microtutor

Yep, they love to tell us all about how they know better, but they don't want to be in the room when the patient code-browns LOL, then we're all professional again!

I did not read all the other comments, but if this happened to me I would leave ASAP - especially if I had another job prospect and it was something that fit my schedule that I really wanted to do. You still have references from your prior workplaces, you don't even have to count this one if you get out fast enough...and they misrepresented what you were getting when you interviewed so they have no reason to think you would stick around and suffer! Don't say 'yes' when you want to say 'no' in general. It is totally normal for people to ask us to work extra shifts, to cover, etc. They will ask and ask and ask - if we can't say yes we shouldn't! I started in acute rehab as a new grad and still work at one per diem. The job is physically demanding, the documentation standards are strict and yeah you do have to work after the end of shift, but not forever unless it was a heck of a day. I like it though - great generalist nursing experience and a very hopeful field helping people gain or regain functionality and independence :) Good luck in your new job, whatever it ends up being!

Congratulations! I have benefited greatly from all your posts, and I wish you joy and awesomeness in your next job, wherever it may be!

I guess I'll give my $.02, since everyone else is. A bunch of RNs I know shared this post on FB. It struck me as an angry rant, which is exactly what the poster called it. Usually, posting angry rants on FB is ill-advised. I am a fairly new nurse, and I agree we don't have enough intensive clinical experience when we hit the floor. I was scared a lot during my first year as a new nurse, and counting on support and mentoring from more experienced colleagues. Thank God it was available! I feel bad for the new nurses out there trying to learn without any mentoring or support. If I were the poster, I would be upset by seeing that situation, and I would be upset by people's "nonchalant" attitude in response to my worry and concern - that would just make me madder, and it seems like that's the response the poster had. However, there's a deep flaw in the poster's logic which others have already pointed out - just because this bad situation happened and it involved a lack of a detailed assessment and a "gloaty" new nurse does not mean that new nurses are the problem! Gloating is a problem, lack of assessment is a BIG problem, and not enough resources in medical care? The biggest problem of all. Those of us who put our licenses on the line day after day to try to care for the sick deserve better than the working conditions most of us have - and our patients deserve better too. It would be nice if patients, families and nurses could be on the same side, since none of us have chosen the current profit-driven healthcare model.

I am a second career nurse; I was a computer programmer for 12 years before returning to school to become an RN. I felt my job making rich people richer was not very meaningful to me. Becoming a nurse made my work days a lot more stressful and a lot more physically demanding. However, making this career change has also made my work life MUCH more meaningful. I love helping patients and families and being part of the healthcare team! Being a second career nurse has definitely helped me in some ways. I've always been a good student, and I know how to behave in a professional manner. Being a programmer, I know how to solve complex problems and I pick up on small details well, also. Nursing is not an easy job. The hours can be flexible, but not always - once you have committed to a shift, it is yours, often enough :) But if you want to make a tremendous difference in people's lives and are prepared to shoulder the risks and responsibilities that go with that? Nursing might just be the job for you! Hugs

I am a new nurse too. I am 6 weeks into my orientation and I have already made 2 med errors - both were missed scheduled doses - so I feel your pain. I was "doing well" so my preceptor & bosses pushed me from 4 patients to 5, then 6. Then, I ended up having 2 days almost completely on my own, due to people not showing up for work, going home sick, etc. People stopped supervising me and weren't around to answer questions or I had to wait to get my questions answered. Sometimes my judgment wasn't good, I realize now - I would just get overwhelmed and "fly by the seat of my pants" trying to get everything done. Now they have put me back to 4 patients and on careful watch because of my errors. I am afraid I'll get fired if I make another one, so I have made a couple of resolutions/changes to try to help me not make another mistake. First, I have a new "brain sheet" I devised with common medication times listed. When I come in in the morning, I circle the times the patient has meds to be given, and I check them off in red when that med pass is completed 100% for that patient. So if patient Joe has meds at 0800, 0900 and 1400, I circle those times next to Joe's name, and after I give him his 0800 meds, a red check. Also, I have to accept that the paper MARs at my facility are very confusing to me. Maybe other people don't find them confusing, or they are so used to them they no longer have any issues reading them...but I find them hard to read. Therefore, I no longer will let another nurse pull meds for me. Sometimes they want to to try to be helpful, but I need to look at the MAR the extra time to be 100% sure I have seen every order all 3 times (3 checks). There are still times when I have to go through the book an extra time or two to find every order. I have to let myself take the time, I realize. I am still new and learning and if my med passes take longer then they take longer. Better to take longer than to miss a medication, give the wrong medication or the wrong dose. I have a list in my clipboard now of "time critical" meds, and every morning when I get to work I pull it out and look at all my MARs to see if any patients have those "time critical" meds and flag those pages with red post it notes - at my facility that would primarily be antibiotics and oral diabetes meds. Then I note it on my brain sheet too. I also note "high alert" medications like insulin, heparin and others. When I have odd dose amounts of narcotics and have to waste, I get someone to witness me up front, so I don't forget to do it later. Sit down and think of ways you can help yourself remember. We can't be perfect, but we want to try to address the problems and give ourselves the best chance of success in a very stressful environment! Prayers and hugs to you...

Nope, this has never happened to me. And I do use a chain pharmacy. However, there are areas - one labelled "Drop Off" and one labelled "Consultation" where you can lean into a sort-of carel, with walls on either side of you. If you speak in a low voice and the Pharmacist/Techs also do, people over in the waiting area can't hear unless they have super-ears (some people just have those). So, it can't be perfectly private, but it isn't as bad as someone broadcasting your health information to the entire room. They could try a little harder to be discrete, especially when there are such stiff fines involved. This happening to you in a small town is actually worse in a way - they don't have to counsel hundreds of people a day - they could probably take the time to explain things to you in private, or at least make an attempt. The next time you get your scripts filled, you should make sure to tell the pharmacist to his face that you know what HIPPA is, and that you think his "demonstrations" might be in violation.

You sound like a really nice person, but maybe not the most assertive? Does your former DON know that you did NOT actually make a med error? Things like that matter, as far as your reputation and future are concerned. Seems like you are in a situation now where you need to move on, rather than try to go back as other posters have said. However, when you land your new position make sure lines of communication are wide open between you and your new preceptor(s). It seems like you failed to receive important feedback on your last job performance until it was too late. Good luck!

Other people covered a lot of them - here are a few I have learned in my last year: 1. Adopt an attitude of gratitude. Things that frustrate you will happen - instructors may make mistakes, yell at you, or give confusing directions or explanations. When you are under a lot of stress, it is easy to see these things as "the last straw" - but try not to. Don't ***** and moan about your instructors - to other instructors, the director, or other students. It is unprofessional and immature. Walk away from this when it starts or try to turn the conversation in a better direction. Instructors are not perfect, but often enough they are instructors for a reason. They have years of experience you lack, and years of teaching experience. Many of them have given their lives to educating generations of nurses. If they get something wrong (maybe) - they deserve our respect and tact when we question and communicate with or about them. 2. Get at least 6 hours of sleep before clinicals. Sometimes you have to stay up very late, or pull allnighters, but the day before patient care isn't the time. 3. If you choose to mainline caffeine, it may stop working for you at some point. Use only what you need when you need it. 4. Be friendly and helpful in the best of spirits, but don't count on making friends. The reality is, you may not. But you will learn how to care for patients, how to stand up for what you believe is right, and what you are made of as a human being. Sometimes you'll have fun, sometimes you'll cry. Every day you will know what you are learning and doing is very important.

FWIW, I have chosen a local school with a hybrid rather than a purely online program. The cost is more than a pure online program but less than the big universities in my area per credit hour. (It is both NLN and CCNE accredited.) My rationale is related a few factors: First, to my experience with online coursework. Its PURE self-teaching and self-motivation. I can do that, but I definitely do better with some face time and real classroom interaction. To me, the extra $$ per credit is worth that. Second, to which schools' programs are considered for post BSN residencies in my area. I want to have a shot at a post-graduate residency. The head of the program said the program doesn't require additional clinical hours, but it is designed so that you can work and go to school at the same time - so I assume I will have a better experience if I find some sort of job to continue gaining clinical experience while participating in the RN to BSN. Good luck to us both, right? :)

Thank you, that helps a LOT. Do you copy the MAR page with a photocopier, or just copy it onto a sheet of paper and have someone verify you got everything? I've never seen Ident-i-hide, but I'll look for it. Perhaps one could simply leave a pen in the patient's room (as long as they were safe to have a pen).

Hi, I'm a student and I had a question for all you professionals... I'm having a hard time figuring out what to do about the third check of Med Administration when the patient is on precautions greater than standard. Should you bring an MAR into the room of a patient on precautions? I would think you would not...but then, how do you do the third check? Any advice is much appreciated!! Thank you!! :thankya:

Ok, I know we're supposed to gown, mask and glove using appropriate equiptment like the N95 for airborne precautions...AND I know we're supposed to do the three checks of medication administration - including the third and final check at the patient's bedside. So, can someone explain to me what to do if the patient is on precautions and I need to give them medication? I shouldn't bring the MAR into the room of a patient on precautions > standard, should I? How do I perform the third check under these circumstances? Please help! Many thanks :thankya:

Thanks, ladies. I'll look into the health department, just in case my call to the claims office comes back "no way".

Hi, I'm getting my pre-Nursing school physical soon, and I have health insurance. However, last year, when I had my physical, my doctor drew some titers and gave me a tetorifice (sp?) booster - and the insurance company denied all of it. I ended up having to pay out of pocket for the vax and the labs, and it wasn't cheap!! Has this happened to anyone else? Should I be worried that it will happen again? If so, what options do I have for getting titers and vaccinations either a) covered by my insurance, or b) cheaper? Many thanks!

I did great in Micro and now I tutor it. I think the key to doing well in the class, for me, was doing well on the unknowns project. I read the labs thoroughly and tried to memorize the media and tests, what types of cells they identify, why you perform them, etc. I think another key thing is to master the techniques - it is like a cooking class, and if you really learn to cook (master gram stains, really put in the time to do all the identification tests necessary to identify your unknowns) you will do great. Luckily, my professor allowed us to work in the lab during other people's classes and on the weekends. If your school allows that, you might want to take advantage of it. Other things to focus on: you need to know organic functional groups and their basic properties (shouldn't be too bad if you already made it through Chem - just review 'em), enzyme actions and inhibitors, glucose catabolic pathways, krebs & electron transport chain, protein metabolism, calvin-benson cycle, genetic transcription, genetic expression and mutation, DNA repair, protein synthesis, infection controls, colony morphology, slant and broth growth patterns Have fun! It really is a fun class :-)

Hopefully, I'll make it through school and graduate in 2013. I'll be 42 years old. I did other things earlier in life; now is when the fun begins!

Maybe this will make you feel better - I came back to school trying to get into a program in Nursing after not being in school for 10+ years. My prior grades were actually good...but I STILL did not get in the first time I applied. It was a disappointment, to be sure. And actually, I had been taking classes for 3/4ths of a year too. But, I just kept at it, took more pre-reqs, applied myself to getting great marks in those, and this year I got accepted. If you want something, NEVER give up. You can do it!!

We did cats in A&P I and II, and we did the sheep brain and eye in A&P I. I personally really did not like the smell, but its nothing you can't get through. The person who got to do cadavers was *lucky*!!! I wish I could have done that. It would be so helpful in terms of learning to actually see the inside of a human body, as opposed to an animal.

If you have "Human Anatomy and Physiology" by Marieb, there's a good summary of this on pp. 400-401 (8th Ed.) If you have another edition it is called "Focus - Action Potential". The graph shows that while the action potential is occuring, either depolarization (Na+ flowing into the cell) is occuring, or repolarization (K+ flowing out of the cell) is occuring. As K+ continues to leave the cell, hyperpolarization occurs. The "resting state" - shown before the action potential and after hyperpolarization shows no ions moving through voltage-gated channels. I hope that helps you

I think you could take anything except A&P II or Micro. Even A&P I you could do if you were very motivated.

This thread is interesting to me, because I got very high marks in my pre-reqs. I have been accepted now, but don't start lab/clinical until Fall 2011. In the process of completing my pre-reqs, I have learned a lot of the same things you guys have, fwiw. First, if I am in a study group, I participate at the same level as everyone else. I stay out of the teacher/advice-giver role, even if someone tries to put me in it. I don't like giving advice ever, anyway, and no one likes a know-it-all, even when they are studying for an exam. I have found that if you are a good student, certain people will want to label you a know-it-all, no matter what you do. So I attend some study groups, and they're not completely unhelpful - but its just a supplement to the studying I do on my own. Second, I signed up to tutor the subjects that I am qualified to tutor. One on one. For pay. That keeps the teaching to the tutoring sessions. Yes, it does help me remember things - it also keeps the teaching to a business relationship. I am not allowed to give anyone advice about anything - its in the tutoring code of conduct. Also, I expect nothing from the student but a minimal level of politeness. After all, I am getting paid. And if the student doesn't think my tutoring is helpful? They can just switch to another tutor, no harm no foul.

That's a very cool story, thank you for sharing it!! OMG.."the shorter the better"?? LOL Too funny!!! I'm glad we can wear pants today. I guess we have the male nurses to thank for that, from what you've related. Thanks, guys!

Sounds horrible!! I am soon to start my program, and I have NO IDEA what I would have done in your shoes. Can some more experienced nurses or students explain what to do in this situation??? I feel anxious just reading about it!! Many thanks!

Can you use epocrates on the iPad as well?