shaas

Hi, mcabreza. Whether you are a new grad or not in technicality, the job market in both NorCal and SoCal are supersaturated (meaning it cannot even adequately accommodate our own new grads here). Moreover, is a huge surplus of BSN and even MSN-RN who are new grads that are struggling to find employment. It takes anywhere from 3 months (if you have connections and know someone) to 18 months (getting a job on your own without any pull) to land a first job for a new grad here. Please, keep this mind that a lot of the hospitals hire based on your preceptorship or clinical orientation there, so as a transplant and a new grad without any experience, I am not too sure if the employment outlook is viable for you. Your moving is entirely dependent on your discretion, but I suggest you gather as much data and information as possible if you are solely moving here for your first nursing job. Anyhow, good luck and march on! Shaas

Two things stand out for me other than what I've mentioned in the other thread regarding coagulation. 1) If your pt. is not compliant with dialysis and has a change in mental status, a red flag (either a high serum uric acid or ammonia values) should go up. Change in mental status with noncompliant dialysis patient tells me her blood may be full of unwanted metabolic wastes, especially the ammonia. 2) There is a strong correlation between bipolar disorder and fibromyalgia. It can manifest as sensitivity to pressure, translates to pain, or joint stiffness, hence pain in joints. It can also manifest as generalized pain anywhere in the body. Good luck!

Both values are WNL. Due to the hypercoagulable state (because of the pt.'s APLS), you need to first check if these lab values are within the targeted therapeutic ranges for whatever anticoagulation therapy the pt. is on. If lower than therapeutic range, then she's at risk for clotting (DVT and, if left to embolize, PE), not necessarily bleeding. If the dosage is high, and the labs are significantly elevated outside the therapeutic ranges, then the pt. is at risk for bleeding. Addendum: Just read your pt. hx. Hepatitis also elevates the pt.'s risk for coagulation. Liver is responsible for many things, among which is protein synthesis (coagulation factors are proteins) as well as the vitamin K synthesis. You also need adequate serum Ca2+ to coagulate effectively. I think that your instructor would be satisfied with either the risk for bleeding (simply because pt. is on anticoagulation therapy) or the risk for ineffective tissue perfusion (having liver and renal diseases really put pt. at risk for impaired circulation and perfusion). If it were in med school, I'd definitely side with the latter possibility (85%) than the bleeding risk (15%).

My $0.02: Content in biochem/upper division chem (including physical chem, which is nuclear chem) is much, much, much harder than nursing. Pre-med, pre-pharm, and any nonsocial sciences (i.e., pure sciences) tackle complicated concepts to grasp, hence, the demand for their knowledge is much higher, be it in medicine or in research. The workload, dealing with the personalities, and other human factors, not content, are what make nursing a pain in my rear end. I've seen pretty much anyone who possess basic academic aptitude being able to plough through nursing programs of various kinds, and, of course, remain successful in what they do. I still keep in touch with my science friends with whom I have tremendous camaraderie, and that's how I keep my sanity and my mind sharp, so to speak. I have a couple of close classmates in nursing, and I maintain my circle deliberately small in it for many personal reasons. For one thing, with a hard science background of two years+, you are able to explain the real "why's" of any bodily phenomenon when your nursing instructor may not be able to explain. Keep your textbooks. Knowing the biochemistry/mechanisms really does help in all molecular interactions. 'Nuff said from me. Shaas

Hi, Ashley. Could it be laparoscopic Vecchietti procedure? VEC does not seem to be an acronym; rather, it could be a shorten form of the Vecchietti procedure. My $0.02 Shaas http://www.mrkh.org/files/ORG/Laparaoscopic_vaginoplasty.pdf

No problem. I am glad to be of assistance of any kind and to learn along with you.

It is mainly due to the inflammation process, to combat the invading and replicating virus (in this case) or bacteria, which is a pretty complicated cell signaling/G-protein-mediated process of nociception involving articular nerves. During the inflammatory process that eventually kill the infected cells many cytotoxic materials can be released, which often exacerbate inflammation response. This process applies to both joint and muscle aches while virus is present (until they are eradicated). I really do miss molecular bio and biochem. They actually helped to build a great science foundation, which nursing schools cannot do adequately. Now, I have to read on my own the medical journal and texts if I want to acculuate any substantive knowledge. I hope that the following articles help: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1010160/pdf/annrheumd00350-0006.pdf http://www.ehow.com/about_4744935_joint-pain-caused-viruses.html (This is non-peer-reviewed/nonresearch article)

Wow. I am shocked to see such a high price tag with so little in return... We are finishing up our first semester by next week. We had minimum of 4 med. passes and 4+ subcutaneous heparin/Arixtra/insulin injections, not to mention some of us got to insert and remove foley catheters, feed medication through NGT, etc. Just be really thorough in your research as to what school to attend. With that price tag, folks should be going to an Ivy league school for their Masters, not WCU... Best of luck to all.

More specifically: RN-ADN = associate's degree in nursing; passed NCLEX and got RN licensure RN-BSN = bachelor's degree in nursing; passed NCLEX and got RN licensure. The essential difference is not in RN v. BSN, but in ADN and BSN. Both routes can lead to RN licensure if you pass your NCLEX. Hierarchically, the degrees conferred are ranked as follows: Associates, Baccalaureates/bachelors, Masters, and Doctorate.

Hi, Kimkim. I believe that they do have a recency requirement for their nursing prerequisites. As far as GPA and scores go, "cutoff line" varies by applicant pool per term and the program's willingness to accept a certain breadth of students from varying backgrounds. Student profile for our cohor include 8 previous-BA/BS people, 3 allied health care people from non-nursing field, a person as young as 19 to as older as mid- to late-50's. Some have impressive backgrounds, some have middle-of-the-road GPA (like 3.0 or even lower, 70%+ or less on TEAS, etc.). There also was a student from previous semester who was repeating. My advice is for you to get that admission category sheet, run through their algorithm with your scores and see how many points you get. Go to the nursing office and speak with a lady named, 'Martha.' Even if one does not have a sterling GPA, test scores, and BA/BS degrees, having health care experience as EMT, LVN, or CNA gives you a significant boost (3-5 points or so) just as well as volunteering experience. So, calculate your spec's and just apply. It all depends on your applicant pool. We also have two veterans. Good luck to you. Shaas

It is very true that not all students will perform at the same level despite having given the same instruction and material on the subject matter; therefore, they'd test differently as well. I believe that the biggest clue was not just tachycardia, but sinus tachycardia. This should trigger thoughts of conduction, contractility, rate, and what conditions induce sinus tachycardia. And, if the student already knows that digoxin has something to do with HR, that means the student had looked the medication up some point in her life, as that specific knowledge is not inherent in her genome. The depth of knowledge is what seems to be the issue. Digoxin specifically works in a certain way (mechanism of drug action) and is indicated for certain conditions because of how it works. One can choose to justify that no fundamentals student would answer this correctly, but there is always someone who "gets" what others perceive as too elusive to procure or too vague to grasp. If I were the OP, I'd introspect where I went wrong and compensate for that deficiency so that I would perform better next time. One gains more by admitting one's shortcomings than justifying the error itself. I wish the best of luck to the OP. Shaas

Digoxin does address HR, more specifically myocardial contractility, but you should really look it up. You need to ask: it decreases HR by addressing what sort of conduction problem and what mechanism of action? For future reference: digoxin is indicated for atrial fibrillation (abnormal conduction site and rate). Good luck. :)

Hi, there. One thing that I can think of is that, in this situation, sinus tachycardia may have been caused by fever or pain (both elevate HR). And, there is no electrical/conduction problem as far as I can tell from the question's stem. The conduction began normally at SA node, hence labeled "sinus" tachycardia. By alleviating the pain or fever, which may be the possible cause (because it does not give you any other physiological clues), you can bring down the HR, hence, acetaminophen is the most reasonable answer that I can arrive at. And, unfortunately, no. Your instructor is not mistaken here.

Hi, there. I'm a fellow first-year nursing student as well. There's not much data that you presented but one thing stands out from what's been written: risk for falling, again. Your client has a history of having fallen more than once, which means that he is at the highest risk for another fall, according to the Fall Assessment Tool. I would give these a shot: 1) risk for falls related to visual or hearing difficulties as evidenced by (insert whatever objective/evidenciary data you have to support his hearing and/or visual impairment); or 2) risk for falls related to previous history of falling as evidenced by a high score on the Fall Assessment Tool. Your goal is to ensure that he does not fall again, so you can write a specific goal and what intervention(s) you must implement. I am as inexperienced as you are in this realm, so I cannot be certain that I'm on the right track. Good luck to you. Shaas

Red blood cells are anucelated cells. So, the environment within a RBC would be considered 'intracellular' whereas the space inside the blood vessel sans RBCs would be considered 'extracellular.' So, conclusively, even within the blood vessel there are two disparate compartments; IC and EC (this is what I've been taught in science courses). Not a new fact; just a well-established yet not-too-well explained fact in some NS programs, I gather. And, below is another long-been-established facts on the contents of the RBCs. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC292863/?page=1

If it isn't a bacterial UTI (which most labs are run for), then could it be Candida UTI since she'd probably been on antibiotics for a prolonged duration of time due to her recurrent UTI previously? Fungi tend to flourish with chronic use of antibiotics. Just a thought. :) http://www.merckmanuals.com/professional/sec17/ch231/ch231c.html

*Disclaimer: Some graphic content and TMI; reader discretion advised. Souzou, you may ask one of your molecular or biochem professors, who do laboratory research, if they need a tech to help during summers. However, as I've mentioned, this is more pertinent for pre-med, I realize. It looks good on your CV, but I cannot say if this helps you in nursing. I don't think mine played any role. As for nursing, being a CNA will acclimate you to the hospital setting and you have the opportunity to provide basic, direct care which exposes you to lots of fun poopily aromatic situations. :) I am not too sure how being a CNA truly plays a critical role in one's path to becoming a RN though. I am planning to be a CNA while I'm in nursing school (we're allowed to get a CNA certificate after the first semester, but I'm still deliberating on this decision as you can see) because I guess I need to train my stomach for poops. Yeah, I'm one of those people who flush frantically even while I do my own business and detest smelling others' poop being cooked in room temp. in warm bathrooms for the entire duration of their fecal elimination). I do have my issues that need to be worked on, so, that's my rationale behind the CNA for me. Surgeries, bloodies, gore don't bother me at all, but I am "afraid" of poops. Ah, well. Life goes on... Useful advice: 1) Many second-degree student profiles indicate (I think I read this on Johns-Hopkins, Yale, etc.) that the prospective nursing students do humanitarian work for organizatons that provide healthcare for the medically-underserved areas. Or, join a mobile clinic that provide AIDS care for those who don't have access to clinics. There are tons of opportunities like that in L.A., so, this will depend on the area in which you reside. AmeriCorps is one, but I don't think it they have healthcare-related projects. I'm not too sure... Also, check out volunteermatch.org. 2) Start volunteering now through a reputable program (clinical care extender internships via Cope Healthcare Solutions) and accumulate volunteer hours (min. 250). My youngest sister applied to UPenn for BSN (Second Degree) and she is a Care Extender through the UCLA Care Extender Program. Find something like this for your area through any universities that have medical centers. 3) To be counted as 'experience,' you may have to really work in a hospital. The positions you mentioned are not related to nursing, so, it will not be counted as direct experience but it will show the review panel that you have general healthcare setting exposure, I believe. Your closest bet for experience is becoming a Volunteer Clinical Extender, CNA, LVN, etc. FYI - Many EL-MSN programs give points for those who worked as CNA and LVN. I bet some BSN programs would, too. I really wish you good luck!

Hi, Souzou. By the looks of it, you've already read a bit about Columbia's Combined BS/MS (ETP) Program for non-nursing graduates, which is pretty self-explanatory. No, you don't need a RN license or an associates in nursing. Just your BS in biochem would suffice, if you are still pursuing biochem. In fact, any college degree with nursing prereq's would do, and a decent undergrad GPA and a reasonable GRE score to add, of course. Anyhow, the principal question remains; whether or not this sort of private, accelerated programs are well worth it to get to your goal of NP, to which I will say that it is your preference. Nursing began as a vocation, rather than an academic pursuit, if you've read its history. So, I believe that nursing is right at the cusp of emerging and defining itself as a serious academic pursuit, and, yes, it is struggling for it at times. If you've read enough threads about nursing's reputation as an academic endeavor or a profession even in this forum alone, and how it is received internally by its participants and peers, you'd draw a more fuller picture of it. Nursing is a fascinating field, to say the least. Columbia, Duke, Yale, UPenn, etc. all have excellent academic programs. If it jives you, then go get that Ivy education for your nursing profession. But, to be brutally frank, a research geneticist (or the like, for the sake of this argument) from these aforementioned schools would get more mileage out of their expensive, pretigeous education than a NP would, in regards to income potential, recognition for prestige among peers or while working as a nurse, etc. Personally, if you're planning for a CRNA, Columbia is well worth it, I think. For your Master's portion (MSN), you are permitted to apply to CRNA specialty, which is an awesome opportunity for a non-nursing combined program. Had I not been so sticker-shocked, I would've applied for it just to see if I could make it at all. But, after seeing my younger sister raking up so much debt at Georgetown for her MPP just to earn a meager living as a NGO strategist, I was smarter to go for an ADN (or so I believe). Private education has its time, place, and uses, but nursing may safely be exempt from it. As I've always told my younger sisters, it's not what school you attend but rather it's what subject you study and how you use it afterwards. Good luck, and do your research thoroughly and you should be fine. P.S. If you want to stick out, then participate in research even as an assistant and try your best to be published. Or, during summers, ask for a research assistant position and hone your technical/lab skills. However, know that these would not directly be applicable for nursing, per se, but would showcase your calibre and potential as these schools are known for their research prowess. Experiences as CNA, phlebotomist, unit clerk, LVN, etc. would not necessarily help you stick out as many people have done and still do it.

Hi, there. There are a few (some CSU schools also) that offer RN-BSN online programs, as well as an out-of-state univ. that has an agreement with the CA BRN. As for me, I am going via the ADN route: get the RN license in two years and enroll in BSN afterwards. I've taken more than enough science courses but none are nursing-focused. So, I am in a similar situation. What I've found out so far is that, at best, it's one year to finish BSN with a full-time student status (taking 12 units+). I have not found anything shorter when it comes to RN-BSN route. Good luck, and here are the links: 1. CSU RN-BSN Online Bridge Programs 2. CA Approved Out-of-State Online RN-BSN Programs

I had to fish that information out by looking at the OP's previous post about the nursing program. :) https://allnurses.com/pre-nursing-student/there-difference-between-515536.html#post4629982

You sound like quite a busy student!:) Yes, it seems a rather sad state of affairs for the new nurses. However, there are jobs if you search strategically. When you get a chance during this winter break, read about the "New Grad Programs" in this forum. There are quite a few in the So. CA as far as I've read. A big caveat is the fierce competition for the available spots, as you can imagine. As for the academic endeavors, if I were you, I'd finish both. However, because you have a paid-internship at one of the Big Four, I don't feel badly to tell you to concentrate on accounting if you had to choose one. They will most likely hire you. I am willing to bet you on this monetarily if I could. My sister's two friends did unpaid-internship while at UCLA and were hired (= snatched up) by PwC after graduation. Both passed their CPA three years ago. One subsequently left PwC to assume an upper-level mgmt position at Toyota and another moved to Seattle with her boyfriend because she absolutely hated accounting. Naturally, you'd end up with a better accounting GPA if you were to solely devote more time to one discipline than splitting your hours into two subjects. Although, ideally, it would be beneficial to finish both because you can easily utilize your accounting degree. Moreover, if you are planning to get your CPA, then you'd be an amply strong candidate for upward mobility in both the accounting and nursing administration, I believe. You do not have to settle for one if you could suffer now a bit longer. I know that it won't kill you with the right support system. If you have to work 25+hrs/wk, then I don't recommend double-majoring. And, the internship at Big Four is nothing to be scoffed at and will play a very important role in your accounting career in the near future. You'll see that soon. Best of luck! P.S. I just read that you are enrolled in a non-accredited ADN nursing program. You may not lose much if you did drop from the said program, especially if your accounting program is at a 4-yr university.

As other have advised, you will have to step up your game on your own, without their help. Go to the extra lab hours, look for videos on youtube on a skill, etc. to make through this session. As you may already know, you cannot change others. You can only change yourself. And, you are definitely not changing to fit into the clique. You are changing your M.O. to be better in clinicals by becoming a stronger student. However, don't do anything if you think that it is going to cause injury to yourself or to the patient. Be vocal and ask for help. It's a safety issue and phrase it in such a way. And, I am not discouraging you from helping others, but, for now, you really need to help yourself first. Reserve that emotional energy and strength to pull yourself through. You can do this!

Hi, GHGoonette. :) My assertion really does not differ much from yours. That is why it is stated that caring should remain an undercurrent trait for both physicians and nurses. It's a human decency issue, and may not be a teachable trait at all. It is an implicit requirement that needs not be stated as it does not need further campagining for it. I believe that the public is well aware of the caring nature of this profession and so do the prospective nurses who enter the field. Who in their right mind enter this profession if they are not ready to do often times the "dirty and thankless" job? As I am reading posts written by many experienced nurses, it is not just the society that is evolving but the field of nursing as well. The demands on nurses evolve and change, and bedside nursing is not exempt from it, it seems. Yet, it has been indicated by many that there is a stagnant impression on nurses as a collective, both by the public and the physicians and other health professionals, and it is not always a positive picture, treatment, or a fitting adjective for nurses' hard work. My post is not quite about whether nurses should be genuinely caring individuals or not. Neither of us can define with absolute certainty what constitutes a truly caring nurse. Only the recipient, the patient, can be the judge. Even then, it is subject to the patients' perceived notions. Nursing theories are great, as long as they are empirically based as they are purported and supposed to be. But, it is not necessarily the right tool to elevate the status of nurses as profession. That recognition comes from other medical professionals and the public. It really has no bearing even if all nurses are gung-ho about these nursing theories and find relevance in their daily practice because the recognition we aspire to attain to elevate our professional status invariably needs to come from others. We already know that nurses do and know far more than what is being recognized by others. I don't think that nurses lack the awareness of social and psychological needs of the patients, or the cultural awareness, irrespective of where they decide to practice. Nurses have been drilled if not already equipped with them from their prior life experiences. Those who do not get it may not get it. Ever. This degree of caring and cultural and social sensitivity are deeply interdependent and intertwined, I think. A notion that a caring individual can be culturally unaware seems fallacious to me. A caring indvidual is more likely to learn these cultural and social variables of the patient to provide better care. But, then, again it is my subjective assumption and a wish. The questions I bore in mind when I wrote the long-winded piece are: 1) Would focusing on nursing theories or the discipline of psychology (following their research method) elevate the status of nursing as a whole? 2) Why do some patients demand "I want to talk to the doctor"? 3) Why do some physicians not prefer to confer with nurses who provide direct care but reserve discussing them with their medical 'colleagues'? 4) What is lacking in an average nursing curriculum to be recognized as a rigorous academic program? 4) Does nursing really differ much and should be disparately considered from the whole picture of medical care provided for the patient? 5) What is the reason for overused slogans such as "caring" and "critical thinking"? I know, I make the readers and myself tired. But, some nights I cannot stop my internal dialogue and I post my thoughts. :)

I know that this is not going to be a popular sentiment, but it is what it is, an unpopular but a legitimate gripe of mine. Please, bear with me. One salient oddity that I've noticed while taking an introduction to nursing class is the nursing academia's desire to align itself with socialpsych./psychology, which baffles me to no end. If you've majored in any known social science discipline (e.g. sociology, psychology, economics, etc.) and have gotten a degree after writing papers coming out of your orifice, singing the same old tune in different keys, then you know this already; these disciplines' aim and pursuit have been gearing heavily toward integrating scientific empiricism and math to add credibility and garner academic clout. They even added 'science' to their moniker because science really does matter, in every way conceivable. To effect a measurable change for Nursing to gain greater respect and legitimacy as a challenging academic discipline is to integrate more science; some schools are already headed that way. The prospective nurses already enter the field of nursing because they want to help others. And, that sort of personality trait will not be affected whether there is more theory added or not. Furthermore, go ahead and examine the curriculum of advanced nursing degrees, be it FNP or CRNA. They all end up taking the undergrad science core classes that are requisite to pre-medical or pre-pharmacy programs. Why do you think that is the case? Nurses are, indeed, a part of the medical team. Nurses are not there merely to be caring and fluffy, solely. For me, medication errors and not knowing the pathophysiological pathways bear more serious implications for deleterious patient care than not possessing excellent bedside manners. Being a caring human being is not a negligible requisite, but the "caring" slogan has been abused to ad nauseum in nursing. I want to be a competent, clinically sound nurse who aid in the healing and coping process for the patients. In the mean time, I want to impart an impression of a nurse who is a knowledgeable professional and not be perceived as someone who posses surface-skimming knowledge about human health and pathology. Caring should remain an undercurrent trait of human decency for both the physicians and nurses, not a central theme that drives our discipline away from what should be added to achieving psychological well-being for the patients. There is nothing wrong with nurses being medically knowledgeable and being able to think "like a physician" or a logical clinician. We already have those nurses around us. As nurses advance, they end up purchasing more medical references than nursing theory books. I sympathize that the nursing as a burgeoning academic discipline would like to align itself with something. I understand the assertion of the importance of nursing theories, but the academic discipline of psychology already exists and nursing should really take no shame in adding more science to its currently word-heavy curriculum. I have encountered and read so much on this forum how the nurses want their profession to be considered truly professional and, thus, be respected accordingly. Unfortunately, being more caring through acquainting more theories is not going to get nurses there. We already have tremendously caring nursing workforce. It's been established. And, I don't think that it would be churning out new theoretical paradigms every decade that will set nursing atop or apart. In my limited thought, it would actually be the rigorous curriculum that does not mimic social sciences but add depths to our existing nursing science curriculum, which reflect what nurses actually do and face on the floor as nurses. Evidence-based means scientifically-based through exercising empiricism. Theories are the mere outcome of these empirical experiments that are subject to scrutiny and to continued revisions based on more empirical data. Lastly, an added bonus to heavier science curriculum would be reduced utterances of this darned "critical thinking" that I hear so much in nursing; as a pre-med/pharm student for two years, never once a professor uttered that phrase because it implicitly comes with the territory. Science does indeed makes you think in a systematic fashion. It continues to prove to be an invaluable training tool for all nurses who pursue and advance their nursing careers. P.S.: I am sorry that this turned out to be a long-winded novelette. However, I really wanted to share my perspective while I am still somewhat of an outsider/public element looking in.

Hi, cantsleep. First of all, I hope that you attended their information session and that you have the admission criteria sheet. I have not calculated my total points because some of the points depend on the administration's discretion (giving points for economic hardship, second language proficiency, etc.). 1. BA in Sociology 2. No healthcare experience, be it paid or volunteer 3. 3.30 Cum. Undergrad GPA 4. 3.75 Nursing Science GPA 5. 87.6 on TEAS IV Good luck, and I hope that you get into the program of your choice. :)