rariel

I have ADHD as well and some anxiety issues, mostly social anxiety. I think the best place you can work is one that interests you. I took a course to be able to work in critical care and found I loved it. I currently work in an ICU and I find being 1:1 with a patient is easier to manage. I only have one patient to be concerned with and know everything about. I don't think it would be a good place for you though. The patients are critical and stuff changes from good to catastrophic really quick with no warning. I've never been a floor nurse on a med-surg unit but given the patient load and required treatments/meds I imagine it may be difficult to manage with ADHD. Honestly, any acute care setting has the potential for things to go very wrong quickly and require you to respond accordingly. Additionally, you're going to have to be able to tell doctors what you want for your patient and defend why. You're the advocate for your patient and sometimes you have to be very firm. The other area I worked in is LTC. I found my ADHD did not negatively impact my ability to work there, but I was insanely bored. LTC, in my opinion, is mostly pushing pills with a few minor treatments here and there (dressing changes, bladder irrigations, etc.). If you're looking for a place where not much happens, LTC is a good place. Other places you may want to look into are: ambulatory care, home care, wound care, and other non-acute care type areas

Sorry I guess I should have explained I'm in Canads. We are heavily unionized. I can go into a temporary position and my permanent position is still mine. They hire someone as a temp to cover my position. Once I'm done I go back into my permanent position. I currently work in a rural hospital, but they lost one of their doctors last Septrmber so have been operating as an alternate level of care unit. We get people waiting for LTC, convalescing, or palliative patients. We also get outpatients for dressing changes, IM, IV infusions, blood, and assist with small procedures like biopsy or lump removal. The reason I hate my job is largely because they constantly pull us to the LTC side of the facility. A small part is I'm bored. We are supposed to open as a hospital by the end of July but it's likely they'll still pull us. In Canada you have to take a formal program to work in critical care. It's 18 weeks long and includes 15 shifts on different units. There are no requirements besides your license though recommend some acute experience. I took the program on my own and wasnt sponsored so I dont owe anyone a return service. I graduated with distinction.

I once had a patient accuse me of trying to kill them with pills and call me some very colorful words. You gotta have a thick skin as a nurse. Patients are often at their worst when you see them. Just walk away if they're being verbally abusive and try not to take it personally.

I'm trying to decide between 2 temporary job positions. One is a 3/4 time on cardiac surveillance unit April next year and the other is on an ICU unit full time until the end of September. Some background info on me: graduated last year, been a nurse for 10 months, and I have no acute care experience. I just graduated with my advance practice certificate to work in critical care. I have a permanent full time so I'm covered job wise no matter what I choose, but I hate my current position and am trying to get out of it. I've never been on CSU but I didn't like CCU. I'm not really into hearts. I enjoy medical issues. One of the benefits to taking the CSU position is it eases me into acute care with more stable and less demanding clients. The ICU said I could pickup casual there even if I don't take the temp. I worry that if I take the short ICU position I'm gong to get stuck back at my permanent position. If I choose the CSU position I'm stuck in it until it's done even if something better pops up. I was originally supposed to go into a temporary full time on MICU but the person resigned their position so the temp is no longer needed. I was really looking forward to it and now I'm struggling with what I want to do.

I was overthinking it. I figured it out. It's sinus bradycardia with a sinoatrial pause. Thank you all for your insight and answers!

Maybe that will work. I'm still stuck on the damn thing. I feel like it's super obvious what it is and I'm thinking too hard. It's an irregular rhythm with a missed beat. I'm now trying to figure out if the slight dip is a biphasic T-wave (prolonged QT) or just normal and I'm imagining things. This is just an assignment of rhythm interpretation. There are no corresponding labs or assessment data. They aren't looking for the why of the rhythm just what is is and then I have to include the interventions. I can get the interventions if I could just get over this brain block.

Hmm...I see the strip when I click on the post not sure why it's not showing up for everyone else.

I put the rhythm strip on there no sure why it didn't post.

I graduated last June with my BSN and decided in December to get an advanced nursing certificate in critical care (required in Canada to work in critical care). I just finished my first clinical and there is a required ECG assignment to go along with it. I need some feedback on my answer. I want to say this is a 2nd degree AV block type I but there is no non-conducted p wave present as far as I can tell. Am I missing something here? I keep going over it again and again, but can't come up with anything. I don't need the answer but some help to point me in the right direction would be helpful. Atrial Rhythm: _____ Regular X_Irregular Ventricular Rhythm: ___Regular _XIrregular Atrial Rate: 50 Ventricular Rate: 50 P Waves: present positive preceeding PR Interval: 0.2 -> 0.24 -> 0.28 sec (then dropped beat but no non-conducted p-wave) QRS: 0.12 sec AV Conduction: 1:1 QT Interval: 0.4 sec ST Segment: _____Isoelectric _____ Elevated X Depressed T waves: _____Positive X Inverted _____Flattened ____Biphasic Interpretation: Anticipated Interventions: ???????

Just wanted to post to say I got my official e-mail from the SRNA that I passed my exam today!

The NCLEX includes both units of measure.

Thanks for replying. That makes me feel better. This was my first attempt and I really left feeling like I failed.

I just took my NCLEX-RN exam today at 08 and finished at 166 questions. I felt awful after the exam. I had lots of priority and SATA questions. I have been checking all day and kept getting the "open exam" message. Just a minute ago I got "Our records indicate that you have recently scheduled this exam. Another registration cannot be made at this time." Is that a pretty good indicator I passed or should I ignore it and not get my hopes up? Has anyone gotten that message and failed? I apologize because I know there is a million posts, but I didn't find the answer I was looking for and just want some reassurance.

I'm in Canada so most everything is paper based. I can't access the MAR or nurse notes to provide evidence that I didn't do what I'm accused of. The Vancomycin was hung up at 0040 but the LPN found it beeping at around 0330. She said it had run dry and was going at a rate of 667 mL/hr. It was a 500 mL bag + 85 mL solution added. That's why I said it makes no sense. It couldn't have been running at 667 mL/hr because it would have finished in less than an hour not 3 hours. I brought up the patient was a drug user because we couldn't identify what the pill was beyond that it was round and orange. It had gotten wet so was very dissolved. They had been previously found hooking things up to their PICC, burnt spoons in the room, used syringes, etc. Thanks for answering. It kind of sucks because I can't back on the unit. This means I can't ask for other nurses I've worked with to provide a statement of my performance or to show that no medications were administered. I'm not the perfect student, but I've been improving and had received favourable feedback from the other nurses I had worked with. Do you happen to know if states that allow nursing students to take the LPN exam will let Canadian students take it? I've been trying to find out, but the only state I've found so far is Florida and it isn't really clear on whether it would be considered equivalent.

In January I made my first attempt at my final practicum. I had 3 month old twins and wasn't getting enough sleep. That combined with hypothyroidism and the stress of full time clinical work ended up with me suffering from postpartum depression. The whole practicum experience kind of snowballed from there. I ended up dropping about halfway through after struggling and being put on a learning contract. I was given the option to continue, but I just wasn't in a good place. Fast forward to September and my second attempt at my final practicum. I felt like I had everything sorted out and was in a good place to be successful. My learning contract carried forward, which sucked but I had high hopes to get off it. My preceptor was a newer nurse (1 1/2 years out of school) and seemed ok. We soon ran into issues when it became apparent they acted as charge on all night shifts and sometimes for day shifts. In all of 15 shifts I was actually observed by them for 4 (one of which was following them around for charge duties). In all I had 5 different nurses pick up duties as my preceptor. My first shift with them was my 6th shift. It didn't go great but we addressed the issues and I learned from it. There were several situations where my preceptor did not act in a professional manner e.g. doing my midterm evaluation in front of 3 other nurses. In general I just seemed to rub them the wrong way or did something at some point to offend them. I don't feel like they were out to get me or anything, but it does feel like there was a personality conflict that resulted in them judging me more harshly than they would another student.The final circumstances that resulted in my failure were: Vancomycin running at the wrong rate, not reassessing a patients pain (an issue that came from my preceptor not the actual nurses I was working with), coming back early from breaks, lack of following up over a missed Warfarin dose. Apparently the Vancomycin I hung was found to have run dry running at a rate of 667 mL/hr. What doesn't make sense is that it was hung at 0040, but the LPN (who really didn't like me) found it beeping at 03:30. If it had been running at that rate it would have been done in less than an hour. The pain reassessment was charted in the nurse notes as I was told to do by the RN I was following. In regards to the coming back early from breaks, I was accused of administering medications without RN supervision (different shift same LPN who doesn't like me). What actually happened was I sat to chart some vitals I forgot and another time I was flagging my 0600 medications. At no time did I have patient contact or perform skills/administer medications. The Warfarin dose (if it actually was that) was about a pill I found in a patients room (a known drug user) when they called me in to help clean up a spill. I didn't know what to do with it, so I brought it to the attention of the RN I was following. It had gotten wet and was dissolving. We couldn't identify it so she said to throw it in the sharps container and chart in the nurse notes. There was a whole situation that the other nurse was not informed because the two nurses don't like each other so weren't communicating (I wasn't around until after the other nurse found out). Anyway, my preceptor used this as evidence of a reason to fail me. Some other things were that I lack initiative (not sure what else I could have done to show more initiative), I did not question a wrongly reported lab value given in report when admitting a patient from ER (I went through their lab work after they came up), and the final issues was that I volunteered to do a care plan (I offered do to it with the RN's help). My preceptor never gave me a chance to even attempt to explain anything and recommended I fail. It was very disheartening for me because I don't think I should have failed. I was improving and other nurses I had worked with did not report any issues. Although I have appealed the grade, I only have my notes, my faculty resource persons notes, clinical evaluation checklists, and my preceptors notes to go on. I can't ask for statements from the other nurses on the unit, copy nurse notes, or the MAR as evidence. Given that clinical grades are entirely subjective I highly doubt the appeal will be in my favor. I'm kind of struggling with what to do now. In my school 2 attempts at one class is all you can have. It's the only class I need to graduate with my BSN. I've looked into the other nursing school here, but you have to give them a clinical reference form. I'm guessing that will preclude me from getting in. Does anyone know if any provinces in Canada will let you take the LPN licensure examination with RN education credits? The other thing I've looked into is appealing the dean for a third and final attempt at the practicum. Does anyone have any suggestions for how to word the letter?