MissJulie

I take my nursing fundamentals final tomorrow (wish me luck) and during our clinicals, we did vital signs, physical assessments, bed baths, clothing and bed linen changes, med passes, catheters, d/c IVs. Of course, as we progressed through our skills in lab, we added more. I mean, we didn't start with catheters on the first day! We built on, little by little. I think my favorite day was actually when I had a patient being discharged and d/c the IV and catheter, did some teaching for at home meds, etc. that evening, I felt like a "real nurse"!!! :)

That is basically what I do, without the phlebotomy (we have an in-house tech that does all of the draws). I started out in reception, then moved to billing (in the beginning, the office wasn't taking insurance, then when they started, instead of hiring someone outside of the company, one of the owners trained me and I'm now certified on the system we use (still not certified as a coder, though)). After I got my CNA, I started floating to the "floor" when someone was on a break, etc. Side Note: My state, KY doesn't require any certification as an MA, as long as the MD is willing to let you work under his/her license, you are "okay."

The problem is that nurses have lost a lot of their/our skills. Someone actually asked me if a nurse was allowed to do an ABG because they're not respiratory! Of course, I've also had people ask me if nurses are even taught to draw blood at all anymore, since techs can do it... Of course, I wanted to smack these people! I'm a student, not a nurse yet, but I still get defensive of the career path that I have chosen. I think originally it was a good idea for nurses to "share" their responsibilities with other fields, but now, it seems that nurses aren't expected to do those things. Then again, it's like my instructor told us, anybody can be taught to give a shot or insert a catheter (for example, patients having to do so in the home setting), but nurses are taught the proper technique, proper sanitation issues, what to do if something goes wrong, etc. It's time for nurses to become nurses again, skills and all!

Granted, this is coming from a student, but from my current view point, working with one patient at a time kills me, but when you consider that nurses have 5+ patients each, for 12 hr shifts, the thoughts make me want to run screaming from my clinical site! I would have given her a run-down of what you do in a shift: - Assessments - Med pass - Dressing changes - Foley inserts - Dealing with lab/doc - etc. I had a similar interaction with a student not in the nursing program a week or so ago on campus at the cafeteria. We were in line, and I had on my uniform (I was in lab that day), anyway, she asked me if I was in the RN or LPN program (my school uses the same uniform for each). "RN," I said proudly. Her response floored me, so to speak, "I think I'd want to do the LPN program, you get paid almost the same, and there's only one class different anyway. RN doesn't seem that hard." Now, granted, LPNs are nurses, and I'm not down-playing the importance that they have to the healthcare setting, but there is a BIG difference in LPN and RN. Of course, one of the biggest, at least at my school, is the education level. RN is an ADN program and LPN is a diploma. That means there are two semesters difference between the two programs, and in those two semesters, 6 courses. I simply responded that if that was what she thought, she may need to speak: to the program coordinator or dean and get a rundown of the difference, and walked away!

I say let it go! Think of it this way, since you were discussing something with the instructor, and I'm assuming that you were holding your own in the discussion, it's possible that he was jealous that you could have an intelligent conversation with the instructor and not get talked under the table, so to speak. Take it in stride, you didn't do anything wrong, and he sounds like a bit of a jerk anyway!

Between school and work, I have no free time! I do manage to find time to keep teaching Sunday School, though, because the time studying the Bible and preparing the lesson helps to keep me centered :) Plus, the kids help me to have a laugh (I teach 10-12 y/o). Other than that, here's my week: Monday - Lab from 8:30 - 12:30; Work from 1:00 - 6:00; Studying until 12:00 Tuesday - Clinical from 8:30 - 12:30; Work from 1:00 - 6:00; Studying until 12:00 Wednesday and Thursday - Lecture from 8:30 - 11:00; Work from 11:30 - 6:00; Studying until 12:00 Friday - Clinical from 8:30 - 12:30; Studying until 12:00 Saturday and Sunday is filled w/ laundry, grocery shopping, preparing for Sunday school, and, oh yeah, STUDYING!!!

Nonparenteral is oral meds (pills, capsules, syrups, etc.), topical meds (ointments, patches like nitro), suppositories (lady partsl and rectal), etc. Pareneteral is anything injected into the body: intradermal, subcutaneous, intramuscular, intracardiac, and intravennous, etc. This includes parenteral nutrition. Enteral is anything placed directly into the digestive tract: NG-tube, J-tube, PEG tube. Hope this helped :)

Never heard of that... The LTC I was at for clinicals this semester had a "shower room" supply that consisted of body wash/soap for residents as well as shampoo and lotions, etc. Most of the residents had their own supplies, though. The hospitals around here also have individual sets that they give patients with shampoo, body wash, deodorant, etc.

I'm not a nurse, yet, but relying on the state to remind you of when your nursing license expires would be like the state reminding you to renew your drivers license, wouldn't it? It seems to me that if a person put in the work to become licensed, either as an RN or LPN, or even certified as a CNA, etc. that they would be sure to renew the license in time. I know the exact date when my CNA cert. expires, of course, I hope I'll have my RN by then :-)

I'm glad you had such a great day at clinical! I love clinical myself, just not my instructor But, we're changing instructors next week, and I'm going from LTC to acute on a med/surg floor. Even though I'm just a first semester, we're already doing assessments and meds (po, topical, subcut, intradermal, and IM), I've loved all of my patients, but I'm looking forward to some different diagnoses, I've learned a lot from the patients that I've had, but 3/4 had dementia as the primary diagnosis, and the other was COPD.

I am currently a student in an ADN program, and was taught to aspirate on every IM injection. If I remember correctly, the reason that the instructors gave was because of the possibility of accidently hitting a blood vessel and actually injecting IV instead of IM. From the research on line, though, I haven't found much support for aspirating with IM. But, since I'm in school, if my instructor says to aspirate, I'll aspirate! Plus, one of the instructors became an RN in 1976 and she was originally taught to aspirate a subcut injection, so go figure!

So, I don't get along with my clinical instructor either, in fact, I don't think she likes me at all... But, the rest of the program is great. We have great lecture instructors, and our lab instructor is AMAZING, we buy a kit to practice with, so we have a lot of equipment, and we can practice as much as we want, both with instructor and without, then check-off by the deadline. Clinical makes me nervous, possibly because of the friction with my instructor, but she seems to be that way with all of the students. (I think it's because she is usually with the second-year students that are able to do way more, and she might feel like she has to "babysit" us or something like that.) Anyway, hopefully it will get better for you and you'll feel more confident. Talk to some people who are ahead of you in the program and see if maybe its just something that passes after you proceed into the program, as in the instructors warm up alittle the farther you get! But, don't let this discourage you from nursing and nursing school. Good luck! We students have to stick together!

That's what I was thinking! My life is pretty simple right now: class, work, study, sleep (about 4 hr); in that order, and sometimes I might actually get to eat a little bit...

Thanks for the replies... It's not that I truly care if she likes me or not, just that she grades me based on my work and not any feelings she may, or may not, have toward me. Granted, she could have been having a bad day, etc., but today was our last day with her as an instructor. And, honestly, I've had a couple of bad weeks myself (medical issues w/ my mother, issues w/ my sister, etc.) and could have just been feeling a little bit voulnerable. However, when you have the director of the program downing your every move, it's a little bit hard to not take it hard, you know? After all, the chain of command is her, the dean, and the president of the college... But, again, thanks for the feedback :)

I'm finishing up the first half of my first semester of an ADN program... I'm doing great in class (B+ average), lab is awesome, I get along with most of my instructors and classmates, but my clinical instructor seems to hate me! Now, I'm not trying to be overly dramatic, but seriously, she does. She returned our paperwork back to us today and on the comment sheet, she wrote that she shouldn't have had to tell me to change my patient's sheets... Ummmm, I did change my patient's sheets, but she is incontinent of bowel and had a VERY LARGE BM that her diaper/brief just couldn't handle and her sheets suffered from it. She had had the BM during the time I was at the nurse's station getting some info out of her chart, and I was on my way to her room. But, no, it couldn't be that simple, I was, evidently, being lazy. Anyway, I was wondering if I'm the only one that had an instructor that seemed to hate them? And, if so, how did it go? (BTW: We're changing instructors after fall break, which is next week.)