nadjjaa

God word back from the doc, the dosage is as it is on the bottle, but they are telling me to give one pill if that is all she will take. They're telling me I'm not violating anything, that the patient has the right to refuse all or part of her dose. Apparently I'm violating more rules if I withhold the medication. I would like to have this "right" in writing....

I would say that was true if I was only offerring her a half of a dose, but I'm offering her the FULL dose and she is REFUSING part of it. So it is not practicing medicine without a license, lol

I work in a Juvenile Detention Center. One of my kids takes Trileptal 300mg...her bottle says she takes 2 at night, but she says that she takes 1 pill. She does not refuse her medications, just refuses to take 2 pills. I have told her that it is her right to refuse her medications, and if she believes she only takes one pill at night, to refuse the other pill. Meanwhile I have been trying to get ahold of the kid's doctor to clarify the order. The evening LPN won't give her a partial dose. She called the Pharmacy last night and they told her that it was 'Prescription Fraud' to administer partial dosages, that the medication had to be administered exactly as prescribed or not at all. I haven't been able to clarify this particular patient right. Anyone know?? nadjjaa, RN

I work in a Kansas City suburb at a county Juvenile Detention Center and make $22.50 an hour. I got my RN license 4 months ago. My job requires a lot of autonomy (I am the only medical personnel on staff during the day) and very good assessment skills. This isn't so much to diagnose people with stuff that is wrong with them, but to figure out if they're faking. Heart attacks, asthma attacks, seizures....they love to fake these things to get trips to the hospital. And then there are kids who really are having seizures, etc and need to be cared for. I think that someone new to nursing CAN work in this field. I do. I have a lot of questions but my boss is a phone call away, and I have two doctors I can call. I also have the internet and a huge medical library. It took me about 3 months to learn what I need to know. I would suggest starting out in a juvenile or adult detention center, community corrections center, or jail. DO NOT start your career working in a prison. You want to have experience dealing with the people and such before begin caring for hardened criminals... I was a corrections officer once upon a time, which gave me a slight advantage. Sounds like I make a lot less than the rest of you folks, but around here, my pay is comparable to the hospital and slightly better than most nursing homes. However, I work 8 hour shifts (or 12s when I want to) and have weekends and evenings off. I get off at 1430! I don't have to lift anyone, and I don't have to put up with demanding, rude, abusive, crabby patients. I give medical care to people but I don't have to pretend that I am their friend. I am here to make you well and keep you healthy, and that is IT! I love it so far. Next I think I will move in to Forensic nursing. Hope this helps.

Sounds like you guys have a different - and better - experience with ATI than we do in our school. We are in our last semester of RN, actually, in our last week of school and have to take 3 ATI tests. We have done this all thorughout the program and had to get a 60% to pass, which wasn't too hard if you studied. This year, with no warning, our school decides to bump the minimum passing score to 70%. We fail it once, we retake it. We fail it twice - WE ARE OUT OF THE PROGRAM AND HAVE TO RETAKE NURSING 7. Yeah, you heard me....we fail nursing school, just DAYS before graduation. I have wondered if this was standard practice for nursing schools, or abuse of the program, now i know it is abuse and am wondering if there is anything I can do about it. All of us acheived close to a 70 - 64,65,68.....and all of us are passing the class and clinicals, however, we can still fail because of these ASSESSMENT tests. I already failed the pharm test and retake it today. I got a 65, which before they decided to change things, would have been passing. (last year they had several people not pass boards, so they are trying to prevent people from graduating and taking boards this year, because it looks bad for the school if people don't pass). Anyway, thought I would rant about my experience. nadj

I am thinking about working in a family practice or some specialty office like the ones mentioned above. But....please don't think I'm judging here, I'm merely asking the question....does working in this type of enviornment have an effect on clinical skills? It seems like you just wouldn't use them as much in this type of setting. And if I tried to go back to the hospital after working in an office, would they hire me? Or am I totally wrong? Do nurses get plenty of practice in the office setting? I also thought about going back for a master's degree in nursing, like a NP...so would the family practice setting (if thats where I wanted to end up) be a good place to learn or a bad place (because the hospital is where you get the most experience?) This should probably be on the career advice forum but since it's related to decisions I'm making in my first year..... Thanks!!!

I know of things you as alternatives, such as research and such, but none of them seem to entry level - all seem to require -3-5 years of med/surg or something like that. Anyone know of any types of jobs that nurses can do that you don't to do wait for? I just applied to work for Bosley (surgical hair replacement)...who knows if they will call me back but it looks very interesting! The ad said no experience needed! nadj

LOL....I'm on summer break at the moment, we start back up in the middle of August, in which I will probably work one shift a week, as opposed to three. No, I could not have made it as far as I have in nsg school if I had been working full time!! So you say that you think that nursing homes are actually busier places than hospitals? See, I was very bummed out because I thougth I had it easy at the nursing home - we have CNAs to help and I think nurses do total care in most of our hospitals - and that my next job (probably in a hospital) was only going to be harder. But then again, maybe more fulfilling, too. I don't know...I'm just going to try and stick it out and wait for the disenchantment to pass, and hopefully I will find my way. As is right now, I'm having anxiety and depressed moods on my days off thinking about work. And of course, when I'm there, I'm just looking at the clock. But the summer can't last forever... Thanks for the replies everybody! Dawn

I have been working as an LPN for about 5 weeks now. I am still in school, and will graduate with my RN in december. The place Im working at is a Rehab Hospital/Nursing Home...it wasn't my first choice for a job, but it pays the most and it is the most flexible, so I thought I'd work there until I got my RN and then look for something else. In school, I remember thinking that when I got out there and actually started working, I thought I would fall instantly in love with my new career. I make more money than I ever have and yes, I'm more proud of what I do now than any job I've had in the past, but I'm feeling a bit underwhelmed by it.... I can hear all the seasoned nurses out there smiling... :trout: It's just 12 hours of hard work. All of my patients are...well...OLD and sort of mentally checked out. Either that, or they're whiny, needy....I feel like all I do is give them pills, pills, pills!!! I don't feel like I'm doing anything good or getting anyting good in return. I wanted to be a nurse so I could FIX people. I sort of dread going to work. I feel depressed because I feel the way about my job that I've felt about every other job...I'm glad when the day's over. If given the choice, I would be somewhere else....etc, etc. I expected that I would walk into my first nursing job and fall in love with it. But so far, it's just a job. OK, I'm not dumb...I realize that I've given it 5 whole weeks. It could be the setting....I don't like nursing homes. I always imagined I wanted to work in surgery or ER or L/D or something, but this job has made me question whether I want to do bedside nursing at all. Is this normal? Am I a bad nurse? A lazy person? Will it pass? I know it will always be hard work but will there be some kind of payoff? Will I ever feel like I'm doing something good for myself and other people....or just pushing pills all day long? nadj

Hey guys, I am a new nurse...I've only been working a month as an LPN in a rehab hospital. I can't say I love it or hate it, but I know I don't want to say there forever. I will have my RN in december, but I am wondering if I really want to go the traditional med/surg route with my nursing career. Trouble is, they didn't really emphasize the other careers available to people with nursing licenses and nursing knowlege in school... As far as jobs/positions...what is out there as an alternative to bedside nursing? I apologize if this has been asked before!! :monkeydance: nadj

Hi. I started using Drysol a few years ago, mostly because antiperspirants seemed to actually make me sweat more. I sweat too, I don't think it's as bad as you, however, but Drysol could definitely help. I'm pretty sure that you can apply drysol anywhere. It is a bit irritating to the skin, but heck, if it means I don't have to sweat and later start smelling bad, it's worth it. Just ask the doctor, I'm sure he could give you a Rx. Anyway, putting another layer between you and your scrubs might also be a good idea (though it might make you hotter....). I dunno, is there any hormonal reasons for this excessive sweatiness?? I'm afraid I dunno much about it. Thanks, nadj

Hey uh, I don't know where you live exactly or how far you're willing to drive, but Neosho County Community College in Ottawa, KS has an excellent program, and we love our guy students!!! If I'm not mistaken, NCCC has the highest NCLEX pass rate in the state and great clinical sites in the KC area (I'm at Olathe Med right now...love it!)

I just finished my first semester of nursing school, and it has been a wonderful experience. Just since January I've made a bunch of new friends - we've gone out together and had BBQs. I'm closer to those in my clinical group, but the great thing about my class is that everyone is supportive of everyone, we're not competeing with each other and so in times of trouble, there's always someone to talk to. I feared failure from the moment I got my acceptance letter, but I found that the people we've lost so far, most of them made the decision to leave - they didn't fail grade-wise. Either they weren't motivated enough (one girl used to sleep in lecture, we weren't surprised to see her go), the rest had gone into nursing school thinking they could work 40 hours a week (I'm not saying it can't be done, but it's got to be awfully hard) and still maintain that 76% required to pass. In the past, our instructors said, students dropped out because they decided to get married or have children or some other very life-changing event prevented them from focusing on school. My point is, for the next two years (if that's your program), your #1 priority has to be to school. Forget the cleaning and cooking (order pizza or Goodcents) and study. In my program, the best thing we did for ourselves was do as well as possible in the beginning to build up your grade so that if something happens and you need to slack off a bit down the road - you have a "cushion". Eventually, my grade got the point where I couldn't do much to change it, but that was okay, because I was sitting at an 89%. For those that didn't do as well in the beginning, they were struggling all through the semester just to stay above passing. So study, study, study, especially in the beginning. Do your reading, as much of it as possible. Take notes in class, even if the teacher gives you powerpoint slides - writing it down helps committ it to memory. And if you're having trouble, ASK FOR HELP. Also remember that if you're used to being an "A" student, prepare to be a "B" student. Nursing school is harder than just taking some pre-reqs. This advice came from my instructors, and it was true for me. I had a 4.0 until I started nursing school, and I took it hard in the beginning, but remember the main focus now is not on getting the best grade, it's learning how to be a good nurse. If you learn the material and skills well, the grade will come naturally. As for good things....I sort of got off track, but you will be fascinated at the stuff you will learn. Inserting catheters, giving injections, sterile technique....I don't know, I thought it was all so COOL when I learned it and got to put it into practice. I've been watching nurses and doctors do that stuff for years, now I finally get to do it. I gave my first injection a few weeks ago.....no big deal, just a Sub-Q.....but I was so excited when I was done. In a few weeks we'll be going into surgery and I can't wait for that!!! You'll learn so much in just a short time. I was surprised at how much I would learn every day at clinical. Oh, don't get pissy with your instructors, no matter what!!! They hold the power over your grade, your degree and thus, your eventual license to practice nursing. But don't kiss up either.....some of them really hate that. Care plans aren't that bad. I also think it's in a student's best interest to have a good stethoscope. Many nurses have told me, "Don't spend the money on a good one until you graduate", but I beg to differ. Without a good steth, it's hard to hear those lung and bowel sounds, and hearing them properly when you're learning is really important. Besides, I've never heard of a nurse having their steth "break down", you can still use it when you're done with school. Also get some comfy shoes. I recommend Nike Airliners - hands down the most comfortable shoe I've ever worn. Way more comfy than all of those "nursing shoes" I've tried on. Stay healthy - get your eight hours of sleep, no matter what. You can pull an all-nighter studying, but you'll probably end up with a better grade on tests if you study a few hours less and feel rested when you take the test. I had my "breakdown" about a week before spring break. Don't worry, you will probably feel overwhelmed about four to six weeks in, but it will pass. There's a book I really like called "How to Survive Nursing School and Maybe Even Love it" by Kelli Dunham. Tons of useful tips. Allnurses.com is even mentioned in it! Okay, that's all I have to say. Good luck, sorry for the long, long post! Welcome to nursing school!!!! nadjjaa :welcome:

Thank you both for your responses - I am learning here! Daytonite - could you suggest some possible goals, perhaps?? I understand what you're saying but the verbage is messing me up - how about something like "Pt will be free from constipation..." or "Pt will...." heck, I can't even think of a second one. I appreciate it, I'm getting somewhere here, but not quite THERE. Thanks.

Okay, so we have a specific mode we have to use each week (Roy modes) and this week it's Oxygenation - Circulation. So my pt. has Diverticulitis. The only one I can see that REMOTELY goes along with this diagnosis is Altered Tissue Perfusion (GI) r/t inflammation 2nd to Diverticultis. But I am having a huge problem coming up with Goals and interventions. Can someone help me??? I've been through the NANDA book and on the internet. I see that altered GI tissue perfusion is an actual nsg dx but I can't figure out what goals and interventions to use. I need to have this done in a few hours, and I'm lost. Also want to say that I think it's silly that we have to make the patient fit the nursing dx each week. My pts biggest problem right now is pain, not tissue perfusion. GRRRR Help from experienced nurses or nursing students would be appreciated. Thanks.