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dudette10 MSN, RN

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dudette10 has 14 years experience as a MSN, RN.

dudette10's Latest Activity

  1. dudette10

    HIV patients

    I have taken care of AIDS patients and HIV positive patients. Standard precautions. I had a spot of blood come from a kinked catheter during IV removal on an HIV positive patient. It landed on my uncovered wrist above my gloves. He looked at me with an alarmed look on his face. I looked at him and said, "Your viral load is undetectable and my skin is intact. It's ok." I'm ok. You're ok.
  2. dudette10

    Skills Lab, Creative ideas?

    Students LOVE skills labs because they feel more "nursey," and it increases their self-efficacy. They will love it, regardless. There are some teaching-learning strategies to consider. The most critical part of a skills lab is assessing the students' needs. Is it a required lab? If so, where are the students in the program (early...close to graduating)? Is it an open lab with students coming in for their own edification? Is it a structured remediation session? Another important point to consider is alignment with their classroom sessions, especially required labs. How closely is the required lab aligned with the didactic portion? Do you have access to the instructional materials for the didactic portion for reinforcement of concepts? One thing that is often overlooked in skills labs with new instructors is the entire nursing process. As nurses, we don't just go in and do a skill...we assess, teach, evaluate. Include that as part of your skills lab, as appropriate, based on where they are in the program. Also, be sure to reinforce good habits, such as hand hygiene and patient identification, and expect that to be a part of their return demonstration. By nature, skills labs are formative experiences; only skills check-offs are usually summative, so be sure to treat your skills lab that way. Consider debriefing sessions with the whole group. I've done them with simulation and lab...and, believe me, students are harder on themselves than we could ever be! Doing a debriefing of affective, psychomotor, and cognitive learning creates a judgment-free zone of learning. They will make mistakes, but you should see improvement over time. Those who make the same mistakes over and over may need remediation. I know my post didn't give you the information you asked for, but I hope it's helpful anyway.
  3. This is what you don't understand about teaching. I get about 20 requests for "exceptions" every single term. One out of the 20 is unavoidable. The rest are bad planning or special snowflake requests. The rules need to be applied in a non-arbitrary manner. So, if you want to talk about fairness, how is it fair to allow some to slide for bad planning when others are never late because they are good planners? I am not going into the details of when something is an emergency and when something is not. I am a compassionate instructor, but I'm often put into a position where I have to say no to ensure that my decisions are not arbitrary. And, I can tell you with 100% certainty that saying "no" to a student is not something I look forward to. However, I have to for fairness.
  4. dudette10

    Let go/resign from new grad 6 months in

    Yes, a million times. Depending on the way things are done on a particular unit, doing a CHG bath and making someone NPO overnight is no big deal, even if surgery is decided against or delayed. NOT doing it with all that information at your disposal would have put you in a heap of trouble. So physician notes, patient understanding of the plan, and off-going nurse confirmation of surgery isn't enough to implement simple prep, which leads to a delay of patient care? And the surgeons are cool with that? Really?
  5. dudette10

    4hr lecture

    Treat each hour as a separate class session. No more than two concepts per 50 minutes, break for 10. Fifteen-minute lecture, 10-minute class activity, repeat x 1, break. Depending on your content, the class activities can be scaffolded. A scaffolded activity doesn't have to be complete at the end of 10 minutes--it only needs to be complete for the concept you just taught. Try not to re-teach what they have already been taught in previous classes. If your school has a separate patho class, don't re-teach patho. Instead, include pre-class homework assignments for a small amount of points about the patho of the conditions you will be teaching that day. Have them complete med cards prior to class for a small amount of points so that you can concentrate on evaluation and nursing implications rather than teaching the pharmacology. Maybe start out with a quick, ungraded quiz on the homework, review the answers, have them keep the quiz as a study tool. (My class LOVED that.) For focused assessment of a condition, use the Socratic method. "What assessment techniques are we going to use and why?" "What are the most likely abnormal findings for this condition?" Guide the class through the discussion and write their correct answers/rationale/abnormal findings on the board. Provide them a pre-made template chart that they can complete as notes. If you spend too much time dumping knowledge into their brain, they won't know what to do with it--and they get bored quickly. Homework can be the knowledge acquisition part; doing a quick review of the knowledge, then teaching them to work with the knowledge can be the focus of your class. Those are just a few suggestions. I don't know what class you are teaching, so these may not work for you.
  6. dudette10

    Eating the patients' food?

    Four 4-oz cups of cranberry juice over a cup of ice was my dehydration elixir at around 3 p.m. on a 12-hour shift. No guilt. At all.
  7. dudette10

    Question about use of Heparin and platelet count

    Are you talking about holding heparin for possible HIT? There is a way to determine via labs and clinical signs and symptoms if HIT is a possibility. I would have to look it up--it's something like a 50% drop in platelet count X number of days after starting heparin. At any rate, you can hold heparin for a short period of time and call the provider with your concerns. But, no, you don't hold it as an independent nursing action--you can hold and CALL, but don't just hold.
  8. I'm not retiring, but the hubs is soon. When he gets SS at 66, his monthly take-home (pension + SS) will be more than he brings home now, and that's not counting the 401k, which we will probably just let sit unless we want to do something extravagant. Plus, I'm still working, the house is paid off, and the kids are paying for their own education.
  9. dudette10

    Can you give a lesser dose than prescribed without an order?

    Oh, what a load of ****. (Not at you klone...at the whole 'nurses are idiots' way that the accreditors are acting.) And, as you indicated at your workplace, this is just a matter of 'tightening up order sets.' Does it really change anything about our practice, except cost the facility money for the HIIM group to change the way the orders read?
  10. dudette10

    School Shootings

    Here is a novel idea that will take some additional research that we currently don't have. This is a bit of a long-winded explanation, but bear with me. Is it possible that today's children are different from yesterday's? I don't mean in family values or culture or upbringing, but BIOLOGICALLY different. Aaron Lerner, Patricia Jeremias, and Torsten Matthias, "The World Incidence and Prevalence of Autoimmune Diseases is Increasing." International Journal of Celiac Disease, vol. 3, no. 4 (2015): 151-155. doi: 10.12691/ijcd-3-4-8. Anecdote: My oldest son is now 20. When he was in 2nd grade, his teacher with 40 year experience said, "When I first started teaching, I could easily handle a class of 40. Now, I'm struggling with 20. The kids are different now. I'm convinced it's our environment." Where are our studies on autoimmune diseases and the environmental factors that may have a role in it. Our food is genetically modified, our air is filled with waves that we can't see and know NOTHING about the effects on our bodies, our waterways are contaminated, and we sit in traffic inhaling fumes. Why are our girls and boys hitting puberty earlier and earlier? Why do we have a growing incidence of autoimmune diseases in the developed world? Do we really think that none of this has affected the growing bodies and brains of our children? We need to found out what type of damage our technological advances can cause. We simply don't know, but we are seeing the effects of without cause.
  11. dudette10

    School Shootings

    Yes, our culture may be a bit different from Australia (but not apples and oranges, by any means), but that doesn't mean we can't look at their INTERVENTIONS and ADAPT them for our own setting.
  12. dudette10

    School Shootings

    Only two of those were a stranger walking in to a building and shooting indiscriminately--the Monash University killing and the Sydney Hostage Crisis. The rest were familicides or feuds with specific people that turned violent. There is a qualitative difference between those kinds of shootings and the kind the US is experiencing.
  13. dudette10

    Nursing Classroom Education: The big bang of powerpoint slavery

    I am a new instructor, and there are a number of issues. The first is the amount of content that schools expect us to teach. It's ridiculous. So many of my colleagues agree. I'm now on our curriculum committee with these same colleagues, and we are committed to making a change. I usually teach a class where I can control the content, unlike most of the classes in our current curriculum. I love it. I have finally gotten my class to the point where students realize they MUST do the reading beforehand to participate fully in the classroom and actually learn something. I haven't completely flipped the classroom, but it is definitely a mixed classroom (the term for the lecture/active learning activity combo). I feel good about it, they are engaged, and they have shown me, through formative "quizzes," that they are learning too. The content creep MUST be addressed for every classroom to be an active one. That takes a lot of hard work via curriculum development and talking the frightened instructors who don't know how to create an active learning classroom off the ledge.
  14. dudette10

    On-call or cancelled? That is the question!

    My last bedside job eliminated the on-call pay all together, but required you to be available after cancellation until four hours after start of shift. I had one instance where I was cancelled, I was called at 11 and told that I wasn't needed, but that I had to remain on-call until 3 p.m. I said, "No, I'm not required to do that. Do you need me now or not?" The answer was "no," so I said, "Then I am no longer on-call" and hung up.
  15. dudette10

    Is the online bls at American Heart Association hard to pass?

    In order to get the AHA BLS for Healthcare Providers, there MUST be a hands-on skills portion. How the hands-on portion is done can vary, but it is required. So, beware of any site that states you can get the certification entirely through an online test. This is a source of confusion for many people.
  16. dudette10

    Employee Complaint

    As I read your post, I could hear and see the exchange. Like a wondering out loud sort of thing with a pleasant response, and not challenging in any way. What you have to remember is that some people LIKE to be offended and feel as if they are wronged some how. I'm not talking about serious, egregious offenses that anyone with half a brain would recognize as true discrimination or the like. I'm talking about exactly what you described--a conversation that, in the moment, went very well. And then you are blind-sided. Why? Because she started thinking about it and decided to get offended. It's clear to me that at the time, she wasn't offended at all, only later. Drama (petty **** blown up into a total ****-storm) makes me extremely uncomfortable. A true aversion to drama, which has the nice side effect of being an easy-going and not easily offended person. I can be passionate and engage in conversations about things that matter, but "drama"--uh, no way, leave me out of it. An acquaintance of mine THRIVES on drama. She is offended by someone or something on a weekly basis, over the stupidest of stuff. That's just the way some people are. They are hell to deal with, but at least you learned something out of this. Good luck!