MJeanRN

Sure there is...if by "nursing shortage", you mean that the hospitals are requiring nurses to take on more and more patients and increase work loads without staffing much needed additional help. It's not because there aren't enough nurses to fill the positions, it's because hiring more nurses affects the bottom line. The nursing shortage exists in hospitals looking to save money. Hospitals are consistently short staffed, which has translated to the media that more nurses are needed. While this is true in some areas, it is self-imposed by many hospitals who are not willing to hire additional staff.

I happen to live in a state where employers are not allowed to "discriminate" against smokers. I found out one day while reading one of the state labor laws posters. Guess it depends on how much big tobacco contributes to the local economy/government. Interestingly enough, many of our hospitals have no smoking on-the-premises policies.

Calm down and breathe. :) Starting anything in nursing is sometimes confusing and frustrating. Whether it's a CNA course or obtaining your registered nursing degree, you have to realize that at some point you have to take resposibility for your own learning. I understand how you feel, and many of us have been there and felt the same way! My advice is this: whether you were told to read the book or not, read the book. It contains valuable information that your state expects you to know about how to practice as a CNA. I'm betting that the book breaks down how to do all of your skills STEP BY STEP. Also, it may contain a link to websites that may give you further information about skills. Fell free to use youtube! I cannot tell you how much I relied on youtube throughout nursing school to learn how to do something. Lastly, common sense goes a loooong way in any level of nursing. For example, would you want to touch someone else's soiled linens without gloves on? Would you want to hold clean linens against your dirty work clothes? Things like that are common sense, and I bet if you thought about it, it's things you would do whether the book/video told you to or not. I'm guessing you actually DO know how to make a bed, it's just the "critical" steps that you HAVE to get right are overwhelming you. Try practicing at home with a pillow to substitute as a resident. Knowledge is power! Read your book and do a little research and you'll be powerful! Good luck to you.

Cannot say enough about how helpful Kaplan was. For our program, it was a requirement to purchase it and attend the seminars, and I'm grateful!

I would say it depends on the objectives. If they're anything like mine were, then it probably isn't feasible (ie, care for a patient with a trach, etc- there may not be a trach on the floor during clinicals!). I would definitely focus on the skills they're currently learning, or finding an interesting case that they can observe. Also, I totally agree with students being abused as CNA's while at clinicals. These skills are usually required prior to, or as a condition of, starting nursing school, and nursing students aren't there to learn how to give a bath. My is to let them shadow a nurse (a nurse who is willing, and doesn't mind having a student), so they get a feel of how it's done, before letting them off on their own. Then, I would give them individual objectives based on their knowledge base. Explaining to them the basis and how to formulate a careplan would also help. The best CP I ever had was the one who made sure we really "got it" at the end of the day. She went around the room and we each shared our patient's medical diagnosis, and then we etched out a careplan together, using simple, common-sense interventions (not the paragraphs in the careplan books). Good Luck!

If he had the Haldol ordered (depending on what the order stated: ie, prn agitation, etc.), I would have used it. Climbing out of bed at all hours of the night makes him a danger to himself. What if you hadn't caught him doing it those 6 times? Did you have a bed alarm on? Even with a bed alarm, what if you were in a situation that didn't allow you to leave to check on him? If he had fallen, would you be able to explain to his family or the physician why you didn't use a prn medication that could have prevented it? If the geri chair had the tray down, that would be considered a restraint, and you didn't mention having an order for one prior to the soft restraints. He may have been calm during report because he wore himself out during the night. Would he have had a much more peaceful experience if he would have had the haldol to take the edge off enough to rest throughout the night instead of wearing himself out to the point of exhaustion? Maybe, maybe not. The point I'm trying to make is that just because you don't believe in "heavily medicating" your elderly patients, doesn't mean that it's not necessary, or in the best interest of the patient and their safety. As far as whether or not it would have made your night "easier" so you didn't have to "run your feet off" isn't what you should be focusing on. Next time, I would suggest taking a step back and asking yourself what the pros and cons are to using the medication. What's the best outcome of giving the haldol (patient is less agitated, not climbing out of bed, and may get some much needed rest), and what's the worst outcome (haldol doesn't effectively calm the patient down)? If it didn't work, then that was something you could have passed on in report, or informed the physician about so that something different could be tried. If you had used the haldol, you may have kept the patient safe and saved yourself from possibly having to fill out an incident report. I'm not being judgmental here, as you have your own convictions for not wanting to use it. However, as I said above, maybe taking a step back and weighing the positive and negative outcomes may help you to make a more objective decision in the future. The confused elderly are a challenge, so I commend you on coming up with a creative solution. Best of luck with this in the future! :)

Practice NCLEX questions, and read ALL of the rationales. Make sure you read the rationales for the questions you get right too, and why the other options weren't correct. Reading and truly understanding the rationale will help to validate whether or not your thinking process is on the right track. Best of luck to both of you!

Just last night my tech reported to me at 0600 that one of my patient's BP was 198/86 during her 0400 vitals. I immediately jumped up and did a manual pressure and got 152/84. When I went to chart it, I saw that her comment for the 0400 BP read "nurse aware". Seriously?! Not to mention that when I came on I had to tell her to change out a small adult cuff to a larger one on a 300 pound patient to get a proper reading. Sheesh!

Out of all the applications I put in, the ONLY call I received was from the small community hospital the next town over. I truly believe that the reason they called was because they weren't all tied up in politics like the big city hospitals are. Where I live you have to either know someone or STALK the HR department, or both, in order to get your voice heard and really stand out. It's not that I'm against that practice, but it takes a lot of energy if you have applications at multiple locations. While I'm thankful to have the job, I know I have to stick it out for 6 months to a year before I can even think about transferring to a hospital I really want to be at. Best of luck to you!

^^ I almost cried! Best. Reply. Ever.

Yes, your exam will be on a dummy. We were required to be CNA's prior to nursing school, and the one that I attended had us write out each skill on paper, and then in addition, the critical steps on notecards. Write them out to help commit them to memory, then keep practicing, preferably with another human (not a dummy), so they can tell you if you've missed a step. Throughout nursing school, anytime we had a skill I would also use drive time to practice. Do this just by simply repeating the steps out loud to yourself anytime you're in your car, or standing in a line, or getting through a tv commercial. Keep your common sense about you. If you freak out and freeze, just think about what the next logical step would be, or how you would want someone performing the skill on you. Practice makes perfect! Best of luck to you!

Thanks for the advice! It's not that I can't hold out for 6 months, as much as it's my bank account may not be able to (and to a lesser extent my sanity). It's currently a PRN position that I'm in, and I've been put on stand-by for the last 5 out of 6 days that I was scheduled to work. Mind you, that was after being promised in the interview that I would have "all the hours I need". I understand it happening every once in a while, but sheesh! A girl's gotta live.

I've always been told that above a 60 on Kaplan tests indicate passing level, especially since all of the QB and TT are considered by Kaplan to be "passing level questions" (critical thinking, analytical questions). That being said, don't focus so much on the score you're receiving, it's more important to focus on whether or not you understand why you got a particular question wrong. I cannot stress enough how important it is to read the rationale for EVERY question (not just the ones you get incorrect). Make sure you're using the method Kaplan teaches for answering your questions too. If you're getting questions wrong because of content, make sure you review it and understand it. Remember, NCLEX tests your ability to practice safely as an entry level RN. Before submitting your answers, ask yourself if it makes sense! (Common sense will take you far in life). Good luck to both of you!

Mine sure as heck was! Our second year started with the instructors saying, "you got through first year, it's our job to make sure you graduate". But, each program is different. You'll be surprised how much you learned in first year that will help you in second year. The confidence that you made it there also makes a huge difference!

Any nursing job should give you valuable experience that will bulk-up your resume. As far as hospitals discriminating against you for nursing experience, I don't personally believe that it's true. Make a list of pros and cons for yourself to help make your decision. Think about how you can list this experience on a resume, and how a hiring manager will view this experience. For example, you'll most likely be responsible for 20+ individuals at a SNF, you'll be able to list your awesome time management skills, long-term disease management skills, and multi-tasking/ care clustering capabilities after gaining some experience there! Try viewing your options through a positive lens, instead of picking out why someone may look down on them. Think of it this way...if you were hiring someone, would you want someone with zero experience, or someone that was able to take a position and apply learned skills and knowledge to provide excellent nursing care to such a vulnerable population? Best of Luck!

Where I live, HR for hospitals expect you to contact them on a weekly basis to keep in contact regarding open and upcoming positions. In fact, one of our hospitals puts your name on a board at first contact, and puts a check by your name each time you call. Whenever a job opens up, whoever has the most checks gets an interview. This is such a tightrope though, considering some HR departments will consider you as an annoyance if you do this, and mentally put you on a "do not answer" list. Ask how often it's appropriate to contact them, and their preferred method of contact regarding positions you're qualified for. I would suggest contacting, or visiting in-person, your hospital's HR department or nurse recruiter, and ask them how to go about starting the hiring process. It's an employers market right now, so make sure you're taking every step possible (contact, resume, follow-up, etc.). Ask if they have any intern/externships available for new grads, utilize your clinical faculty as referrals, and for goodness sakes, make sure each time you show up in person, you're dressed appropriately/professionally (hospitals had given that tidbit to our school instructors as reasons they haven't hired individuals recently). Also, I know a hospital job is at the top of most new grads lists, but think outside the box and check out ALL of your options as an RN (school nursing, doctors offices, immunization clinics, camp nursing). Any position will give you experience. Good Luck!

"Milking" the finger after the stick can result in interstitial fluid being mixed with blood and causing abnormal glucometer readings as well. Make sure you're getting good circulation prior to a finger stick.

Double-like TstormRN!

It's never too early to start learning pharmacology!

I'm not saying it's not possible, but I certainly wouldn't recommend it.

:yeah:Congrats on getting in! I felt the exact same way before I started nursing school...and then every semester until it was over! Nursing school is hard, there's just no other way to put it. Keep your chin up, and study, study, study! My advice to you is to try to read your lecture information prior to going to lecture. After lecture, try to go over your notes before the end of the day (you'll be amazed at how much you don't remember from lecture!). If you don't understand something, ask, or better yet, look it up. I used my textbooks (especially the on-line resources that come with them), google and youtube more than I ever thought I would. Sometimes you'll do better than you expected, sometimes you'll question if it's worth putting yourself through it. Write out inspirational quotes to take a look at during the latter, and make sure you have a good support system. Best of luck to you!

The worst anyone can ever tell you is no. Make sure you include on your resume that you've started pre-req's for your BSN.

My mom told me once that I shouldn't become a nurse because, "it becomes your life". Well, duh, that's what a career is, lol! I never let her comment bother me, because she was the one that told me growing up that I can be anything I want to be. You already know that it takes a special kind of person to want to take care of other people, in all of their "glory" (ie: wiping their butts, cleaning up their urine, etc), and someday, your "friend" may be in a position to rely on a nurse to take care of her, and will be thankful for nurses like you that are willing to wipe butts besides their own. I'm sorry that she's not supporting you and what you want to become the way a friend should . But, kudos to you for not turning the other cheek, even though it would probably feel really good to let her have it. And, graduating or attending community college doesn't bar you from ever attending or obtaining a bachelor's degree at another institution, it just means you're being frugal with your resources, and not overpaying for classes offered at both institutions. Keep your chin up, and if she continues to try to make you feel bad about yourself, let her know that her words are hurtful. If she can't understand that, you may want to re-evaluate your friendship.

I very rarely go off of my "night shift" during my time off, so I just eat like I normally would during the day. If I can't get a bowl of cereal in before I go into work, I take some type of granola bar and an apple or orange and eat it on my way to work. Since we don't have an open cafeteria either, I always pack my lunch (usually tuna for the protein and something with some fiber for the fullness). Sometimes on my nights off, I cook a couple of meals in advance so that my husband has something to eat while I'm at work, and so that I get a hot lunch every once in a while. I may snack on something on the way home, but I usually wait until I get home to fix something to eat for dinner. Recently I've been having Ensure once a day too, since it has extra calories and vitamins. And ditto on the hydration! I have to force myself to drink water at work, and on my days off! I don't know what it is about staying up at night that makes us forget to drink, lol!

NCLEX is set up as computer adaptive testing (CAT), meaning that as you answer questions, the computer is able to analyze and predict how you will continue to answer upcoming/remaining questions, making it an interactive exam. The difficulty of each question is determined based on how you answered the previous question. If you answer incorrectly, the next question will be slightly easier, if you answer correctly, the next question will be slightly more difficult. I would recommend focusing on questions that require critical thinking skills rather than recall/comprehension questions. NCLEX tests minimum competency, so they want to make sure that as an entry level nurse, you can practice safely. I used Kaplan to review for NCLEX, and they teach a particular method for breaking down the questions, and taking steps to answer them correctly. Some think NCLEX is more about knowing how to take an exam than actually knowing content, but IMO I think it's a combination of both. The minimum amount of questions you can receive on NCLEX is 75, the maximum is 265. Regardless of the amount of questions you receive, there are 15 pilot questions included. You have a maximum of 6 hours to take the exam before the computer automatically shuts off. You can pass or fail with any amount of questions (75-265), since the computer is predicting and analyzing your answers as you go. If your computer doesn't shut off at 75, don't freak out! As long as your still getting questions, you haven't failed! It just means that you may be dancing around the passing line with your answers, and the computer cannot determine how you will continue to answer. Study, study, study...and best of luck!