nicubee

Your replies have really helped me, and I'm sure others will benefit too. I am also a pediatric OT and HouTx, you're right. When I work with an infant or toddler using balls and toys, I know that it just looks like I'm playing with them when really every action is carefully aimed at facilitating specific muscle activation or sensorimotor response. I failed to realize the same thing occurs with nursing. Cuddleswithpuddles and Snowyowl, You helped me focus in my fog of little sleep and test stress. You have reminded me that there were many classes in OT school where I felt we were losing the big picture by getting too far down into the nitty-gritty. Now I'm glad for those classes and that knowledge-- even if I don't use it in every pt encounter. Thanks! I will press on!! :)

OK so I'm halfway through the semester and liking the procedures lots more than the theory: nursing process, care plans and science-based content (like fluid/electrolyte balance and pharmaconutrition). I get the impression that we are expected to learn everything at level much deeper than we will ever use in practice. Honestly, I have never had a physician perform a physical assessment at the detail of my physical assessment final check off. I would love feedback from any practicing nurses on the comparison of book learning to actual practice.

Thanks for your replies! I'll let her know that it may not be an option to work L&D until she finishes her RN.

This is such a relevant topic for me! I am a 1st semester BSN student but am also a practicing occupational therapist x 13 yrs. I provide family education for the infants I serve on a daily basis, do inservice training for our nurses on infant feeding and neuromotor development. I even train the med students and residents in neurological examinations during their NICU rotations. All that comes like second nature. But get to class and I can hardly answer a question or make a 2 minute presentation without choking from trying to coordinate my breathing with talking! I feel like a trembling mess! Go figure! I have been trying controlled breathing exercises to help, but really feel that it is a case of not feeling competent with the material I am discussing. Being a health care provider does not seem to make this any easier for me. I'm hoping someone will have some good suggestions...

I got 100% on my presentation on this topic! Actually, writing about it in this thread helped me organize my thoughts, so thanks for asking about it! :)

I can help with this topic-- I am an OT and a BSN student. Muscle tone refers to the amount of resistance to stretch muscles have while at rest. Most of us, whether we're fitness trainers or couch potatoes have "normal" muscle tone, meaning our muscles are in a state of slight contraction and ready for immediate activation while they are at rest. People with normal muscle tone are also capable of sustaining a prolonged contraction, then relaxing easily (picture carrying a 10 lb box, then setting it down). Muscle tone is not the same as muscle strength. The amount of muscle tone a person exhibits is regulated in their cerebellum. There are lots of disorders and diseases that have an impact on the cerebellar function, and thus on muscle tone, causing hypertonia or hypotonia. Hypertonia and hypotonia are abnormal. Because abnormal muscle tone affects the way a muscle responds to stretch outside of the person's conscious control, it is not possible to accurately do muscle strength testing on individuals with abnormal muscle tone. Hypertonic muscles are hyper-reactive to stimulation, causing over-reactive contractions. They also sustain contractions longer than needed and have difficulty returning to relaxed resting levels because they tend to re-fire easily. Hypertonic muscle tone is associated with spasticity. In more severe cases, a person can be rigid, but this is still hypertonia. As a side note, hypertonic individuals usually have a high metabolism because of their state of constant muscle activation. Hypertonic children often have poor weight gain and slow growth. Hypotonia is the opposite of hypertonia. Hypotonic muscles are more relaxed at rest than "normal". They are also slower to contract with stimulation and do not have the same ability to contract fully or sustain a contraction. Hypotonic individuals often appear "lazy", but really they work harder to achieve and sustain muscle contractions. Hypotonic muscles appear floppy at rest, and at their more severe level, can be flaccid. Hypotonic individuals usually have slow motility and may gain weight easily due to their slower metabolism. Hypotonic individuals are at risk for joint injury due to lax ligaments and hypermobile joints. Hypertonic individuals are at risk for joint deformity/contracture due to lack of joint mobility. Basically, muscle tone presents along a spectrum from flaccid to rigid, with "normal" being in the middle. You should also know that a person's tone is what it is. People are not hypertonic one day and hypotonic the next. Working out in a gym will not improve your muscle tone, since it does not change the cerebellum's regulation of muscle contraction at rest. Working out simply reduces the fat to muscle ratio to make your muscle appear more defined. Not the same thing, but often confused by smart people (even exercise experts and nursing text book authors ). Nursing assessment of muscle tone involves inspection and palpation, using test items for musculoskeletal and neurological assessment. Go back and review your textbook and it will start to make sense, with your new understanding of tone. The funny thing is, I am giving a presentation on this topic to my class in a few days. I think it's an important topic for nurses and I don't understand why it's not taught in school. Here's another side note on ROM (for marcma03, because of your reference to "active.") Active range of motion (AROM) refers to a person actively moving his joints through all their planes of movement without assistance. Passive range of motion (PROM) is when the caregiver performs these movements for the patient who is unable. Active assist range of motion (AAROM) is when (I bet you can guess :)) the caregiver helps the patient move through full range, when the patient is unable to do the complete movement pattern independently. When a patient has only one side affected (CVA), they can use their unaffected side to provide their own active assist. Hope this has cleared up some confusion. I wish there was a way to add this to the nursing topics covered in school!

My daughter is in her mid-20s and is getting ready to move home so she can go back to school for nursing. She was originally going to do an ADN program, but wants to finish quickly so she can return to the metro Atlanta area (we are near Macon). So she is looking at an LPN now, with plans to bridge afterward to an RN. Her ultimate goal is to be a CNM. My question is, with the terrible job market, will there be LPN jobs available in the Atlanta area (especially in labor/delivery/perinatal) and will she be able to support herself on the pay while she does a bridge program?

I'm jumping the gun because I am a BSN student, but I am trying to understand what an MSN-neonatal CNS is and if there are specific positions in NICUs for nurses with this degree. If so, what would be the general role and pay difference for the CNS versus the BSN? I already work in a level III as an OT and have a pretty clear understanding of the NNP role, but my real interest is ongoing direct patient care and family education, not diagnosis/treatment. I'll appreciate any information you can share-- thanks in advance.

I, too, am an older BSN student with 2 previous degrees. The last degree I completed was in an allied health profession. I currently work in an acute unit alongside nurses, earning a much higher salary. I won't begin my first nursing course until June, but working with these nurses has introduced me to the kind of social structure I will encounter in school. In my unit there are definite social cliques: the 30 year veterans who have never been on another unit, the new-comers, the social butterflies, the "popular" group... Sometimes it reminds me of high school! In my current field, practitioners tend to be both respectful and supportive of one another and universally very professional. I have worked in this discipline in multiple settings for 13 years and know that it will be somewhat difficult to adjust to the immaturity of certain colleagues within nursing. In fact, this has been one of my concerns in choosing to expand my skills into nursing. But also in my unit there are several nurses who are simply respectful and professional and do not easily fit into any stereotypical social group. These nurses are highly knowledgeable, provide great care to their patients, and interact well with their teammates. I realize that they are the inspiration for me continuing my education, and I plan on following their example, both in class and once I am a nurse. I think the trick is keeping sight of why you selected nursing as your next step in life and remaining true to your personal goals. Avoid getting caught up in any drama, while maintaining that level of professionalism you have already mastered. You will be an example to the students who have yet to reach your level of maturity, and you will stand out as a role-model in the eyes of your instructors. It's not about being given the respect you have earned through your previous accomplishments. It's about using these achievements to stand out as a true professional and model the respect you seek to receive. :)

Sharye, I must have missed your post-- I'm sorry! It seems that so many people have been rejected!! It is so sad that they do not interview and get to know all the candidates on a personal level. Everyone on this post is so articulate and enthusiastic-- just what they need in the profession. Make sure to re-apply!!

I'm sorry dkwmom. You have a great attitude and that will take you as far in your profession and your life as you choose to go! :) Check with the office-- I don't know if they offer the programs in the same location for spring (In the past, they have switched campuses to Warner Robbins, if I remember correctly). Some of you applying may think that's even more convenient.

I'm so sorry Lvance7. What an incredibly difficult process this is. But be proud of all that you've accomplished so far. You have met all the requirements for admission and are ready for your opportunity. You are doing the right thing to see your advisor-- if there is no way for you to improve, it is still a way for them to see and get to know you. Keep positive-- it will happen! :redpinkhe

Congratulations hc123!!! To everyone else camping out at their mailboxes, may ALL the forces be with you!! :)

It doesn't surprise me that ASN letters have not gotten to you yet. I bet they avoid confusion and errors by waiting until after the seat reservation deadline for BSN, so they are not receiving reservations back for BSN and ASN at the same time. Since the BSN deadline was 4/13, I'm guessing that the ASN letters will be in the mail anytime now. :)

Hi OT! Have you seen the area on this site dedicated to school nursing? Click on the "specialty" tag at the top of the page and go down to "nursing specialties." It's there among the options, listed alphabetically. :) I'm thinking you might have some good responses to your questions in that area.