report would hold any ground. In regards to getting your steth back, I agree with others about communicating with them, and give them your facts in writing. Legally they cannot hold it. (as far as I know, I do not live in the US :) Good luck, I am so sorry you have experienced this. It must be so frustrating.

My question to you is, how comfortable are you with your communication an skills? I hated my clinical rotation but now that I am comfortable with my stuff, I love it. Nursing is so diverse and everything is not for everyone. Han in there, and if you don't like something, try something else. We need management nurses, bedside and emerg etc nurses. I am heading more towards emerg but you could not pay me enough to do the scheduling and beurocracy stuff. Keep going, there is something for you. That is why nursing is great!

Hello all nurses, I am in my first semester of nursing school and have just started my clinicals. In my clinicals, one of my duties is to wash my clients face. I know how to wash a face, but my client has a skin condition, of which at this time I do not know what it is. In appearances he has pustules all over his face about 1mm thick by 3 mm long. Inside is a yellowy pus-like secretion. They look really delicate. How do I properly was my residents face without popping these pustules and adequately clean his face? Any help would be appreciated. Sugar-phosphate:confused:

I cut my hair before my first semester as I wanted my natural hair color back. Now it has been one month and I despise my hair. I would recommend not cutting your hair. After your morning shower pull it into a med to high pony tail. Take the end if the pony tail and warp it until you have most if your hair in a bun-like fashion. Take the end of your hair with the opposite hand and push it towards your head and pin it down. It creates a updo that is elegant, easy and professional. 5 minutes tops. Finish with your favorite spray or gel prior to putting up to tame fly-aways.

Mine is mon - thurs 8:30-3:30 +/- 30 min. Fridays 8:30-11-30. This is set for the first 3 weeks then I have clinicals on Tuesday and Wednesday from 6:30-2:30 the rest the same. I am in semester 1 of 8 for my program

I would recommend using some cavi-wipes for immediate disinfectant, but be VERY careful with bleach. Many chemicals that housekeepers use such as Virex, for normal cleaning, and Virox5, do not mix well with bleach. When mixed they release a chlorine gas, that is extremely harmful to yourself and your patients. I had a nurse do this once, and I flew into her, we had to evacuate px's from that room until it was ventilated enough. So I always caution bleach, unless you know what your housekeepers are using, and what kind of a reaction you will get. If you want the best cleaner, Virox5. This is the chemical of choice for terminal cleans on, for example: C.diff, norovirus, SARS, MRSA, TB, Chicken pox, etc. I would not use peroxide, as was mentioned, is not very effective against some gram-negative bacteria etc. For clarity, I would not use cavi-wipes on isolations, I would use Virox5, IF virox5 is not available, I would use EtOH, which kills all microoraganisms in biosafety level 2. Check with housekeeping if you are unsure what to use, read the label and MSDS.

Almost finished my Bsc, in Microbiology and Genetics. Now Fall 2011, BScN.

Emerg is my near goal, but long term I want to get involved with infection control. I currently have microbiology experience and LOVE my little 'bugs'. I start in 24 days whoop, whoop!! The more chaotic and stressful the more I thrive! But hey, the sky's the limit, right?

I am in a similar situation and will be working friday-mon. I have it a little easier, and my boss loves me, he bought me my littmann for school, but the rules for me say no school at work. BUT, I work also in a really slow work environment and my boss in not there all the time. I like my boss, but like you said I would rather study than watch paint dry. I say it can be done, it wont be easy, but it can be done! Things may change a little but my boss is willing to work a little. Good luck, and try, I think you can do it. I work for a retail job, and use it as my motivation. If I don't do well, I may be stuck here watching paint dry for the rest of my life! Cheers!

Math for Meds is the best!