shelliemarie

Ok so I just graduated in May and I start a Hospice job tomorrow! Im so scared, I have no experience beyond my clinicals. I had a brief "training" when I got hired today, and they said that it is pretty easy and self explanatory and if I need any help just to call the on-call RN. So I am hesitant, What should I do?? It seems like I should shadow someone or something, but they are not offering that. What would you do? Is Hospice relatively easy?

1.) The program costs $4500.00 2.) For Summer I took a Stafford loan, Fall and Spring are Pell Grants so I don't have to pay anything! 3.)My school is Alvin Community College 4.) Its located in Alvin, Texas about 13 miles from Houston TIP- Community college is ALOT cheaper than some of these private/technical schools. My sis went to Medical Assistant School for 12000 at a technical school, when they offer the same programs at community college for like 2-3 thousand

I can't believe they won't let you record lectures, Your in college lol. The only thing we can't record is Clinicals, but why would you record that anyway. The recordings vary in different classes. I don't have a learning difficulty, I just like to record what they say becuase when I am reading and writing my notes etc. I can refer to anything that they might have said about a certain thing. Or alot of times they disagree with the book and tell us something different so I want to make sure that I am studying the right thing.Or one instructor in particular talks faster than the speed of light lol so I like to record her because I can barely listen and understand what shes saying let alone take notes. Just because you record does not mean that you have a learning difficulty,or that you are an auditory learner. I learn best by doing and writing, just like to record to!

Our syllabus was pretty long, but not that long. Maybe like 25-30 Pg. But we didn't have to pay for them. Are you attending private school or something?

I would just ignore it. I am the same way, I don't socialize or participate in study groups. Thats not why I signed up for school, I signed up to be a nurse. I have noticed some people might say something about me, but I don't care, and you shouldn't either. Your instructors see you, and at my school they told us from the getgo that students who don't socialize etc. tend to do better and make it through. I do however have classmates who come to me to ask me for help, and I always help them. I just don't associate with anyone outside of school. Basically just let them do or say whatever, don't let it get to you. You are there doing what your supposed to, so don't mind them!

They grade us on the order of priority for the patient. So if theres 3 diagnosis, they want them in order from the most important down. So Decreased Cardiac Output is the main diagnosis, then Excess Fluid Volume, then Impaired Gas Exchange? lol Thats what I had in the beginnig, and i have been killing myself all weekend over this plan. So I hope that is right, because like I said the director is grading it, so I really want it to be right. Thank you!

You think so? So then Impaired Gas Exchange R/T Alvolear edema AEB SOB W/minimal exertion and RR 28, Then next Decreased Cardiac Output R/T Impaired myocardail contractibility AEB 3+ pitting edema To Bilat. Lower extremeties, Crackles in Bilat. Lower Lungs. And then the last one would be Excess Fluid Volume R/T Decreased Cardiac Output AEB 3+ pitting edema, Crackles. Does that sound right? Then Director of nurses is grading this one lol, so I really want to be right. Thanks for ANY comments/Help VERY much appreciated

I don't think they are, this is a "scenario" on a simulated manican (don't know if I spelled that right). They give us an assessment data sheet and why they were admitted age/sex and then we have to do the Nursing Care Plan. I think what I meant earlier was impaired gas exchange. So I have 4 diagnosis to choose from, I only need 3. Decreased Cardiac output R/T impaired myocardial contractibility AEB 3+Pitting Edema to Bilat. Lower extremities, Crackles in Bilat lower lobes and HTN 154/89. Next is Excessive Fluid Volume R/T decreased cardiac output AEB 3+ pitting edema, crackles. And then I have Activity Intolerance R/T Insufficient Oxygen AEB SOB w/Minimal exertion. I want to know If I should use Impaired Gas Exchange R/T Alveolar Edema AEB Crackles in Bilat. Lower Lobes, SOB w/minimal exertion,RR28. I was always taught ABC ABC ABC sometimes the NCP book is not going by Abc, like they will put a psychosocial before a physiological need. In my book it has Risk for impaired gas exchange as the last diagnosis, but I don't think its a risk because shes on oxygen and on Bedrest and her respirations are still high, as well as she gets SOB so easily. That makes me think somethings now right! HELP! I spent all day yesterday trying to figure it out, which one comes first?

I record lectures, read assigned material/notes 3 times, and re-write chapters in my own words/summarizing. Also when taking tests, I cover the answers and read the question 2 times, then underline key terms (best, initially, etc), Then I ask myself what is this question asking me? Then I REMEMBER DON"T ADD TO QUESTIONS, whatever info is there is all you can consider. Then I look at the answers and choose which ones best. On alot on NCLEX type questions there are more than 1 right answer, your job is to pick the BEST one. I started doing these things and I am improving, Hope this helps you Good Luck

I am almost finished w/ my first semester, and we used Fundamental Concepts and Skills for Nursing (Saunders) and I bought the Study Guide, and to be honest, it has not really helped. I am sure it would help if I had time to do all the questions and stuff, but I just record lectures, take notes, and read the chapters. In my book at the end of the chapters there are NCLEX questions pertaining to the info, so those I will do. I would say skip the study guide because you probrably won't have time to utilize it, unless it is required you buy it. Hope this helps!

Read ahead, don't socialize, practice nclex questions, do your best on every test/assignment even if you have a 100 in that class, and study study study study! And yes, lots of coffee/ibuprofen, i would get a good recorder to record lectures, and a laptop for studying. If i were you if you know what books to get get them asap and start reading becuase the more you read ahead the more you will get out of lectures/labs. And most of all congrats!

Ok, so I am near the end of 1st semester LPN school. I am doing my last case study, on a patient with CHF. Patient has had CHF and HTN for awhile, and has just been re-hospitalized. The Assessment data is RR28, Crackles in bilateral lower lobes, Short of Breath with minimal exertion,and on oxygen 4/L/Min, HR 85 w/regular rhythm, BP 154/89,Cap Refil less than 3 sec, 3+ pitting edema in bilateral lower extremities, Has a foley cath, Moves all extremities well, and has no wounds, etc, all skin is warm dry and intact. Now I have to have 3 diagnoses, and in my NCP book it says the priority is Decreased cardiac output, which is causing all of the abnormal assessment data such as the Crackles, SOB, Edema, etc. So I think this is my priority Diagnosis, however; You always prioritize as Airway Breathing Circulation, and in my opinion this patient is having alot of trouble breathing. So would I diagnose Ineffective airway clearance, or the Decreased Cardiac output??? The Decreased Cardiac Output and Excess Fluid Volume are what is causing the Crackles and SOB, so If I used those as priority then I would like to think that would address the breathing issues, but I am just unsure, I figured if I address the cause of the problem, then that would be better. If her cardiac output was increased and the excess fluid volume would get to regular parameters, then that would address/remedy the crackles and SOB?? I really need to do awesome on this plan to. So Please help me if you can! Thanks