catechin

Thank you! This is really helpful. It sounds super interesting and the more I read about it the more excited I get. Yes, this department is located in a major hospital - ICU/CCU, interventional radiology, open heart, the whole shebang. Do you think this will be a good stepping stone for a student who wants to someday work in cardiac? Or would it have been better if I went straight to med/surg or tele?

Hello all, I am a nursing student and I just found out I will be completing my final capstone/preceptorship in a cardiopulmonary clinic. I have not received any information yet on what the scope of responsibilities for the student/RN are in this setting. My friends have been telling me it could be anything from a doctor's office/clinic setting, a more rehab type setting where we will be doing stress tests, ekg, echos, and exercises. I would really like to prepare the best I can for this, but I can't seem to find much online. I also tried to search the hospital website to see if the dept. was listed, but it was not. If anyone has any tips or info to point me in the right direction, I would greatly appreciate it!

Definitely get a care plan book if you can as well as a NANDA nursing diagnosis book. I got used ones from Amazon for a couple bucks. I have the Nursing Care Plans book from Elsevier. Just search in Amazon and it will come up. I also usually check the sample care plans in my med surg book and nursing care plans book to find guidance and then use both to tailor my own care plan that is individualized for my patient. Remember, we aren't supposed to be reinventing the wheel here. There are generally certain goals, interventions, and outcomes that you want to aim for with each dx. Also, word to the wise. Try to make your nursing diagnosis relevant to the disease. And prioritize. Usually, the nursing dx that you can die from should be the priority. Ex. If your patient has an acute mi, your priority nursing dx should not be risk for pain. Sure, they have pain, but can you die from pain? That is always what I think in my mind. The dx that you can die from, such as ineffective tissue perfusion or something along those lines, should be your priority. Another ex. if your patient has COPD, is their priority nursing dx going to be risk for ineffective coping, or impaired gas exchange?

Thank you for the vote of confidence. Usually I feel like this, but this week was especially hard. I mixed a med wrong to give via ng tube, to no fault of my own - I was following the MAR but the RN forgot to tell me she wanted to hold the senna bc pt. had been having diarrhea at night.. I didn't give the meds, reordered from pharmacy, waited, re-mixed without senna and then promptly tripped and spilled them as I was walking into the room. At this point I wanted to crawl into a hole and die. I sucked it up, explained what happened and my RN who was awesome burst out laughing. I was already frazzled at that point but took a deep breath and kept going. The next day was better - I had been doing really well until at the end of shift my stable patient who had been NPO for over 12 hours suddenly went hypo, I reported it to RN, and I had to be in the room with him constantly, getting juice, reassessing, calling doc and hanging d51/2NS (with my RN). My other pt. had an elevated BP so I had asked another student if he could reassess for me which he did but he also moved the pt. and didn't reset alarms (which I did not ask him to move pt). I got the BP from the student when I came out and reported it to my other RN who didn't say anything but she had been totally pleasant before and after I came out of the hypo room she had changed into another person. i didn't know any of this happened with the pt. getting moved until after clinical. So I left with one RN thinking I did awesome and another RN being super mad at me (I think). I just wish I had known before I left so I could explain it. I did rush back when I found out to make sure he was restrained and all alarms were set...but they already were and I couldn't find the nurse to apologize. I literally just felt like I wanted to crawl into a hole and die. Here I had been doing ok all day and then one thing (a big thing, no doubt) completely ruined it for me. I had really wanted to work on this unit after I graduate but I am afraid this has ruined it for me. And I am totally obsessing and beating myself up about this week. Please tell me I will survive nursing school.

I am a 4th semester nursing student (BSN) just wondering if others have felt the same. I often leave clinicals feeling like a giant idiot. I am ok at my tasks: putting in IVs, hanging meds, calculating drips, patient care and nursing skills. I always try to make sure I give my patient a bed bath and change their linens, always, because I know the CNA appreciate it. There have been three times I was the first to notice a critical change in my patient and reported it (and I was right about it) and I get excellent evals from my instructors. But after I get home I often remember something silly that I forgot to chart or that there was a time I forgot to lower the bed and the CNA had to come by and do it for me, or didn't raise the third bed rail, or I didn't know that you have to plug a bed alarm in to another plug when moving from bed to chair, or I forgot to chart % of lunch or something like that...and the list goes on. I try to be cognizant of these mistakes and each time I make one I add it to my clinical "brain" and bold and highlight it so that I don't forget it next time. But each week there is another something and my list keeps getting longer! I feel like I am constantly overwhelmed and struggling with time management. I don't know how I will manage after I graduate and have to do this on my own. I often wonder if the nurses think I am just a complete moron, and if they do I wouldn't blame them because I feel like a complete moron! I am worried that by the end of the semester they will be so sick of me that they'll be like: oh no, here she comes!!!! :sorry:Sometimes I feel like I can slightly grasp the *bigger picture* but there are all these little miniutiae of tasks and skills that nobody tells you about and that I am just clueless on. I feel like I'm constantly screwing this up and I am seriously worried I will do something serious or worse. Please tell me it gets better because right now I just stare at the ceiling at night in hopes that I will someday figure out what I am doing.