StudentNurse2011

I depend on my brain sheet too, but it helps to only concentrate on the abnormals. If a pt has a CBC and CMP, I don't waste brain cells worrying about a WNL CBC when I have a K+ of 2.9. The exception to this is lab values or VS that I need to know before medicating a pt. If I'm giving a pt dig or cardiac drugs, I make a mental note of their pulse and/or BP. If the pt gets warfarin, I make a mental note of their INR. I don't consciously remember or ignore any facts; my brain just seems to automatically weed out the information I don't need. It comes with practice. Don't sweat it; at first, just write down everything you think you'll need to remember. In time, you'll find that you remembered without looking at your brain. When I first started as an RN, I was amazed at how much information everybody could remember. My head spun even when writing everything down. Now it's just second nature. You'll get there too. :)

Thank you for this article; the story, writing, and emotions were beautiful. Yes, it brought tears to my eyes as well. I've had a patient for the past two days that is going downhill very quickly. I was with her yesterday when the MD told her there was nothing more we could do for her. She's a precious lady - very gracious and ready to rest. I spent as much time as I could with her yesterday. I held her hand while the doctor broke the news to her, and we hugged frequently throughout the day. We celebrated her life together, and yes, we cried together. Typically, I consider tears to be the highest expression of weakness, but I've learned that sometimes it takes strength to cry. Suppressing emotions is a way to protect ourselves from having to feel them. It takes strength to allow our vulnerabilities to show - and yes, sometimes our humanity. As difficult as yesterday was for me, I wouldn't change a thing. The patient was still alive when I left last night, but I've wondered about her all day today. She declined so quickly - right in front of my eyes. Being a nurse means being a professional, but sometimes it also means being human. Most of the time a patient's needs are physical, but sometimes they're emotional or spiritual. I believe it's our duty to be there emotionally and spiritually as well as physically, and I believe that's what nursing is all about. Godspeed, sweet lady. I hope I touched your life just a fraction as much as you've touched mine.

My husband isn't a nurse, but he still knows better than to pull a stunt like that. LOL He gets front row center seats to my frequent rants about what I'd love to do to the inventor of the call light if I ever got the opportunity. I have to brag on my husband; he's a restaurant cook who works 2nd shift. He cooks all afternoon and evening, but on the days that I work, he still comes home and cooks dinner or brings dinner home from the restaurant. He knows that I'll be wiped out after my shift, so he doesn't expect me to do anything after work. Bless his sweet heart, I'm sure the last thing he wants to do is to come home and cook more, but he takes care of me. Call bells are even worse at my hospital because we recently installed a phone system that's tied to the call bells. When a pt hits their call light, it calls the RN. Even worse, just answering the call doesn't turn off the call bell; we have to physically go to the room and shut it off there. Of course, 99% of the calls could be handled by the aide. I entertain myself with thoughts of all the ways I could heap torture on the inventor (and buyers lol) of this system if I ever came face to face with them - and could get away with it.

I'd probably get their phone number from my caller ID and call them in the middle of the night the next time I worked night shift. LOL But I'm just mean like that.

NOBODY at work has my cell phone number, and I never answer the landline phone if it's from the hospital. I listen to the voice mail after they hang up. I am not on call for this hospital, and I refuse to be treated as such. If you only have a cell phone, you could always assign a special ring tone for your supervisor. My choice would be "Dirty Deeds Done Dirt Cheap." LOL When you hear that ring tone, you know to ignore the call - without even having to look at the caller ID.

Lab coat - never. Warm-up jacket, maybe but doubtful. I'm too hot-natured anyway. I burn up just wearing regular scrubs and doing my job. If I wore anything extra, I'd positively melt. LOL I wear cargo style scrub pants - the more pockets, the better, and scrub tops with at least 2 pockets at the hem. More pockets are good, but I can deal with just 2. I *like* a breast pocket for my pen, but it's not a must. I've been known to clip my pen to the neckline of my scrub top so I don't lose it in the multitude of "junk" I have in my pockets.

Honestly, at this point, if I were you, I'd put all the books, study guides, websites, and anything else NCLEX related away. Take some time to relax, and don't even allow yourself to THINK about anything NCLEX related. Do something fun with the kids, your family or friends......SOMEthing - ANYTHING to forget about the test. Somebody else already gave you great NCLEX test tips, but I have a couple more to offer. Remember that everything on the NCLEX happens in this fictional NCLEX hospital where it's never short-staffed, every supply imaginable is always at your fingertips, and everything is just perfect. (In other words, you aren't in Kansas anymore, Dorothy! LOL) Ignore the clock and just concentrate on the one question in front of you at that very moment. Read the questions and all answers before you answer. Make sure you know exactly what they're really asking, and don't add to the scenario. One of the best tips my professors gave us was never second guess yourself. If you put an answer, do not go back and change it. Trust your first instincts - unless you know for an absolute FACT that the first answer is wrong. Oh, and there's a really easy way to get a pretty close estimate of heart rate from EKG readings. 300-150-100-75-60. Find an R wave on the line of a big box, and count the "big lines" until the next R wave. If there's only one big box between the R waves, the rate is 300. If there are 2 big boxes between the R waves, the rate is 150, and so on. If you can find 2 successive R waves that are both on a "big line," the count will be more accurate. Even if you can't find 2 successive R waves on a big line, it'll still give you a rough estimate of the rate. Relax, and good luck!

Ugh, RC, I feel for you. This is one of the (many) reasons I can't wait to finish my year of med-surg and get back to the procedure room. Here's what our hospital does: We have rounding sheets that go in every patient room. During day shift, there's a place to time, initial, and note the reason for pt. contact on an hourly basis. It looks something like this: SN 0745 VS. Either the RN or the PCT can sign it, depending on who was in the room. Frequently, there are blocks signed both by the PCT and myself. It's a total PITA because it does take a little time every time you walk in the room, but you can prove that the patient was indeed cared for every hour. It might be toileting, pain control, assessment, meds, repositioning, pt. sleeping, to cath lab, or whatever, but somebody was in that room every hour. At night, instead of every hour, it's every two hours. Maybe it would be a good idea for you to suggest something like that to your nurse manager. It's a proactive solution that you can offer her. Of course, as somebody else also mentioned, your charting already covers your....you know....but it never hurts to be able to show the family a piece of paper that everybody has signed - every hour - proving that we were in the room. Our NM knows that we're in and out of the rooms all the time, but it's nice to have proof in writing. The fact that the paper hangs in the room a full 24 hours for the family to see doesn't hurt either. One more thing - please allow me to offer my sincere appreciation for all of you who spend your careers in bedside nursing. I couldn't do it. I simply don't have the personality or patience for it. I am in AWE of all of you who work every day in a basically thankless environment in which the patients and families consider you little more than waitresses who pass meds - and always with a smile on your faces. I saw a quote today from a nursing-based Facebook page that said, "Save one life and you're a hero. Save a hundred lives, and you're a nurse."

I think we've worked for the same NM.

I go to work for the sheer joy of helping people. :rotfl: OK, now that I can breathe again after that laughing spell, honestly, I go to work to pay the bills. Once in a great while, I have an exceptional patient who realizes that I really went above and beyond the call of duty to help them (like yesterday), and they tell me how much they appreciate the extra effort. THAT's what really makes the job worthwhile.

Awesome article; thanks for the tips! May I add an addendum to Academic Tip #3? One of my nurse friends suggested that for the 1st 2 semesters of nursing school, I should study from an NCLEX-PN book. The last 2 semesters, study from an NCLEX-RN book. It saved my life. Between the NCLEX books and ATI study guides, I very rarely picked up a textbook - and did very well in school.

I'm not a nurse yet; I'm still a surg tech. Can I please play along? To the nurses in my department, I love you guys. I couldn't have gotten through nursing school without you. Thanks for the support, the impromptu tutoring sessions, and for understanding when I couldn't be at work because of a school assignment. You guys are awesome! I want to be just like you someday when I grow up. To my charge nurse: You are the cream of the crop. I can't say enough good things about you. Thank you - for everything. I love my work family. They're sometimes more my family than my own family is. Yup, we argue and disagree. We're as dysfunctional as they come, but we put the FUN in dysFUNctional. :-)

In my school, self-plagiarism is still plagiarism. You might want to check with your professors and your school policy.

I'm 45, in my 3rd semester of nursing school, and work a part time job. My daughter is a senior in high school, so I'm not quite in the same position you're in. Most of my classmates are in your position. A couple of us have grown kids, a couple don't have kids yet, but the rest have small children. You can do it! I won't lie and say it's easy, but it'll NEVER be easy. Teach the family early that Mom's study time is sacred, get them to help you (housework, studying, whatever you need them to do) any and every way you can, and don't forget to spend a little time with them too. Most importantly, delegate, delegate, DELEGATE! I've found that the kids are more supportive and helpful than husbands are, but that's another thread. :-)

Definitely math for meds. You might want to consider medical terminology as well if you haven't had it yet. Since your school offers pathophys, it would give you a huge advantage - especially when it comes to the dreaded care plans.

thanks, ruby. i just aspirated my spaghetti. does anybody here know how to take care of that? *note to self* you really must stop reading while you're eating your lunch...

:yeah:I almost spit my coffee! Thanks; that statement really needs to be a motivational poster hung in every nursing lounge in the country! To be honest, I think the NM was aiming just for that type of response. It seems like s/he was paying lip service to the doctor's complaint, knowing full well that nobody would implement her suggestions. As a PP mentioned, I would smile sweetly, ask her to put it into writing as a policy change, and then I'd gladly obey. Many times, managers back down from, umm, not-so-wise edicts when they know their name (and license) will be attached to it.

:hhmth: Must.remember.that.one! ROFL Hilarious!

I've discovered that even though nurses can deal with some of the grossest stuff you'll ever see, everybody has something that gets to them. I can deal with blood, guts, and every body fluid out there, but if I see my husband pull a hair clog out of the shower drain, I lose it. You really do get used to a lot in this job. I've worked in surgery and endoscopy for many years. We can be up to our elbows in blood, guts, butts, stool, or whatever, and trying to figure out what we're having for lunch. If we have a student or new nurse in the room, they turn so green that it's comical. Of course, we'd NEVER make a newbie sick on purpose.

A previous employer usually isn't allowed to disclose details (of course, that may vary according to company policy). They're only allowed to give the dates of employment, job held (title), salary as of termination, and whether or not that person is eligible for rehire. Since she quit voluntarily, she doesn't have to put on an application WHY she quit, but the fact that she's not eligible for rehire usually says a lot to a potential employer. Assuming that she learned a VERY valuable lesson, she'll have to come up with a good story to match the fact that she quit but is no longer eligible for rehire. That being said, it's been my experience that the medical community is pretty small - even in larger cities. The hospital grapevine is alive and well - and it's not limited to just that hospital. There's a real good chance that the story will make it to other hospitals.

I once had a charge nurse who was famous for using the computer for, shall we say, non-departmental shopping. Once she was away from the desk for a meeting and I had some downtime while waiting for a doctor, so I took a screenshot of her computer's desktop and set that as her desktop wallpaper - then disabled the icons. Of course, the next time she tried to surf the net, nothing happened. By the time she got back to her desk, I'd already left for the day. IT got to come figure out what was wrong and fix it. It was the talk of the department for days, but nobody ever figured out who did it.

ok, I think you just trumped every gross story I've ever heard or witnessed. You get 5 gold stars just for keeping the contents of your stomach down those days. lol

Rectal foreign bodies are all too common - and the bane of most endoscopy personnel. We joke that you can't call yourself a GI nurse or tech till you've come in for at least 1 rectal foreign body. I've never had to retrieve a light bulb, though, and I only know of 1 of the docs I work with who's had that experience. People put crazy things up there. I don't care what people do in the privacy of their own bedrooms, but for God's sake, I wish they'd use something that's *intended* to go there.

Many years ago I worked in an ER with a doc who was a former teacher. She was famous for making copies of charting errors, circling the errors in red ink, then returning them to the guilty person. One morning I found one of her charts that she'd charted, "Pt had a bowel of corn flakes for breakfast." It was just too good to resist. I made a copy, circled the mistake in red, and pinned it to the bulletin board at the desk she shared with the nurses. Everybody got a big laugh out of it, including her, and as far as I know, she never corrected our mistakes again.

The definition of diplomacy: telling someone to go to **** in a manner that makes them look forward to the trip. My ex could do that; I'm working on it, but I have a long way to go. It's definitely an underappreciated art form. My goal is to be able to chew somebody out, but they don't realize what happened until about 5 minutes after we part company. When I achieve that, I'll work on making them look forward to their trip to h*ll.