stefanyjoy

I should clarify just for full disclosure - during the pre-op interview the circulating nurse told the patient he would have a safety strap. The patient expressed severe anxiety over this, as he had a big fear of being confined. He almost seemed like he wouldn't proceed with the surgery because of it. She eventually agreed to not strap him until after he had received anesthesia. I guess since this changed her normal routine, she forgot about the strap after he had been anesthetized until the incident occurred with the leg.

I think when your instructors say, "We cannot teach prioritization", they are more referring to the fact that they cannot teach critical thinking. They teach you your ABC's, Maslow, etc. and all the tools you need to prioritize, but they can't sit there and tell you every single little thing such as raising the HOB vs. giving O2 first. As far as instructors being inconsistent, teaching a vast amount of information in one lecture, etc. these are all common complaints in nursing school. My classmates and myself all whine and groan about the same exact stuff. I'm not saying that you should just accept it as-is, but either you deal with it or you don't. I have one more year of this god foresaken program and I'm praying my nursing preceptorship will help fill in the gaps.

It's been over a year since I posted this thread and I just wanted to give an update. I'm an NAII now and halfway finished with NS. I've only worked in hospitals since but I have a much better understanding of the daily grind of an NA. This was abuse, neglect. These details are not fabricated, this is not hyperbole. I'm so happy to say I've only seen patients in the 2 hospitals I've been at receive only the most respectful care from the NA's. I don't understand how anyone could defend the behaviors of these "healthcare" workers. I still think about that first patient I ever had and wonder what became of her. I hope her family got her out of there.

Thanks for the input. While observing a skin graft was a really exciting experience for me, some things just left me reeling. The sterilization (or lack thereof) of course, but also, the circulating nurse forgot to strap the patient on the OR table. During the procedure some equipment broke and she and the surgeon left the room. I forget where the scrub nurse went but she wasn't there either -it was just me and the CRNA. The patient began to cough and heave while under general and his leg fell off the table. He was over 300 lbs so it almost brought him down with it, had I not grabbed it while the CRNA was trying to handle things on her end. Also, something was wrong with the dermatome blade and the surgeons made quite a mess with his thigh. They got a new dermatome but then opted not to use it and just to make due with the raggedy pieces of skin they had. I don't mean this to be a dump on the OR team and I know things can go wrong in even the simplest of procedures, but it just all seemed like quite a big mess to me. This facility is home to the best burn unit in our region so it kind of left me a little surprised and disappointed.

I am a nursing student and I had an OR rotation last week. I observed a split autograft and xenograft. The procedure was "clean" and not sterile. I asked the resident as to why it wasn't a sterile procedure and he simply stated there was just "no point" in having it be sterile. The scrub nurse didn't really have a definitive answer for me either. I just wanted to ask - is this normal?

65 in my nursing program year (I think 2 of those dropped by mid term) 15 in my lab 32 in my lecture 8 in my clinical group

I'd probably go with a risk dx here since it looks like he's well underway with his care. Risk for Ineffective Airway Clearance would be my best guess, unless you're allowed to make a dx from the initial admission then it would be Ineffective Airway Clearance. Remember your ABC's...

I just finished my first semester. I'd say... just rest. Take naps. Watch TV. Spend time with your family, your friends, drink wine, enjoy yourself. Pretty soon you won't be able to enjoy that as much anymore :) Every nursing program is different, but for mine, I guess reading up on patho would have helped, especially on things like diabetes, congestive heart failure, COPD... maybe review medications that you'll see a ton in clinical, like morphine, dilaudid, lasix, lovenox, insulin... read nursing care plans, see what they are, what common nursing diagnoses are and their interventions. Good luck to you.

I don't think it's fair to your older children to have them assume parenting roles. My mother was a night shift nurse and I always had to hold down the fort, and yes, there were emergencies sometimes. I am in agreement with your husband, sorry.

Thank you for this post. I start nursing school tomorrow. I feel scared ******** and unprepared. I have to work 25-30 hrs a week and I'm a single parent. Hi to the General Nursing Student board though, feels nice to finally post in here...

Aside from studying a bunch, I also used Mr Ford's videos online Mr. Ford's Anatomy and Physiology -- worth the $5 per lesson. When my eyes were too tired I would just play his videos over and over, it stuck. I made a high A and didn't even have to take the final.

Curious as to why some people would think I would make something like this up. I work full time, am a part time student, was just accepted into NS for this fall, plus I am a single parent. I have a lot better things to do with my time than to troll a nursing message board. I come here for advice, feedback, information and a funny story after a long day. To those wondering, the unit I was doing my clinical on was for mainly Medicare/Medicaid recipients (they actually had a seperate hall for people with private insurance - in the front of the building - so it looked all plush at first glance). I'm guessing the little family I did see visit just didn't have any other options. I know a lot of them did complain about it smelling like poop all the time in the halls. Most of the residents I was assigned to did not have family that visited, which is why they stuck them with the CNA students.

Don't feed the trolls...

I'm so afraid I'll be so nervous I will forget everything! My CNA class really sucked, the instructors could never agree on anything and always gave conflicting information. I just feel so unprepared Do the evaluators do anything to try to get people to relax or is it going to be a really rough 30 minutes?

When I decided to go back to school full time, I also worked full time (still do). My then-advisor laughed in my face and told me it was impossible especially because I was a single parent. He said I was making a mistake because I'd end up with a bunch of W's or bad grades if I didn't drop. I switched advisors. I made straight A's with those 14 credit hours in that Fall semester. I also won several monetary awards at work for working on projects and making a "frequently exceeds" on my end of year evaluation. It wasn't easy, but I did it. My idiot advisor just didn't know me, what I was capable of, and how determined I was. Only you can decide if this is possible for you. You have to be willing to put the work in and not give up no matter how overwhelming it may seem sometimes. Good luck to you.

Thought I'd come back to this thread now that my 3 week CNA clinical is over. This LTC was nasty, disgusting, HORRIBLE -- I would not allow my dog to live there. The treatment of the elderly lady on the first day was just the tip of the iceberg. I had to report this LTC to the state as soon as my clincal was over. I have never never in my life seen such nasty, disgusting treatment of human beings -- bloody, oozing decubitus ulcers all over every patient that were not treated, when reported they didn't care at ALL, people sitting in filthy diapers for days, incomplete medical records that had not been updated in 6 months, dried up turds on the shower floors, this one lady had the circulation in her feet cut off for a substantial period of time from too-tight, nasty socks that hadn't been changed in god knows how long and when I took the sock off her nasty, long long long infected toenails came with it, and when I went to get the RN to tell her this woman was in intense pain and needed to see a podiatrist immediately and the RN came in and told her to be quiet and stop crying. Her feet looked like something out of a medical dictionary. It looked so incredibly painful. RN's that would leave meds out on the med cart and just walk away for long periods of time. CNA's that would not change diapers or incontinence pads but just throw another pad on top of the nasty, soaking old one. God this place was awful.

:w00t::cheers:

Forgive me for oversimplifying your post here, but it to me it says, "How can I discourage people from their dream without making it seem like I'm trying to discourage people from their dream?" Would you tell someone trying to get their masters in education that teaching sucks and it's an underpaid, thankless job? Or their BSN in russian literature? computer technology? philosophy? Would you tell them they're wasting their time? I mean really, most every job market sucks right now. If you warn a nursing student that finding a job might be difficult and they reply, "well, this is my dream." then there is no reason for you to press the issue. I would find it insulting telling someone I am working hard to get my education to achieve my dream and they do nothing but spout usless statistics on the job market. Finding a job as a new grad nurse, difficult as it may be, is not impossible, and if it's someone's dream, more power to them. I'd understand correcting a person that was like "I'm going into nursing because it's recession-proof! there are jobs everywhere!" but discouraging a person who simply states it's their dream to become a nurse is asinine.

Umm.. how do you know they weren't dental hygenist students or cosmetology students? they wear scrubs as well. I seriously doubt an entire group of nurses who were in contact with bodily fluids all day would wear their dirty scrubs to a bar. It is more likely they were either students or employed at a place that doesn't require getting "dirty". Either way, it's none of your business.

Oh, dear. I feel that institutional covered entitites rush their HIPAA training so quickly that it basically says "PHI PEOPLE! DISCLOSE IT AND BE FIRED! NEVER BREATHE A WORD!" Keep your list, with patient names and whatever else, in a LOCKED location at work that only you have access to.. basically, got a locker? Your individual facility determines if PHI is allowed off the premises, not the government. However you are responsible for proper disposal of the information should you choose. It needs to be shredded, burned, whatever. If for whatever reason your locker is to be broken into one day and someone steals your list, or it magically combusts and your notebook sails out into full view, report it immediately. I work in health insurance. Claims. Medical records. I've got PHI coming out of my youhoo. I WORK AT HOME! AWAY FROM THE OFFICE! Everybody gasp. Don't mean to sound like a you-know-what. I'm the throes of cymbalta withdrawal. stupid drug.

I think she meant on the back of the thigh, close to the buttocks. Thanks for your input Leslie. I know that CNA's have many patients and can't provide such unique care to each and every one, but if she was my only pt then I don't see why the CNA had such a hard time just letting me care for her. This woman was very cognizant that I would just be there that one day. It was like talking to any other adult, and I didn't think she was too demanding. I should also mention she had a stage 1 ulcer on her buttocks, which is why I was concerned about keeping her clean and dry. I guess in at the end of the day I thought of how I would like her to be cared for as if she was my own grandmother. I definitely would be upset if someone treated my relative like that.

Good afternoon everyone. I just need some perspective on what I witnessed today to see if I can expect to see this kind of thing everywhere. I'm not sure if I can handle it. This is going to be kind of long but I really just need to describe my first clinical experience to someone. I am in my final 2 weeks of my CNA course. I have applied for an RN program for this fall, but I am required to be on the CNA registry to begin. Anywho, today was my first day of my CNA clinical at a LTC facility. I was assigned to an 82 y/o female resident that suffered a CVA three months ago while at an ATF and was moved to LTC. She is a total care patient. She is unable to move very much at all but she does not suffer from dementia whatsoever. When I arrived this morning, I went into her room to wake her for early morning care and to wash my hands. When I turned the sink on, some black crap sputtered out that turned yellow. I went into the employee break room to wash my hands and used foam sanitizer. When I got back into her room, I noticed her emesis basin was on her night stand, and it was really crusty and disgusting. Her toothbrush was inside it and it was totally yellow and had some brown stuff crusted on the bristles. In fact her entire room was pretty nasty. I got out her wash basin and went to fetch her CNA to ask where I could fill it because the water in her room was yellow. The CNA yelled at me to just use the water in the room "de trays are comin out!". Eventually I found clean water to wash her face and hands and perform peri-care. It took me awhile because we had not gone over diaper changing in my CNA labs and I kind of had to wing it. I have one child but obviously changing a full grown adult is a lot different - and while I was performing peri-care she had a major BM. I cleaned that up and did my peri-care all over again to be safe. Naturally this was my first time doing this on a real person and it was taking me a while, and the CNA or my clinical instructor were MIA. So the CNA comes in and yells at me again for being so slow, and starts aggressively pushing this fragile old woman around to put her ted hose and bra and the rest of her clothes. I mean, she was just throwing her around on the bed. I could barely watch. I asked the CNA when I would have a chance to perform oral care because the resident still had her bottom row of teeth with god-knows-what caked between every tooth. She said "we don't do dat! she have dentures!" (she only had top dentures) and just threw the dentures in her lap even though she is completely paralyzed on her left side and her right hand tremored badly. During this time, all the resident could talk about was that she wanted her red vest that was in her closet. The CNA yelled at her to just wear the clothes she put on her and let it go. I kept moving toward the closet to retreive the vest but the CNA kept turning around saying "Don't get that vest!" like it was such a huge deal. I waited until she left and went into the closet to get a very easy to put on red fleece vest that had the Cornell University logo on it. Her granddaughter was coming to visit today and she attended Cornell. The CNA was ****** when she came back in the room and the resident had the vest on. Why? I have NO IDEA... but the resident was as happy as a pig in ****. I had reviewed my resident's chart the day before and noticed she had lost 20 lbs since she was transfered to this LTC in November. She is literally skin and bones. So I knew that I really wanted to encourage her eating when I got a chance to feed her breakfast. When the trays came I saw on the card that she had ordered an english muffin, cheese grits and oatmeal. I opened the tray and it was french toast and bacon. I went to find the CNA to tell her she received the wrong meal and the CNA said "that card don't mean nothin!" but the entire time I was trying to encourage the resident to eat she kept talking about the english muffin she wanted and she hated french toast. I felt terrible. I asked her why she's lost so much weight and she said it's because she doesn't like the food there. After breakfast my resident needed to be moved to her wheelchair because her family was coming to visit a little later. Since she only weighed 107 I asked my instructor if I could use my gait belt instead of a lift (since we were not allowed to operate them just yet, and I wanted some kind of belt practice). With her blessing I went to get my gait belt but when I came back the CNA was in the room putting the resident's shoes on. I said I could handle the transfer to the wheelchair and started to pull out my belt. She said "No, that take too long!" and just heaved her up and into the wheelchair like a sack of potatoes. Mind you this LTC has a no-lifting policy. The resident had asked me if I could wheel her to the nurses' station so she could read the menus, so I asked the CNA where the foot rests to her wheelchair were. She snapped at me that the resident just needed to stay in her room. I repeated my request, "Mrs X would like to read the menus" and she started yelling at me that she just needed to stay out of the way. It was like she didn't like the resident for some reason - plenty of other residents were out of their rooms and just hanging out in the hallways and common areas. Luckily at this time her family showed up a bit early, so I just let them be. Now would be a good time to mention the overall demenor of this resident. She was obviously a very educated woman, as the entire time I spent with her we discussed our families, education, traveling, literature, good food, politics, her upcoming 63rd wedding anniversary, pretty much everything. At one point before her family came she asked me if I liked poetry, and then recited Walt Whitman's "O Captain, My Captain" from memory. I actually had to turn away so she wouldn't see me tear up because my heart was breaking that such a beautiful soul was stuck inside such a broken body. She seemed so incredibly grateful that I was clumsily providing such basic care. Anyway... While the family was visiting, I went to join some fellow classmates to assist with their residents. One girl said her resident had a nasty pressure ulcer on her thigh but it was not being taken care of, and she had to clean liquid poo out of the ulcer. One had told me that her resident had such a dry mouth that scales were falling out during her oral care. I told her about what my CNA said about oral care and she looked shocked. I went to my clinical instructor and told her that my CNA said she doesn't perform oral care, and she told me to do it as soon as I could. After the family left I went in to do oral care but then remembered that her toothbrush was disgusting. I threw it out and went to look for a new toothbrush but could not find one. I asked the LPN's at the nurses' station and they sent me on a wild goose chase looking for toothbrushes in every supply closet, but eventually I turned up empty-handed. The charge nurse just sighed, "I'll tell them to order more." I had to try to gunk out the resident's mouth with swabs. I was horrified the crap that came out of her teeth and I didn't even get most of it because I didn't have a toothbrush. At some point during this time the CNA yelled at me for cleaning her mouth and dentures ("she about to eat lunch! we don't clean dentures just put them in the water") but at this point I was so disgusted by how neglected my resident had been I just ignored her. After I performed oral care my resident told me she would like a new diaper. I went to get linens and my CNA of course stopped me to ask what I was doing. I told her I was about to change her diaper and provide care for her and the CNA grew furious and said "She's not that wet!". Of course at this point I had grown so fond of my resident through our conversations that I just didn't care what the CNA had to say whatsoever. And plus, she's my only patient, so who cares if I pay this much attention to her?! At this point I had to move my resident from her wheelchair to her bed. She looked at me and said "Ok, so you get my legs and can get my head?" like the CNA's just fling her back onto the bed. I was horrified and explained to her I would be using my belt. So I get her back onto the bed and change her diaper, at which point she shows excitement to receive two AM changings, poor thing. She asks me for water so I go to get some. The CNA starts of course yelling at me about getting her water "The lunch trays are coming!" and I ask when, she says in an hour and a half. What? So what? The resident wants some water now. So I ignored her and went to get my resident water and whatever else she requested of me today. Ice? Lotion? Lip balm? Sure. I was having a good time caring for her, talking with her, making her smile, and she needed some extra attention. All the while the CNA is telling me to stop getting her stuff because "she'll run you all day!" and getting very angry that I was just ignoring her ranting. I was documenting all her fluids even though she was not on I&O (I don't know why, she is practically a skeleton, they seem kind of content to let her just circle the drain, which is none of my novice business but at least we could make her happy and comfortable). Her chart indicated she was just to be made comfortable, she was not on any kind of therapies or procedures scheduled or anything. Her only med was ambien. A few other little things happened but this post is already too long and I think you all get my gist. During clinical I reported my concerns to my clinical instructor and I think she may have spoken to someone at the LTC about it. I'm worried that tomorrow when I go in (I'll be assigned to a different resident/CNA) that I will catch hell from the staff, but I couldn't let this precious angel of a woman be treated so poorly. It got to the point where I prayed she would pass soon so she wouldn't have to bear being stuck inside such a shithole LTC for much longer. Can anyone give me some feedback on this? Is this common for LTCs? Did I do anything wrong? Am I just too green?

Durham Technical Community College doesn't do a wait list, it does a point system for admissions (based on number of pre-reqs completed) but the application deadline has already passed for Fall 2012 so the soonest you could start there is Fall 2013. There are a lot of ADN programs here in NC going toward a point system though, so you might want to do a little googling and find one that is still taking apps for Fall 2012 or at least has a program that starts in spring 2013. Good luck.

No, I wish! I'm in 2 now and it sure would help.

They don't?