tinkrbll_bel

Here, (in Colorado at least), an RN can pronounce death, so I have a hard time reading some of the comments that discuss how "the doctors do it," as an RN you have to remember that you are a participant in the process. I've been fortunate to never be placed in this situation (with reactions of anger towards staff), so I thank the OP for the topic because sometimes I need to be reminded of all the different sides when this happens. I just wanted to remind everyone that by being an RN, you have a place by your profession to discuss death with patients and their families (whether the pt has already died or is about to). "How you say it" also includes saying it in the first place: often times we just side step or don't say these things because we are afraid we are going to be opening a can of worms (in this "get in and get out" world); but actually bringing it up (out into the open) is often therapeutic and patient's families are (not always but often) appreciative of the nurse using their knowledge about the dying process (since we do see it a little more that the public, let alone how it is often different than what people see on tv) and sharing. Death is often so abrupt in patient's families' eyes (even when it's been anticipated for some time) that any info helps them to feel like they have a grasp (or more of a grasp) on their situation. While the family might not be vocal or in the mood for communicating with each other about "the death," any attention the nurse can give is remembered by that family and even the little discussions about death can actually facilitate the family discussing amongst themselves or with the pt (if they are still alive). In my opinion, you are better off discussing death than not discussing it and the family feels like they got the cold shoulder.

It is not going to "hurt" you to have this many within a period of 9 months (the dose put under your skin is not going to give you the TB and since you are negative each time, this just means that your body does not "react" to the dose). BTW, your previous tests should be enough to only do a 1 dose test, if you give proof of your previous negatives. Go here, for more in depth info:http://www.health.state.ri.us/disease/communicable/tb/faq.pdf

I think the hospital 80 mins away sounds like it's out: after you've pulled a 12 hour shift of clinicals the last thing you need to be doing is commuting. Also, it helps to be near your school, just incase you need to run in to check on something, hand in some stuff or get into some office hours with a professor. There are 2 ways to look at the rural vs urban school thing: you could go to a rural school/hospital that will teach you how things will be done if you decide to work in a rural area, but you may be stretched to have patients on some days, possibly even for getting a variety of patients; if you go to an urban school, you may see a lot more "up to date" cases (newer technology used, newer science based processes) and have the chance to see a variety of things. To put this into a scenario: if you are at a rural hospital and have a pt with chest pain, having an MI (heart attack) then you will likely see TPA (it's a clot busting drug) and probably be shipped to an urban/bigger hospital; if you are in an urban setting, and the same patient would go to the "cath lab" (which is angioplasty) done quickly. Both of these instances would be neat to get to experience as a student nurse but you are going to get two very different experiences. Have you looked into speaking with current nursing students at either of the schools to find out what they think and if they feel they are lacking by going to their school versus the other? If you ask the nursing advisor (or the department head, even a department secretary, or get in touch with a nursing student association/club) at the schools, I am sure they can get you in touch with students who can answer your questions via email or might be willing to meet up with you. I think you definitely need to give this a go: there is a lot that you can find out, and I know that this whole nursing school thing looks really big and scary right now but you can gain a lot of insight from getting in touch with a student or two (plus, you may have some one who will be there when you start school who you can borrow/buy their old books and they can help you feel comfortable/reassure you when you start school and are feelng overwhelmed). Lastly, you also want to look into how long the waitlist at each of the schools can be: this might make your decision a little easier to make. Either way, I don't think you can go too wrong with either of the places: you can be miserable through school and unhappy and still do ok if you are willing to keep positive and concentrate on what you need to do to get the job done at the end of the day (which is, pass your boards). After you pass your boards, no one cares where it came from as long as you can get a good recommendation from someone and you have some work history (which I am assuming is the case since you have a previous degree). Best of luck to you! -Bri

I always forget what list of meds I went to the pyxis for (I usually remember the letter their last name starts with so I am good on remembering their name, but I get to the pyxis and go "I know I need lisinopril, no wait, it's the lovastatin, oh and there was another 5 I needed too" and then I have to go back to my PC to get the list and not forget it before I go back to the pyxis. Oh, and our pyxis doesn't list the administration times on the meds so this isn't there to help either. Aye yai yai! Oh, and I tend to forget my flush whenever I give an IV med (we aren't allowed to carry flushes on us or put them in the pt. room or whatever...they have to stay in the supply room until we need one, which is no where close to where the pyxis is or the IV cart), so I go carrying my morphine in its syringe, that I drew up out of the cartridge and then put into a flush to dilute, and then grabbed my heparin to administer in another syringe, and then their solumedrol in another syringe, so I have 5 different things already in my hand, and I forgot to grab my flush. Now I have to truck it all back out of the pt's room to go get one. Ahh! It's always the little things!!! And why can't I ever grab enough alcohol pads and put em in my pocket in the am? I grab 4 and I need 20, I grab 20 and I only need 2...there is no happy medium! Sometimes I imagine having a nurse's toolbelt that had everything I need in one place (just in case!) but then I am sure I'd still find I was missing things anyways, or I'd be so mad that I couldn't bend over to wipe up something because of the infirmary I was carrying around with me. You just can't win I swear!

Fleur, and really anyone else who feels a duality between considering to continue with a BSN program vs. an ADN program. First, I want to let you know that mulitcollinarity and anne74 have had some great advice, and much of what they have already said is what I wold say. Second, I am relieved to read your Oct 13th posting talking about speaking with your fellow students! Isn't it amazing the peace of mind these serendipitous findings can bring? I graduated in Aug 06 with my accelerated BSN. Now, I want to first say that every concern you have voiced in your postings is identical to how I was feeling almost EVERYday of nursing school, especially when I think back to a year ago. I even went to the CCs in the Denver area (there are like 6 that have ADN programs) and every single one of them were reluctant to take someone who left a BSN program, no matter how much I could give examples for why I wanted to leave (again, the same as what you said were your concerns, plus the BSN school I went to had some major organizational problems so I felt like I wasn't receiving the education I could have gotten at a CC where the atmosphere is more hands-on and intimate...if anything, this is a major plus to the ADN nurses out there). To address the organizational problems...in no other programs will you be able to manifest your destiny than in nursing programs because it is reliant on your own self will/determination through self-learning, so don't worry about the equivalent of learning in an ADN program vs. a BSN program: everyone is still subject to their own abilities to learn in the clinical setting and how much they will put themselves out there. Also, like you, I didn't realize my counterparts were having the same concerns at the same time...and you know what, we are the ones that got ourselves through nursing school: not the teachers or instructors, etc. If you started an ADN program you'd see that they are in the exact same position with a LOT of stress and a LOT to learn, and MAJOR feelings of inadequacy that saturates your entire life. But truth is, if you started the ADN program you'd already be light years ahead of your fellow students, since you've already done a bit of the transition into nursing school that they haven't yet experienced (and most likely you'll find yourself bored and feeling awkward at that). On the flip side, if you stay with your current program, you guys already have a bond and are already supporting each other: I know this because I was in an accelerated BSN program and looking back on it, I realize now how lucky we were to be in the same boat. It's not because there are "certain" people in your program or anything, it's because you guys are experiencing this together, and in some weird way, the stress you are experiencing together and the changes you are experiencing as a result, make you bond. That is priceless. In the first few semesters we were all uncomfortable with each other, and did anything to prevent making mistakes in front of each other. In the latter half of school we felt more like brothers and sisters (heck, you spend so much time together!) and we really found we fueled each others' learning (humor, serenity, sanity, comfort, etc). Now, the $$ thing: just as some have said: you can't equate the 20K to what CC ADN program would cost. You are comparing apples and oranges in that sense. To compare apples to apples, you'd have to factor in the cost of more semesters + the cost to get you to a BSN after your ADN. No matter what the ADNs tell you, it IS a different degree (and I am not trying to spark a superiority dispute about ADNs vs. BSNs either: you just have to admit that they are different because they are...anyone who had an ADN and then went to get a BSN will probably second that they are different: you can't listen to an ADN who says that there is no difference when they've never lived what you've lived). I've spoken with MANY RNs who first had ADNs and went back for the BSN completion: every one of them said it was much harder to do this and that there are monumental differences. Plus, on the $ front: how much money would you be not earning waiting to start your ADN/taking the extra time to get your ADN, that you could be earning in the months that you finish your BSN earlier? I am sure that 20k would be at least equivalent to what you'd be losing. And you are right, the theory classes and management classes seem kind of frivolous, but the second you stepped into an ADN program you'd find yourself asking "yeah, but if this happens..." or "why wouldn't you look into that?" Besides, you'll find yourself using some of that stuff by the time you are through...believe me, it will just sneak up on you! So, I had said I was in your position just a year ago, and now I am done. Hands down I am happy that I stuck with it 20,000 times over! It didn't kill me. And it didn't kill my relationship with my husband or my family, it didn't ruin my life, and it didn't ruin my career: it made every single one of them better (much to my surprise)! Besides, I kept figuring that even though I was thinking "what if" about not going to the ADN program, if I dropped out to be in the ADN program, I'd still be thinking "what if" about the BSN program. Ask any experienced nurse if they learned more in nursing school or on the job and 99.99% of the time they will tell you it was after they had their license that made for the most learning. Oh, and I think it was Anne74 who said that the nursing school stress peaks in the middle: this is absolutely true! It got easier after that 3rd semester (I was in a 5 semester program) and while Med/Surg 2 seems scary after Med/Surg 1, it IS...but it pays you back because this is really the time you start to realize that you DO know what you are doing AND you REALLY HAVE learned something since you began! Plus, you begin to get see that you have more questions about why things are the way they are in Med/Surg 2 and that you end up getting them answered by the content you are learning Oh, and you mentioned that the CC at least knows you. I bet by the time this semester is over, you will feel just as comfortable in your program as the CC...again, back to that bond thing. You'd be surprised how much that dept. of nursing at your school notices about you. Sometimes talking to them, just as you did with your school mates, will bring great clarity, and maybe you can learn something from their hindsight. Fleur, the best wishes. I promise you will not look back and regret that you stuck with it in the end! You will be a better person for it, and it will really teach you that the potential you have is far greater than you could have ever imagined! -Bri

your type is [color=#d000a0]infp [color=#d000a0]introverted [color=#d000a0]intuitive [color=#d000a0]feeling [color=#d000a0]perceiving with reading the analysis it is dead-on!

Apparently, you have been fortunate enough to not know what hiring for a new grad is like in Denver. I graduated in Aug. from a school in Southern Colorado. Graduated with honors, held positions in many organizations, was a nurse intern. Still have no job. Everyday I get up and I sit for hours on the phone, online, etc. trying to get my foot in the door. The whole new grad RN thing in Denver is, to just put it short, ridiculous. Right now, I am seriously having to consider moving to another area to get an entry level job, let alone be in a specialty area, and I'll be working nights. So, I just read your blog, and while some of your concerns are valid, I do think you are being a bit choosey and are taking for granted the job you already have. Especially for being in the ICU already...the new grad positions (and you will still be considered "new grad" even with your 8 wks experience) are really just the ones at hospitals no one else wants (psych, rehab, etc. and they are all night positions, but 70 people want them, because they are in the same boat as I am)...and they aren't hiring at this time of year anyways. BTW, Children's isn't hiring new grads, and I assure you that the NICU won't hire you, even if you did spend time there while a student: being a new grad is a whole different thing. Trust me, don't do anything drastic. I'd kill to be in your shoes right now. If you decide to leave, why don't you give me a heads up because I would take the job your leaving. I hate that I sound hasty and really negative, but I really want to impress into you that the situation could be a lot worse and that there are people out here in unemployment land who are having a rougher time than you (and your being paid too). It might be beneficial to just accentuating the positive inorder to get through this first little bit. So what that you have a new preceptor every day...this way you are getting to experience and examine different ways to go things (you could get stuck with someone you aren't compatible with and spend months loathing that person and the exerience) and I think it is reasonable to request an 18mos. contract or pay for the course, otherwise they are paying for you to attend a class and you leave anyway (expensive). Besides, what is 18 mos.? Nothing, and if you stick around long enough, maybe you'll see you end up liking it afterall. Save up the money in the meantime, and if you break your contract, all you'll have to do is pay back for the course, yet you got more than 8 wks. experience out of it. And some time to look for positions elsewhere. Again, sorry for the pessimism and negativity but, like I said, I am trying to give you the flip side.