RachRN66

I wish you all the best. I have 6-7 years of managment/CM/DON experience in home health and hospice. I NEVER want to be in the office again, I am not a paper pusher (although that seems to be what HH is becoming). I didn't like managing staff, I do enjoy patient care and teaching. I like my job but it's becoming too much. I know how you feel. I hope that you find what works for you and that you like it.

I know that the "care homes" or "group homes" that are established by individuals in the community have different laws and regulations than to SNF/LTCF/ALF. About 8 years ago I was assigned this "home/ALF" group of residents that consisted of about 35 beds. The living conditions in this place were HORRID. Most of these residents were people that couldn't live on their own, but had no money to go any place else to get care. Basically it was a DUMPING ground, located in the worst part of our City, and the residents had nobody to stick up for them. This was at a time when our agenc was making money on patients that had medicaid and we could go assess them q60 days and supply them with incontinent supplies. So, generally my visits there were to do q60 day visits (general assessment and documentation of incontinence) and order diapers and chux for the upcoming 60 day period on the residents. It was not fun and games, the visits were always recert visits which included lots of extra documentation, (not OASIS though, because we were providing "unskilled medicaid care" and time. This Horrid place had residents with scabies,lice, roaches crawling on the walls and no "real place" to wash your hands, to say the least. Since there were so many incontinent residents, and not all of there "cert periods" fell on the same day, I spent many days in this place. We also provided "skilled" care to residents if needed. I got a call from the "head CNA" that worked at the facility one day that Mr X had a bedsore and could I take a look at it. After securing orders from the MD I made my visit. His entire sacral area was a hard, black eschar area that measured >30 cm in diameter. I called the MD and asked if he would see the patient and eval, and the MD told me to put hydrocolloid on it, and change it q 3-4 days and PRN. I did that. I also instructed the CNAs about proper care for this wound..turning, changing, cleaning etc and tried to get the MD once more to see the patient. Every time I went to see this gentleman he was laying in the most horrid pile of incontinent mess I had ever seen. So I would clean him, change him, do wound care, and turn him. And one day I put my initials and date on the tab of the diaper. I went back 3 days later to find the SAME diaper on this man. I was LIVID. I called my supervisior and said NO more...I called the MD and reported the issue, and I called our social worker to get some advice on how to contact Adult Protective Services. Two days later the man ended up in the ER with a temp....duhhh??? I got called into the office and was told that the "ALF" was in charge and that our social worker could most certanly NOT call APS. I told my supervisor I wanted a meeting with OUR director, human resources, the social worker etc. I told them all my concerns about this place. And they most graceously took me out of the facility and assigned a new nurse. I called the abuse hotline and reported the situation. The facility got shut down about 3 months later. A year later, they were back in business. I don't go there, and I don't know if they have better practices, but someone in the "powers that be" let them open back up. I pray that they let them open with stricter conditions, but I don't know. I don't know what to tell you, but I know I've seen some awful things in Home Health in the 18+ years that I've been in practice. My agency did not pick them back up as Medicaid suppliers when they did re-open. I was told that the ALF chose a different provider. Occasionally we get "skilled patients" in this ALF today, but I will not go back there, and my agency knows NOT to send me there.

RN in training: I am a female with a lady parts, but foleys go into the urethra of a female, not in the lady parts... wouldn' be very effective IN the lady parts if the purpose is to assist with the elimination of urine. Urine doesn't come out of the lady parts in a female.. we have 2 separate openings that both serve different functions. Sorry to be nit-picky, but I just want you to be clear about this before you take your NCLEX or get out in the "real world of nursing" and try to put more foleys in lady partss. :) OP: I think it's great that you're trying to figure all this out for yourself BEFORE you take the leap. You may not be "mature" as some people say here on this thread, but you ARE smart enough to try to figure it out before you get started and then realize it might not be for you. I give you props for that! Good luck in your studies.

I've been a home health nurse for a very long time. Yes, we start PIVs. Mostly for lasix protocol for CHF patients, but often we get a short term antibiodic in the home that we will do with a PIV. If the antibiodic is to last for longer than 3-4 weeks we generally contact the MD and ask if we can send them to radiology to have a PICC inserted. We also have an infusion clinic in the area that does more of the "monthly infusions", We seldom see those patients. But we have a few clients that can't get out to go to the infusion clinic, so we provide services for them. What you need to look for is a home health agency that has their own pharmacy (I work for a company like that) because as other posters have stated you are responsible for getting your own med through the pharmacy and if you use Rite-Aid, you may not be able to get the med in the home setting. Sometimes your insurance provider can be helpful. For example, they may contract with CareMark or other "national pharmacies" the may provide the med for you. There is a whole issue of what your insurance will cover in the home setting also. So you should check with them for assistance, and also check with discharge planners/social workers that work at your old hospital. And you could check with the "more local" hospital to see if they would consider administering the med on a monthly basis through out patient. [sorry....i just read OP again and see you did try the local hospital..are there any others nearby?] I hope you find what you need!

This is an example of a nurse in one discipline of practice (ER) thinking she is much better skilled and qualified than another discipline of practice (LTCF/SNF). You all took the same NCLEX or LPN version of NCLEX (I don't know what this is called) to be licensed to practice. You have to use your nursing judgement. I am a Home Health RN (BSN). Many hospital nurses "look down" on others as somehow their experience or practice is far superior. You did your job, you don't have to take flack from someone because they are having a bad day or because they feel superior. Tell her to have a good day, and let her deal with her own insecurities.

Why do you have to communicate? To 1) get to know them 2)elicit pertinent information 3) be a NURSE..nurses are treating the whole body HOLISTICALLY, that means the entire person, not just their diagnosis, meds, etc. You need to be able to address their sexual questions, their spiritual problems, their financial problems, their emotional problems etc... You won't find that out by saying, "Mr Jones I'm going to check your temperature and your blood pressure right now," or by saying, "Mrs Smith can you turn over to let me look at your wound." You might find out by talking to them that their blood pressure is elevated because of pain that they were afraid to mention because they didn't want to bother the busy nurse. You might find out that the wound is not healing because Mrs Smith can't afford to pay for her medicaion or her food that she needs in order for the wound to heal properly. You might even find out that that old man with dimentia used to be the CEO of a very big company, just by asking questions. It's important to know this stuff as a nurse. You bond with the patient and you learn to address their needs appropriately. More than 25 years ago, as a junior in my BSN program (straight out of high school... I didn't even really know what a nurse did) I made pretty good grades. I did well in my clinicals and never had a problem, but ONE instructor pulled me aside and told me she didn't think I would ever make it as a nurse and I should drop out of school right then and persue a career as a CNA. She told me that was all she felt I had potential for. However, when I asked her why, she really didn't have a good answer. I asked her how she thought I could improve and she didn't really have a good answer. I told her that day that I would be a nurse and a damn good nurse..and she should just watch me soar. I put her nonsense out of my head and continued with my studies. If she had told me specifically what I was doing wrong, or specifically how to change it...I would have made an effort to do so. But just because she didn't "like me" was not a reason for her to tell me I could not do something. And everyone that knows me knows that I am just stubborn enough to prove them wrong... I am proud of the nurse that I have become, and she did not influence my life one way or the other...maybe just made me more determined. Take some communication classes. Go out with your friends and chit chat. Talk to the guy sitting beside you on the subway and find out how his day went. Go out of your way to talk to the person that is limping across the street due to an ailment. If your instructor told you to talk...then you should talk. I understand that your personality may not be the 'chatty kathy' type, but if you work on it you'll be amazed at how easy it will come to you with some practice. Maybe you are just in the beginning of your nursing career, but maybe your instructors are really afraid that if you don't get it "right" now, that you will be the quiet type of nurse that will never speak up and ask questions about serious stuff... Like your patient has a PICC line and you've never taken care of one of those before. You don't get a chance to just try it by yourself.. this becomes LIFE and DEATH. You have to get it right the first time with NO mistakes and you have to learn to ASK for help until you feel comfortable. So starting to improve your communication skills now by making small talk is a way to build your confidence so that when you get out in the real world you can be as assertive as you need to be to SAFELY care for your patient. This is your chance to get it right...be proactive and go do it. If you can't do it, you really don't need to be a nurse, and this may be the way your nursing school weeds you out. Good luck!

I would also recommend barrier cream applied librally and thickly to the skin before going to bed at night and then cleaning as soon as possible in the AM. Using a thick barrier cream with zinc oxide is my preference...like desitin, balmex etc.

I have dealt with many sci patients over the years, some on a personal level and some on a professional level. I can tell you that no matter what you read, every patient regardless of where their sci is located, is different. No matter what you read, no matter what you see in a book, they are different, depending on many different factors. Whether it's a complete sci, or a partial sci, whether they are in "spinal shock" or post spinal shock, and if they have dysreflexia or not, and depending on age, and other "medical" problems. I recently completed this ceu course that you might find helpful. Interactive Online Continuing Education for Nurse Professionals I don't know how to make that an active link on this forum, but it's basically a "general understainding" of SCI and urilogical problems. If that "link" doesn't work go to www.rnceus.com and look for the course Bladder Management after a Spinal Cord Injury: A Practical Approach. Good luck!

I am an old nurse. I went to nursing school before HIV/ AIDS was known, graduated when AIDS was treated by suiting up in a martian like outfit and approaching the patient. We, as medical professionals have come a long way. I recall my aunt, a RN now in her late 80's saying that they used to spend night shifts sharpening needles and autoclaving them for use the next day. WOW..can I say it again?...medical profession in general has come a LONG way!!. And along that way, we are responsible as professionals to keep up with the times. I see patients now in the home health setting that would have been in the ICU or DEAD when I went to nursing school. Now I get the privilege of teaching these patients to become independent care givers or patients, and manage their own disease and medications at home SAFELY. It is your responsibility as a professional to learn and keep learning, keep current and knowledgable. My education started with nursing school, but it has not and won't end there. To the OP, I don't know how much experience you have, but with years of experience you do learn to listen to patients, look at lab results, ex-rays, etc and tell the patient what you see...not what you "diagnose", but what is interpreted, and then refer to the MD about appropriate treatment. It takes time, lots of continuing education, and most of all a lot of bed side care in order to feel comfortable in your own shoes and learn these things. Your nursing school was just to prepare you to "enter" the nursing field. NOT to be a "master" at your career, otherwise you wouldn't have to spend so much time with a preceptor at your first nursing job, or at a new job after years of experience and change your field of practice. You should have learned enough to be able to enter the nursing field and be safe at your practice, not everything there is to know about nursing/medicine/disease management or medications. These things evolve every day, new treatments/diseases/medicines etc are being developed every day. The learning comes when you start delivering care to your patients. You have to know how to crawl before you walk, and to walk before you run. If you feel you are not learning fast enough, then seek it out on your own, don't just sit around and whine that you can't do it. If you love nursing, then stick with it. If you feel you made the wrong choice in your career decision making, then use your nursing education to afford you to continue your studies and go to Medical school (or aerospace engineering...or underwater basket weaving). Do not expect it to be handed to you on a silver platter, or that you can absorb it by osmosis, it does not work that way. If you want it...SEEK it out. And if you thought you should have learned it all in nursing school....well you'd have to constantly stay in school because it changes every day! Good Luck!

I don't call for other disiplines or other doctors. If they need information relayed then they need to relay it. I work in home health and do a lot of MD calls, but a week or two ago I was called by my manager in the office to say that OT wanted me to call the MD because patient had a heart rate of 42. That's all the info that was relayed to me. Because my manager told me to call, I did call the md. Then the nurse at the MD office started asking questions, was this patient taking meds correctly, what meds had the patient taken that day, was the HR at rest or upon exertion? Was the patient symptomatic? Was this an apical pulse or a palpated pulse from an extremity? I had NO clue, all I knew is that my manager told me to report the HR of 42. The doctor got on the phone and chewed me out for not having proper information. I charted all of this, and then reported to my manager that if the OT could not call the MD, then SHE needed to triage the call. Subsiquently, I called the OT and asked questions that the MD needed answers for and told her that she needed to relay the info to the MD because it was HER assessment. Every disipline has their own license to protect. I protect mine, and the OT and my manger need to protect theirs. I'm not a secretary, further more, if I didn't assess it, or don't have the documentation to support it (OT had not transferred her laptop yet, so I had no notes from the OT to go on) then I don't have correct info to report. IF the RT didn't get the dosage s/he wanted then they should have called the MD themselves. You can't relay all the pertinent info to the MD if you don't have all the facts, and relaying "hearsay" can get lost in translation. These are all professional people that you work with, they all have their very own license to protect. It's not your job to do the talking for them. If you do it, and you don't get the facts straight, then YOU become liable! Protect yourself..

My supervisor seemed a little "stunned" like she was almost put in her place when I told her about my conditions. I did not mention specific medications that I take, I just told her it was not safe for me to be out driving and seeing patients without adequate rest after taking medications. Her initial approach to me was that I had "called out of work to punnish her for me having to go out late at night". I also cleared that up with her by telling her that I am an OLD nurse and I do not have time in my life to play tit for tat games. She kinda just slumped down and didn't have much else to say. I am just worried that she will somehow use this information against me as she is young, inconsiderate, and power hungry. I hope that she appreciates all that I do for her and the company and just leaves it alone. It has been several months since this happened, and nothing has ever been said since. However, I just stumbled across this allnurse website and started reading threads that put me a little uneasy after reading other people's experiences. I do not take meds that "put me under the influence" but I do take meds to keep me stable and functioning. I do plan on talking to my psychiatrist about this issue at our next appointment. I never even realized I was a nurse with a "disability" until I started reading some of these threads. I do not expect any special compensation from my employer, but I do expect that they allow me to use my Paid Annual Leave time when I am not fit to work. I do not use my PAL time frivolously. I have been an employee of this company for more than 13 years and have over 6 weeks of saved PAL time. If there is a day or a time when I am sick due to my bipolar/anxiety/ADD problems then I do not work. Again, this has only happened a few times and I sought out FMLA on 2-3 different occasions for said issues, and only when I am VERY sick, usually involving hospitalizations/and major med changes. I have read from some nurses on this forum that they have gotten in trouble with the BON for taking these kinds of medications and have been considered "working under the influence". I do NOT want that kind of problem. I just want to know what is the right thing to do? I will contact the ADA and ask what are my rights. Like I said, I just realized that this COULD somehow be a problem, and it has me a bit concerned. I feel that knowledge is power, and so I feel I should be informed. I, as a nurse tell patients all the time, "you can not be out driving if you are taking pain medication." I know they need pain medication for their pain, but while they are taking it I know it is not safe for them to be out driving, and I tell them that they could be considered "being under the influence" if they were to have an accident. In all these years of nursing, I never thought that my disease/medications fell under that same category. I have to have meds to function, just as they have to have meds to be out of pain. I never correlated the two as being one in the same. I don't know if it is considered as being the same or not. I guess that is what I need to find out. Thanks for your help!!

I have been treated for BiPolar for many years, and have been on and off so many meds that it makes me sound like a pharmacy if I'd list them all. Some meds with terrible side effects then I'd have to take other meds to combat the side effects. Xanax is for severe anxiety/panic disorder. I take it PRN for that reason, and the Adderall is for ADD that I have had for more than 8 years...(YES I guess I'm a psych nightmare). But I do function pretty well most of the time. the Ambien is used to put me to sleep after the Adderall has done it's job for the day. Otherwise I'd be awake 24/7. I have to be careful to not go too many nights without sleep, or I become manic. But if I don't take the Adderall for ADD then I can't function either, I'm constantly losing stuff, racing thoughs, can't complete a sentence and can't teach my patients. I have never discussed this med regime/or my issues with my employer. However, I do know when I can't work. I could not work the day after being out until 3am doing wound care for sn on call patient, then take meds and be expected to be up and out the door by 7 am the next day. My boss was being pushy so I just told her the truth. She's a younger nurse with lots of letters behind her name and she is power hungry. I'm just afraid that she will try to use this somehow against me. Maybe I'm being paranoid. But I've been on some sort of med regime for bipolar and ADD for many years and nothing has ever been said, no complaints about my work etc. As a matter of fact I've been told I'm an "exceptional employee" and always have gotten above average evaluations in the 13 years I've been employeed there. I just do not understand the laws, I've read on some of these disability threads that the BON considers you to be "under the influence" if you take these kinds of meds and work. I can tell you from years of experience that if I did not take my medications that is when I would be too "impaired to work". I can't take care of a patient if I feel my heart is pounding out of my chest, I'm sweating profusely, and feel like I may pass out from anxiety, I can't take care of my patient if my thoughts are racing, I can't complete a thought, keep up with my pen, find my car keys, lose my jacket from ADD, and I can't take care of my patient if I am so depressed I can't get out of bed and life is so dark and dreary that I can't even bathe myself or eat from depression, And lastly I can't take care of my patent if I've been awake for days and not sleeping because the adderall has kept me awake OR mania has set in from the other spectrum of bipolar. I have found a balance in my life with these medications and I am really grateful that I have my life back and that I can function. What to people do that have to take these kinds of meds to function? Is it considered being under the influence by the BON, what are my rights as far and the EEOC is concerned? I've tried looking that stuff up, and reading about it as much as possible, but it is so "general" that I can't interpret what they are saying...maybe it's meant to be like that so you would have to be evaluated on a case by case basis if something did happen. I don't know...

Your company should have a policy/procedure about how to manage PICCs in the home setting. For example, our company says to flush unused PICC lines with 5ml of 10:1 U heparin daily, PICC line dressings 'and end caps are changed weekly. IF the PICC is ONLY for the use of the OutPatient Chemo dept, and the agency is not using the PICC for labs/infusions then the OutPatient department needs to supply the patient with flushes and dressing kits, and they should be the ones to change the dressing if the patient is going in to the Out Patient department at least weekly. Then if that is the ONLY skill that you are seeing the patient for, she does not need home health, as it should be managed by the Out Patient department. That's our company's policy. If the MD ordered you to get labs from the PICC then you should be flushing with NS before/after the procedure and with Heparin daily, changing picc caps after blood draws and weekly picc line dressing changes. Supplies then would be coming from your agency/pharmacy etc. I hope this helps.

I'm a nurse with 20+ years of experience. I have worked at the same home health job for more than 10 years. In that 10 years I once was out of work for 2 months because of my Bipolar disease. I had been hospitalized with a lot of med changes, and my PsycMD felt I was too "manic" to perform patient care, not sleeping enough to be effective on the job, and she took me out of work. FMLA, nobody ever said a word about it. Fast forward 5 years and I got sick again, went through a lot of med changes, and had to be out of work for a few weeks on FMLA again. I seldom have to be out of work and never do I just call out unless I'm extremely sick. I am on a SLEW of medications, but I'm a darn good nurse. If I am not "medicated" I can't work. I can't function. I take meds for ADD each morning before I walk out the door to go to work, I take antipsychotics, sleep aids and PRN anxiety meds every night before I go to bed. I have to keep myself healthy and take my medications in order to perform my job. They have have NEVER questioned my nursing skills, judgement etc. I used to be known at work for having a bad attitude and after some med changes I can see that they were probably correct. I never really discuss my illness with my co-workers or my managers. But a few months ago, I got called in by my young, power hungry supervisor. This is what happened. I got called to go out at midnight to go do a vac dressing change. We have an evening nurse that works 3-11 for these types of things but for some reason that night he did not answer his phone, so after trying to get him on the phone for 2 hours the triage nurse finally called me stating she was sorry but someone had to go. Our policy is that the patietn put a wet to dry dressing (with verbal prompting of the triage nurse) on the wound and wait for a nurse to come the next day to reapply the dressing. However, the primary nurse did not leave the patient with any wet to dry dressing supplies, so I had to go out. I had not taken my slew of "bed/head meds" yet, so I went out. It was a 45 minute drive to the patient house, an hour visit after documentation and 45 minutes to drive back home. Now it's 3AM and I have to take meds. At that time I realized I would not be able to function the next day safely, starting my day at 7am, after just taking meds 3-4 hours prior. So I left a very detailed email about the patients that would have to be restaffed the next day, and called my manager and left a message on her voice mail that I could not work that following day. She called me into her office to have a meeting with me stating she felt I called out the following day to "punish them for me having to go out late at night." I was furious. I just said to her, "Honey, you are sitting across the desk from a bipolar/ADD person that has to take medications to function, and after taking said medications late, due to work, it was not safe for me to get out and drive let alone see patients. And I'm a old nurse that does not have time to play tit for tat games" Now I take call about one night every two weeks, and because we have evening nurses it is seldom that we do get called out at night, if I do get called out late, after I've taken my "bed/head meds" I always ask my room-mate to drive me and I try to do the best that I can. I've never even thought about asking if I could be taken off the call rotation because of my disease. I just suck it up and do the best that I can. Our health insurance company requires employees to do a slew of blood work yearly and fill out health and physical forms. I waive that requirement and pay an extra $25 per pay period for "unhealthy premiums". I don't think they have any business having my health info. I have never divulged to my company exactly what medications I am on, or much about my disease, until that day. That has been a few months and I've had no reprocussions from this. But I really did not want to tell this power hungry young manager that I have an illness. Being a "full time nurse and taking part in the on call rotation" in mandatory if you want to keep health insurance benefits. If I don't have health insurance I'd probably have to be institutionalized. I, after all these years of being a nurse never realized that they can consider you as being under the influence if you are required to take these meds to manage your disease. It is just what I have to do to funtion and be healthy. What can they do to me? What should I be doing? Should I ask to be taken off the on call rotation because I have an illness and have to take meds? I really have never had a problem until this incident. I read some about the employees wtih disabilities act last night. I honestly never considered myself as having a "disability"... I function quite well ON my medications, it's only when I don't take them that I get sick. Is taking these meds (adderall, xanax, seroquel, ambien) really working under the influence? I really don't want to be treated any differently than other employees.

I read through this entire thread, 22 pages. I see some people whining, and some people here with some genuine concerns. I want to say a couple of things. To the nursing student that c/o failing a test because the teacher put things on there that they told you were not going to be on there....I feel bad for you, but think of this... Pretend you are now a licensed nurse. You work, say in Ortho, and because all the Oncology beds are full they stash an Oncology patient onto your ortho floor. Not fair? I know, so sad... but somebody has to be their nurse. Yes, it takes more time because you are "out of your element" and you might have to ask for some help, or look up some meds you are not familiar with, but this stuff happens. I am an OLD 20+ years BSN nurse. I work in home health. I don't get to pick and choose my patients based on if I know how to take care of them, I have to learn about their disease processes, teach medications that I might have to look up, and help them become as independent as possible in taking care of themselves. That is what nursing is all about. Just a few months ago I got a patient at home with an LVAD. I was more scared than he was. When I went to nursing school there were no such means of keeping someone alive, and if there were means to do this..it was in an ICU ..Not in home health. I did a lot of research, I did a lot of on the spot learning, and I got him and his wife comfortable enough to manage at home without the constant assistance of a nurse. I could have been whiny and say, "I don't think this is fair that this patient took up so much of my time"...etc, but it's part of being a nurse. YES nursing schools weed out people that are not fit for the job, who do not possess critical thinking skills, or are dangerous to themselves and others. Yes sometimes it happens unfairly, people EVEN INSTRUCTORS have preconceived notions about people (students) and sometimes it is not fair. Life is not fair. I have patients that don't like white people, and therefore make it more difficult for me to do my job. That's OK... I live and work in a very culturally diverse world. I treat them fairly, and I do the best job I can do to be their nurse. You have to adapt as a nurse and survive. I agree it's not fair that some instructors are on a power trip, but MAYBE, just MAYBE some people don't need to be a nurse. I used to take 4th year BSN students out with me on home visits. Most of the time I enjoyed teaching them and precepting them. These are students that are getting ready to graduate in a few months and are prepping to sit for the NCLEX. I had many students filter through with me, and they did a great job, even making huge teaching plans that were impressive to me for some patients. However, I once had a whiny student, who showed up late and made the day start off wrong anyway. On the way to the first patient house we talked about the patient, what was wrong with her, the meds she was on and what we had to do for her at that visit. We had to give morning insulin. I observed her draw up the correct med, administer the med correctly, and then the patient asked me a question as the student was walking away. The student proceeded to the patient counter and tried to recap the needle and stuck herself. That is BASIC nursing, stuff you pick up in the first semester of nursing. So I spent the rest of my day filling out forms, taking her to employee health, and hearing her whine because it happened. SHE KNEW BETTER... At 3PM, I'm finally done with the incident, the student goes home and I now have 6 more patients to go see and get home after 10pm at night. The student cried when they drew her blood, she whined all day about how much her finger hurt, I sat patiently with her through the whole process. I had to go make another visit on my patient to draw blood for HIV and HEP B etc, and drive that blood to the lab. I was furious on the inside for such an incident happening, but I maintained my cool. I then had a conference with her nursing instructor the next day, and I asked the instructor if she felt this student would be competent to practice nursing in the real world. She was a safety hazzard to say the least. I have no control if students pass or fail. Sometimes they do stuff to fail themselves, and I do not know if that student made it through nursing school. I know that was the last day I ever took a student out with me. I myself was an average nursing student. I studied hard, and I did a lot of research on my patients/care planning, looking up meds and procedures the night before clinicals etc. I, like every other student would sometimes get blindsided because the doctor would start the patient on a new med/new procedure etc and I didn't know about it till I got on the floor that next day. I learned I had to be flexable and keep on trying. One day in my junior year of school an istructor pulled me to the side and said, "I don't think you will ever make it as a nurse. I think you should drop out of school right now and get your cna license and make that your career." When I asked her why she felt that way, she didn't have a good answer. I told her "Thank you for the input, and watch me soar..." I went on to tell her that her doubts had just inspired me to be the best nurse I could be and someday she would eat those words. I then failed the NCLEX on my first try after graduation, and I felt like she must be right. But the hospital I was working in at the time told me I could keep my "new grad pay" until I could take the NCLEX again in 6 months. They told me that my preceptor had faith in me, and that was all I needed to hear. So I continued to study, learn and fight harder. Back then, it was a 2 day test and you colored little dots on a piece of paper for your answers. There were no computers. We made "med cards" on index cards for all the drugs we gave and had to learn about, there was no smart phone to quickly look up the meds. All I'm saying is YES some people NEED to be weeded out, they are not equipped to handle being a nurse. Nurses, unlike many other professions deal with peoples lives. Life and death, not just "oh I'm sorry I put your groceries in a paper bag and you wanted plastic" but LIFE AND DEATH. It is seriouis stuff and you have to be prepared for anything to happen, and have enough critical thinking skills to handle it approriately. Sure, in my careeer there are times I found myself crying in the bathroom after a horrible thing had happened to my patient...but I never once cried because I did the wrong thing. I make mistakes, nobody is perfect, but learn I from my mistakes, own them and go on. I've worked with a lot of different nurses in my lifetime. Some I would love to have as my nurse some day, and some I wouldn't want them to care for my animals. Nurses are a strange breed. We have a lot of responsibility, and we have very little time to react. Some people are just not cut out to be nurses and they should be weeded out! If you KNOW you want to be a nurse and are getting treated unfairly, don't whine about it...suck it up and take it as a learning experience. Life is not fair..and if you think that it should be, then maybe you shouldn't be a nurse.