bustthewave

Hey everyone, I hope I'm posting this in the right area :). So I'm incredibly nervous, and want to make sure I pass on the first go around (primarily for financial reasons). It's really psyching me out and making me doubt myself. So I figure I can help myself alleviate my anxiety by clarifying some of my concerns. For the skill "Assists with use of bedpan," There's a step that bothers me. For clarity here are the steps I'm having difficulty with- 5. Places bedpan correctly under client's buttocks. 6. Removes and disposes of gloves into waste container, and washes hands. 7. After positioning client on bedpan and removing gloves, raises head of bed. What bothers me about these steps, is I don't like the idea of having to leave my patient to wash my hands in a potentially painful and/or uncomfortable position before raising the head of the bed. While i know this is technically acceptable, would the test administrator fail me for removing and disposing my gloves, raising the head of the bed, THEN washing my hands? Second concern: It's often listed that you take dirty linen to the dirty linen receptacle near the end of the skill (this goes for "making an occupied bed," "Dresses client with affected right arm," "modified bed bath," and a few others I believe). So then whenever I have dirty linen, but still have more steps before I need to dispose of it, is it fine to place it on the edge of the bed? It just seems like a possible contamination issue. I think I'm over thinking things... I tend to do that... and ultimately the over thinking is what causes me to fail, not my ability to perform (so I'll definitely need to keep that in mind). For anyone who's tested in NC, I did have a question about how some things are set up. With the occupied bed making, how many total sheets do they use? I've been practicing with 3, plus a pad and bath sheet to cover the patient (forgive me i can't remember all the names, but a fitted sheet, a top sheet, spread). Thanks in advance for any information, help, hints, tricks, tips you guys can give me :).

Hey guys let me just say- Thank you all very much for the honest feedback. I have really read every post and thought about it. What I've learned here is that, if I'm going to be dedicated to nursing I can't give up just because instructors dislike me. I'm the only one who can make me feel defeated. In dealing with my instructors, I decided to let it slide, and let clinicals speak for itself (I foruntately got clinicals with the instructor who is nice, and now after almost being done with clinicals I feel like I am leaving a very good impression of being a hard worker, and caring for my patients no matter what). If after clinicals, I still get pushback, I will, instead of complaining about it and feeling defeated, pull the instructor aside. What I think is my fault in all of this? My attitude. Even though I didn't try to show an attitude towards the severe lack of organization with this class, I felt it consistently. It must have shown through somehow. Maybe I made a comment that I thought the instructors couldn't hear, or maybe it just showed on my face. Either way, even if I'm frusterated by how things are done, my goal should be to getting that RN degree and license. If I'm having a bad attitude, bad enough that it's showing, then I'm allowing something external defeat me, and not really being fair to my instructors. So yea, thanks again for the very thoughtful replies guys. I have one more week of clinicals left, and I will pass this class with flying colors! :)

Wanted to fallow up - If the nurses are overworked that's a different problem entirely than what I was seeing here. What I was seeing here is that there is no delegation from the top down. The charge nurses are in charge of the world, and beyond stressed. They do not delegate their stress down to the nurses, who in turn casually hand out meds and make rounds. There was absolutely no sense of urgency in their work, and several times I saw one of the LPNS or RNS hanging out in the nurses station (which I mean, they were charting and making phone calls, but again... there was no sense of doing this quickly or needing to get it done, which means that they clearly had enough time to walk the halls and check on the CNAs, which as far as I'm concerned, is apart of their job). The CNAs then have absolutely no supervision, they work on their own terms. Each CNA has maybe 5 patients tops. This IS a very high end facility, that's what makes me so angry. It's one thing to have horrible care in a medicaid facility, but this is something like $8,000 a month for the same humiliating care. The difference here, is that the CNAs have 2 hours of complete downtime after lunch before shift change. I mean COMPLETE downtime. Which is the entire point - the entire point is, they have enough time to show the kind of care needed, which means the PROBLEM is their lack of hummanity. This is what I find disgusting, is that this care is done by choice and no other factor. This is the jaded healthcare world we live in, the jaded precious USA we live in, where the "free" are so selfish, and self centered, that even the hurting and needy go suffering despite the tools to change this. Why the hell are we becomming nurses, or CNAs, or doctors... when we aren't invested in making the world better, or giving hummanity back to people? And why are we even bothering to keep our elderly alive when we give them this kind of care? What is the point? i'm paying dearly for this government care every year when I can't afford health insurance, and I can promise you the elderly would rather not be around than to recieve this care. So yea, sorry for my public break down here, but reality just hit me like a ton of bricks and you all are witness to this. I'm going to journal this as recommended by a friend, because in 10 years... I don't want to be apathetic like many of you. I will be stopped at every turn, defeated in every way, to fight the fight of human dignity, and I promise that I will need a reminder of what I'm fighting for. I'm more than capable of becoming apathetic and not caring, and I know it's very possible that it can happen as quickly as before these clinicals are over. But someone has to give a crap right?

Your very welcome :). Just know you aren't alone, and what you experienced really is normal I promise! What you may be doing is internalizing this too much. Don't let it decide your worth, or ability, because it isn't accurate. The big thing is, do not let this defeat you! I do this sometimes and it's been a struggle for me. I would start a new job, and make really stupid mistakes. Sometimes people would say "no problem, you are new," but sometimes they would expect more than was fair. Either way I judged myself very harshly, and I consistently thought I was stupid. If I finally got the hang of a job, I would find that a month down the line I would have an off day, and then once again feel like I couldn't do anything right. Because I felt this way, I would have an off week, which would lead to an off year, which would lead to me being that employee nobody wanted to work with. I would apologize all the time which furthered my feelings of being defeated, and being stupid, and more than this - it gave others that impression about me. But when I finally began to build some self esteem, what I found I was lacking was confidence. When I developed the confidence, yea I would still have off days... and do something REALLY stupid, and then do something else even more stupid five minutes later, but I wouldn't let that define me as stupid. So then I started seeing promotions, and raises, and hours. I have been a manager at every job I've worked in the past 6 years, and have been offered higher management positions (that I had to turn down) at every job in the past 6 years. That doesn't happen for people who are stupid. The thing is, you are smart and it sounds like you did a great job given that you were in a brand new environment. You will still forget basics sometimes, because you are human and that's always the first to go when you are nervous. Hold out for a year, and know that you are MORE than capable of doing this, and see if clinicals get easier for you, and don't let ANYTHING defeat you!

Can I just say... I work as a vet tech and this is really depressing! But it's true, animals completely have a sixth sense somehow about disease and death. They just know when it's coming. I can't tell you how many "crazy" cats we've euthanized. I'm talking the kind that love to spit, scratch, claw, bite... the kind you can't get near. The second that catheter goes in the vein, more often than not (MUCH more often than not) the cat would become calm and sweet. Whenever an animal is dieing, and the owner doesn't want to euthanize, the other animals we have typically pick up on it. Most of the time, it will go from extreme barking to extreme silence. So I dunno, this entire subject of people smelling things and having sixth senses for me is not out of the realm of possibility. I think it's also really cool, and really weird at the same time. And now I have yet another worry if I ever get cancer, I will worry that I stink.

I'm bumping this, because I think it's an important resource for the health of a significant American population. What I am wandering about, is does anyone else have experience with GLMA? Is it really a good way to network (escpecially for students like myself), and any local chapters?

Wow, OP don't worry! I can totally relate, and just had my first day of clinicals, and my second day (pre-nursing, so nursing fundamentals, CNA stuff). The first day was really tough, and I felt REALLY awkward because this work is so new to me! It's like that first day of class where you don't know anyone and you can't figure out where to sit at lunch. The only way you can get anything accomplished on your first day of any new job, is if someone holds your hand every step of the way, and that is a terrible feeling (and always makes you feel like you aren't good, or going to be good at the job). My first day of clinicals, all my basics just went right out of my head. I didn't know how to start up conversation when feeding... I was so nervous about performing the actual skills (like bed bath) that I barely remembered to wash my hands! At one point I had everything read, gloves on... and I had to stop and say "I haven't even washed my hands..." I found it really hard to keep basic things in check like cross contamination and such. But day two the job and it's expectations came together MUCH better. Because some of the awkwardness went away, the basics returned, and little things like hand washing and glove removal were second nature (and not things that made me feel absolutely stupid). The point is... your at that very, VERY awkward stage of dealing with that 'first day.' But you made it through! Be proud of yourself! It will only get easier, and that "new" feeling, will only subside. I would most certainly stick this out. The big thing here is - don't make this issue bigger than it really is. It's not about how good you will be as a nurse, your social skills, or even your ability to think on your feet. None of these things can possibly be tested on your first day of clinicals... because if they were, no one would pass!

Can't say for sure, but my assumption is that it's more specialized and legitamtely so. I have actually found more resources on the actual nurse liaison role (it's easier to find once you take out ICU, but either way it's mostly found in critical care). It's apparently different enough to warrant articles, general salary reports, and national conferences, so I my inclination here is to believe this is a new and distinct role.

Thanks anyway :). Your post is still helpful because it demonstrates that it really is a new position. I have found only one other hospital with this role - http://www.nepeanicu.org/liaison.html, and it's definitely not even in America. But they have a good definition of what this role is and does, though I think it's differently (maybe not fundamentally in terms of end goals, but certainly methods and short term goals vary widely with no set standard) defined from Mrs. Cranfill. These are the most important quotes about the definition of this role as far as Cranfill is concerned - Manager said to her, "We want to develop a role to work with families. Would you be interested?" the Role "wasn't defined at all. It was just a concept, an idea. I sat down and wrote up what this job description should entail..." "I think the hospital approached this role as a cusrtomer satisfier, 'making families happy when they were here.' I approached this role a little differently. And that it wasn't about being much concerned with their happiness as it was about meeting their needs. now you accomplish one through the other, but the mindset is very different." "The patient family experience as they moved through the ICU shifted completely. Now there was someone to offer support, have more time to be able to spend with them, to help them understand, sit with them when the physician was there so when the physician left, there was someone there to make sense of what was just said. Because so many times after they leave, the patient is left scratching their head." -------- ----------------- This actually seems like a really good, viable alternative to the black and white debate about more restrictions, or less restrictions, on visitation in the ICU. I'd love to also get your opinions on that :)

Hey guys, so I'm in an english class right now. We have to write a paper interviewing someone in an area that is concerned with our major. I was lucky enough to have my dad pull some strings (he's a chaplain at forsyth medican center, in winston salem NC) and got me an interview with Marsh Cranfill, the ICU nurse liaison. She said at forsyth this was a new position (6 months to a year) and she, as well as the directors, worked together to create the position. But since she has spoken at national conferences, and the role is branching out to other hospitals (she wasn't the first ICU nurse liaison obviously, but according to the interview, she is helping to pioneer the position). SO! In this paper I'm looking to expand on this role, providing more history and talking to hospitals and nurses about this role. Google has very little info, except that other countries are utilizing this role. So if anyone could tell me a bit about their experience with this role, and also tell me places you know that utilize this role (if you know of any), that would be great! Thanks guys

Thanks :). And don't nurses take an oath to never willingly or knowingly cause harm? Isn't that the pivitol corner stone of being a nurse? I strongly (I cannot emphasize how strongly I believe this), believe that turning a blind eye to harm is the same as causing it. You CAN effect what other people do, and you SHOULD. You can't change people's beliefs, but you can work the system to your advantage. If your the nurse, you are in charge of the CNA period. If you are a CNA, you can go to the nurse. If you are the nurse, and the CNAs do nothing, you can take it to the charge nurse. If the charge nurse does nothing, you can take it above her. If this does not work, you can always try finding another job and taking it to the media. But bottom line is, you don't work in a vacuum and allowing other people to provide bad care while doing nothing to prevent it, is the same thing as providing bad care yourself.

and nope, not at all. It's my opinion. I would rather die now than to grow old where life ends in complete loneliness and isolation, with no dignity. It kinda makes the rest of the stuff you did before then meaningless. I actually think people are being in general under-dramatic. How easy it is to not care about the people in these situations, and how little those people can do to change it. You will be old too, and with our healthcare and culture there is a good chance you will make it to an age where you will need that kind of care. It will be too late then for you to have a problem with it. Obviously I'm not saying I'm going to kill myself (that would be over dramatic actually), because there is a ton of things I can do between now and then to add some value back in the world, and a ton of things I can do to prepare for old age.

Well, clinicals again today. It was MUCH better! The CNA who worked this time actually cared about her patients, and managed to get things done on a timely manner. She didn't turn on MTV, she spent time with me showing me how to care for them, she talked to them like they were human beings. It was a breath of fresh air. Thanks everyone for the advice, I'm obviously sticking it out I just don't understand how it's so easy for people to become so callaced to other human being's needs. I mean sure, being a CNA sucks... and is terrible pay, but it's the job you chose so do it right. But fortunately I found my instructor today, and got her help to do total care on this bed bound patient (who REALLY needed it, she was one of the ones who's family was bad mouthed in front of her by aids, and where the aids decided to watch MTV while providing care... she was bed bound, unable to speak, and pretty unable to move). We did a complete, and thorough bed bath (where, unlike last time with the CNAs, we used blankets and bath blankets to keep her warm, instead of just laying there completely exposed) which took about 45 minutes (extra time because I'm new at this), we changed her bed, we combed her hair, and gave her a back rub, and even did range of motion on her entire body, and I swore she was smiling at the end. Then for good measure we turned her to her side, which probably never happens (it wasn't done monday anyway). But she was so stiff, the range of motion didn't have much range, though I could physically feel her muscles loosening as we did it. Anyway, it was a much better day. I mean if you have, as previous posters say, like 1 cna to 60 or more patients, care in any manner would be impossible. But then what's the point of keeping these people alive when they get to that place with that level of care? But I think as a nurse, I can have some say over what at least my aides do. I mean, we are technically above them on the totem pole right? I guess it would be facility specific, but if I'm a nurse on a floor, I'm going to make sure the aides are providing good care to the patients (in a respectful way of course, I'm just saying I'm not dealing with the attitudes of the CNAs that I'm seeing at this facility).

That's what I was afraid of... and that's really sad and pathetic that healthcare is like this... I understand how jaded you can become, doing the same things every day with no help or support, and only being defeated by families and those in charge, and that good things you do go un-noticed, but careless things will get you fired. But frankly, none of that compares to the indignity of treating someone like an object. I dunno, I don't think I am over reacting at all honestly. And what is worse, and scary... is that I will most likely agree with you in a few years that I was completely over reacting. When did it become okay to treat the elderly as objects? Just because someone can't speak, doesn't mean there aren't moments of understanding, where they at least are aware of being exposed and naked, maybe not on a detailed level... but it must be scary and confusing none the less. But even if they were completely un-aware of their surroundings, is it still alright to bash their families and play MTV in front of them? These are human lives. They don't stop being human just because they are old... I think I'm going into the wrong profession if this is the norm.

I'm taking my nursing assisting class, a pre-nursing requisite. I started clinicals yesterday, and I'm dreading going in again tomorrow. Not because I'm doing a bad job, I'm doing a good job, and the CNAs I'm shadowing love me. The patients who I got to know love me too, and the charge nurse loves me for volunteering to come in this weekend to play piano. It was terrible because I hated the way these patients got treated... and because no sanitation is used! It's an assisted living facility, I worked on a unit for those who needed daily care, who were dealing with dementia. The day started okay, I helped with breakfast, I helped with feeding and cleaning and all that. It started when I had to assist in helping with a bed bath. This woman was completely bed bound, unable to speak. My guess is it was alzheimer's at a very late stage. The CNAs I was working with decided to let me and another student take over for this, which was fine because I needed the experience. They sat in chairs. But then they turn on MTV, and banter back and forth about this woman's family, and how horrible her sister is. This was after they removed her clothes and left he laying there completely naked on the bed, no bath blanket or anything. I asked for a bath blanket and they said "oh we don't really do that... I guess you can check the linen closet." They threw towels on the floor... one of the CNAs didn't even wash her hands or wear gloves. This type of insensitivity went on throughout the day. After lunch is "down time" because everyone takes a nap, so the CNAs literally do nothing. They sit in the work station. I wander the halls looking for things to do, I see a call light on (I haven't gotten used to checking for those yet... but the woman claimed it was on for 30 minutes, and I believe her). She was sitting in her wheelchair, and said she needed so many things and I wouldn't be able to help her. but she said she was cold, and wanted to be in her bed. I told her that her needs were very important to me, and that I would go find a CNA and we would help her. I finally find the CNAs in the work station, they tell me, "oh she's always confused after lunch. She'll give you hard time if you let her..." "Is it really a problem to move her to a bed when everyone else is in a bed?" "She doesn't know what she wants, just turn her call light off." My unit wasn't nearly as bad as a unit down where some other students were (leaving patients on standing lifts for 15-20 minutes, who can't hold themselves up because it's 'easier to clean them that way.' Not cleaning their bottoms, or under skin folds, or even their legs... where they constantly smell like poo and urine). I go in again tomorrow, and I don't know what to do. I know that for my standards I need to provide the kind of care that gives dignity, but I can't dictate to a CNA, when I am just the student who will be here for a few weeks. What can I do? Is this kind of thing normal? I work as a vet tech... and I treat dogs better than this... This experience in all honesty has made me want to die in a car accident tomorrow, before ever getting old and being in that situation. I would rather lose the rest of my life now, than to end up being in that situation later.

K... so I'm not a nurse yet but OP you're being completely rediculous... I mean come on, I deal with this type of thing at every job I've ever had, "this person does less than me for X reason and it's completely unfair for Y reason." What I don't understand is this - how in the world are you surprised and upset as seen on page 5 by all the offense when you blatantly disregard and entire group of nurses? And furthermore, how are you still thinking your justified in your attitude? Here are your options, and the AN community has nothing to do with your options - 1. Get over it (this is probably your best option). So what if they think you are lazy. Who cares? Do your job the best you can, if you know you are in the right then let it go, and don't socialize with them. No one is asking you guys to be friends. 2. Confront them. This may or may not get you anywhere, but it's clearly bothering you so it may be worth a shot (just don't tell them they spend all night shopping online). 3. Find a new job. I would suggest a night shift. So instead of doing exactly what your night shift nurses are doing to you, except on a MUCH larger scale, how about you grow up and deal with this really... REALLY minor issue as an adult?

K so I'm looking at these skills (68 total step by step skills in a big thick handout given by my instructors) and these appear to be about 10 times the ammount of skills that are actually in the pool for testing. It appears there are 24 skills total. But I can't find an official source to confirm this... Can anyone direct me to where I can find the exact thing I need to study? 24 skills is SO easy compared to what I've been doing... I'm sure I'll use everything I have practiced though.

So I'm in nursing fundamentals right now, not quite in the nursing program yet. Originally (like... last week) you just had to take this class and pass the clinicals as a pre-req for the nursing school. Now, as of this week, you have to be a certified CNA. I'm alright with this, I'm just REALY nervous! So... I'm practicing my skills, and I want to do a really good job (bed making is the worst for me... of all things) but I'm wondering... how strict are they? As I'm practicing the skill "collecting speciman from patient under transmission-based precautions," I just "collected my equipment" before "washing me hands," reversing the two steps... too me this seems like it's not a big deal at all, as the equipment wouldn't be contaminated either way since it would be collected outside the room if full PPE gear were required anyway, BUT! It's out of sync. Would something as seemingly minor as this make me fail the entire test? Then there is feeding a patient... according to the skills sheet that I have provided from my instructors, washing hands is not the first step here, it's the last. BUT! Providing basic nourishment (water, or food... whatever) washing hands IS the first step... is this a mis-print or am I missing some common sense here, because that doesn't make sense to me. It's these kinds of things that I don't get and it's making me really nervous! How should I study/practice for this, and am I being too... crazy... about the specifics? If it makes a difference as far as testing is conerned, I live in NC.

So it's hard to believe there is any kind of a nursing shortage right now with so many new grads not able to find jobs. It seems though to be highly based on location (for instance... if you live in california, good luck). There seems to be in my area though, central NC, tons of new grads getting hired. I thought it would be a good idea for us to compile a list from personal experience (not scientific) of best and worst places, and help with resources. I haven't graduated yet, but I know that when I do I will only care about getting the job, not where it's at (even if that's halfway around the world). So I think someone trying to get a job in NC, is going to look and feel vastle different from someone trying to get a job in California, and would skew their ideas about the universal job market for nurses. Oh, and this was about the only useful article I found on the matter - http://nursinglink.monster.com/benefits/articles/7980-10-best-and-worst-cities-for-healthcare-job-hunters?page=1 So what are your opinions about your area for new grad hires?

Yea, I know "code browns" will totally be up my alley , and I'm also confident I can suck it up. I just am not sure I can day in and day out soothe somebody who is dieing... if it's a situation of like, getting a patient up and moving, I'm more the type of person who is good at cheering them on, and supporting them. But touchy feely, emotional stuff... I.E. maternal type stuff... if that were the main part of my job, I'm not sure I could thrive doing that.

So the lesson as I'm understanding it - Doctors are complete jerks... who if they didn't want to be called for emergencies really shouldn't have become doctors. And patient restraints are a HUGE deal And hospitals will throw you to the wolves in a moment's notice. I've worked hard at every job pre-nursing school. I've learned that every job has required plenty of rule breaking and bending to get it done effectively. They were minor things, that ultimately benefited customers, employees, the store... exc... but as it turns out, corner cutting in a hospital actually does get you fired. That's really scary to me. So what am I going to do? Call the doctors for EVERYTHING that I am required to call them on, at ALL hours, and if they have a problem with it, tell them they should have chosen another profession.

Thanks, I wish it was something like this, but I'm pretty good at reading people, and instructors in general. I know when I'm being rode to work harder. The issue here is, I was told in a defeating way that I'm the worst in the class essentially (or at least the least motivated), which is far from true. I know what being pushed is, and this wasn't it. This was just mean spirited. There are lots of other indications that are generally petty and not worth mentioning, but exist none the less with her dealings with me. It's just something about me that really ****** her off somehow, and despite her advanced age she can't grow up beyond acting like a child, so she gets petty and passive aggressive... sigh... I hate people sometimes.

So I'm just now going to school to be a nurse. My long term plan is CRNA (it'll unfortunately be after they force the doctorate I think haha). I think the pace and the crazyness of the ICU is a perfect match for me (based on research, not experience), and think being a CRNA is a perfect match as well for similar reasons. What I don't understand is... is this considered bedside nursing? What constitutes bedside nursing? I envision in my mind, a long term care facility where the patients need constant everyday care... which sounds horrible to me. I couldn't survive in that environment, I'm male and not in the least maternal. I care about people, I care about patients, I want the best for the world and the people I deal with but... if bedside nursing is like working at a nursing home, I'm not cut out for it. Sure I could do it for a year or two to start out, but I wont start out looking for that kind of work. So if that's what bedside nursing is... I think this original post is a little unfair.

I should start doing this but... (and I should have asked this before), what does documention include? I'm invisioning keeping a journal, but is there anything more official that's included in documentation? I guess if I e-mailed myself the documents, then I would have a date that can't be refuted which means I couldn't of made a bunch of documents one night when I was bored...

Gawd I have to learn how to work in this system... I mean, I typically know how to make teachers like me and think I'm a good student, and I know how to gear my work towards what they want most of the time while doing the bare minimum to get the A, but this is throwing me. But man if I could figure out how to make this screwed up system work for me... the school went downhill over the past year or so. I got a C in a class last semester that despite endless e-mails, and countless attempts, it still remains a C (when I have all the work and grades printed to prove I earned a really high A). It's happening again this semester in one of my online classes, where I'm getting weird grades I don't deserve, or can't figure out. Not to mention in every class, it has a feeling of being way un-organized, and overwhelming. I've been a good student, and am now getting lost in all the transition, and I can't get my voice heard. That coupled with this class is making me feel extremely defeated.