All Content by JRDeeRN
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Dealing with crappy tech/assistant performance
How many patients do you normally have ?
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Decreased cardiac output r/t CABG - Graded care plan HELP!!
Love talking about the heart :) no problem:)
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Decreased cardiac output r/t CABG - Graded care plan HELP!!
and also after surgery we have a lot of patients who third space their fluid rather than pulling it in their vessels... these patients will often have a lot of swelling or in your patients case it sounded like he had some fluid build up in his lungs.. which most of them the docs will put on lasix
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Decreased cardiac output r/t CABG - Graded care plan HELP!!
Then i would definitely say with my patients they are at risk for decreased cardiac output because this heart surgery has irritated the heart significantly and it is trying to heal at the same time from the surgeons stitching the graft and what not. When the heart is healing some of our patients with go into dysrhythmias such as afib, vfib, aflutter, svt, VT, A MULTITUDE of cardiac dysrhythmias. of course if your heart is not in normal sinus rhythm, these rhythms will impair cardiac output because it's not the normal electrical pathway of the heart to follow, so it wont pump as effectively as it should providing the necessary cardiac output. This is when we either start a cardiac drip (for afib) or of course if they are coding we will do more intense interventions :) From experience, that is the way that I am looking at it. OF course their EF will never be great because of possible heart injury before the cabg. but as far as why a patient is at risk for decreased cardiac output after cabg, that would be my answer. hope that helps.
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Decreased cardiac output r/t CABG - Graded care plan HELP!!
Also did you mean after the CABG procedure as to what could affect cardiac output or before the CABG intervention? if before CABG intervention, i agree with the previous poster.
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New Grads, How much do you work?
graduated in May 2012 and have been working on a critical care heart unit for a year in June... i have a FT position and will sometimes pick up an extra 12 or or 8 hr shift.. or both in one week :) helps when you really love your unit :) I really think it should be easy to find a FT position
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cried in front of my boss, is it too bad?
not bad. youre human and youre a nurse dealing with literal life and death situations. Just today I had a nurse cry to me talking about a patient deciding on end of life decisions. It's normal. :)
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Decreased cardiac output r/t CABG - Graded care plan HELP!!
In working on a cardiac floor I would say pt is as risk for decreased cardiac output if they develop a dysrhythmia after surgery which is very common. Happens to about 30% of patients after CABG...Is that maybe what you are looking for ? Or am i even hitting close lol
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Which is the hardest part of the nursing program?
The middle was the hardest for me.... beginning is simple nursing and getting introduced. middle is man it's getting harder and im not quite thinking like a nurse should and now i really have to learn critical thinking and content.. the end is a little easier yes we deal with harder concepts but have almost mastered thinking like a nurse so it doesnt seem impossible like it did in the middle. I spent about 3-4 hours a day studying. However the 10 days to a week leading up to a test I would increase my time by a lot. The day before it wasnt really unusual to spend about 8 hours if I had the free time just sitting in the library all day finding different ways to study.. group study.. individual study/notes, book, videos on the internet, re writing notes.. nclex trial questions. I might have done overkill with it but i wanted a fail proof plan so I wouldnt have to worry about whether or not I could succeed or not. It's worth the hard work and its my greatest accomplishment to me in my life so far. Just try to look at it that way :)
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Patient ratios progressive care units
we are 3:1 dealing with vascular, heart, lung and endocrine (thyroidectomy) patients. as well as overflow ER patients... i honestly dont see how I could manage a 4:1 ratio with the work list i have with my patients. i was running around all day it seemed like today. barely enough time to eat lunch much less making sure every patient felt like they received the care they needed. luckily my unit is a very team oriented unit so that helps.
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Care Plan: I need to know if this nursing diagnosis is legit
Oh lol I used those kind of NDs in school all the time but maybe they weren't as strict about them at my school as long as it got the point across lol nevermind then
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Care Plan: I need to know if this nursing diagnosis is legit
Ex. Risk for injury related to disturbed sensory perception secondary to disease process
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Care Plan: I need to know if this nursing diagnosis is legit
Is his eyesight bad related to the disease process of diabetes ?? That would be a good one a lot diabetics have eye problems because of uncontrolled diabetes ... Just a thought !
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Working while in Accelerated Nursing Program?
Honestly depends on the person. I did an ASN program and could barely work 10 hrs a week but my friend could work 2 twelves as a cna and got thru it. Depends on your dedication and self discipline and how much time you study to grasp a concept. I always needed to study 10x more than the person next to me to get thru nursing whole some people got it all within 4 hrs of studying. I know that's not very helpful but that's about all I can offer
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How hard is NCLEX compared to Kaplan?
Also the Kaplan setup of questions looks just like nclex... So I felt like I was doing Kaplan questions when I was taking the nclex
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How hard is NCLEX compared to Kaplan?
You'll do fine if you're getting those scores on Kaplan. I thought Kaplan was harder than nclex... But don't underestimate the nclex by any means. You've studied you've down your best and have prepared you should be fine. But in my opinion Kaplan questions are harder and a little more tricky than nclex but there are still those tricky questions on nclex so I guess I'm saying don't let your guard down lol
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Accredited vs. Not
Very important...... Very. You will not be able to pass the nclex... Is what I have heard.. Not accredited means they don't meet requirements of other nursing schools which provide success. I wouldn't do it but that's just me.
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Cardiac drips?
There's really not much that we do differently with cardiac drips. I'm a step down unit cardiac nurse and we do amiodarone, cardizem, and rare cases dobutamine.. They All should have order sets about what to run them at and if you know basic cardiac rhythms and strips and how to identify them you should be fine. Ie: atrial fibrillation requires to start an amiodarone drip.. Bolus and then decrease rate after a while. Hope that helps we deal with these almost every day in my step down unit idk if that's what you'll be dealing with
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Should I get my ASN then BSN or should I just go straight for the BSN?
Yea so far it's worked out really great... One thing i did also while taking my ASN classes was take bachelor pre requisites like for example : speech English math history psychology and all those kinds of classes that way I will literally only have to complete the bachelor nursing classes. I graduated with more credits than I needed for ASN but just enough credits to complete my BSN. if i didnt complete those classes i would probably had to extend the length of time to fully complete my bsn.It really worked out in my favor... So now I only have to take a year online while still working with a RN pay check... It's nice :)
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Should I get my ASN then BSN or should I just go straight for the BSN?
The only reason I started with my ASN then to bsn is because most hospitals will reimburse your schooling for BSN. So you get out sooner as an RN get money as an RN and then get paid to take online classes for a year to get your BSN. Eventually all hospitals will require BSN I just did the other route to work out better financially
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speech
Unfortunately there will be classes in nursing where u have to present a group project more than likely... its not so scary. You're not the only one who hates it I'm sure... And everyone has to do it. So everyone feels the exact same I'm sure. I'd say go for it :)
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I need Fundamentals of Nursing HELP
What I had to realize about nursing school when I started was that its not about memorization it's about actually applying and understanding the information. And learning what takes priority. Abc. Airway breathing circulation. Which patients do u see first? Airway pt! If its a psych question think safety. Write all over your test... And take every question on the test one at time. As far as studying goes, each disease has a definition, cause, med treatment, surgical treatment, nursing treatment and lab values and clinical manifestations associated with it. Know these! And if u don't understand it, look it up not only in your book but online. I used to go on YouTube and look up certain procedures or diseases until I could confidently explain to someone what happens. Dedicate a certain amount of hours per week to study. Mine was about 20-25 hours per week. That's roughly 3-4 hours a day. But write out a weekly plan of what day u are studying and what times and commit to it. Ask faculty many questions.... That's why thy are there ... Join study groups... Get a fail proof plan and run with it . :) hard work pays off and that's one realization I had to have to get where I am today .
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What to do?! Waiting to hear back from employer!
woops this is a really late response, i just saw this. If you still want examples of what was asked during my interview let me know!
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Words of wisdom?
GO FOR IT! I am a failed student and I never hesitate to tell people, because dangit, nursing school is hard!!!! IF it is truly what you see yourself doing, then yes, go ahead and try but have a plan of action that is fail proof. My issues were prioritization in my life and not asking questions and seeking out faculty like the previous poster said. Find different and creative ways to study to make it more bearable until it actually becomes fun to begin to study. I ended up cutting a chunk out of my social life and dedicating a certain amount of hours each week ONLY to studying. If you dont set a goal, how can you achieve it? make a commitment no matter how much you don't want to study, make the hours of studying that you set for yourself. I ended up writing out the name of the disease/problem.. Causes.. Medical treatment. Nursing implications... and what to look out for. I then would look up youtube videos about the specific topic i was studying to get a better visual i could picture while taking my tests. hope this helps :)
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Failed check off
talk out loud the whole time! i found that it actually helped me to run through the steps out loud. I didnt even care if I looked ridiculous. to this day I will talk out the steps in my head while taking care of my patient