Llawver

Hi, all. I am in my second semester so I've been where you're all at and guess what...I survived :) I have a 3 and 5 yr old who I constantly have to say "I can't play now...mommy's gotta work". I felt really bad and sometimes I still do. But when I start feeling that way I try to focus on the big picture. They are the reason I'm doing this. To give them the life they deserve. If you don't mind a little bit of advice.... 1-) Don't focus too much on the AP part of the chapters. Most of the test questions apply directly to the nursing process. 2-) It's sometimes just not possible to read all of your assigned chapters but at least try to skim them before lecture. 3-) All programs are different...what I have to get to pass is a 77 or above. Don't get too fixated on achieving a specific letter grade because you'll drive yourself absolutely insane. During pre-reqs I was a steady 4.0 and in the nursing program.....2.5. I passed and that's all that counts. 4-) Do not compare your performance or grades to others! A colleague of mine was always achieving high 80s on her tests and it made me feel inferior. However, she is 19, lives with her parents and has much more time to dedicate to studying. I myself have to juggle a job, two little kids, and a household. Just focus on doing the best you can do...and don't get discouraged. Good luck to you all

What you are feeling is totally normal and we've all been there, grown from it, as will you. My first semester my clinical instructor basically just threw us to the wolves. Assigned our patients, checked our preplanning sheet and sent us out onto the floor. Just remember it is a learning experience. No one has ever just walked into a hospital and became a nurse without going through this. If this is your first clincial I'm assuming this is your first semester? Lung sounds are really hard to differentiate, and apical sounds are even more difficult. Focus on the technique...like where to place your stethoscope, landmarks etc. Patients are usually very forgiving with student nurses. Hang in there...it will come to you. Best of luck :)

So regardless if you had the two answers correct they had to be in a certain order?!!?!? Unless it was a priority question,which sound as though it was not, that is messed up. Instructors insist that these test questions are designed to "prepare us for NCLEX" and "not to trick us" but I think that is a load of crap. I'm the type of student that excels in lab and clincials but I absolutely stink at the tests...I am barely passing. It makes me so angry because when we are on the floor everyone comes to me for everything, my instructor sends me in to deal with combative patients but there is a possibility I won't make it through because I can't decipher those stupid questions. Makes me wonder how many others' would have been excellent nurses if things were different. It makes me mad just thinking about it. But I agree, that is a stupid exam question.

Well the fact that you said you "like helping people" shows that you do have empathy. Maybe you are just unsure of yourself and nervous how you would react in a situation? That is completely normal. There are a lot of different ways to comfort patients that don't require you to be outgoing. The best thing is listening to what they say, and letting them know you are there for them. ie "What can I do to help?" You'll run into a lot of patients that don't want bothered because they are feeling too sick, and most of them do not like to be touched or coddled so to speak. It sounds to me like you want to go into nursing for the right reasons and your just a little nervous about it. If it's something you really want to do try it. Once you do a few clincials you'll know if it's for your or not....and if it's not that's ok.

Have you been in isolation at all before? I don't mean to insult you in anyway. I'm just asking because it sounds as though you don't feel comfortable with putting on all the PPE's. I had a patient with c-diff about a month ago and the worst part for me was the smell and the stools. Normally feces don't bother me but c-diff is just raunchy. This gentelman used the bedside commode and couldn't make it from the bed and there was diarhhea literally everywhere. We had to clean him up, completely change and wipe down the bed, clean the bedside commode. It was awful. Funny you should bring up the shoes because I had feces all over mine. Fortunately, I keep an extra pair of scrubs in shoes in my car at all times. I placed the shoes in a bag and literally soaked them in a bucket of straight bleach on my porch for about two days. Anyway, here is my advice. Keep a change of scrubs and shoes in your car with you on clinicals. This is a good idea anyway even if your not in isolation. Grab a few extra pairs of gloves and keep them in your pockets. You never know when you might get into a sticky situation, especially in isolation and with c-diff. All the ppe's should be near the door so you can get em on before you interact with the patient. All of the equipment should be in the room as well. Depending on the hospital you may have a dynatec. There should also be a stethoscope...they aren't the greatest, kind of like the ones you can buy at Wal-Mart. Take the wipes with the yellow lid to wipe down the equipment when your finished but make absolutely sure you don't shed those gloves until you are finished touching everything. I removed my watch with c-diff just because it could easily get contaminated. Last, and perhaps most important, be sure to wash your hands thouroughly with soap and water after you shed your gloves because hand sanitizer does NOT kill c-diff.

Definitely not. I am 31 and just entered the program. Assuming I pass, I will be almost 34 when I get my license. Good luck to you :)

Thanks everyone for your support :) I did ok with the ABG levels and metabolic/respirtory acidosis/alkalosis. What I found difficult was differentiating the symptoms for each electrolyte imbalance. They are so similar. Almost all of them have muscle weakness, confusion, nausea and vomitting. I developed a little system (which didnt work obviously)...kind of a symptom review for comparison. Breathing, BP, Heart GI, muscle/skeletal. I put all the norms on flash cards...but those weren't on the test. It does make me feel a lot better knowing that others have trouble wih this subject.

I can empathize 100%! I am about two weeks away from finishing my first semester. I was a complete straight A student doing all my pre-reqs...I even finished A/P with a 100% average. Then came the nursing program! Our scores have to be a 77 or above to pass. Despite countless hours of studying, reading, practicing the NCLEX style questions on ATI each test would come...and I would end up with a 78. This past week we had a test on acid base and electrolytes which I failed. I literally studied for three weeks. So now I am right at the edge. I am one point away from failing. We have a test on periop, and our cumlative final which accounts for 25% of our overall grade. Nothing like more pressure. It makes me feel stupid to be quite honest. I am stuck in an unhappy relationship right now with two little girls and no way to support them unless I get through school. If I fail out I will be stuck here for even longer. Sorry this is long but just know that you aren't alone in your feelings and concerns.

I don't mean to be a downer but in all honesty....that's just the way it goes. I'm awesome with patients, on the floor, and technical skills. I passed AP with a 100% average, and have been a 4.0 student until nursing. The highest grade I've gotten so far is an 80! Those NCLEX style tests are really hard. If you worry too much about your GPA your gonna drive yourself nuts. Just focus on passing :)

Look up respirtory alkalosis. Alot of the symptoms you are describing relate to that. If you just need one diagnosis I would go with impaired gas exchange r/t pneumothorax e/b increased respirations and hypercapnia. As far as tissue perfusion I would not go with that because his 02 sats are to be expected with his condition. A good way to know if tissue perfusion is inadequate is to check capillary refill and radial and pedal pulse. If the pulses are thready and weak it's a good indicator that not enough blood is reaching the extremities. They will often have tachycardia because the heart is trying to compensate and pump blood faster.

You'll practice on a SIM man first. It's easier to do on men than women and it is nothing compared to starting an IV! You'll do fine.

The more comfortable you get with your skills the easier it will be. As a few other people said, a lot of patients are uncomfortable with you touching them too much. You don't have to be loud and boisterous to be a great nurse. The most important thing you can do as far as "bedside mannor" is listen to them. People can tell the difference between nurses who care and those who don't...and you don't need to be loud and outgoing to demonstrate that. There will be times you have to be assertive....but know how to choose your battles. For instance I had a client who absolutely refused to take a bath. I didn't push the issue because if someone isn't going to co operate than it's just gonna be hard for you both. I've also had patients in the past who were perfectly capable of doing things for themselves but insisted I did it for them. A good example...I had an overweight client who was using the bedside commode and absolutely refused to wipe his own rear end. Don't get me wrong, I have no problem whatsoever assisting someone who needs it. But there was no call for that. I simply got him a few wash rags, pulled his curtain and told him to press the call light when he was done so I could empty his commode. I also had a client with staph on his scrotum who wanted me to apply his powder. He was young and in good health and there was no call for it. So I gave him the powder to keep at bedside (after checking the order) and left it at that. I could go on and on. The point is to trust your judgement, always listen to your patients, and don't be afraid to say no. Good luck to you

Hi everyone. I'm new to this site but it is so helpful to see others who are going through what I am and being able to relate. I was a straight 4.0 until nursing school! I tend to overanalyze and I hate those darn NCLEX style questions. So my average is about three points above passing. I'm much much better with technical skills, dealing with patients, and clinicals than I am with the tests. Infact last night I failed a test on fluid and electrolyte balance. I got a 74 and 77 is passing. So I have one more exam on periop and elimination. Hopefully I do allright with it. I really want to be a nurse and would be so humiliated if I failed out

I'm gonna go with c-diff diarhhea. Normal feces dont bother me but I had a client with c-diff who defacated all over his bed, clothing, and the floor. Took about half an hour to get everything cleaned up and some of it even ended up on my shoes. Terrible

Congratulations on doing so very well. I've found that some people never outgrow that high school mentality. I'm sure your classmates are behaving this way because they are jealous. It's easier for them to be hostile to you than face that fact that they have problems. You should be very proud of your accomplishments. Don't let them bring you done. You are almost finished and more than likely will not see too many of them afterward.