MsKayleigh

Thank you all so very much!! I found all of your answers helpful and useful. The outcome of maintaining status quo was what I opted for; I have always had outcomes that were progressing towards something, so doing maintenance was a bit foreign to me. I actually needed two diagnoses, but one had to be an "actual" diagnosis. The risk I went with was for impaired skin integrity. Again, thank you all very much!

I'm working on a nursing care plan for my pediatric clinicals at a sort of long-term care facility for children with disabilities. I am struggling a bit with establishing a realistic, measurable outcome and appropriate interventions for my client. Some background: 5-year-old female with a progressive neurodegenerative disorder (and nobody seems to agree on which one) and myoclonic seizures. Some of the diagnoses scattered throughout her chart include static encephalopathy with resultant spastic quadriplegic cerebral palsy, West Syndrome, degenerative brain disorder, seizure disorder, and developmental delay. Assessment: Client is wheelchair bound, completely dependent for all cares, and wears orthoses for a few hours each day. She has a gastrostomy for tube feedings, secondary to decreased alertness and limited responses and communication. She is non-verbal, and her communication is facial expression. (There's a lot more I could add here, but for the sake of keeping things brief, I will stop here; let me know if there is more pertinent information I should be including!) Care Plan: The priority diagnosis I am working with is Impaired Physical Mobility r/t neuromuscular weakness and spasticity aeb dependence for all cares, confinement to wheelchair, and use of orthoses. Where I'm struggling is with a realistic outcome as well as appropriate interventions. I've looked through my textbooks, but most of the interventions are inappropriate for my client (mostly geared toward those who still have some mobility and increasing mobility). My instructor has told us that our outcome should be measurable in the long-term; it's unrealistic to expect outcomes within a shift or even a week. However, with my client staying seemingly stable (as her chart reads), I'm really not sure what sort of outcome I can develop, aside from maintaining where she's at currently. Thoughts or experiences? Any input would be greatly appreciated! Thanks in advance!

I didn't personally witness this, but heard about it from the eye witness nurse. The OB/GYN doc, who had been doing OB forever, had just delivered an infant and was waiting to deliver the placenta. The nurse walked in at the right moment, right as the mother was giving a push. She saw that placenta FLY out, hit the doc square in the chest and knock him off the stool! Then, she saw the mom look down and ask, "are you alright?" He was there one moment and gone the next!!

I am currently in an accelerated BSN program, and I don't find that I have had to say goodbye to my family--except that I moved nearly 1600 miles to go to school. So I don't see my family, and I don't see my fiance, except on Skype. I do get to talk to them on the phone quite a bit, so I feel grateful for that. I find that I have plenty of time to get my homework done, as well as have a few hours of downtime (depending on if finals are upcoming!). Consider, though, that you have exams every week, usually, and sometimes there are two or three exams in some weeks. There are a few of my classmates who still work very few part-time hours (might even be on-call). I agree with a previous poster that you would have to have a pretty flexible job to accommodate your ever-changing schedule. Your class and clinical schedule, depending on the program, will vary every so often, and then you want to set aside some time for open lab practice and check-offs--which are done on your own time, in addition to having time to study and do assignments. I am currently half-way through this program, and I think we are on the down-hill side of things. Term 1 was 8 weeks, Term 2 9 weeks, Term 3 is 12 weeks, Term 4 will be 9 weeks, and Term 5 will be 12 weeks classifying this as a 12-month program. At the beginning, they told us term 2 would be the most time intensive (and they weren't kidding), but that term 4 will be the most academically challenging. Please let me know if you have any more questions!! I'm happy to share any of my experiences!

Worry you not! Yes, they do teach you some of the basic things you do need to say, and often other conversations develop or don't develop depending on the type of person you are caring for. I did theatre, so I don't really consider myself shy or quiet. BUT, my issue is that I'm very task-oriented and I struggle with having those "extra" conversations that really foster the connection to clients. Plus, being in school still, I don't feel I've gotten to the point where so many of the routines are second nature, to where I can comfortably be doing part of an assessment AND talking to my client at the same time. The best advice I've gotten to help with that? One nurse told me, "Take 5 minutes and talk about something not related to medicine or why they are here. Then, they will feel like you care about them as a person and will feel connected to you, and you will feel connected to them". Solid, amazing advice--and it has worked for me so far!

I'm not sure of your learning style--personally mine varies upon the information. Pharm is just a LOT of memorization. It's the only class so far that I've made notecards for! And I made a TON of notecards. This helped me a great deal. What helped me was to really, really know the autonomic and somatic nervous systems and the neurotransmitters and receptors involved. If you know that, you will know where the action of some of the drugs are (alpha1 blockers, beta2 blockers, etc.). That is where I think I struggled the most with the class--remembering where those drugs have action! Good luck!!

Interestingly enough, we don't want people to stop pursuing nursing. We are facing an impending nursing shortage, what with the large number of nurses soon to be retiring. In fact, studies are suggesting the demand for nurses will exceed supply by 20% in the year 2020. That is HUGE! The problem you are facing is related to the lack of nursing professors and/or the lack of space in hospitals, which limits the number of students they can take. All of this adds up to nursing schools being exceptionally competitive! Don't lose hope, though. I applied to and was turned down from one nursing program twice. Then I tried another program, and was turned down. But, by that point, I had enough college credits to pick a non-nursing major, complete a degree, and have a bachelor's degree. This made me eligible for the accelerated BSN programs out there. I applied to one, was put on the waiting list, and then found out I had a position two weeks before classes started! Talk about cutting it close!! I consider myself a fairly competitive applicant--and look at what I had to go through to get into nursing school! Basically my point is don't give up if you really feel nursing is for you! Do what you have to do to get into school--if that means taking some English classes or getting a tutor or buying one of those study books to better your reading score on the TEAS test, then do it. Best of luck to you!