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Bedside_Life RN

Bedside_Life RN

Surgical Intensive Care
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Bedside_Life RN has 3 years experience and specializes in Surgical Intensive Care.

Bedside_Life RN's Latest Activity

  1. Bedside_Life RN

    Time management in clinical

    So provide a detailed breakdown of the requirements you are going to be assessed on and the time limit that they are required to be completed in. It is head to toe on three patients and AM care. What is the AM care that you are referring to?
  2. Bedside_Life RN

    Help with NCLEX style questions!

    Fundamental Success is decent, but you have to understand the basics. I cannot stress this enough. Yes you will have to memorize material but you have to, have to, have to, be able to apply it. This is the most frustrating part of nursing. Saunder's is also a pretty good resource. At this point NCLEX review text may confuse you because they are based on the understanding that you are preparing for the NCLEX. If you can find someone with a Hurst review workbook that was filled it out during the course; this may be of some benefit. Also, ExamCram is a pretty good resource. Whatever it is that you choose to review (Even your textbook and case studies will help some) get together with a small group and have everyone write their answers down and then discuss why you think your answer is right. When there is a disagreement take the time to look it up in the book and read that section from the beginning so that you have a good understanding of why the right answer is the right answer. Ask if there is a Senior student that is available to tutor. The instructors will pick someone who they know is doing well and "gets it" or as you will hear, so god awfully many times, "thinks like a nurse". Remember THIS IS YOUR GOAL! THINK LIKE A NURSE! HAVE A QUESTIONING ATTITUDE! And you have to choose the SAFE answer. This will follow you through licensure. Every test that you take is not only a Nursing test but it is a Safety test. That is what Nursing tests are and that is what the NCLEX is. One big giant Safety test. For example, think about this ever so often used scenario......You are the nurse taking care of Mrs. Pat. Mrs. Pat has been admitted to your unit from step-down, and has a temporary tracheostomy. Mrs. Pat has been very congested and you decide to change her crusty saturated collar because at your hospital respiratory therapists do not always take care of this issue. So, like suuuppperrr Nuuurrrssssee you are going to rise to the call of duty and take some action! You are a Nurse now, remember?...... So you get all of your supplies ready, you have put her on the pulse oximetry monitor (because this has to do with Respiratory right, and you are going to do everything you can to shine like a star for Mrs. Pat). You have hyperoxygenated her and have wall suction ready (because you are thinking ahead of course). Now, you have removed and cleaned the trach, using aseptic technique of course, and you are about to attach the trach. strap, and wouldn't you know it, it is one those real fancy nice ones that has pads and velcro. At this point you are already thinking of ways to rub it into your friend's face about how you saved Mrs. Pat's life today. And about this time sweet Mrs. Pat decides to help you out by clearing her throat and you watch her cannula fly across the room like a bottle rocket and it lands right on the floor next to the trash can. I mean, you saw that line hanging from her trach. and you know it had to be used for something right?..... so you deflated the balloon at the beginning; that is what it is there for right? Obviously not considering the circumstances..... So now think about what do you do, super nurse....? The nurse who gave you report left out the size, details, and forgot to send the bedside replacement trach with the patient "because the family must have grabbed it". Now you have some very important decision making to act upon..... Do you call for help? go to parstock for another kit? put oxygen on Mrs. Pat and bag ventilate her? grab the cannula next to the trashcan, wipe it off, and pop it back in, or maybe just stand there, frozen, hoping someone will save you, in awe of how things went from top of the world to "OMG FML" with one cough?........ What would you do? Really think about it. The correct answer is how a competent nurse should think.
  3. Bedside_Life RN

    Interview help - roleplay scenarios?

    Safety! Safety! Safety! That is what they are looking for. When in doubt go to facility policy (this will never be wrong). I take that back, going by facility policy will never be wrong as long as it does not interfere with the scope, rules, and regulations set by the BON. For or those who have asked me about interviewing I usually give them some topics or things to think about, such as the following: You may be sitting with a couple of CSM's, a couple of RN's, and possibly a Nurse Aid. There may be more or less people than that. some will stay for the entire interview and some may not. They will all introduce themselves and their title and will give you a chance to say hi and introduce yourself. They will ask you why you want to work specifically for their unit. It's a good idea to mention a fact about the unit or the hospital like magnet recognition or their mission statement and goal. Every person will ask you different questions. So be ready to answer things like: - How are you going to benefit the floor. - What is your dream nursing job. - What have you struggled with in clinicals/work, and what did you do about it. - Where do you expect to be in 5 years. - What would you do if you did not agree with a policy or procedure, or you saw someone break these. - What is an example of a time that you found yourself unable to manage your patient load and how did you handle it. What would you do if you absolutely did not get along with a co-worker and were scheduled to work with them all of the time. - When was a time that you found yourself in a situation where cultural diversity caused an issue in your care and how do you handle that. - When is a time that a family member or members have put you in a bad situation and how did you handle it. - What do you believe is your biggest life achievement. - How would you handle a situation when a task that you delegated or another nurse's task was not completed correctly, or not at all, and it continually happened even after addressing them. - What made you decide to become a nurse. - When is a time that you fell behind and how did you handle it. - What would you do if the shift before you continually set your shift up for failure, and would you try to pick up the slack. or.........? - How would you deal with the stress of getting into a situation that you felt out of control and just could not handle it, while at work. - When is a time that you feel that you have went above and beyond, and what does that mean to you. - What would you do if you had to complete a procedure and did not know how to do it. What would you do if the shift before you continually set your shift up for failure, and would you try to pick up the slack. or.........? - How would you deal with the stress of getting into a situation that you felt out of control and just could not handle it, while at work. - When is a time that you feel that you have went above and beyond, and what does that mean to you. - What would you do if you had to complete a procedure and did not know how to do it. - There will be delegation questions, safety questions, priority questions, and culture questions Remember, TEAMWORK, PATIENT SAFETY, and EFFECTIVE communication are always good things to include. Look at everyone at the table when you are talking. Make eye contact and smile. Include how important every team member is and how they should be respected. Don't forget to show them that you are not a nursing robot and have a good personality. They are looking for a good nurse but also the best fit for their "family" haha. Good Luck!
  4. Bedside_Life RN

    I need help with Anatomy.

    What is the body system you are being retested on? Have you found a tutor?
  5. Bedside_Life RN

    Hypertonic/Isotonic/Hypotonic

    It isn't the dextrose, alone, that determines this... Think about the kind of fluids your patients have had during clinical and most importantly KNOW WHY. So with isotonic solutions, if you walked into a pt. room and saw fluids such as D5W, D5 1/4 NS, what would come to mind?....has the client been vomiting, burned, etc. and you also need to be thinking about why isotonic solutions would not be given to the pt. with HTN, heart disease, or renal disease (although I'll let you think on that and come to a conclusion). The same goes for hypotonic solutions such as D2.5W (since your question involved dextrose). Would this be acceptable to give to the pt. with HTN, renal or cardiac disease; experiencing the fluid loss in the same manner as I mentioned above? Tell us why it would or wouldn't....What about the client with hypernatremia? And what s/s would you be looking for if your pt. was receiving this fluid?....you should be thinking of the s/s associated with either fluid volume excess or fluid volume deficit.. which could it be? Now, in regard to hypertonic solutions such as D10W, D5LR, D5 1/2NS, D5 NS... you should be thinking LOTS of particles! and what will that do to the vascular space in relation to volume?....what kind fluid issue is this pt. at risk for developing? So when thinking about fluids, think about the individual components that make up the solution; not the dextrose alone. This seems to be a topic that you may want to pay some special attention to because I see a lot of people overlook the importance of the fluids that THEY are giving to these patients. Don't forget that these fluids deserve the same attention as the medications you are giving.... and some of these patients, especially if they have severe edema/3rd spacing and are receiving a hypertonic solution may need to be monitored in the unit. Just a thought. Also, don't let the question "why?" intimidate you, this is an important question if you are going to be taking care of people. Just respect it for what it is, because knowing "why?" will soon be a mandatory part of your career in nursing.
  6. Bedside_Life RN

    Keeping a sterile field

    First, you are a student... you are there to LEARN and your professor knows this. Read in your skills book and practice at home, or have another student monitor you while they are looking at the skills list. Don't get in a hurry, once those gloves are on put your hands together (sort of like you are praying) and take a moment to think about what is next, have I completed everything that is not sterile that needed to be done, and do I have the items that I need set up in such a way that contamination is out of the question, PERIOD! if not, look at your professor and say I think I have contaminated my field or I would like to start over, I've forgotten something. Your professor wont discredit you for being honest and independently making the decision to do it the right way. That is what they are testing you on... they want to know if you are going to be safe. Set yourself up for success... Put the pt. in a good working position and at a good height, have your materials gathered, set them up in such a way that you can open them in the order that you will use them, put your work area where it is easy to reach and you are not having to turn your back on it. If you do have to get something out of reach, walk backwards around the table if you have to, just make sure it is always in your sight. place the trashcan in a good place so that you can drop items into it and it wont fall on your pt. or your work space. If you have to move it, move it with your foot and don't worry if it falls on the floor instead of in the trash. You can clean that up later. Just remember, if you even have the thought that you may have contaminated yourself or the field, consider it contaminated and ask to start over. You are not on a time limit and you are doing this for you, not to compete with your peers. Practice, practice, practice. Good Luck!
  7. Bedside_Life RN

    Endocrine system and disorders

    I sent you an email, no notes, but more than willing to help with such an important, under taught subject.
  8. Bedside_Life RN

    Help please HPN with DM Type 2 patients

    First, consider what causes hyperglycemia in type 1 diabetic clients and what causes hyperglycemia in type 2. Remember, Insulin is the "key" that opens the "doors" on cells to let glucose in. So.... in type two DM is there a lack of "keys" or an excessive accumulation of a substance in the blood that blocks these key holes. Note: what are the ill effects of hyperglycemia on vessel walls? and what is another substance that can cause the vessels to become more rigid... most often it is because of these substances that vessel walls are unable to expand and the result is "HTN". Tell us what you think....