pinkkitty11

Well there's your problem. Every time the dressing is changed, you are exposing the insertion site. I do one of these changes approximately every shift.. At my hospital we change every 7 days and as needed if soiled. I also make sure I have 2 pairs of sterile gloves, one to change the dressing and the other to change the caps. I also change all of the tubing.

@thywillbedone:: If you can at all save up for the hurst review, I would. I was never a strong student in nursing school and hurst review made everything just... Make sense. The hurst is 350, and you get online lectures (or you can attend a live review somewhere) and 6 tests similar to Kaplan. I test in 9 days but am confident! Wishing you the best.

Thank you to all of you who replied to my post! It was really helpful to see that I did have a lot of this all written down.. and then the things I didn't know off hand were just a result of my inexperience. :)

Johnny Knoxville straight caths himself twice a day in order to prevent buildup of scar tissue after he sustained some sort of, ahem, "injury" during Jackass. In peds I once took care of a patient who had a copper deficiency which caused him to have a multitude of problems including a need for straight cathing every 6 hours.

I took a quiz yesterday in which our instructor was just assessing our overall 'critical thinking'. She said she wasn't concerned with us knowing specifically which interventions to use for these patients, just how we would go about it. So I really felt like I knew they were bad situations, but didn't know what I was supposed to do, and was just looking for a little bit of help :) 1) You receive a patient who had a recent bowel resection and is complaining of pain at 8/10 even though just having received pain meds. The patient's systolic pressure rose from 70 to 130. What would you do? 2) You receive a patient who is post surgery, and has a chest tube. 800 mL of dark red discharge have gone into the chamber in the last hour, and the current vitals are 170/100, pulse 130. What do you do? 3) You receive a patient who is 2 hours post stent placement. They complain of a sharp chest pain at 5/10, and current vital signs are 160/84. What would you be doing for this patient? Thank you! My inexperienced intuition was just assess and call the doctor. Lol.

I have worked at the Mayo Clinic in AZ since last May, and I have to agree with all the previous posts. Mayo is just truly different. It is an amazing hospital where the nurses are respected as much as the doctors are, and patient care is different. They truly take care of their patients as though they are family members, and the nurses that work there WANT to work there. I have also spent time at other hospitals here in Phoenix that claim to be bigger or better... but nothing can compare. They have an amazing nursing new grad training program as well, and even in the bottom of the economy they continued to have a new grad program for RNs because they care about education. I don't want to work anywhere else!

I don't want to discourage you, but I am going to be honest! I am graduating from ASU in May with my BSN, and I think that the classes were as hard as A&P, honestly. Things are overwhelming, and you definitely will feel (at times) that you will not be able to push any further. However, I thought it was much more REWARDING than A&P. And I felt less pressure to "get straight A's" like I had to in the prereqs in order to get into the nursing program. Plus while you are in theory and lecture classes, you are also in clinicals, learning things, and making connections with patients, families, and nurses, that will change your life. It is an AMAZING field and I am extremely happy with my choice, regardless of feeling at times like I was going to freak out. Plus, I have met some of my best friends in the world while in nursing school, because you all are going through the same thing. Plus, its 2 years, and you will be making $50K/year (at least) afterwards. Right now, people in my semester are freaking out about the fact that there "aren't any jobs". So I am going to give you a piece of advice: Be optimistic.. Don't let other people get you down, because it is a great career and if you have the work ethic, you will pass. So in the end, the classes are different. It's more adjusting to the program and the schedule than the classes being hard. Believe in yourself!!

Pathophysiology was hard, but it was such a great class. It was definitely one of the best classes I have ever taken during school. I recommend that you take it seriously and really try to do well, because I have pulled out my patho notes several times during the nursing program (I am graduating in May with my BSN), especially with critical care. Good luck!!

When I first started I used report sheets from other people, but found that most of the time it was better to make my own-- something that made sense in my brain! I don't have a formal report sheet, but here is what I do: Get my kardex/patient profile sheet in the morning, and flip it over. I write on the left hand side all the different systems, N, Heart,Resp,GI, GU, Skin. Then on the right hand side I write their name/room number larger in Sharpie, and if they are a DNR I write that on the top and highlight it in purple ( I like colors :) ) then under that, I write "Hx", where I write down why the pt came in, important history points, etc. Then I write down "Rx", and make note of what time (and how many, or a note if it is a complicated medication (TPN or something that will require extra time to set up) I will be giving meds during my shift, as well as PRNs. Seems like the first time you go into a patient's room they want to know what the plan is and when they can get pain medicine. Lol. I also make it a good habit to write down all of the labs that are important, and any that might need to be done, such as Vanco trough, H/H, heparin recheck, etc. The assessment section I talked about earlier, I use to jot down notes after I listen to my patients, before I am able to sit down to chart. We do have computerized charting and mobile laptops you can bring in to the patient's room to chart, but I always feel like I am distracted by the screen, lol. I recommend that especially when you are starting out that you take time to write EVERYTHING down. because worst case scenario you cross it off your list. The Rx/PRN section I use to give report to the oncoming nurse as well, and make sure to tell them about anything I may have given. As for working in the ICU, I would recommend under each heading to have a section written out for things such as: vent settings, drips, ECG monitoring/rate, and check off when you are medicating and suctioning. I hope this helps you get a little more organized! Sorry it is so wordy. Once you spend a little bit of time in the setting it will make more sense what is useful and what doesn't need to be a quick reference.