tsm007

Extremely helpful! It looks like they added instructions at the top in orange to help to find where you're actually supposed to click to renew. I wonder what genius designed this. I did get mine renewed. I never did receive any email though about renewing.

This is what I got back after emailing their help email about where the "RENEW LICENSE" option was. Guess I just hate to wait.

Very frustrated. I cannot figure out how to renew my RN license. Anyone renewed their license with their new database.

That would make me extremely uncomfortable! I do not perform well when someone is standing over me like that. I have absolutely no desire to work in a place with that kind of culture. Personally I'd be looking for another job ASAP. Also, they very well could be trying to establish a paper trail to fire you.

Take anatomy and physiology if it's offered in high school and medical terminology. Those two classes will help you a lot to be ready for the college level material.

Wow, serious troll food. I can't believe I'm going to bite. Plenty of RNs worked their butts off to get there. Please don't act like everyone who has an RN degree just had rich mommies and daddies to pay for it. I can tell you I put myself through school with kids in tow. It was HARD work and until you actually go through the RN portion of a program you don't know what you don't know. Not everything can be learned through hands on experience. Somethings do require opening a book or listening to a lecture. I don't honestly care if a nurse can "run circles" around another nurse. It's not all about tasks! It's also about knowing and thinking. I have one nurse I work with that is SLOWER than molasses, but I guarantee you if I had a PE or a impending complication she is the one I'd want to take care of me. She has excellent assessment skills and critical thinking.

Heck, all of those sound like typical new nurse mistakes. Heck, most of them we've all done! I don't do it a lot, but I have thrown out a med still before scanning it when I'm tired. It happens! For me mistakes are just a part of how you learn. I'll give you an example. Forgetting to open the clamp on your secondary IV tubing. Ugh! Done it more than once when I first started (and have seen experienced nurses do it too). It happens. Now I am almost OCD about checking those clamps are open. Nothing more annoying than realizing you accidentally ran your primary bag at 300 ml/hr for 20 minutes. Oops. Not too long ago I was floated to another floor and I swear to God I counted the narcotic drawer wrong 3 times! I wasn't expecting this med to be a controlled substance and it popped open like a regular drawer would so I had already had meds in my hand and then it asked me to count. Well guess what I still had the pills that I pulled in my hand and was not counting them with the pills in the drawer. Oops. I did figure out what I did wrong when finally on the 3rd time when a discrepancy was opened that I still had the med I pulled in my hand. The problem with being new is instead of doing this stuff occasionally you do it often. You'll get there. Next job you watch you'll be the nurse that's getting it when the other one isn't. Don't beat your up, but don't discount the advice you're being given. You probably are the slow nurse right now, better to be the slow nurse than the stupid nurse. You haven't said anything that makes me think you don't have clinical knowledge. Don't sweat it. And if you have to get another job, you won't be the first nurse that it's happened to. I went through 2 jobs in 3 months when I first started. It sucked. I felt like a moron. It gets better! Hang in there.

Does not surprise me at ALL. Navy veteran here. Corpsman are more than CNAs. They do get a lot of training on "skills". They can do a lot of skills that traditional techs would not be able to do because they are under military laws/guidelines (but only in military facilities, can't do them anywhere else). Some of them are super cocky and think they are nurses. Some of them are fantastic. However, many of them are kids that went straight from high school to boot camp. A lot of them are still growing up so honest doesn't really surprise me. When I first heard of the article my very first thoughts were I bet they were corpsman and not nurses.

Pet peeve of mine, nurses who quote things as laws or policies and don't actually know where said law or policy is in writing. It's a 50/50 shot whether it actually IS a policy/law or not. I almost always find the dang policy in writing then put on my clipboard so when I tell someone this and they look at me like I'm stupid or wrong I can make a copy or hand it to them. I'd venture to guess that this "law" you are citing varies from state to state and challenge you to find the actual law for your state as a reference. Some states do have very specific laws so I'm not challenging you that you are wrong. I suspect you are right, but I think it's worthwhile to know the actual laws on this in your state.

I'd take the semester off. I had my baby the last semester of nursing school and didn't have to take a semester off because he was due end of November. Our clinicals ended the week before he was due and then we had a gap in clinicals again until January with Christmas break. With your baby being due smack dab in the middle of a semester I think it would be really difficult. Also, yes, you *could* do it, but this is time you will never get back. Taking one semester off in the big scheme of life won't affect your career, but you won't be able to get that time back with your baby. You will make new close friends with your next cohort and your old friends will be helpful to you so you can prepare ahead for the next semester. Just my thoughts anyway.

This! I want to thank all of you who responded. I have a much, much better understanding now.

I went to WGU's prelicensure ONLINE program. It's hybrid. Theory online/clinicals in person. Love, love, loved it. I got more hands on clinical time than most of the other students I seen at the hospital. I got to actually do stuff because I was paired with a nurse one to one. Where the other schools had to sit around and wait for their one instructor for what 6 to 8 students to be around to supervise them. Instead I was supervised by an RN. It was awesome. Secondly on the floor I can tell you I am the nurse my coworkers go to when they need help with technology. Who knows don't be surprised when your boss has a Master's degree from an online program.

Okay, I *think* I may have found the problem. I think the nurses I work with may just not be using precise terminology and that's why I am confused. Maybe??? I found this article I think what they may be referring to is intrathecal OPIOIDS vs local anesthetic being used in the spinal. I think. I'm going to do some chart digging in the next few weeks but I think this is why I am seeing some people having "spinals" in report, but not on "intrathecal" precautions.

Well maybe that's it. I see "intrathecal precautions" on our floor, but you know I think you may be right. I am going to start reading all the anesthesia notes and comparing it to what I hear in report and see if that this is just one in the same and I'm making it harder than what I need to be.

Last question, I have been reading and searching, but lost here. What the heck is the difference between intrathecal and spinal? My searching is getting me nowhere on this.

Boy, I feel like a dummy. Okay, I watched this youtube video. It was made for patients, but extremely helpful to me.I realize why I've been so confused. I'm mixing up the 'anesthesia' with the 'sedation'. Now this is all making so much more sense. I still have more reading/video watching to do, but this was an aha moment for me. Thank you for your help.

Yes, this! With them switching blocks recently I am getting different thoughts from different nurses and honestly not sure that any of them really know.

Yes, this is what I'm looking for. They just switched to Exparel and I think that it is not as great as they are hoping it to be. People are moving faster, but I'm having trouble anticipating pain needs with it. Also not quite sure why intrathecals are monitored so much more closely. Going to keep reading. I am big on understanding why things happen and most of the nurses I work with don't seem to care about the why of things. Understanding pharmacology, mechanism of action, and pathophysiology just puts the pieces together better for me. Thanks for the info and appreciate the comments.

Work on your test taking skills. Here's my best nursing school test taking tips. Test taking strategies If I am stumped and there are two answers and they both are similar for example you have 4 answers and two of them were say - lack of appetite and upset stomach and the third answer was headache I would pick headache (this is not even knowing what the question is at all) because those two answers are so similar. Now, that strategy doesn't always work, but if you are totally stumped and making a random guess it is a better guess than just grabbing at straws. Plus a lot of times if you have 3 good answers and 2 of them are similar then I'd pick the 3rd one that isn't similar. Another strategy, if you see an answer on your test and you've never heard of it before even if it looks really good don't pick it. I find myself sometimes reading a question thinking heck I don't know that looks right, but I just don't remember reading it. I have stopped picking that answer. I think of it is as a trap. Priority questions - know you're priority assessments and interventions. If they asked which was most important I use ABC MASLOW strategy or with psych SAFETY, but again know your diseases and priority assessment. Do not try and memorize everything, you won't remember it all, but remember the priority assessments and interventions. If there are two answers and both look ok pick the one you are 100% sure is right. I know there was some that I knew one was right and I thought another one was right too. Go only with the one you are 100% sure is right even if the other answer looks better. Also, here are some of my studying strategies. I am copying and pasting this from a post I made years ago when I was going to school, but the info is the same. Studying tips The point of NCLEX questions isn't to memorize the answers, but to learn the process of answering them. There is a trick to it, but you really need a lot of practice to get good at them. I personally do not make outlines or flashcards to study, not that I think that is wrong. I read the chapters and do NCLEX questions and bunches of them. If I find there is a topic I'm getting stuck on then I will look at that topic some more. I also have 1 study guide book for each area (med/surg, OB, etc). I used to buy 2 or 3, but realized they are all kind of the same so now I just get one and use that. (If you get them used they aren't that much money.) I generally don't reread the chapter but try and find another source for the same topic and sometimes 2, 3, or 4 if I'm really stumped. I will also use Google and Youtube and search the topic until I get it. I find reading on the same topic from different authors helps because sometimes one person just explains it better or a way that makes sense to me better than others. I generally do not start doing extra searching on a topic though until I've done NCLEX questions that way I can figure out which areas I really need to study more on. I really like Med Surg Success and have recommended it often. It's got a ton of questions and really helped me practice for tests. You can look up for other books with NCLEX questions and I would definitely start using them to prep for ALL of your tests going forward. Find ones particularly for the subject/class your in. Hope these tips help.

Definitely wash your hands IN THE ROOM. There are a couple pt rooms where I work that the sink is not near the exit to the room and that's very frustrating to me. We actually had this discussion recently and our safety/infection nurse who is very knowledgeable and good at her job says wash in the room even if you have to pass back by the pt's bed before getting to the door. I don't like this so I usually doff and wash hands then hit hand sanitizer again at the door (WHICH I KNOW DOES NOT KILL C DIFF), but any other germs that I might have hit before the door it's not going to hurt right. Then I immediately wash again at the closest sink outside of the room. In the perfect world the sink would be at the door where you doff, but keep in mind many facilities are older so they just weren't designed that way.

That was helpful. Question though when an adductor block is used what kind of anesthesia usually goes with it to put them to sleep while the procedure is done?

I work on an orthopedic floor and am still feeling inadequate understanding the different anesthesia used and the implications for me as a nurse taking care of a pt the first 24 hours after surgery. We use generals, spinals, and intrethecals on our floor and then they've been using an adductor?? block. Don't understand exactly what that means. Honest I don't think all the other nurses really do either. I know generals they are put under and have some type of airway. Intrathecals I know that they're vitals are closely monitored for 24 hours and narcotic administration is discouraged. What I don't understand is how to know when blocks should wear off? Implications for pain management regarding the different anesthesia and implications on assessment findings I should/or should not expect from one anesthesia versus another. At the moment I kind of assess everyone the same, watch vitals closely, neurovascular checks, and address pain as it is reported. I'd like to be able to skim the post op anesthesia report if I don't get details in report and have a better clue what the info in thier reports means to me in caring for the patient. Mostly pain management implications. Also we have been using Exparel recently and the other nurses will say they used an abductor/adductor (sorry I'd have to get a chart open) block. From what I can tell from reading that has nothing to do with anything except the location of the block? I think what they should be sharing is the medication in the block because I would think one medication would be different than another. I also don't really understand why one is better than an other, why they choose one over another other than maybe pt history, but not got a firm understanding on this. Just feeling very inadequate in this area and keep trying to read on this, but just not finding great resources to answer the questions I have. Any links, info, books, podcasts, etc or just your personal two cents would be greatly appreciated.

Blah. Surgery grosses me out too. I can deal with gushing wounds, but the slicing an incision I almost always have to look away. The idea of standing in a room with a mask over my face makes me claustrophobic. Kudos to the OR nurses, I'm not knocking them. I just have no interest in that. Lots of different areas of nursing out there. Every nurse here will have something they really don't like and something they really do. Pick the areas you like.

When I was doing agency I was at one place (and it was actually a really nicely run facility) that didn't have med carts. They had locked cabinets in each of the patients meds in the patients room itself. There was one key that opened all the cabinets. If all the locked boxes are in each room and the baggies are in each room and your not going room to room carrying them then not sure what the issue is. We have meds labeled from pharmacy in individual tiny little bags for certain meds at my current job. EACH pill is in one bag though not just a bag full of pills and I would suggest that if that's not the case. If there isn't a box stored for each patient in each room then I would suggest that and could see that being a problem. As far as hand sanitizer I have been to plenty of facilities that do not have installed wall hand sanitizers - especially ones trying to provide a home like environment. What they do have is bottles of hand sanitizers available at the nurses station or that you can carry in your pocket. A lot of the nurses I see just carry one of those clip on pocket hand sanitzers to their uniform. You can refill it with the hand sanitizer provided by the facility.

Depends on the location. Some states are more competitive than others. I didn't have a degree. I did have a lot of credits though and a certificate from a medical assistant program. We had other people though in my cohort that had no degree at all. It's not essential. Your grades are competitive. Just nail your TEAS test. Study for it. It's a weird test. I did okay on mine, but my enrollment counselor was really pushing hard and I didn't have as much time to study for it as I should have. I definitely could have scored higher had I specifically studied for it. I think you got a good chance at getting in. Go for it!