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lillymom

lillymom

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  1. lillymom

    IM Sites

    It depends on various factors. Here is a link to an article that breaks it all down for you. Large-volume IM injections: 
A review of best practices - ONA
  2. So this may sound crazy but talk to yourself. Seriously, I mean act like you are going to teach someone what you know or find someone to teach. Start by verbalizing what you know then think of some questions that someone may ask you and if you don't know look it up then teach some more. I have always felt the best way to learn is by teaching because it uses verbal, visual, and interactive/cognitive thinking. For example: CHF is the loss of the ability of the heart to pump blood. Why? Various reasons including MI, HTN, bottom line the heart has had to work too hard, S/S well class that depends on the side of the heart that is affected. Right - generalized edema Why? because there is a back up of blood due to the decreased ability of the heart to pump so it accumulates in the body. Left - SHOB, orthopnea, pulmonary edema, and right sided failure too. Why - because the blood is now backing up into the lungs and they are literally drowning. There is just not enough pressure (due to decreased muscle strength) to adequately empty the heart (low BP). Also relate the body to things that you know. Again, with CHF, a failing water system - someone threw a cheeseburger in a well (clogged arteries leading to MI). The cheeseburger went into the pipes and got stuck blocking some water but the pumps know that more water must go through them so they continue to pump harder (HTN) to get more water then the cheeseburger is dislodged or someone removes it (cardiac cath). Well the first pump (right side) is tired after all that and burnt out so it quits. Well eventually the pipes get full and the well is overflowing even though the other pump (left side) is working hard to get all this water circulating because now its doing the work of two pumps! It can't possibly keep up because it wasn't designed to pump that much water. So the water backs up into the well, into the pipe, into the first pump, and into the pipe between the two pumps and now you have a problem. The pump will work but will eventually get tired to from working two jobs and it too will quit. There are quite a few other components involved with CHF but you understand the concept and how it is a chain reaction. Many systems and functions of the human body can be likened to other things that we know and use daily and it makes it much easier for me to learn that way. Just an FYI I taught myself this way through school and I was one of the top students in the class and passed NCLEX on 75 questions in 45 minutes or so. Good Luck!
  3. lillymom

    Kaplan Questions!

    They have said to aim your Q-bank scores around 65%. Any specific content area that you score less than a 55% is a weaker area and needs further studying. On question trainers 1-4 they recommend a score of 65% or higher and Q trainers 5-7 a score of 60% or higher. Some of this information will be in the front of RN Content Review Guide and it also has a study plan depending on how long before you take the NCLEX.
  4. lillymom

    when did you receive your authorization to take test

    The wait is killing me. I have registered with Pearson and my state board, completed my fingerprints, turned in my photo identification, my background check is complete. The only thing I am waiting on is for the Dean to turn my approval into the state board and I finished my classes last week. It is driving me crazy because I have a job offer and I want to start ASAP! Good luck on the exam. PS: I would call Pearson if I were you.
  5. lillymom

    Things you didn't learn in nursing school

    I am still a student but I have over 6 years of experience in various health care fields. I often get answers wrong on tests because I use what I know from real life and not what is written in some random textbook. When I challenge the answer the instructor says but we are wanting the correct NCLEX answers not what you would do in practice!
  6. lillymom

    My first clinical course and I hate it

    You are just beginning so they don't expect you to know much. The reason they ask questions and do the reports are to help you to think critically and be able to understand complex concepts. It is much easier for most people to understand things when they are directly working the issue. I hate clinical. I have since I started and that will not change. I feel the same as you about not doing enough or doing too much. I work as a CNA in LTC so when they give me a pt and all I do is CNA work it irritates me but that is what I always expect clinical will be. I feel like a nuisance to the nurse and the patient. If I were sick in a hospital I would not want a student nurse to come and wake me up at 7:30 for assessment/bath,etc. just to turn around and have the nurse do the same but I still wouldn't refuse or say anything because it is important for them to learn. I wouldn't mind any of this if I was a nurse because it is my job and it is expected of me by the patient as it is pertinent to their care. I don't mind it at my work for the same reasons. I just feel like I don't belong there and I doubt that will ever change. I also like to have a schedule so I don't feel so crazy. I don't know anything about my pt. until my day begins so I usually listen to report with the nurse then I will look up their information in the chart. After I feel like I have all the information I need to properly assess and plan my day I go in and assess, only if the they are finished with breakfast though. I usually do a pretty through assessment just because it is good practice but I don't usually look at their backside until I do their bath. After my assessment I usually just write down the vitals and abnormal findings and then get ready for the med pass. I write down all their meds in my paper and what they are for or any special considerations about the meds so I can be properly educated when I give them. After that I leave them alone for a while to chart or do some paper work. I usually go back in around 10:30 and help them with a bath and such so they are clean and ready for lunch and then I go to lunch. The rest of the day really just depends on the pt. but most of the work is done by this time.
  7. lillymom

    Normal nursing grades..

    AT my school they tell us that the test questions are more complex than the NCLEX questions to make sure that we can pass the NCLEX. They tell us that they aim for the majority of us to score 80-85 on our tests. Sounds pretty crazy to me!
  8. lillymom

    Clinical Preps Rant

    My clinical groups get our information on our patients when we get to the clinical site. The instructors don't even know what patient's we will be getting. I think that would be a horrible idea and it does not relate to what an actual nurse does. Nurses don't go into work the evening before to figure out how to treat their patient the next day! This is just crazy to me. We do have all that paperwork to do but it is done after clinical and due before the next clinical day. It helps a lot because I live in a rural area and there have been times when there are only 3 patients on medsurge but 8 students, and our instructor at that time wouldn't let us go to any other areas. These are great times to complete any paperwork that we have.
  9. lillymom

    Calling all moms

    I am in an ADN program, a mother of a 4 year old, and I also work 30 hours per week. I do not get to spend near enough time with my daughter as I would like but when we do spend time together I focus completely on her and we do pretty much whatever she wants. I usually take at least one day per week and do this with her, assuming that I have a free day that week. My program and work often does not allow me much free time. As far as I can tell it doesn't affect her at all. I have always made sure that she is independent so she is not so reliant on me and I feel this helps with any separation anxiety that she occasionally exhibits. There are days though that I need to study and she absolutely will not let me! I just put away my books and entertain her while resigning myself to study after she is in bed.
  10. I use the same book the previous poster mentioned. I also use the lippincot, ATI, and Davis's Success series Davis's Success Series Text Catalog on the Behance Network (these books are separated by courses). Our tests come from a mixture of all of the sources listed above and our instructors strongly recommend any and all NCLEX study materials and provide students a resource library of all these books. I don't worry about contradicting test questions because if we can prove where we found the information and the rationale it will usually get thrown from the test.
  11. lillymom

    are there nurses who ACTUALLY care ?

    This is why I despise group work. Everyone has a different opinion and what you may consider wonderful work, the others may have thought that it was not that great. It doesn't really matter though because even though you are all in the same group you are all still in school and school is one big competition to be the best. Honestly, work is like that as well regardless of where you work or who you work with. This is what makes the difference here. I am not there to look out for the welfare of my fellow students as I would be with a patient. I am there to succeed and become a nurse. Which makes school all about ME. While I do consider the feelings of my fellow students and I really do like the majority of them I have a realistic concept of people in general especially regarding success. If you don't people will bulldoze you. I care about everyone but in particular I care about my patients because they NEED me to care for them. My fellow nursing students, not so much, as they can care for themselves. I personally wouldn't care since you received a good grade. I just make the work that I do alone as best as I can and that should be enough to show your instructor what you're made of. Good Luck!
  12. lillymom

    Out of Scope of Practice?

    I agree with Nascar nurse. A Hospice nurse came and spoke to our class last month and she said that anyone can call and get an appt. with hospice. She said that they could make a guess if someone would be eligible but they would need an MD order to actually evaluate them and give a definite response. Mostly they just talk about what hospice means and what they can do for the patient and the family. She also said that the hospice nurse can send an order to the MD to sign so a nurse is not needed at all for a consult. The nurses where I work send for a consult (not evaluation) all the time. I think more people in general, and especially nurses, need to be educated about this because it is a great resource, not only the patient, but the family as well. As far as what the nurse said there are some doctors that will not tell the family the truth about the patient's true condition. We had this situation in our simulation lab and our role as nurse was to explain to the family what the MD failed to explain. Basically that the patient was dying and what was likely to happen during this process.
  13. lillymom

    CNA question

    From what I can tell your NC NA I certification will stay active unless the 2 years are up and you haven't recertified. The website is ncnar.org.
  14. lillymom

    How to write up a verbal warning for indirect behavior

    I believe I would just tell her she is practicing out of her scope and not a team player. She is not a nurse and therefore is not allowed to do an assesment or give advise based on her personal assesment. I am a CNA and I have a co-worker who has this type of behavior and it infuriates me because she thinks that anything she does is okay and doesn't act like she has a limit to her scope of practitice, all the while belittling all the other CNA's.
  15. lillymom

    Abolishing the Pinning Ceremony

    I am in an ADN program and this was one of the first things they told us we would be fundraising for. The faculty have very little to do with our pinning ceremony but they do advocate for it. The only one who can pin us is the Dean and they do show slide shows of our time in school and a couple of people speak and recite poems. I think they are much more important than a regular school graduation because nursing students (at least at my small school of 20 students) spend much more time together than any other program. We all have the same classes together so we feel a little more like a family (albeit a dysfunctional one) and a college graduation is so long, boring, and tedious. I would much rather prefer a small intimate ceremony with those I care about.
  16. As a student I have to say that I love your approach to teaching. There have been a lot of changes made this year to my nursing classes as well and not only are the student having difficulty so are the instructors. I have great instructors but I really appreciate your concern for your students. Thank you for giving them all the opportunity to succeed!