futureTBA

I work in a level 2 special care nursery and discharge teaching varies depending on the needs of the infant. Are you supposed to focus on mom's discharge from postpartum without her baby? Maybe her discharge with a 36 week late pre-term infant who never went to the nursery? Define pre-term. I would start with that - figure out your target audience. A relatively late pre-term infant who is not separated from mom but rather discharge straight from postpartum with mom might have teaching focused on safe sleep practices, breastfeeding resources in the community, when to call your doctor (signs and symptoms to monitor), car seat safety (especially going into winter!) and more A mom going home without her baby may need some different information. Her 33 weeker is in hospital for the next several weeks at least, what does she need to know? Maybe about mental health resources in the community for things like PPD (also important for any mom), lactation/breastfeeding resources to help with pumping for a preemie, information on safe milk handling and storage, parents like to google medical info (and google is a scary doctor!) so sometimes I provide them with a couple of reputable medical sites to do their research on (like the Mayo Clinic or the Hospital for Sick Children in Toronto) Figure out who you're targeting and think about what you'd like to know if you were the parents.

Thanks for all the feedback! Looks like the poll splits us 50/50. Glad to know it's not just us. I was going to ask the educators on my next set in whether I had misunderstood in training! I definitely hope it will get faster, right now I feel like a turtle swimming through molasses could do it faster than I can (And thanks Missie Hannie - it's been fascinating so far - and a little nerve wracking but I will eventually settle in)

I am a new grad and had the great fortune to be hired into a level 3 NICU. I have finished my class based orientation and am starting my preceptored shifts this week. During our orientation I learned that our unit does sterile line changes. Essentially any PIV or Central Line is changed under sterile conditions. We have a 2 nurse system to put together the new lines and then it takes 2 nurses to get those lines connected to the infant. The level 2 NICU where I did my pre-grad consolidation didn't follow this practice so I'm wondering how common it is. So - do your units change lines under clean or sterile conditions? Thanks!

Hi rlsdhounds, I am just finishing my fourth year in the BN program at Humber so I can't tell you too much about the PN program. I will suggest that you might find more helpful advice in the Canadian forum (you might want to ask a moderator to move this post there!). Nursing will be pretty time intensive. You'll have classes and clinicals, including weekends sometimes. Classes may not look like they take up that much time, but once you factor in study time and mental fatigue, it's a more tiring day than you'd expect. Courses are tough, there's much more reliance on self-teaching. No one will give you week by week homework. No one is checking to be sure you're doing what you should be. It's on you to make sure you've understood what you were supposed to learn, even if it wasn't explicitly covered in class. That takes a lot of people by surprise. But as much as an instructor's job is to instruct, it is a learner's job to learn. Do you readings (maybe not all of them if you run out of time - or fall asleep!). Cover your objectives. Watch the skill videos (trust me!). Don't freak out about memorizing all the details, worry about understanding the patho - that will help you figure out why we look for certain symptoms, or why we perform certain tests or other actions. Good luck!

Trillium in Mississauga runs a Clinical Nurse Extern program every year. The app usually goes up around March I think on their website. They hire for the summer but often extend into the school year.

Oh- and I'm going to ask a Mod to move your question to the Canadian forum just so you might get more information from other sources who are familiar with the various options.

Ok. So, I'm not completely familiar with the Sheridan program. I am however really well acquainted with the Humber program. If you have taken university level courses in high school and maintained an over 80% average then all three options are available to you, Pre-Health, Practical Nursing and Bachelor of Nursing. If you didn't take U level courses or your average was under 75%, then you are usually looking at only Pre-Health or Practical Nursing. There are so many streams available in Ontario but all of the nursing programs are very competitive. Last year at Humber the admission cut off for the bachelor of nursing was about 81% according to the associate dean I spoke with at their open house last weekend. You have a few options: Option #1: Pre-Health --> Practical Nursing (3 years total) Option #2: Pre-Health --> Bachelor of Nursing (5 years total) Option #3: Practical Nursing (2 years) Option #4: Bachelor of Nursing (4 years) Option #5: Practical Nursing --> Bridge to Bachelor of Nursing --> Bachelor of Nursing (5 years total) I don't see a point in doing option #1 unless your marks in high school are not competitive for the PN program. Option #2 is good if your grades aren't competitive for the BN program or you didn't do U level courses but you want your BN If your preference is to get your PN diploma and start working ASAP, then option #3 is your best bet. If your preference is to get your BN degree then #4 is best, but you can also take on option #5 as an entry if you didn't do U levels and it will allow you to work as an RPN casual/pt while you do the BN bridge. Take a look at all of the schools and what they offer. Humber offers all of these programs, Sheridan does the Pre-Health and PN but I don't know if they have bridging agreements with any BN programs. Often, the bridging option is restricted to graduates of the PN program from the same school as the BN program (i.e.: Humber PN to Humber BN). Go to the health fairs, contact the schools you're interested in. If you have any questions, just ask!

Hi Dawntoearth - second year was way different from first year. Second year was tough! I actually try not to scare people but go into second year expecting to study more and to adjust your study methods. It was tough but definitely do-able. Just keep up with everything because if you get behind (like I did) it's a pain in the butt to dig out. Just remember, the majority of people pass every year and so will you :) Don't worry about trying to prepare, unless you have a driving interest in reading really dry textbooks, I would prepare by relaxing over the summer so that you're in the right head space for the start of year two. Good luck!

I took a LTC placement in Oakville. Got an awesome instructor (although she's on mat leave now so you wouldn't have her). Honestly, first year I would just pick the location closest to home for you. There is so much excitement for the first clinical placement, but it's really just focused on learning how to interact with patients. You'll do fine wherever you are! Congratulations on your awesome GPA -and best of luck on the upcoming exams!

I graduated with about an 83 as well, but I was applying as a mature student. I got into Humber/UNB and I'm really enjoying the program so far.

Where did you graduate from? Your best bet is usually to check with them as some schools only offer the bridging program to their grads. For example, Humber's bridge is not found on their website because it's currently by invitation only based on grades in the Humber PN program.

Thanks NicuGal for all the help - I just got my feedback yesterday during my last clinical. My instructor actually asked me to email her my care plan (they were submitted in hardcopy) so that she could use them as examples for future clinical groups :) I'm so pleased. And I think I might have the same nerdy tendencies you do, 'cause once I got the hang of it, they really weren't that bad. It's just about thinking it through. (Oh - and I'm glad you picked up on the blanket over the crib. The nurses in the Special Care Nursery were all doing it so I thought it was protocol but managed to find the back to sleep info and realised it wasn't.)

Thanks! I've now moved on to the mother half of the care plan. This one is going a little easier :)

Hi NicuGal! I wound up going with imbalanced temperature given his low birth weight and prematurity. But I'm happy to think this one through. So, the phototherapy was complete. The bili levels should have been taken the day I was there (although they might have been with the lab and just not up yet). Bilirubin is excreted through the feces, so I know we checked his diaper every three hours before his feedings. I did his diaper change twice and both times he had a transitional stool, nearly milky. So it looked like he was probably excreting the excess just fine. I would explain to the parents that feeding should occur every 2-3 hours to help pass the bilirubin through and that if he was getting more jaundiced rather than less after discharge from the hospital, he should see his paediatrician as soon as possible.

Sorry, it cut me off. Bili levels were: Day 1 108 Day 2 (am) 103 Day 2 (pm) 89 Day 3 108 On the day I was caring for Twin B his vitals ranged quite a bit HR 125-165 RR 16-62 (irregular) T 36.8C - 37.2C We transferred him from the isolette to the crib that morning. Here's what I have for my care plan so far: Risk for imbalanced body temperature r/t premature birth, low birth weight, reduced levels of brown fat due to prematurity, recent transition from isolette. Outcomes: Infant will maintain temperature within normal range of 36.5C - 37.2C during shift. Interventions: 1. Infant to remain dressed in gown and hat 2. Crib to be placed away from any source of draft (doorways/vents) 3. Blanket placed over top third of crib (taped to edge of crib to prevent dropping onto baby's face) 4. Axillary temperature to be monitored Q3h and prior to any care Thoughts?

Thanks Esme! I've seen you post this before and it's the only reason I'm close to completing a care plan :) I decided to go another route. We were not really told how to go about this, and it's based on a child that I've already spent the day with and won't see again. Unfortunately, we don't go in for our assignment the day before, which is too bad because I think I'd like to try putting a care plan into place and following it. Anyways, here's what I have (bearing in mind we don't have to pick the most important, just any nursing diagnosis). Twin B Assessment: Infant born 4 days ago lady partsl birth (twins), transverse presentation, vacuum assisted extraction Estimated Gestational Age: 33 weeks 2 days Birth weight 2155g (4lbs 12oz) APGAR scores at 1 and 5 mins were 8 and 9 Mom experienced premature rupture of membranes at 30 weeks. Celestone administered twice. IV antibiotics as well. Mom has history or IDDM, hypothyroid and low platelets Twin B is being fed formula by NG tube Was started on IV antibiotics after birth and these were discontinued on day 3 Jaundice was confirmed through elevated bilirubin levels and phototherapy was done (d/c before I saw the baby) Bili levels were:

Hi everyone, I'm working on my first NCP and am feeling like I'm failing miserably. We were given no direction at all, just welcome to clinical, please have two NCP ready for Thursday (3 weeks after starting clinical on Maternal/Child). There's a blank NCP template on our Blackboard website, so I'm assuming we have to use that, but my instructor is a first timer so she isn't a whole lot of help sometimes on the school stuff (although, she's a great hands on instructor during clinical hours). So -my question is this - I had an infant (born at 33weeks 2days, 4lbs 12oz). Bili levels were elevated and he was diagnosed with jaundice. Phototherapy was started and discontinued before I even arrived at clinical. I cared for him about 24hrs after the end of his phototherapy. He looked like he was still fairly yellow to me, and my nurse agreed - said they'd likely do another bili in the morning. Can my nursing diagnosis be risk for neonatal jaundice? I know he was previously diagnosed with this, so risk for doesn't really work - except would he have been considered "cured" after the phototherapy? I guess what I'm wondering is if I can focus on the possibility of the return of jaundice given r/t his history of jaundice, prematurity, mom is diabetic (which I know is a risk factor) and the fact that he's not breastfeeding? Thanks in advance to anyone who makes it through that jumble of thoughts and can help :)

Yup - waiting is the absolutely, hands down worst part of the whole process. I'm dying waiting for timetable options to be posted and I know that it won't be for weeks As for the lab kit, it's included in your fees. The uniform scrubs were $40 I think for the set? Don't quote me on it but that sounds about right. The fundamentals we use is the revised fourth edition. First year psych was boring as heck and so were the two nursing courses. Second semester gets more interesting.

I haven't really gone through the kit in full. Inside there was the stethoscope, BP cuff and individual packets for each year. Mostly looks like general supplies to practice things like wound care, iv starts etc.... In all honesty, I wouldn't worry about buying anything "nursey" until you're well into the program. I mean, I'm sort of glad I already had my Littman since it's a different colour, so it stands out. But other than that, I haven't needed anything else. Getting excited for registration?

She And thanks for answering. I really wish this was something available to all students, that's an incredible opportunity. Good luck on the CRPNE!

Hi jordynnmac! I wish I could answer your question for you. Unfortunately, I'm actually asking one of you instead :) You said you completed a BscN to RPN bridge at Georgian but I can't find any trace of it on their website. I wondered if you could give me a link to the program, I'm starting second year in the fall and this is something I'd love to do if it was an option. Thanks!

1 - classes can be anywhere within the school, and for some reason, mine always seemed to be 3 floors apart Overall there's enough time to get where you need to go, the school looks massive but once you get to know your way around, it's actually not so bad. 2 - Scrubs used to be different, as of last year, all students must purchase the school's uniform scrubs. You do it at the bookstore part way through first semester and pick them up around exam time. They're navy blue with a light blue trim at the collar. Not bad, wouldn't be my first choice of fabrics. Oh - and don't buy any of the extras you hear talked about on this site - the school provides a kit with everything you'll need for the four years. It will have a Littman stet, BP cuff and all the materials you'll need for the clinical labs. 3 - I did my CPR through the school last year and I'm doing it with Red Cross this year. You don't actually need the First Aid portion - they only require it for the practical nursing students. If you have any other questions, let me know.

Hi sweetpeony, I'm sorry you've had such a bad time of it already. I'm getting ready to start second year at Humber and I've had a pretty good experience overall. To be perfectly fair however, I wasn't a fan of the admissions office and I haven't had to deal with financial aid yet. I can see how it would feel like a bad omen and I wish I could say it will get better, but I know there are some people in my class who had trouble with administration. I just haven't been one of them I have found in general that being a mature student has been an advantage, we tend (generalization here) to be able to work with a wide variety of people, both staff and students. Good luck in your studies and maybe we'll see each other on campus :)

Well, fingers crossed, but if I get the casual position, it's actually unit clerk on an inpatient psych unit. The community access centre is essentially helping case managers with data entry, phones/reception, calling in appointments that type of thing (as far as I know anyways). It is just making me so stressed to know I'm under consideration but have to wait so long for answers I don't do well with waiting.

It's frustrating isn't it! I'm so glad you found the one though. If it turns out not to be the "one" one, then at least you've got the experience they all claim to be looking for in order to get hired elsewhere. Are you doing PCA or unit secretary?