MeganS

It always makes sense to get experience and knowledge. The decision on whether to go to LVN before your RN is your choice. If income and experience is a consideration, go for the lVN/LPN license and then enter as an advance nursing student in an ADN or BSN program or a program designed for LVN to BSN--if that works for you. If you decide to wait for the RN program or go for the LVN route, you can start reading the books and taking notes. The best time to learn is when you are not under the stress of nursing school. :redpinkhe

I don't know your program and it may be best to consult the LPN/RN program's website. In my state, if you wish to go from LPN to RN, you must satisfy all the requirements because the RN degree is an ADN degree. You must satisfy any missing classes before you can graduate. The best thing to do is talk to a nursing counselor or consult the RN program website.

I would be more concerned if you had a question and did not ask for direction. Sometimes people work together and form a clique. Any new employee creates turbulance within their group and to support their insecurities they will belittle a newbie. Use your job as a learning situation. With time, you will be comfortable with your surroundinngs and the equipment. At that time, you can decide whether you want to stay or move on. I know it can be difficult, but continue to treat your coworkers with respect despite their actions.

All the advice you received is excellent. I had some difficulty hearing hert sounds. I finally researched amplified stethoscopes. Littmann has an electronic stethoscope that has ambient noise reduction. Not only is it light weight but you can increase or decrease the volume. It works great but it is expensive. They did have a free d loaner stethoscope program to enable buyers to play with the unit and determine if it is a good fit. I don't know if the program is still available.

From what I understand you to say: you do not like nursing because of working on a med-surg floor. Some nurses do not like working on the floor and work elsewhere. The best thing about nursing is there is so much flexibility. If you do like nursing but not on the floor, have you considered home health, private duty, nurse case manager. You mentioned an interest in geriatrics. There are so many assisted living and/or retirement facilities who hire nurses. If you are interested in clinical trials or research, there are jobs in that area and it does not require acute care nursing. There is a need in transplant nursing or organ procurement (post death, that is). Don't give up on the profession and your training. Do a little research, there should be something that will fit your needs. Don't feel bad, not everyone wants to work in acute care; I thought I would like home health. Found out that was not for me.

I don't know if this has been asked. I have a very narrow foot. Does Crocs come in different widths? The only Crocs I have seen/tried on are far to wide for my foot -- even with socks.

I can't comment on GA, but in CA, fingerprints are required. What happens here is: everything is submitted and then we are given a date for the NCLEX. Only after passing will the board process your file. I suppose the rationale is that it cuts down on paperwork if they weed out those who do not pass before processing the file. Check with your board. Do they give you a NClEX date before they process paperwork or afterwards. :redpinkhe:redpinkhe

I had difficulty with cardio in the last med/surg class. The department offered an EKG class and that greatly helped. I also purchased some of the Lippincott review books which helped reinforce what was presented in lecture and the book. The series starts with, "How to get A's in _____ (med/surg, peds, maternal/child, family, etc.)

I worked with a student-nurse nursing-assistant when I worked for Cedars Sinai in Los Angeles. We worked together on the ICU and he was greatly respected by the other nurses. During vacation time, he took time off from the student job and worked overseas with his MPH. He felt that he had to get his BSN to be able to accomplish his goals--which was to work in public health overseas. I should note that he was bilingual; it helped with his employment.:redpinkhe

So noted. Thank you for your response.

You discussed commuting distance from the area you are will reside if you make your move. We have a subway (aka the Redline) and it runs from 0445 to 0100. This is the easiest way to commute downtown. There are many hospitals located along the line (the subway goes from downtown LA out to the San Fernando Valley. Universal Studios is the next to the last stop on the line). Additionally, we have the Metrolink that is not a subway, but connects various parts of the metropolitan area t(San Bernardino, Anaheim, Lancaster/Palmdale, Ventura, Long Beach) to downtown. While it is not as convenient as the subway, using the Metrolink would enable you to live in one area of LA and commute to another. Otherwise, you will have to use the very congested LA freeways. Most often a comute of 30 miles will take a min of 2+ hrs. One could try getting up early to avoid the traffic, but the freeways are already full at 0500 and congested by 0545. Consider the high cost of housing, gas, utilities, and transportation in Los Angeles when mulling over a change of local. Other than that,if you decide to come up here, keep in touch. :heartbeat

Carlotter, Congratulations for finding a good fit with your program. I am certain that your program is excellent, but for me, Excelsior is that is not recognized in my state--and others. My state's BAOA requires a certain amount of lecure as well as clinical hours (beyond the capstone internship during the last semester/quarter), which is not offered thorugh Excelsior.

I appreciate your rationale and applaude you for your volunteerism on this site; however, that does not explain the need for website housekeeping. My question remains: why should we wade through so many Excelsior posts when it would be easier to have an Excelsior only site--the way this site has for ISU posts. Whether or not Excelsior has more students, etc is an invalid rationale for forcing people to trudge through numerous posts that have nothing to do with their program.

a quick view of the first page of the distant learning site indicates a need for website housekeeping. while i appreciate the rationale, the distant learning site appears to be predominantly devoted to excelsior while other distant learning programs are dumped into one or two huge sites. one would think that there is a bias toward excelsior. let's look at the first page of the distant learning site as an example--here are some of the excelsior posts on page 1: starting with health safety here is my schedule...apr 13, 2010 03:46 pm’ it's the last one... apr 17 02:40 pm staying motivated apr 17 11:20 am passed chronicity!! apr 17 11:10 am i got a date!! apr 17 11:05 am another mycaa and ec exam registration question... apr 17 03:15 am should i try to find floor experience to pass cpne??? apr 16 05:14 pm i passed fcca now on to cpne!!!!! apr 15 10:13 pm okay so now i'm finally ready to begin the ec rn program... apr 15 04:40 pm any canadian/international excelsior grads out there?? apr 14 09:04 pm tutor for the cpne ? apr 14 04:54 pm excelsior yahoo group moderator apr 14 01:53 pm cpne study partner in s.e. ga. apr 14 12:36 pm need excelsior cpne advice please!!! apr 14 04:00 am passed cpne apr 14 12:59 am mycaa users and excelsior apr 14 12:56 am anyone using caa to pay for excelsior adn? apr 14 12:55 am it only seems fair to use the same rationale for excelsior as used for other distant learning programs. to eliminate the need to wade through all the excelsior posts to find the appropriate distant learning program, let’s start an excelsior only site. feel free to contact me personally if there is a problem.

From what I understood, the writer was tossing out an idea and seeking clarification. We do that all the time here and people often respond with their experiences. Clearly the writer will need to research the problem at length to find her answer. If anyone came to the conclusion I was offering medical advice, then...hmmmm. I am going to reread my post. Sometimes I forget that I changed professions from that of a malpractice paralegal to nurse/social worker. Sorry if anyone felt I was giving medical advice...and you know what they say about free advice...it is as good as what you paid for it.

I note that there are many, many threads for other distant learning sites about various subjects, but when I try to start a new thread for ISU, it is dumped in one huge single distant learning thread. What gives. Why not have one thread for Excelsior, one for other distant learning sites the way ISU distant learning is treated?

Anyone out there who have ther 4 challenge exams, submitted all the paperwork, and are now waiting to hear whether your are conditionally accepted to the ISU LVN/LVN to BSN fall 2010 program/ If so, where are you located?:redbeathe

Are you talking about the comprehensive study modules for the 4 challege exams? or are there more study modules for phase III classes offered by TCN?:redpinkhe

Remember LA County King/Drew hospital...they lost Medicare/MediCal and then lost their accreditation...it is sitll closed but the county is trying to revive it. I remember at the El Camino CC nursing job fare that the King representative was going on and on about the high rate of pay new nurses got when hired by King and King was hiring. I passed as I wanted my first job to be with a hospital who offered quality care (and my instincts were right because the hospital closed down within 6 months). There are so many hospitals in So Cal. If that does not work, try VA, Sheriff's dept, home health, private duty, travel.

BTW my 90 yo mom did not have DM or >glucose level. In fact, this frail 90 yo woman has labs anyone would love to have. My problem, other than hyperkalemia, is getting her to eat protein. She would prefer to eat her veggies and does not care for sugar or bakery stuff. Suppose that is why she is 90 and has labs that we would all envy. Apparently her food preferences were not inherited by me--darn.

"I need an answer.... I am a new nurse on a MSP unit. But I am noooooo dummy. [...] A family member of mine was admitted to the ICC today where I work with acidosis. I left my shift early and sat in the ER with her till she could go to her room. As I sat there I noticed a 250ml bag of 20meq Potassium running into her. So I asked the nurse what that was for....no real answer...I asked what her Potassium was....was later told 5.2[...]I kept asking.....why this bag was hung? [...]The question I pose is this....." Here is my experience when I took my 90 yo mom to the ED. After a routine phone call to check on my mom, something alerted me to a problem. I went over to her home and found food containers scattered around her lazyboy. Apparently she got her meals on wheels but was unable to take the leftovers/dishes to the kitchen. A very odd situation for my hyerclean mom. Assessment revealed irregular pulse, weakness --> off to ED. After an hr with supplemental O2 with 100% sat, she started having cardiac irregularities to the point of 3rd degree heart block --> off to floor to be admitted for a pacemaker insertion. When she was comfortable in her bed, she was hooked up to an IV for supplemental hydration which also contained K+. This was odd considering she has great difficulty clearing K+ and normally runs 5.0-5.3. Apparently the doc never looked looked at her chart before orders (her HMO has chart info on line at the facility; no excuse). Explanation I received was it was normal for elderly pts to receive K+ with the IV. But no one asked us about her K+ situation nor did they look at her labs. Go figure. After discharge, her K+ was still 5.1, and we were given Kayexlate to be administered at home. If I had not been present or noted the K+ in her IV, her K+ would have increased beyond her highest level. Goes to show that pts need an advocate; errors can happen.

The question is: which came first? Mouth irregularity and mouth breathing or mouth breathing leading to mouth irregularity. My guess that 99% of the time mouth breathing is directly related to genetically inherited facial/mouth irregularities.

You got my attention and I looked up the article: Mouth breathing: Adverse effects on facial growth, health, academics, and behavior By Yosh Jefferson, DMD, MAGD Featured in General Dentistry, January/February 2010 Pg. 18-25 The article described my daughter and the photos of those children with the 'disorder' looked just like my daughter. She was tall for her age, thin, had long legs/arms, a mouth breather, and suffered with a high palate. Fortunately her dentist caught the problem and referred us to an orthodontist when she was about 7 because her teeth were too large for her face and were crowded. Over time, the orthodonist pulled some teeth, used the appliance described to open up her palate, and eventually applied orthodontia appliances. It took some years to correct the problem, but her teeth are beautiful and her face is normal--although reflective of a tall, thin person. My daughter is now a beautiful 6' tall blonde amazon with face, arms and legs that match her stature. But, I believe you asked what can a nurse can do. The article states, "The importance of facial appearances in contemporary society is undeniable. Many studies have shown that individuals with attractive facial features are more readily accepted than those with unattractive facial features, providing them with significant advantages. However, many health care professionals (as well as the public) feel that individual facial features are the result of genetics and therefore cannot be altered or changed—in other words, the genotype ultimately controls the phenotype. However, more and more studies are showing that environmental factors may play a significant role in facial and dental development and may alter the phenotype." Further, the author noted experiments with monkeys to produce the same problem that occurs from genetics: "In the most definitive experiments to study the relationship between airway obstruction and craniofacial growth, latex plugs were inserted in the nasal openings of young rhesus monkeys. The sudden change from nasal respiration to oral respiration caused changes in the function of the masticatory muscles. The first noticeable changes were functional, as the animals altered their neuromuscular pattern of activity to breathe. With their nasal respiration blocked, individual monkeys achieved respiration in different ways; some postured their mandible with a downward and backward (retrusive) opening rotation, while others lowered and raised their mandibles rhythmically with each breath. Still others postured their jaws in a downward and forward (protrusive) position. Each in its own way was able to respirate; however, all did so via mouth breathing." As a mother of a child who had this problem, it is my belief that for the most part it caused by genetics--there were no environment factors affecting my daughter as her father and some siblings has the same problem. You asked what can a nurse do: a thorough assessment and if a high palate, crowded teeth are noted, referral to a qualified dentist/orthodontist.

Possibly I have missed something. What does "CSM" mean?