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  1. Jeniele

    End of Shift Note

    Thanks everyone for your advice, I appreciate it!
  2. Jeniele

    End of Shift Note

    Hey everyone, looking for some input on your end of shift note. I'm a second year nursing student and I struggle with this. Each of my clinical instructors have had different requirements for it, and of course each facility I am in has a different EMR which makes it different as well. But overall I am left with a void on what I should be noting there when I'm out in the real world. I've read some articles on it and they would have you list everything, no matter how insignificant which seems impractical as no one is going to read your 5 paragraph "summary" of your shift. Some of my instructors have had me write SOAP or DARP notes but I don't see that being done by the RNs in the facility. So what is it that you put in your end of shift note? Thanks!
  3. Jeniele

    Job vs grades while in school more important?

    It all depends on how rigorous your program is and how well you succeed at it. My first term in my program, our director asked a few second year students come in and answer any questions we might have about the program and share some tips. Two of the three second year students had failed out their first year due to working too much (in their own words). My program is very difficult, average test score is about 84. I work Per-Diem, which might be a good option if you can get one. I work holidays and then can call staffing to fill in shifts on weeks that my study burden isn't as high. BSN is a great goal, but you have to get through the ADN program first so that should be your first priority. Especially if you're not having to worry about paying for food and rent.
  4. Jeniele

    dropping human anatomy with a W

    It all depends on the programs you are looking at applying to. You said you're not worried about the W, so does that mean those programs only take your highest score? All the programs around me (including the one I'm in now) use a point system and only allow for one re-retake and then the grades are averaged, with a W counting as an F (0.00). So you need to be sure what the criteria are for applications before you make that decision. You also say that it would require you to get a B on everything here on out to finish out this term. That's entirely doable. I know that not getting a 4.0 hurts, I was in the same boat; my second term of A&P was a 3.5. But in my scenario, taking a W would have given me a lower application score than the 3.5 did, and at 41 I didn't want to postpone my application another year. Since you're concerned about postponing your pre-requisites further, it might be best to tough out this term and see what you get, especially since you've already paid for it. You can always give it another go next next year if you apply to nursing schools and don't get in this year, but you might get lucky in get in. Schools can give you average scores of students that get in but it really depends on what everyone you're applying with has that year. Some years are more competitive than others. Additionally, it can be amazing what you can accomplish when you know the stakes are high. I had several classmates last term that had to get 89 or better (better than they had done all term) on the final to continue in the nursing program and a few were able make it and are doing much better this term. Anatomy is a beast. I dreaded every second of it and everyone said that nursing school was much harder. I don't know how to explain it exactly, but the rote memorization of A&P killed me but nursing school has been more conceptual. In nursing school it's primarily the physiology that counts. We're expected to be familiar with the structures, and yes know where the tibia is; but so far in my musculoskeletal unit no one has given me a slide with a muscle on it and asked me for it's name, origin, insertion, and action. I am however expected to understand the bone remodeling process and the role of calcitonin and PTH. Hope this helps you.
  5. Jeniele

    Nursing School Study Tips

    Something new I'm doing is that after reading a chapter in a text, is to go back to the chapter objectives and answer them. I do this on a sheet of paper in a concept map format to make it a study resource to review for later.
  6. Jeniele

    Day One and already dealing with...

    Lurker here as well, but take a look at the info on a product called Lice MD. I don't sell it, not affiliated, just a really frustrated mom that got some great advice from an awesome nurse in the ped's office. First time my daughter got lice it was bad before I noticed it (I don't think she is particularly sensitive to their saliva). I tried the typical treatment and literally wore myself to exhaustion cleaning and steam cleaning everything and spraying the pesticide spays on everything I couldn't. Fast forward a week and we repeat the cycle all over again but with all three kiddos this time. This went on for a month before I called my pediatrician literally in tears. The NURSE at the office suggested I try the Lice MD. It's not a pesticide, it's lube...but allows you to comb all the nits out of even the longest hair. First treatment and they were gone, finally. Plus you can repeat until you finally see no nits because it's not a pesticide. Fast forward three years and my daughter has lice from horseback riding lessons. I grab some of the super lice lube, sit outside on the porch and comb for less than a hour, wash her clothes, jacket, and bed linen. No lice, no worry. It does make the hair greasy looking for a day or so, but better than the really bad dandruff the pesticide shampoo gave my daughter.
  7. Jeniele

    Come On People, How Stupid Are You??

    Stupid question here. What about the patient's pulse? Side effect of hydralazine is tachycardia, so if the PT was tachy wouldn't that be an indication for holding the medication and considering an alternative for the hypertension? I've seen scenarios when nurses have held BP meds for HRs of PTs in both instances of tachycardia and bradycardia.
  8. The real issue with nurse burnout and exhaustion isn't the length of the shift in my opinion, but the staffing ratios and acuity of the patients. Add in the "pamper policies", customer service expectation, and downright mean and rude patients and you have a recipe for disaster. Everyone will have a shift length that works best for them at their current time of life, and thankfully nursing can typically offer some type of employment that will fit that need. Patients in acute care are very sick and it boggles my mind that the hour before the patient was "sick enough" to be 2:1 in ICU but is now "well enough" to be 5:1 on the floor I work. I get that improvement can happen rapidly and that is very good for the patient. Most of the time we run out of ICU beds and we play the patient shuffle. So unfortunately what happens is that an acutely ill patient that may not necessarily need intensive care is sent down to a nurse that is now 5:1 and that's when bad things can happen. It's not fair to the patients, and it's not fair to staff. I'm usually a second set of eyes on that patient to be on the lookout for any changes (despite having a patient load of 10 myself) while the poor nurse tries to catch up on their med pass (that's already an hour late), after which they try and figure out what the plan is for this new patient. Somewhere in this mix we both try to deal with the total care patient, the "needy" patient who calls every 15 min, and the high fall risk with injury confused patient who attempts to get out of bed every 10 minutes "to go to work". We have 2 patients that the physician said will go home today during their rounds who are on their lights wanting to know when that will happen, though no orders are in yet for discharge and the charge want's to know who we will have ready first because ED is calling up with a new admit. The total care patient is a "feeder" and it's 12:30 and family wants to know why no one has been in yet to feed their family member and I haven't had a chance to sit, pee, or eat and I've been there since 0630. This is why nurses are exhausted and that's not even what I would call a horrid day. We need legislation to dictate safe patient ratios based on acuity, until then I don't think any admin or management will listen. Because when something bad does happen, it will be the nurse's fault not theirs.
  9. Jeniele

    Didn't do to hot on my first exam.

    So I studied about 50 hours per week for just A&P. Find out what your study style is and make your own study guides for that style. I used concept maps, made my own power point flash cards from A&P revealed, and used EZ Notescards and Quizlit like crazy. I would also photocopy the diagrams from the book, use white out to cover the names and make a million copies for my own fill in the blank practice. Most schools will average your grade or deduct points for re-taking the class so I agree with sticking it out. I got an 4.0 with A&PI but had to do A&PII at a different school due to my husband getting laid off and having to relocate to a new state. I got a 3.5 in A&PII and still got into a nursing program so you don't always have to get a 4.0 in everything.
  10. Jeniele

    Nursing school schedule

    You might find a school that's flexible but the schools around me are not. We have a set schedule, lecture on Monday and Wednesday from 8-12 followed by lab in the afternoons on those days. Clinical is on either Tuesday or Thursday, you don't get your schedule until the start of the term and it may include an occasional night, weekend, or both days on a given week. Additionally, we have our exams every other Friday. My advisor had me sit down and calculate out the numbers of hours I would be sitting in or attending class, followed by the "recommended" number of hours to prep or study for each class. This totaled to about 60 hours per week that we would have to devote to school. After writing that down, my advisor told me that the school doesn't recommend that we work our first term so that we can develop a study plan that works for us before trying to work.
  11. Jeniele

    Help. Microbiology

    My instructor provided powerpoint slides for her lecture. I recorded the lecture with the recorder app on my surface (can use phone too) and I used the comment function (under review) to add additional notes or remarks my instructor made during the lecture that weren't included on the PP. I found OneNote at the end of the course which made it even better. As soon as possible after class, I would listen to the lecture and then add in anything I missed and highlighted the things she repeated or specifically said "know this." I also used the online study modules provided by the textbook publisher and almost always did the end of chapter review in the book. I put in a ton of hours studying for micro. My instructor was above par as far as college instructors go, so she gave short answer essay questions as homework and these were always what was on the exams. So if you did well on the homework, you could expect to do well on the exam. If you did poorly on a homework question, you could study that weakness and ace it on the exam. That class was truly the best educational experience I have had, and I have a previous Bachelor's Degree. So if you have a crappy instructor, it can make it difficult. I had that issue with A&P. Another option to help is concept mapping. I just learned about these and think that they would have been very helpful for me in my pre-reqs and plan to use them extensively in pharmacology this fall. These especially help if you are a kinesthetic learner. Finally, look at quizlet and EZ Notecards for practice study questions. You can find test questions that are specific to your textbook on there and are great for practicing for the exams. If you have specific issues, let us know and we will see if we can help.
  12. Jeniele

    Malpractice Insurance: Do you carry your own?

    So A. I am not a nurse, and B., given A I am obviously not a school nurse. That being said, you guys have great questions on your threads and I wanted to post to give a different perspective in case it might help someone else. Regarding malpractice insurance, I am a CNA and I carry a one million dollar policy through NSO. I run into people all the time who don't realize that it's available for CNAs and I am floored by the number of nurses I have to tell you can't not afford it when they tell me they don't have insurance because they can't afford it. I have a great manager and love my position at a very busy medical center, but I have no illusions that my employer wouldn't throw me under the bus if it could get them out of liability. As a CNA, since my scope and therefore liability are low my policy is less than $60 a year. That's like cutting back on one Starbucks coffee a month. I can totally afford that for the peace of mind I get, especially with those "special" patients who leave AMA hollering " Give me you name and credential number, I'm going to sue you all!" Lucky for me, I don't have my license number memorized, ha! When I finish nursing school and get my RN I plan to keep a personal policy in addition to the one provided by our state nurses association/union. I can see where inadvertently not following just one tiny aspect of some policy would release them from covering you and I am unwilling to take that risk. For a couple hundred dollars a year, it's worth it to protect my livelihood and educational investment.
  13. Jeniele

    I'm not sure I'm cut out for this

    You're well prepared then! Like you said, finding your niche is what it's all about and nursing offers one of the widest scopes for that over most any other career. Toss the bad apples aside and take a look again at the barrel, I'm sure you will find that the experience was an exception rather than the norm.
  14. Jeniele

    I'm not sure I'm cut out for this

    Hi Jen, I know you wanted advice from nurses and not students but I thought I'd poke my nose in anyway. I start my nursing program this fall and shortly thereafter will celebrate my 42nd birthday, so I get it with wanting a good paying career without all the bubbly altruism. I have worked in a busy regional medical center as a CNA for almost three years now and I can say that at least in my facility the culture just not like what you are fearing. Bravado in nursing exists, but it's mostly on here, kitschy t-shirts and mugs, and TV dramas. The nurses I work with are very humble, view it as a job that exhausts them, and rely heavily on the entire team to get through their day. My nurses also affirm that I am a very valued member of the team, even as a CNA and they take time to help my learn new things knowing that I'm working my way to nursing school. I don't mean for it to sound boring, some shifts are totally not; but for most of us we have very full lives outside work and that is where we focus ourselves. Sure, there is that super-rare individual that feels they need to place a class structure on the them (RNs) vs us (support staff), but mostly everyone ignores them and rolls their eyes and say "what was that about?" when they're out of earshot. I apologize that I don't know your situation, but I encourage you to try to work or volunteer in a hospital to really get a feel for what nursing is and if it will be a good fit for you. I mention a hospital in particular because in my personal experience, SNFs can be where bravado pervades and facilities are highly variable in their workload, etc. so they may not necessarily give you a good picture of what it's like to have five patients with acuity all over the place and three call-lights blaring simultaneously. Though seriously, days like that it's a wonder any of us come back the next day, and yet we do. Typically for a paycheck.... If after that, you decide that nursing isn't a good fit for you and your family; then, with your prerequisites you are set up to get a Bachelor's in Science in a number of fields in short order. Best wishes to you!
  15. Jeniele

    TEAS VI Calculator

    It is just like the basic calculator that you can pull up on your computer desktop.