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Altra: I admire the way you explain. It's like ... soothing! Thanks for wishing me well in my studies. Dudette10: I was stubborn but not arrogant. I was asked to clarify, and that's what I did. I am not angry, and I wasn't saying I am right and she's wrong. I know I am wrong. I don't take message boards personally, but I want you to know I regret pushing the issue and making myself look like a here's-another-a$$hole-who-knows-everything to the rest of you. Cherrybreeze: It's my fault. Sorry. To RubyVee: There's no need for experience to admit I'm wrong, and there's no need for you to be rude and insulting, either. I put out a disclaimer right in the beginning of my initial post to let you know I basically know nothing. Next time you encounter the likes of me, ignore. That's what most did. I am sure you have more important things to do than pointing out people's ineptitude. Can we all have peace now ... please?!?

no one else used the words "the system," but they are discussing it. the pharmacists, the doctors, the nurses...are the system. if we are not, define it for me, please. what does your system consist of? basically the same. when i mentioned "health professional," i was actually referring to the same examples you listed. actually, it's the opposite of saying "the planet earth is the universe." that would be saying that the responibility falls on to one, and i'm saying it does not. and i said all along it can fall on a combination of things, as opposed to just the nurse, doctor, or pharmacist. pharmacy is a part of it, nurses are a part of it, physicians are another part of it. so are hucs, so is the computer system we use to enter orders. however, it responsibility falls most heavily on those that prescribe, prepare, and administer. i'll ask again, what other specific people/units/variables are involved? i don't think i need to elaborate more on this. you are narrowing my definition of "we," not me. i didn't. you mentioned "we" as your specific definition. you insinuated that only living, breathing individual providers comprise a system. there are many different types of med errors. you should see the list to choose from, when filling out an incident report about a medication variation. errors from transcription, to preparation, to dispensing, there are a couple dozen choices. multiple checks are in place already. it's not something that you're going to fully comprehend when you're not doing it day in and day out, and have never seen it even. i am not sure what you mean by, "we are blaming everyone." not at all. but somewhere, despite the checks, things fail. who did depends on the specific error. if a medication that is prescribed, for example, that is not a proper dosage: the md who wrote is first at fault. s/he may have written the wrong dose. the huc entering the order may not question it, although if they have to type in an amount of 10 tablets to equate the written dose, that would be a red flag. if it's not questioned at that point, the pharmacy then gets the order. the pharmacist should question the dose. if they do not, they send up the med. lastly, the nurse receives the med, to give to the patient. s/he is pretty much that last stop on this trail, and at this point could (should) question the dosage. if s/he does not, the patient might even question it, when it's given to them. they may say, "i take 2 pills of this at a time at home, why am i getting 10?" however, most patients don't have a good understanding of their meds, so it may not happen then, either. for this type of med error to happen, every one of these checks has failed if the patient takes that med. but the checks are in place. this example is a totally different type of error than mentioned in the op, though. i think you get the idea. i am not sure what you're trying to argue here. all i am saying is not all medical error is attributable to individual negligence or misconduct. i am merely focusing on the improvement of a system and not blaming individuals. if they decided not to go after the "little people," i am not understanding your comparison to a witch hunt. wouldn't that mean that they do go after "the little people?" witch hunt is an analogy that refers to the lynching of "perceived" wrong-doers. again, i am implying that there might be a chance, no matter how slim, that the doctor, nurse, or pharmacist is not at fault here. "claimed?" that implies that you think i'm lying about that. claim means to assert. i don't see, in any shape or form, how i am implying you're lying. believe it or not, there are meds that i give literally every day at work, some multiple times, so yes, i am very familiar with them and no, i do not need to look them up each and every time. (for example, toradol...i know that our guideline states to push it over at least 15 seconds. i know that i need to check their creatinine level prior to giving it, and that we shouldn't give it in patients with a history of renal problems, stomach ulcers, allergy to aspirin. i know that i may not give it if they are having low urine outputs post op, since we may not know if the cause of that is dehydration or renal insufficiency). although you imply otherwise, there is nothing wrong with that. to say that i "use a little discretion" when administering meds does not contradict that at all. discretion meaning, that if a physician has ordered iv ativan, morphine, and benadryl all prn, just because they're ordered doesn't mean they can or should all be given at the same time, it depends on a lot of factors. in fact, it's from having a knowledge of these medications that prompts knowing to use them with discretion. all of these meds have the potential to sedate the patient, and i know this. if i give them a dose of morphine, i am going to see how they react before giving another one. "discretion" when administering also means that, if a physician orders ativan 1-2mg iv every 2 hours as needed, i'm going to look at many factors: the other meds the patient receives, their vital signs, respiratory rate and quality, size/weight, and medication history when deciding if i should give 1 or 2 milligrams. that's my nursing judgement. i can respect your point here, although i have to admit, this is beyond my comprehension. you assume complacency. knowing something doesn't mean complacency in any sense of the word. when you've looked up and given a med literally hundreds of times, you can know something. i know that iv ativan needs to be diluted at least equally with normal saline and pushed over at least 1 minute. i know that we give iv metoprolol at a rate no faster than 1mg/minute, and that we check a heartrate and blood pressure both before and 15 minutes after administration. i know that benadryl is pushed over at least 5 minutes. i know that on the floor, we can't give more than 5mg of morphine, 0.75mg of dilaudid, or 35mg of demerol in a single dose on a prn schedule. what i do always do is look up compatibililty with another med. if i am giving a med to someone with a pca, i always check to make sure the med i'm giving is compatible with the pca med. you seem to assume that my saying having knowledge of some med means i'm saying that i have knowledge of all meds, and that because i say there are things i don't have to check, that i don't check anything. that's both untrue, and unfair to assume. some meds, i can literally recite our guidelines word for word from the manual (see above). do i sometimes still check them anyway? you bet. that doesn't make me complacent. i wasn't assuming. i just elaborated on your exact choice of words. until you know what the job entails and actually do it, please don't make assumptions about those who do. let me get this straight. are you saying i don't have the right to talk about nursing until i get a degree, pass the nclex and actually do the job? i think you're arrogant. this is a message board. it's a place to share opinion, not facts. it's a virtual place where making assumptions is the general rule. just who are you to curtail my right to speak? respond if you will, but i am done here with you.

I just had my nursing school interview. I have been accepted, and you might be able to use some of the following pointers. Don't talk too much. It backs you into a corner. Instead, address the question briefly but accurately (think precise and concise). Nothing less, nothing more. You can do this by keeping your answers to 10-20 seconds. If you're unsure on how to begin an answer, repeat the question. This buys time. It also prevents you from stammering or having that "deer in the headlight" stare. You should avoid saying, "As a new grad." Say instead, "As a nurse," or more specifically, "As a newly hired nurse at your organization." This way, you are assuming and exuding subtle confidence. During my interview, I was asked a seemingly hard but trivial nursing scenarios, something I wouldn't know anything about since I don't have prior experience. The purpose is to stress you out, but they're also looking for the right answers here. Just as important, they're gauging whether you are composed and prepared. Practice a lot of worst-case scenarios that applies not just to nursing but to any work environment in general. And practice in great abundance. Finally, as mentioned by the first respondent, the "Tell me about yourself" is important. It's your chance to highlight yourself. You need to pitch this without any glitch. Give a minute of speech that emphasizes a few good points about yourself, such as work ethic, experience (oldest to the most recent), attitude, philosophy, grades and activities in school, and volunteerism. A few points will do, but expound on them. The underlying point here is to align your qualities with the qualities they're seeking. Good luck, and thanks for giving me the opportunity to type something here!

If you became agitated by my initial post, I would like to tell you it was not my intention. I merely brought up the "system" since no one else did. Maybe it's because I haven't started nursing school yet, and my frame of mind is still different from the rest; but I don't think my opinion is improbable like you think it is. That makes me feel inclined to address some of your comments. When you say we are the system, that's like saying planet earth is the universe. I would like to think a system is an entity that is comprised of many interrelated parts. Organizational philosophy, company culture -- even the manner of reconciling patient records -- that's a part of an intricate system. They all blend to achieve a common goal. It's more than just "we." I also gave the example "redundant checks" as "imposed" by a system because such process forces a particular behavior that limits, if not eliminates opportunities for medical errors. We're blaming everyone, ignoring even the slightest possibility that perhaps, something rather than someone might have played a major role. You asked me how a system can fail, and I would like to answer that with an example. The pediatric dose of Heparin that nearly killed Dennis Quaid's newborn twins a few years back had the same size, shape, and color that could be easily confused with the adult dose. To me, the medical error is caused by several things: First, the health professional failed to double-check the lablels; second, although the manufacturer had prior awareness of such incident and began shipping Heparin with redesigned labels, it failed to recall the old stock already sitting in hospitals; and finally, the hospital where the newborns were admitted failed to foresee the possibility of such error occurring. I think if the appearances were not confusing, the error might have been prevented. And as far as I know, the Quaids are not putting the blame on the health professional. Instead, they are fervently going after the drug manufacturer. It seems they decided not to go after the "little people," which also addresses your bewilderment regarding my allusion to witch hunt. On a final note, I'd like to point out that when you cited certain meds, claimed that "you don't have to look up" to know what they are (implying a confident level of familiarity), and said to "use a little discretion when administering," you were self-contradictory. When a health professional starts to become complacent and chooses not to double-check a mundane task, simply because he or she is familiar, it opens up opportunities to make an error. I think such decision constitutes lack of discretion.

I am not sure whether my inability to draw a clear answer regarding this query can be attributed to my lack of familiarity with the topic in question. One thing I do know, what I'm reading here resembles the proverbial modern-day witch hunt. The majority is blaming all individuals involved -- patient, nurse, pharmacist, and doctor -- and does so with such alarming finality without ever questioning whether the system failed. I honestly believe such incident can be prevented if hospitals, for instance, can impose an effective means that will force personnel to do redundant checks concerning drug reactions.

I will be starting my BSN program this spring. Like you, I thought about the costs and benefits of a four-year degree compared to an ADN. In my case, a BSN makes more sense. I already have a degree from another field, and my nursing program allows me to graduate in less than two years. I am also exploring other career areas in nursing, such as NA, just like you. This is why I am compelled to respond to your thread. I can assume the majority knows a BSN with an excellent academic standing is a basic qualification for NA (or NP, for that matter). However, that is not to say an ADN can't help you become one step closer to your end goal of becoming a CRNA or NP. The advantage of an ADN is obvious: It's shorter and more cost-effective compared to most BSN programs. Additionally, you can have a job as an RN in an ICU in roughly two years while inching your way toward a BSN. You can also get your CCRN certification while working in the ICU. In essence, your job-related skills and certification make you an ideal candidate for NA school. You can also start applying for NA school before you are finished with your BSN degree in some cases. However, I am not so sure about your assessment that it's easier to get into an ADN program compared to a BSN. Competition for both programs is keen, and more than 60 percent of qualified applicants in some states are turned away. I can assume acceptance into NA school won't be easier. From what I gather, you have to maintain all A's with rare B's to even be considered in most NA schools. With all that being said, my suggestion to you is simple. Make yourself available to either degree program. Work hard, commit yourself, and be deliberate by not rushing things.

I understand you guys completely. My experience of competing, applying, and waiting furiously for a coveted spot in a nursing program was also without trepidation. I've had recurring nightmares about it. I kept dreaming I was the ONLY student (among hundreds of applicants) who was turned away by the university. It didn't seem fair! The revelation finally came to me last week in the form of a university packet. In it was a letter, signed by the director of nursing, congratulating me of my acceptance to the BSN program. I am not religious (except during Thanksgiving), but I did thank the Lord rather profusely. This is undoubtedly the best news for me in this relatively new year. To those who are waiting, your time will come, too. And to those who have been officially accepted, congratulations!