Kaychell

We are a super small hospice (Staff of 5, census of

I have a Litmann Lightweight and I love it!

We use Kozier & Erb for theory and Perry & Potter for lab

I agree with the previous comments, take it one semester at a time and ALWAYS have a back-up daycare. I'm married with 2 small children (5, 2), my husband leaves the house at 6am and my school is a 72 mile one-way commute. I also spend the night in the town that my school is in on the night before clinicals so I don't have to get up and drive at an ungodly hour on clinical days. Oh, and the kids stay the night at my moms on Monday nights to help us out. Here's my daily routine for this smester: Sunday night:I get everything together that I'm going to need for Monday and Tuesday since I don't come back home on Monday nights. This includes school stuff (books, papers, laptop, etc), clinical stuff (name badge, pen light, steth, bandage scissors, notebook, pens, etc), iron my scrubs and lab coat, pack my bags (jammies, socks, tank top under my scrub, undies, hair dryer, shampoo, makeup, etc). Monday: 5:15-Alarm goes off, up to get dressed, hair, makeup, load the car. 6:15-I get the kids up, dressed, fed, backpacks together, etc 6:45-Oldest gets on the bus headed for school 7:00-Load the youngest in the car and I take her to my mom so mom can take her to daycare (daycare opens at 7:30) 7:15-I'm on my way to school for the hour and a half drive. 9:00-I'm in lecture class until 11:00 11:00-Out of class, 2 hour break to study and eat lunch 1:00-Lab until 4 or 5:00 4 or 5:00-I head to the hospital to pick my patient for clinicals the next day, I stay here and get all my info that I need (allergies, history, meds, etc) 6 or 7:00-Leave the hospital and go back to the library on campus to write up my careplan and do my med cards for clinical. 8 or 9:00 pm-Leave library, go find food, go to friends house and crash on her guest bed. Tuesday: 5:00am-Alarm goes off, get up, take shower, get dressed, get all my crap stuffed in my pockets for clinicals, get my clipboard and all my careplans and stuff together 6:30am-On my way to hospital 6:45am-Wait in the lobby for the clinical group and have a little pre-clinical day conference 7:00am-Get report from nurse and am on the floor for the day 3:00pm-Report off, go to post conference 4:00pm-Drive home Wednesday-No class, I spend all day running errands, housework, etc or if it's a test week, I spend from 8-5pm in the llibrary studying Thursday-No class again, I spend most of the day in the library studying Friday- 5:15-Alarm goes off, up to get dressed, hair, makeup, etc 6:15-I get the kids up, dressed, fed, backpacks together, etc 6:45-Oldest gets on the bus headed for school 7:00-Load the youngest in the car and I take her to my mom so mom can take her to daycare 7:15-I'm on my way to school for the hour and a half drive. 9:00-I'm in lecture class until 11:00 11:00-On my way home and done for the day We have a back-up daycare just in case daycare is closed. We also have back-up people (friends) to take the youngest to daycare just in case my mom isn't in town or is sick or something. I am away from my family ALOT. I miss ALOT of things. However, the weekends and evenings I'm home, we make up for it. It's a sacrifice, but it's one that will pay off in the end. I LOVE what I'm doing, it feels very very right. We take it one semester at a time.

I took anatomy online through EduKan (I already had taken phys.). My school accepted the online anatomy without a problem. EduKan is a kansas based program that links a bunch of Kansas schools together and offers the classes online. I'm in Oklahoma and went through Dodge City Community College for anatomy. I had a bunch of students in the class that were in california, michigan, new jersey, etc. Anyways, they have a ton of science classes they offer online.

I take notes during lectures, then two days a week I spend A LOT of time (read 8 hours/day) in the library reading the chapters, making flash cards, relistening to the lectures, rereading the lecture slides, using my Saunders NCLEX review book and then doing the practice questions on the website and CD that came with the textbook we use. I found out that study groups do not work for me AT ALL. I made my lowest test grade of the semester the week I tried a study group. Anyways, this method has worked out for me REALLY well. I've got a strong B in the class and a good grasp of the material.

We say "Mr or Mrs ____". We have one who's last name is kind of difficult so she goes by Mrs. and the 1st letter of her last name. 'Ex. Mrs. B"

Yesterday was my first clinical at the nursing home. I observed a contractured bedbound patient being given a bed bath. The aide bathing the pt, did a quick bath and had some difficulties bathing the patients contractured hands without causing a significant amount of pain. I would like to select this patient to take care of next week. I'm looking for any suggestions you all might have on bathing the inside of the pt's hands without causing a lot of pain. One hand is significantly contracted (fingers balled into a fist). Do you all have any tips or suggestions? I would like to be able to give a really therapeutic bath to this patient.

After working at a university and now going into nursing, I agree that both should be paid $50/hr. Nursing and educators both have to deal with a public that is less than pleasant at times. Kids with an attitude or families that are a bunch of crazies. However I know that a lot of people are getting into the education game only because of the hours, 8-3 M-F 9 months a year, with holiday breaks. And those people are turning out to be very poor educators that don't deserve $50/hr. I've also met some nurses that don't deserve the $50/hr either. You take the good with the bad!

Now we haven't done any dressing changes or anything like that. The week before last we learned how to put on sterile gloves, isolation techniques, restraints, bed baths, bed making and handwashing. Last week we learned pulse points, BP's, temperature taking, and respirations. I think next week we learn ambulation.

We had a quiz yesterday and one of the questions was a definition and we had to state the word that belonged to that definition. When was studying for the quiz I was so focused on being able to spell the words in the definition correctly that I forgot to study the word that belonged with the definition. Totally missed that question, I was so mad at myself! I will never forget how to spell necrosis tho!

I got an 86 on our first exam and a 90 and an 86 on our first and second quizzes. Don't over study Get at least 8 hours of sleep the night before Eat a good breakfast (protein and carb, not snicker and diet coke) Don't hurry through test Go with your gut Use the ABC's, then safety, Maslows, or nursing process Do some practice NCLEX questions online, even if you don't know anything about the info their asking, you'll at least get used to the format of the questions.

Our prof. told us that it was patients, then went to clients, and now it's patients again. I think I read in our text that it went from patient to client because patient sounded like people were being included as an active participant in decisions regarding their health or something like that.

There's a ton of websites that have review questions. www.nursingcrib.com www.atitesting.com (if your school uses ATI) http://caring4you.net/tests.html Do a YAHOO search for NCLEX practice questions and a bunch of websites should come up. Also if your textbooks came with CDs, they may have ?'s. As well as at the ends of the chapters of your textbooks will have ?'s too. Saunders has a good Q&A book (the orange one).

I posted a couple of replies under the Critical Thinking post on the Student Nursing Asistance board that may be helpful to you!

We just learned how to do this on Tuesday. I can find the pulses at each point a lot easier on others than I can myself. I have a very very faint ulnar pulse, however, my husbands pulse at each point can be felt very easily. You'll have to look around a bit on each person because the point is in a little different spot on everyone. DH's temporal pulse is a little higher up than where I can feel my own. I think the only pulse you use a steth to find is the apical pulse. Everything else you use your 2nd and 3rd fingers. Don't press too hard, that can make the pulse harder to find.

Also try using these questions (sylvia rayfield & assoc): ASSESSMENT Which is the priority assessment for infection in this situation? Which vital sign should be (documented, followed-up, discussed with other team members?) Which client should be assessed first? Which assessment would best accurately determine the client's identity? Which assessment would best determine the effectiveness of the PRN pain med? Which assessment would be priority for this client (elevated bp, low blood sugar, sob, fluid draining from ears, etc?) Which assessment best determines hydration status in this client? What is the next priority assessment? ANALYSIS Which is the priority of care in the client with (infection, SOB, tachycardia severe pian, diarrhea, etc?) Before this drug is administered the nurse should (check lab data, alternative agents, pulse, allergies, ineteractions, etc) Which PRN med, should be utilized from protocol? Which order should be questions? The most appropriate staff person to be assigned to the client is? The most appropriate client to transfer to the (cancer, ped., OB) unit will be? Which staff member (LPN, CNS, & RN) would be assigned to which client? PLAN Which plan would be best to ensure proper ID on a (psychiatric, neonatal unit, etc?) Thirty minutes prior to or after this proceudre the nurse should plan? Which health care member should be collaborated with in this situation? Which plan would be best (prevention aspiration, prevent infection, promote wound healing, protect the client from injury?) Which (drug/food/alternative agents) should the client be taught to avoid? Informed consent should be planned. D/C instructions include? IMPLEMENT Which interven. would have the highest priority? (2nd, 3rd, 4th, etc) Which nursing action will best prevent (infection, loss of skin integrity, etc)? What is your best response to ensure client confidentiality? From protocol choose the best interven. for the client w/(bradycardia, tachycardia, non-catured pacemaker, resp. arrest, cardiac arrest, choking). Which techniques will be best in (d/c'ing tube, decreasing pain, increased vascular perfusion, protecting the client from self-injury, caring for client on ventilator?) Which nursing action is priority? (W/the ineffective funct. of tubes, catheters, infusion pumps, 02 admin., restraints, mobility aids, etc) EVALUATION Which eval would indicate a therapeutic response to this (drug, infection, procedure, hydration, altern. therapy)? Which is priority teaching at the time of d/c? Which doc. would be (most appropriate, illegal, priority?) After eval. of (infusion site, skin integrity, IV rate, fall risk, etc) the nurse should?

These tips are off of a Hints For Tests that one of our professors gave us: 1. Look for a key word: first, initial, essential, severe, best, most important, priority, pregnant, adolescent, early/late, pre/post, before/during/after, on the day of/after, several days, acute/chronic. Essential is usually a safety answer. 2. Elminate incorrect answers. One word can make it incorrect. 3. Words that make it incorrect 99.9% of the time: all, nothing, only, never, early, always, any, none, total, everyone, nobody, completely, sole. Absolutes are a no-no. 4. Words that would probably make it correct 90% of the time: usually, may, should, nearly, seldom, almost, sometimes, few, maybe, often, frequently, partial, normally, probably, generally, some, commonly, occasionally, average. 5. Prioritize with ABC, then safety, Maslow or nursing process. 6. Treat each question individually. 7. Answer with textbook and ideal situation. This is only patient and all options are readily available. "Hospital Eutopia, everything is perfect" 8. Use national standard, not local or regional or where you work. 9. If you don't have a clue, reread the answers starting with D. (D, C, B, A) 10. Be positive about exam.

That was a generalization, not directed towards you. Sorry, should've clarified that. I went off on a tangent. Anyways, a lot of nurses around here have that attitude and I don't like it. And I agree, I highly doubt anyone would jump up and say, "YES I LOVE WIPING BUTTS!" LOL I highly respect the DON that pulls up her sleeves and dives in along side the CNA's to help them out. :) Again, sorry if that first reply seemed directed at you, it wasn't meant to be....just a soapbox of mine. BTW, I'm not one of those people who loves wiping butts, I can't wait for my 2 year old to be potty trained! LOL But I'll wipe a patients butt if they can't, lord knows I'd want someone to wipe mine!!! Oh, and I forgot to put in the original post, I think it's as or more embarassing for the patient to have these things done for them as it is for us to do them.

I can't answer your ?'s, as I'm a first year NS, but I wanted to say I'm sorry to hear about your possible divorce. My husband and I separated for 6 months two years ago and it was the hardest time ever. Good luck in your decisions!

Okay I put my answers in bold, however I wanted to answer 4 and 5 separately. It bothers me when I hear a nurse say, "That's not my job, it's the CNA's job to give baths, wipe butts. I went to school to not have to do that". I have NOT been a nurse OR a CNA. I'm a first year RN student. I think the BEST care you can give someone is through the human touch. Touch can be a HUGE factor in the healing process. To say you're TOO good or TOO educated to perform some aspects of your patients care is a disservice to that patient and yourself. Your CNA needs to be your best friend at work. In my observations, they are often the first to alert nurses of possible problems. If an RN delegates vitals of a patient to a CNA and that CNA notices that the BP is dropping or temp is rising, etc they can either chose to alert the RN or not. It's the RN's job to assess those vitals and you have no right to be upset with your CNA to not let you know. That is just my opinion however. I think either way, you need to go into nursing with the attitude of you will be wiping butts and giving baths on a daily basis.

Student loans is covering ALL of my ADN. They covered ALL of my Masters degree and part of my bachelors degree. When I first started college I was on my own so I had a lot of PELL grants, scholarships, etc. Now that I have a post-graduate degree, I'm no longer eligible for grants, etc. So student loans are the way I'm going. I am going to a CC this time so the cost is MUCH MUCH lower compared to my previous two college experiences.

Thank you SO much CheyFire. You're post is incredibly helpful!! I've been wondering about do's and don'ts of charting!

I've never been bothered by getting up early. In fact I'm up at 5:45 right now since I have an hour drive to NS. I'm just concerned that night shift will be all that is available in our small town and how it's going to affect my family! Thank you all for your information! I appreciate it!

Thinking about this, wouldn't this policy open the hospital up for a lawsuit? I mean if you have 2 or 3 big donors in and your nurses and docs are all tangled up with them and you have a regular Joe in the ER waiting room that dies from a heart attack because he hasn't donated 50K to the hospital. I would think that this policy would be an open door for abundant lawsuits. Especially in a day where eveyone is lawsuit happy and so many lawyers are chasing ambulances.