jenndavis

Thank you all so much for the advice and words of encouragement. My interview is today in about an hour, so we'll see how it goes.

This may be me worrying all for nothing. I'm a new grad looking for my first position. I've applied for positions, but there really hasn't been any openings or opportunities for new grads at the local hospital. Today I applied for a position at an outpatient behavioral health clinic and was called to schedule a phone interview. While I'm really excited about this opportunity I worry about future growth. If I start at an outpatient clinic in psych, am I going to be "stuck" there? I enjoy psych nursing and have a previous bachelor degree in it, but I'm not sure i want to be there for the rest of my career. I also worry about not having an acute care position. Any advice is appreciated.

Hello All, I've posted in the Alaska State thread, but haven't heard anything back from anybody. I'm hoping I'll get some advice in here. I graduated with a BSN in March of this year (2014). I recently received my license info for Alaska, so I'm all set to start working. I also have a bachelors in Psychology, as well as a Master's in Behavioral Science. I'm looking for positions at the local hospital, and while they have open nurse positions they don't have any new grad positions. The career search page literally says no new grad. My question is, is it possible that they would overlook the new grad status for some of these positions they are looking to fill? I understand that they are looking for experience and totally understand being passed over. I've tried emailing the recruitment folks, even before I was finished with school, but haven't heard back from them. I am planning on making a trip to see them in person. There is only one hospital in town, along with a hospital on the military base. I guess I'm just nervous that it will take me forever to find a job and I don't want to lose all of my skills and knowledge. Thanks for any advice =)

Hi! I took my NCLEX today; 75 questions with a good pop up. No one can walk feeling like they rocked it, but I wasn't crying when I left. I used VATI and loved it. There are quite a few practice quizzes you can work on along with "assignments" and case studies that get you thinking about how to apply the knowledge instead of just memorizing it. For each subsection there are quizzes where you are given access codes. These are nice cause its like mini NCLEX practice. I asked for extra practice in the med-surge section and my "coach" gave me access codes to like 8 more tests. I like it also because you get rationales for the answers, why something is right and why something is wrong. The predictor is great at giving you confidence to walk into the NCLEX test and know you know your stuff. You need to find what study method works for you, but I used this and iPad NCLEX question apps to study.

Hello All, I graduated with a BSN in March of this year (2014). I took the NCLEX today and feel really good about it (I also got the good pop up, so fingers crossed). I also have a bachelors in Psychology, as well as a Master's in Behavioral Science. I'm living in Fairbanks, well North Pole, but ya know.....anyways, I keep looking at Fairbanks Memorial, and they don't have any new grad positions. My question is, is it possible that they would overlook the new grad status for some of these positions they are looking to fill? I understand that they are looking for experience and totally understand being passed over, but I'm really excited to get started in this career. If anyone knows of anyone else hiring or available positions, I would love to hear them. Also, if anyone knows of any good job search sites. Some of what I have been finding is a lot of old positions that are no longer under any consideration. Thank you all so much =)

You already have your test date Carly! Good for you. I'm still waiting to hear back from Alaska. I don't have much to add to this topic, but you are a strong student and will be a strong nurse. I hope someone is able to answer your question.

Phew, thank you so much for your guidance. This patient's picture is finally starting to fall into place.

Thank you for your responses, and also thank you for the article Esme. It took me a bit to read, but it was interesting. I'm thinking that this leads back to my Pt's uncontrolled blood pressure. When contacted, his daughter stated that she knew he hasn't been taking his meds. the friend that called EMS said that there were full bottles of pills at the house, but he forgot to bring them, so I am unsure of what they really are. I'm kind of going off daughter stating they were blood pressure pills. BP at ER arrival was 170/109, 166/112, 177/126, and right before transfer to ICU 185/109. I thinking he probably stopped taking meds, BP became even more elevated (who knows how compliant he was or how the meds were working) which has led to some LV problems. No ECHO or ultrasound was performed, so I don't know what the heart really looks like or ejection fractions or the like. I'm thinking these previous problems complicated by the decreased renal clearance may have caused the increase.

I'm working on my large care plan for my critical care rotation. As I'm going through my pt's lab values, I'm trying to explain why some would be elevated and some would be low. This is all making sense for the most part.....pt was experiencing kidney failure so high K+ (8.1) and was found in a house that was near 100 degrees so Na+ was high as well (152). What I can't explain is his elevated pro-bnp. This was 3815 (normal 0.0-1800)! I know this is used in relation with heart failure. This pt has no history of heart failure, although he was not a reliable historian (neither were his ex-wife or ex sister in law). Could this lab test be elevated due to the renal failure? I know that BNP relies on the kidney for excretion, but would failure lead to such a high number? All other heart values came back normal so I know there wasn't an MI that occurred. His EKG did show a 1st degree heart block and prolonged q-t interval but I don't think that would effect the bnp that much. Does anyone have any ideas, or am I thinking right with the kidney failure reason?

My class is preparing for a SIM Lab dealing with Septic Shock and Multiple Organ Dysfunction. I think I'm on the right track for a question, but I'm not sure..... The Question: Explain why myocardial depression is almost always present in a patient with septic shock despite an initial rise in cardiac output. My Answer: In septic shock there is a release of vasoactive substances due to the inflammatory response. This leads to vasodilation. This vasodilation decreases systemic vascular resistance and leads to a high cardiac output because of the decrease in peripheral resistance. Despite the elevated CO, abnormalities exist in oxygen extraction in the tissues. As shock continues, compensatory mechanisms, which were previously maintaining adequate perfusion of organs, become ineffective. There will be a decrease in coronary perfusion which leads to a decrease is CO. Am I on the right track? Thank you for your help.

Thank you all. It is always a terrible feeling when you have no IDE where an answer came from. I appreciate y'all checking my work. My teacher said it must have been a typo, but I couldn't get a hold of her prior to panicking.

I thought I understood dosage calculations, and I normally do well on exams. We had a practice test and there was an IV question that has me super confused. Pt is to receive Dopamine at 5mcg/kg/min. Pt weighs 80 kg. You have 1.6 Gm/250ml. What should the nurse set the ml/hr too. So here is what I did (please correct me): 5mcg x 80kg = 400 mcg/min 400 x 60= 24000 mcg/hr 1.6 x 1000 = 1600 mg/250ml 24000/1000= 24 mg/hr 24mg/hr ________ X 250 ml = 3.75 ml/hr 1600 mg The correct answer is 15 ml/hr. I have no clue how this answer was reached. Thank you for any help.

Thanks for the link. I'm going through family focus right now too, and this monitoring business can become confusing.

Hello All, I will start my summer semester shortly. During our two week break between semesters, we (as a class) were asked to complete our OB care plans. I had a diagnosis of Beginning integration of the infant into the family. I have no idea what I am doing with this diagnosis. My other one was pain, so the goals and interventions weren't so difficult. This one though has me confused. I don't understand how to write a long term and short term goal for this, or what type of interventions I need. On top of that, I am not allowed to use a care plan book for rationales for interventions. I am supposed to use a textbook. I've been searching my maternal newborn book, and trying to pick apart the family dynamics section. if anyone has any experience with this diagnosis, I would appreciate some guidance. Thanks

Thank you so much for this resource. It is beyond helpful. Still feeling a little shaky but not so stressed. I appreciate all you do to help us students.

That's what I was planning on doing, but we are suppose to cite symptoms from our text. That's the part that didn't make sense. On the form there is no place to list our pts signs and symptoms. It's just weird. I did use Esme's suggested research sites and in my own way relate it back to my pt. thank you for the response =)

This format is just not what I thought it would be. Hopefully I will receive some feedback as to what I am doing from my instructor. Thank you for responding and for providing a reference.

Hello. I am currently working on my first care plan. I originally thought that I had a basic understanding of how to create my diagnoses. Our format for school though is super weird though. It is separated into three columns: First column is for NANDA diagnosis. I understand that. Second is for supporting Pt data (relevant symptoms/defining characteristics/specific data gathered from assessment), instructor told us to put the related to part here (this seems to be the AEB part to me). The last column is for Dynamics (defining characteristics from med-surge book; supports this as a problem). We were told to look for signs and symptoms from another source that supports out diagnosis. How do we even do that. I have been confused since Thursday and I tried to get clarification from our instructor, but it was hectic during post conference due to the next group coming in. I was under the impression that our diagnosis was to be assessment driven. What does the patient's symptoms tell us, that leads to the diagnosis. I don't understand how to use another source to support our diagnosis? If anyone has any ideas and would like to share how to attack this I would greatly appreciate it. Thanks.

My first exam is on Monday, Health Assessment. I'm worried but trying to stay calm. I think I'm most stressed about not knowing how the questions will be worded. She has practice exams and they are not in the NCLEX style I'm used to seeing. So.... we will see how this goes.

"Here is the secret of inspiration: Tell yourself that thousands and tens of thousands of people, not very intelligent and certainly no more intelligent than the rest of us, have mastered problems as difficult as those that now baffle you." When I start feeling confused and frustrated this is what I tell myself.

Perhaps over spring break I can get an article together. I just finished my second week of an ABSN program and things are moving quick. I wouldn't have it any other way though. First exam on Monday......eek!

Thanks for all the input. I'm learning a ton about her and her work. It really is quite interesting.

Thanks for the suggestions. I will look into that book. Also thanks for the info about the nurse scientist program. I knew a little about it, but like I said was having a hard time finding more info. I can now tailor my searches a little bit more. I appreciate your help.

Hello. For my intro to professional nursing class we are making power point presentations over different theorists. My presentation is over Madeleine Leininger, the foundress of transcultural caring. The problem I am running into is that we must discuss these individual's top three influences. I am having a hard time finding two other contributions due to the vast info dealing with transcultural care. I know that she was involved in different educational and political things, but can't find real information about those events. Does anyone know of any resources that I can look into. I would appreciate it. Thanks

I'm feeling overwhelmed and panicked as well. I will begin my first semester of an absn on Monday. I received an email from my clinical professor about completing tests to be allowed to attend class. I have no idea where these tests/quizzes are! So now I'm anxiously waiting to hear back from her. I'm sure we will all be fine once we get into class and get settled with schedules. Right now though, I'm a confused mess.