2bNurseCai

I worked 40 hrs a week and went to nursing school full time. It was hard and there were times where my work or my school work suffered because of it. However I never pulled in anything less than a B and I am graduating from nursing school tonight. If you're willing to work harder than you've ever worked in your life (and be prepared to have your teachers try and dissuade you from working full time), then you can do it.

Absolutely beautiful. ?

Oh my goodness, thanks for all of your responses. Now I just have to pore over them all :) *disappears into the site*

Is anyone out there good at explaining how cardiac physiology works; particularly the depolarization/repolarization of the cells and how it correlates to phases 0-4 and what that means in the conduction process? I've read it several times in my text and I'm also using the ECG Incredibly Easy book too but it keeps going right over my head

Me too! I know most of it has to do with working full time along with school; so that when I'm home at night I'm too tired and unmotivated to do much. Plus I find myself getting easily distracted. Just gotta keep plugging away...

I'm sure it hasn't crossed your mind, but did it ever occur to you that there is, in fact, a middle ground? When I say I enjoy looking a bit feminine, I did not mean (or mention for that matter) overdone makeup (I wear none), fancy jewelry (my wedding band and that's it) or fancy crap I don't need. And I wear whatever uniform the place tells me to and I have no problem doing so. But if I have a choice to wear a fun color or pattern (nondesigner thank you), I see nothing wrong with doing so and I don't need you to try and tell me I'm unprofessional or less of a nurse for doing so.

That's exactly what I meant; oops!! Clearly can't study and browse here at the same time.

I use the CDC for current guidelines and also NIM for all sorts of information. :)

I agree! I spend 99% of my life in scrubs between school and work; nothing wrong with wanting to look and feel a little feminine! If someone is going to judge a nurse based on the color of her scrubs rather than her skills and knowledge, then it sounds like someone else has the issue; not the nurse.

This may seem like a no brainer question, but I feel like either I'm overthinking it or missing something completely, so I am looking for some help. I am doing a cardiac case study and my patient has just been discharged with an order for nitro. The question asks what statement would show that the patient requires further teaching? a) "At the first sign of chest pain, I will stop what I'm doing and sit down" b) "I will place one nitroglycerin tablet under my tongue" c) "If the chest pain does not stop, I can take another tablet in 5 minutes" d) My husband will need to call 911 if the chest pain does not stop after three nitro tablets" Now, at first I thought A; because many doctors tell you that you should take the nitro before activities that could cause angina and therefore head the pain off- but the question doesn't ask about that and I feel I'm reading into it too much. B is correct as far as I know. C gave me pause only because some doctors want you to call then after the first dose does not work and they may tell you to go right to the ER rather than take another dose after waiting 5 minutes. Again, reading too much? D is correct, I believe. So is this a trick question?? All answers seem fairly reasonable to me. Sorry if this is a bonehead question but I could use some input! Thank you :)

That's so helpful! :) I mean I know there's always going to be the people who are rude and use their phones for personal stuff on the floor, but this technology we have now can be so beneficial to learning! I wish more places were more open minded about it! Do you mind sharing the list they gave you?

This is actually the first semester we've been encouraged to use our phones. My clinical this time around is at a small regional facility; maybe they're less upright than big name places?

Hi all :) I am beginning a med surg clinical rotation on Monday on a Tele floor. Cardiac is not my strong suit and we haven't gone over reading rhythms yet in lecture. Any good apps out there that I can use to help me with cardiac and/or tele during clinical? Thank you!!!

I agree about the methergine; the risks definitely don't outweigh the benefits. As to why she's on it or why she's on so much fluid, the case study doesn't say and doesn't give me the option of changing it. It's more of a question and answer type study where my prof wants us to get a feel for the different maternity meds and their uses rather than looking at the patient and determining whether or not something needs to be changed. It's frustrating!!

Thanks!! I just downloaded it and it seems awesome :)

As a student nurse looking to keep up with medical news and trends, I'm curious what nurses in the field find to be the best read. I've been looking at AJN and Nursing (Nurses?) 2013 to name a couple. Any input? Thanks :)

Ok, sorry it took me so long to get back to this- working lots of overnights. Thanks to all for your help, it has helped me to put things in perspective. I'm wondering if I didn't give enough info with my initial question though. I understand why they're using MgSO4 and what the general use for methergine and pitocin are. However, given her history with pre-eclampsia and the contraindications surrounding that drug with methergine, I'm just wondering why she's on it and Pitocin at the same time. Here is the full story and the exact questions I'm still struggling with (bear with me!) :) 23yr old G1P1 DOD of a NSVD w/ midline episotomy w/ 3rd degre laceration. aspirin allergy. baby is 8 lbs 8 oz. has mild-moderate pre-eclampsia. on 2gm MgSO4/hr IV, 20 units Pitocin in 1 L D5 1/2 NS over 8 hours IV, methergine 0.2 mg IM after delivery and then TIDx24 hours. temp 36.8, BP 130/90, pulse 66, respirations 18. clear lungs. fundus firm, midline, 1 cm down from umblicius. moderate lochia rubra, negative homans. soft breasts. breastfeeding with good latch and positioning but c/o mod-severe uterine pain when feeding. HCT 22, O negative, non immune rubella, GBS positive, 75,000 platelet count. So, I'm just confused on why the methergine if Pitocin does almost the same thing and it's unsafe to use with her condition. There is also the question of whether she should continue on the methergine, to which I am guessing not. Thanks again for all the help, sorry if I've repeated myself a bit; just having a hard time understanding it.

That's ok :) I appreciate you trying to help me. Thank you!

Kind of. But it also said that her fundus is firm and midline and had no delivery complications. Her baby was 8 lbs 8 oz so the LGA baby makes sense. But with her preeclampsia history, it seems odd that she's on methergine. That, plus the pitocin, plus the natural oxytocin released during breast feeding seems like overkill.

I have a case study for maternity that I am working on and one of the questions has me a bit stumped. I think I have an idea as to what the answer may be, but I'm looking for some feedback. I have a patient who is G1P1 DOD with a history of mild-moderate pre eclampsia. She is currently on 2 Gms/hr MgSO4 IV, 20 units of pitocin in 1L of D51/2NS over 8 hours IV, and methergine 0.2mg po TID x 24 hours. She also received an IM dose of methergine 0.2mg upon placental delivery. She has only moderate lochia rubra and has moderate-severe uterine pain while breastfeeding. The question is why the client is on Pitocin given Methergine also does the same thing. The only things I can think of is a) the MgSO4 lessens uterine contractions and maybe the Methergine isn't enough to keep the uterus contracted after birth or, b) since Pitocin also causes a decrease in blood pressure when initially administered that it may be used to help control her blood pressure, which is a major factor in preventing eclampsia. So does it seem like I'm on the right track? Let me know! Thanks :)

Got an 86 on my first Med Surg/ Maternity test! It was wicked hard and I thought I hadn't done well, so this makes me feel like I'm on the right track! Also gave my very first shot and IV push at clinical this week! I felt like SuperGirl :)

Don't feel so bad! I had one last week (I'm in my first year) and when my sim patient's O2 sats went down, I panicked and forgot what to do next! Mind drew a total blank! That said, sims are a great teaching experience! Focus on what you did well :)

This may sound stupid, but what is a nurse externship?

I will be graduating from an ADN program next year and I am starting to think about the best way to gain experience to get a nursing job after graduation. I have two ideas in mind and I am looking for some advice as to what may be the best option. I have been working as an RP (responsible person) for two years now at a level four rest home. My duties include passing meds, dealing with emergencies, documentation, transcribing orders, revising the MARs, and dealing with the MDs and the pharmacy. However I have been thinking of leaving this place come summer as applying for a CNA or unit secretary position at a hospital to get my foot in the door. So my question is: which looks better? Which would help get a leg up? I can see how longevity at a single job looks good, especially since I have experience dealing with things that CNAs don't get to do and most nursing students don't get to do before licensure. However, I know hospital jobs are tough to get and working as a CNA etc prior can help come graduation. Thoughts?? Thanks! :)

I was the theatre geek who wanted to be on Broadway (except I can't sing or dance). I was very smart but got bullied for it in elementary and middle school, so high school was all about boys for me- made a lot of dumb choices involving guys. Didn't have many friends; I was kind of a ***** and a lot of people thought I was a skank. I had all honors classes but I did not care enough to pull down the grades for it or take advantage of opportunities it could offer me. I really didn't like myself and started down a path that I didn't get off of until the year I graduated college. That's when I finally began turning things around.