Parkerone

My worst patient ever was the aids patient with dementia who kept removing his super huge open wound dressing and spraying blood all over the place. I believe he could not be restrained due to the dementia. I had other patients in the hospital to tend to but by the end of the shift I was tending myself ( now lol). Whewww...

I was told in one case that if I took online courses that required clinicals they would be set up with the local hospitals. Just ask the person in charge of the program how that would work. You could also take whatever prerequisites while waiting, if there are any you need to take. You don't necessarily need to be matriculated to do this either. You can matriculate once you get to the clinicals if it is a local program you are considering.

Oh and also, keep ALL of your transcripts from other schools.

One of the first things I was told by my first nursing director. Make sure the school is accredited, make sure your instructors have masters IN NURSING. Also that your credits from other schools are transferable.

I have had a couple of experiences with hospice patients. One experience was with my mother in law. I had to manage the whole end of life episode with her. Bottom line is that THE MOST IMPORTANT aspect is COMFORT. A nurse needs to know that the management of pain and anxiety are very closely related. The patient knows they are going to die, the family know it also. It is a very frightening awareness for both. Not to be rude or condescending, but that is why the patient is on hospice care, end of life care. Depending on how close they are to dying is how close the meds are going to be given. Family members are more acute at knowing the the more familiar grimacing a patient may do and subsequently may push for more meds, even if the patient does not or is not able to respond. There should be a hospice nurse supervisor that you can bounce questions off of. They were very helpful with my situation and knew that I was a nurse. It depends on how aggressive the family/patient desires are for the situation. In my mother in law's case it was very clear in her written wishes what she wanted. She wanted to go quickly and pain free. So we monitored the morphine (respirations) and her anxiety. If she became conscious of what was going on she became fearful, verbal and restless, so up went the morphine and up went the Ativan until you could see on her face that she was peaceful and in comfort, not thrashing around. The hospice super and the nurses there were very helpful. We ended up transferring her home from the hospital and that is where she "blasted off". In retrospect, you may want to get a hold of a morphine and Ativan protocol and review it or have someone else review it with you. Also the chart should explain the patient's wishes. Hospice care involves a different use of medication as opposed to what we are taught in school. Good luck I hope this was helpful.

For the Pleasantville campus, yes there is a bus. I did it, and it was doable for prereq classes. A little difficult if you have to go to the library. Go early and know what the schedule is so you don't miss the last one. Most of the hospitals are accessible through the bus system in that particular area.

duplicate, sorry.

I like the idea of taking a college class a semester. Keeps the mind goal oriented. Have you tried subscribing to John Maxwell's "Minute with Maxwell"? He is pretty uplifting and today's subject about "mindset" is pretty good. I don't know if the leadership training he provides is something you are interested in but give it a try.

Perhaps try some volunteer work at a hospital or nursing facility; you could do this while working at a coffee shop or something similar to get your feet wet. Also you could take some beginning classes at Hunter College or similar. Start with an English class and work your way up to the hard stuff. Take a basic math course to get your brain used to calculating again. Stay in school until you know which avenue you wish to pursue, then declare your major. You will have an idea after doing these few things which direction to go. Personally I think the BSN is the way to go. Also don't forget to go to the library and ask the librarian where the section is that deals with scholarships. There you can learn how to write a letter on how to get a scholarship from an organization to help with funding your dream. You are only 20 so think carefully about all of your decisions which will affect the rest of your life.

Hello GRN what is the status? Just a friendly inquiry.

Remember to listen to lungs when there is a possibility of aspiration. Upper, mid, lower.

Hi, just a few of my own thoughts, from a hundred years ago: First of all not to throw the baby out with the bath water: Did that patient who aspirated, have a temp at anytime before/after that? Did anyone order a speech eval because obviously the patient needed more teaching about swallowing, etc. Also were any chest xrays done, even if no temp to rule out pneumonia after the aspirations? PT/OT/Speech personnel are very helpful, get to know them. Now for thought provoking stuff: There is a really good book that was used in my BSN course. It is called: From Novice to Expert by Patricia Benner. This book was like my bible when I finsihed with BSN after ADN. You may want to review this book, ESPECIALLY in the back, where no one says to go and read. There is a little section called Guideline for recording critical incidents. This is a wonderful guideline to sit down with (even after it is memorized) to make sense out of ANY situation you may come across. Here is the cliff notes version: A. What constitutes a Critical Incident: An incident in which you feel your intervention really made a difference in patient outcome, either directly or indirectly (by helping other staff members) An incident that went unusually well An incident in which there was a breakdown (ie, things did not go as planned An incident that is very ordinary and typical An incident that you think captures the quintessence of what nursing is all about An incident that was particularly demanding B. What to include in your description of a critical incident: The context of the incident (e.g., shift, time of day, staff resources) A detailed description of what happened Why the incident is critical to you What your concerns were at the time What were you thinking about as it was taking place What you were feeling during and after the incident What, if anything, you found most demanding about the situation C. Personal Data: name (optional) title institution Amount of time on current unit Amount of time in nursing practice Unit where incident took place D. Describe incident in detail addressing part B questions F. Describe a typical day at work you had recently G. Describe a day at your work that was unusual in some significant way. This little guideline will help to refocus your thoughts back to solving the problem and thinking in the right direction. Good luck.

Thanks Steeleworks for the information. Are there any particular books you would recommend? Also where did you get the information about the water?