nursingmeatball

long story here, but mainly i'm having a hard time swallowing what was done at a patient's bedside the other day, and i'm loosing sleep over it!here's the gist: bad trauma (opening ICPs over 130, ICPs maintained in 80s-90s despite treatment) needed a wound vac to abdomen. to "save costs" the surgeon rigged up his own wound vac at bedside with a sterile towel in the cavity, two OG tubes in the space, your typical occlusive dsg over top, and hooked the OG tubes to a sump pump. will this save costs? sure. was the procedure sterile? yes. will this be effective treatment (in a long term sense)? i don't think so. now, maybe his reasoning was that we simply needed a quick fix, and this pt was sure to die or have care withdrawn soon. i guess i can accept that. but if he's going to be doing this sort of thing routinely, on pt's that are expected to live - even if it is just temporary - i don't think i can stomach it. i think even a short time of having that fibrous (cotton) material in a wound bed is dangerous and sets up a bad cellular environment for more inflammation, greater risk of infection, decreased healing, and increased chance of adhesions forming later on. i base these assumptions on both common sense and on the fact that i have a masters degree in cellular and molecular biology, so understand a few things about cell/tissue behavior and signaling. i've only been a nurse, however, for a little over a year, so maybe i don't fully understand some of what his thinking was, beyond a quick/temporary measure that saved lots of money. has anyone else seen this sort of thing? am i worrying too much? i feel like i should discuss this with my nurse manager. thanks :)

I chuckled to myself when I saw this post.... I was a HS teacher for 10 years before going in to nursing. I've only been a nurse for 8 months, but I think that the first reply above made some salient points, and basically outlined some of the reasons I made the switch to nursing. Here's a list of my thoughts on the topic: 1. I do not take work home with me. (Unless, of course, you count the studying/reviewing that I choose to do on my own time because I am so green at nursing and do not know enough to be a super-nurse yet.) 2. I have a better schedule (in my opinion) than I did as a teacher. I don't care what people think about teachers "getting the summer off." It's a bunch of BS, because in reality I had to have a part time job during the school year as well as a summer job to make ends meet as a teacher. Not only that, but I took home piles of work each night and every weekend, and was always working on improving curriculum and materials over the summer - for NO PAY. Near the end of my 10 years I was approaching a good salary where this was no longer true (but I had also acquired 2 master's degrees by that point), however my nursing salary right now is just about adequate, and it too will increase with more time and experience. Plus, I can work 3 days and have 5 off or work 4 days and have 7 off, and well, you just can't beat that kind of freedom on a regular basis. 3. I am less limited in what I can do. As a HS teacher, I was really "locked-in" to what I could do, which was basically teach the same topics year after year after year. Sure, you get electives now and then, and different kids, and new materials, but really, the thought of it started to get depressing. Despite how much love I still had for my area of teaching. As a nurse I'm currently working in an ICU. Is it for me? Will I stay there forever? Truthfully, I'm not sure. But that's part of the beauty of it - I can work a floor, in a doctors office, at a nursing home, in home health, in IV or infusion therapy, at an urgent care center, in a dialysis center, for a pharmaceutical company, etc, etc. The possibilities are seemingly endless, and as long as you are not afraid to make changes and try new things, I think you can seek many different opportunities as many times as you are able. And if you are brave enough to make a career change, then you are certainly brave enough to try different areas of nursing. 4. I am hoping that some day, in some way, that I will be able to combine my experience as a teacher with my nursing skills/knowledge. Not that I don't already do that in terms of pt education, but I mean as a professional for maybe a dialysis company or an organ recovery organization or a pharmaceutical company. That, to me, would be ideal and I think would fit me perfectly. It won't happen right away because I have to learn to be a good nurse first, but in 2 or 3 years, who knows where I might wind up? 5. Here's the only down-side. I left teaching at a high point in my career. I was highly educated in that field (remember, 2 master's degrees) and very good at what I was doing. Now, as a new nurse, I am in my mid-thirties, and struggle every day with what I do. Little good does all of that education do me - not in my practice as a nurse, and not in my salary. And as the poster above pointed out, when I was a new teacher and screwed up, nobody wound up dead. It didn't matter how bad I was, I was never at risk of killing a student. (Though there were times I would have liked to... haha.) But every day my patient's lives are in my hands and that is a very scary position to be in. Just yesterday I was reduced to tears in front of my co-workers and one of my managers because I was just so overwhelmed by what was going on. At my age, that's pretty humiliating. But I will carry on, keep studying, and try to learn from the experienced nurses on my unit, no matter how dumb they think I am. I learned how to be a great teacher, and I think that I will eventually learn to be a great nurse as well. Just be aware that it will be very challenging. That's about all I can think of right now... good luck to you, and keep us posted!

your final words are an inspiration to me: "the gossip, the finger pointing, and the lack of support i have experienced as a nurse still blows my mind. showing up to work everyday made me feel like an abused woman going home to my abuser everyday. despite this, it will not deter me from continuing in this career and it should not deter you too. i just landed another job at a better facility with better pay because i have two years of work experience under my belt. so, hang in there everyone...!!! if you have to cry, vomit, etc. before or after work, then do so... but hang on!!! there is better out there once you have experience." this has given me a small glimmer of hope. i could have written most of what you did about your experiences as a new nurse - the bit about feeling like a "speed bump" in the way of the other "super nurses" was dead on accurate to my feelings and present experiences. but to know that you have progressed, and are determined to persevere, and that you are finding new opportunities out there with your hard earned experience is a relief to me. i know i am not a stupid person. i know that i am likely more intelligent than some of the "super nurses" on my floor. but i simply have not progressed to their level of experience yet. and maybe, just maybe, once i have been there for 5 years, i will be at or above their level. it is something to look forward to. and shame on me if i get to that point and do not treat new rns on my unit as i would have liked to be treated.

Glad to see this thread... I think that I am so overwhelmed by my lack of knowledge, that it is hard to tell if I like what I'm doing. I graduated in May 2010 and passed boards in June. I work in a Surgical/Trauma ICU. My positive feelings at this point are: I feel like I can get through my day, do the tasks/things I need to do, give decent hand-off report, am about 75% familiar with policies/procedures/paperwork, I connect and communicate pretty well with my patient's families, and I think I provide good care to my patients themselves. My negative feelings are: I do not connect well at all with my co-workers, and they all intimidate me. I feel that I am missing the boat on the big picture, and could really easily miss something when it comes to my patient that the experienced nurses would be right on top of. When the doctors round, I just have nothing to contribute, and feel like a complete idiot. Sometimes, my patients will need a chest tube, or an invaisive line or other bedside procedure, and so help me I am all thumbs and my mind races and I don't know what the heck I should be doing, etc. I don't even know enough to effectively express what I'm trying to say in this post! It's been 8 months, and I feel like I will never reach the level of competence that my co-workers have attained. I left a successful career to persue nursing, and I wonder if I did the right thing. Maybe I just don't have the brains for critical care. Maybe I don't have the right personality. I do like the variety, and caring for my patients, but I'm scared that I will hurt someone with my lack of knowledge and basic ineptitude. I hate feeling like the weakest link on my unit, but that is exactly what I am right now, and everybody knows it. I have no friends on my unit, and don't think that I ever will. Which is not to say that my co-workers are bad people, we just don't have anything in common, and do not click. I don't think they hate me either, but I doubt that they like me. And I'm sure they think I'm a complete moron. Which makes it sooo much harder to approach them with questions. Anyways, that's about it. I'm glad to have had a place to vent! Thanks :)

I am interested in finding out more information on Travel Nursing. Honestly, the idea appeals to me very much, however, it seems like a possibly unstable way of maintaining employment/benefits/etc. I'd like to hear from some experienced travel nurses on the pros and cons, as well as any advice on good agencies and/or what you think I should look for in a prospective agency and employment contracts. Thanks!

I moved away from NJ a little over two years ago, and I can tell you that the lack of phone calls is extremely common in today's job market - so don't take it personally. I would recommend following up with your own phone call to places where you have applied about 10-14 days after you mailed in or submitted your applications. You still might not hear back, but at least it puts a little bug in their ear to give you some kind of response. NJ.com used to be a good website where you could go to classifieds/jobs and search all NJ newspapers for specific job openings. Try that, and agencies (lots of private duty available if you are in the northern and more wealthy areas of NJ), but word of mouth and just getting to know people in the healthcare business tends to be the best way to go. Good Luck!

I'm still waiting too!!!! But I'm also still thinking good thoughts for everyone :) I finally caved and tried the PVT this morning, and got the good pop up, which has prevented me from being completely psychotic. Now, I'm only slightly nauseated... haha. Seriously: 75Q's, high level of difficulty, lots of meds, AND the good pop-up??? It's hard to not be optomistic that we all did well :yeah:Stay positive everyone!

i took it this morning also. it shut off at 75, over 20 sata which i'm taking as a good sign.... it's really all a blur. i'm too scared to try the pearson vue trick. i will just keep checking my state board of nursing website to see if my license "flips" from temporary to active. my legs feel like jelly! here's hoping we all passed :)

Oh - I just had another idea - sometimes local public libraries have review books that you can use, or maybe the library at the school went to. So, that might be free if you can't afford even the $50. Good Luck!

Try an NCLEX review book that comes with a CD. Not free, but $50 or less. I have the Saunders Comprehensive 4th edition, and I think it's pretty good. With the CD you can kind of simulate an NCLEX exam with 100 questions and then it tells you weak areas to focus on, which I think is absolutely worth it. The CD contains over 4000 questions total. The book contains both content review and practice questions. Maybe you could find a used one on amazon or ebay. I do know that Kaplan has a facebook application with one question per day, but that's hardly enough to study from. THough it is one question more than none. :) Anyways, I'm doing Kaplan - my employer paid for it, otherwise I would have stuck with the review books and CDs. I'm not sure how good Kaplan is, but it is definitely challenging, which is good. I would check out what kinds of online reviews they offer - maybe there is one in your price range. Good Luck!

I know exactly how you are feeling! I've been asking myself that same question - why did I schedule 4 weeks out when I could have done it sooner??? BUT... I think you have to address two questions here - 1. How much have you been able to prepare so far? B/C I think the more you can practice Q's and review some content before hand, the better off you will be. 2. How much "out of your comfort zone" are you willing to be? Will you be nervous driving around in an area you might not be as familiar with? Will getting up and out over an hour earlier than you might have to mess with your anxiety? Will sleeping in a different bed make for a bad night's rest and therefore a potentially bad testing day? Maybe being with your family will make you feel better, and maybe you are more comfortable in that area anyhow. You know yourself best. Either way, I wish you lots of luck!!! :)

I'm very interested in the Women's Health NP program at Frontier, but have only just graduated with my RN. I do have a BS and an MS in Biology, though. I have three questions: 1. I know I have to have one year of nursing experience in order to apply. Does that mean I can't apply until I have the year experience, OR can I apply in anticipation of completing that year by the time my classes would begin? 2. I have to re-take statistics, since the class I took for my BS is too old according to the Frontier website. Do I have to take it through them, or can I CLEP out? (Or take it elsewhere - though I'd prefer to CLEP.) 3. I've sent two emails asking for information, but I have yet to get any feedback or info from them. Not sure what this means, or if I am just impatient, but it's been about a month since my last request. What's up with that?? -Thanks, and good luck to you all!!!! Hopefully I'll be there in 2011

Wow - I went to OCC years ago - long before there was anything such as an online course. I went on for both a BS and an MS in Biology, and I always thought the classes I had there were top notch. Glad to see it's still a great school! Good luck to you! :)

Hello all- Like you, I recently graduated and am studying for NCLEX. I took the KAPLAN review and have been using that as my main review/study/practice tool. On all of my Q-bank and Trainers, I score between the low 60's and mid 70's. This is freaking me out, and I'm getting more and more anxiety-ridden every day. How bad/good are these scores on KAPLAN? Does anybody know? I'm taking NCLEX in about two weeks, so if I need to be dramatically changing my strategies, I need to start now. Any suggestions or insight??? Thanks...