TypicalFish

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I'm proud of what I have learned. I don't have them on there to impress anyone; I earned them and it makes me happy to see them on there. (No, I've never had a pt ask what any of the initials stand for-they could care less) :yeahthat: :yeahthat: :yeahthat: :yeahthat: :yeahthat: You have the best attitude r/t this topic.

If you do things "just to pi$$ people off" you must be a joy and a pleasure to work with; a real professional. Letters after your name shows that you went to school and studied and accomplished something; it does not in anyway show whether or not someone provides positive care. I have worked with some excellent ADNs and BSN and even CNPs; I have also worked with some pretty crappy ADNs and BSN and even CNPs.

I started school at 40. I had been a ST for 15 years. I was worried about being older-but about half of my class was near my age ( incl. two men) or even a few were older. You CAN do this. It takes a lot of hard work, but you can do this. I started nursing school at 20; met my dh and quit to move; I started at 25; had a baby and quit; I started at 30; had my third child and quit. I am 43 and now have an excellent job as a critical care nurse working in a 28 bed ACCU; you need to realize that with your age, you bring your life experineces and maturity-a benefit to you as a new nurse and to your unit; it can be a plus to be older; think about it. I am working on my CCRN and plan to go back to school this fall for my ASN to MSN degree. I wasn't-I thought I was too old. But I am not, and neither are you. DO not let anyome talk youout of it, if it was something you want to do. Best of luck, and just go for it.

Victor- There are two things that I find r/t the topic of your article; usually, and very generally there are two kinds of patients; the ones that are naturally compliant and those that will likley never be compliant with care. You could add a third, "kind of compliant"-but generally there are those two. Most patients that I deal with have a strong sense of the present, and a lack of belief in their mortality (it is a known fact to them that all people eventually pass, but not them, and certainly not now or soon). For some people, it takes a major event for them to really want to comply; and that's the thing for many people-as long as they feel "fine" or can "get around" they do not believe that they are "really" sick. They treat their disease based on severity of symptoms, or even on decreases in quality of life, but there is a qualifier to even that-the sicker that some of them get, the looser they define "getting around" or for the elderly it is either so gradual as to not be noticeable as a vast change, or they and their families feel that it is simply "getting old"; which leads me to my sort of point; you can educate a patient about their disease process, but until they are ready, you'll be able to teach them nothing. And often, as in the case of acetaminophen, pts can make things worse by treating themselves with OTC or even self-change of Rx med schedules. They don't always connect feeling poorly or having a headache or being dehydrated with CRF, or trouble breathing with CHF ("oh, I just get a little winded now and then")-they can isolate the symptoms and disassociate them from disease process. Also, just as we often need to continue to review and learn as nurses, or go over something several times before we learn it; a patient will not absorb, comprehend and integrate everything in one, or even two sessions, so it is a continuing battle to create a baseline of understanding to build on. Plus, sometimes you are asking a patient to change a lifetime of habit-and then throw in culture, faith, family, educational abilities, and finances (If your patient can't afford their meds-what steps do you take to help them before you even teach?) I'm not sure if I have helped very much-just kind of my ramblings on the topic. Yes, very often pts do think of their diseases as separate symptoms and not as a physiological whole-but for many different reasons.

I can't think of many questions and answers except to have a clear idea of what you goals are and why you want them-and while it is a given that you want to help people, try to also think of other reasons; for me it was the growth and being able to use critical thinking skills that nursing provided. Also, even if you are nervous, sit up straight, make good eye contact, and smile (when appropriate): often what separates your answers from others is the first impression and how you carry yourself; they'll remember that. It would also really help if you knew a little something about the program that you are entering, and comment on it. Something about the history of the program, or better yet, something about what it is currently doing. ex "I was reading about how students from the program, do classwork as well as clinicals; how does that work?" Ask them a few well thought out questions, showing that you are interested in their program. Best of luck. Let us know what happens. And always thank them for the opportunity to interview.

I'd just like to know the basics (Ive read things online, but its better to hear from real working nurses). Is it real stressful, is it busy, are you always moving, are you treated well as a nurse by your co-workers and doctors, do you usually get attached to patients... you know all that. Thanks! Alice; I work in a 28 bed adult critical care unit; we see everything from cardiac patients to trauma. I am lucky to work on a unit where there is a team approach; we have a team of intensivists (doctors who specialize in critical, or intensive care medicine) that are in our unit everyday-they rely on the nurses as a part of the treatment team. That means that we don't just do the physical aspect of nursing (bathing, cleaning, turning, assisting patients) we are expected to be critical thinkers-use our knowledge to help the docs create an effective treament plan, and then we implement that plan. It's really great-when I first started working there and a doc would come up and want to discuss a patient's status, treament plan, etc with me, I would be like "why is he talking to me?", now I really enjoy the chance to learn more and feel like I count. Most docs seem to understand now that the nurses spend much more time with the patients than they do; we have a good understanding of how they are doing, reacting to treatment, what they may need, so it is very positive. Also; as a nurse you can really go anywhere, do anything-be a bedside nurse, giving care; be a nurse educator; go into management; be an O.R. nurse; creat you r own job-there is a huge need for diabetes educators; there are countless specialties, but you always have a job. You're young-try travel nursing and see the country. It a wide-open field, full of choices. The other side is of course, that it is hard, back-breaking work; and some days you think "I did this on purpose?"; You follow a nurse who might be slightly less tidy or efficient than you are; Your unit is understaffed and overworked-the stress level is through the roof; You have pts that are incontinent "code-brown day"; who are unpleasant; you lose a pt who you fought for; You go home and worry about something you forgot, or did, or didn't do; a family member drives you nuts and then complains about you; you don't get a break all day; but then there are the days where a family member thanks you, sends you a card; you leave know ing that your hard work helped keep the "code brown" pt clean, human and kept their skin from breaking down; a cranky pt is actually glad to see you are back again; an eldery pt holds your hand, you realize that you helped a pt die with dignity and supported their grieving family afterwards. You laugh about not getting a break all day with you co-workers, you go into your rooms to find a co-worker has gotten all the linen and trash bags out, or goes in to that demanding pts room one more time, so you don't have to; someone makes a fresh pot of coffee; you go home feeling like maybe, just maybe, you actually made a difference in someone's life.

WHen I worked L&D, a nurse I worked with had a great answer when someone asked her a health question-like at a party or something; "honey, I'm a L&D nurse, and unless you have a baby coming out of it, I can't help you." In addition to that, on our unit we used to keep a notebook (this was pre-hippa) that was entitled "I can't believe it" that we recorded the obvious....it was so funny

I meant that all authorities should be notified, but not in your suggested order; we had an incident here where the local school board hired the dh of a teacher as a teacher "to help her out"; he had a AS in agriculture from an "open university"-he couldn't find work. when a parent found that her child was being taught by an unlicensed teacher and went to the school board first, by the the time the state got involved, all of a sudden the dh was an "aide" helping out-even though he had clearly been a teacher for several months in charge of students-the documentation now stated otherwise. that would be my only concern with going to the school first-if this person has been subbing there as a nurse for years-or a long while-how quickly would the school board realize that they have left themselves open to legal action-and suddenly, it is all abig misunderstanding; she's not a school nurse, she's an "aide" or "health room tech" and the op is made to look silly.

Don't give up; I can't say that it will be easy, but you need to go in and talk to the program director and find out what they suggest that you do; at my school, students who failed out were given 1st prefence for admittance the next semester. One girl I knew failed the final exam to graduate; they didn't tell her until we were reviewing for the NCLEX a week later. She cried for a week. Then she picked herself up, and applied to a 4yr program. She is doing great now, and has one semester to go. Do not lose faith in yourself. You can do this-just find out what you need to focus on, what you need to do to suceed and don't give up. I started nursing school when I was 20; met my dh, moved and quit; I started three more times, and either had to quit due finances or a new baby (usually both). I am now a critical care nurse, and love it. I would not change the road I took to get here even though at times it seemed like it would never happen. Best of luck, and a big hug.

First off-"I know in the grand scheme of things nothing related to my mom was a huge deal..." it is a big deal; your mom wasn't getting good care, and having the ice packs changed, nutrition and pain management taken care of would facilitate her having a positive outcome. And then, well, it is easy to sit here and say "do this" or "do that" but if you had a concern about the roommate (and transfusion protocols and pretty much the same everywhere); you had an easy out "Excuse me, I'm a nursing student, and I noticed that (whatever) wasn't done; are the protocols for giving blood different here? In school they teach us XXXX." or something similar, as in "I'm just a curious nursing student, and I'm not saying that you are wrong, I'm just trying to learn" And yes, you are hyper-aware; it is a career-hazard. But a good one-one day you'll walk into YOUR patient's room, and use that hyper-awareness to be a great nurse. Hope your mom gets better soon, and good luck.

. " can you pass this information onto the school, the BON, or an anonymous letter to the dept of education? " Sorry to post again, but I would skip the notifing the school or board of Education-they are guilty, and would likely (to my cynical thinking) be more in a hurry to cover it up than to rectify the situation. I'd go right to the BON, the news, or even, if you can find them, some parents of the children attending that school.

License = Nurse No License = Not a nurse What this woman is doing is illegal, and if the school knows about it, they are in trouble as well. I would report this this to the BON at the very least; it would be one thing if this woman was presented/presented herself as an "aide" or something but to be called a nurse, call herself a nurse and to practice as one requires a little thing called a license. As an aside, I would also be concerned about her doing what she is doing while stating that she let her license go because she "lost faith in the medical community"-Then why even pretend to be a nurse?

I used to tape the wrapper (short-end) to the bedrail and return the yankauer to that; however, now, even though I like the above method-the yankauer is secure, I usually fold a washcloth over it and stick it under the pillow-but not always. I do this now because one of the educators on our ICU has found research that states that placing the yankauer back in the package allows secretions to collect at the bottom of the bag and grow "wonderful" things. While I understand this thought process, I also question it to some degree for a couple of reasons-1) I get a new yankauer at the beginning of my shift and 2) I usually rinse the yankauer out by suctioning a small amount of h2o through it after using it on patient, and then letting it run dry (it only takes a few extra seconds). I also change it if it is nasty or hits the floor. It seems unlikely that much will grow in 12 hours, plus even if you keep it in a different spot, if it is that pathogen-filled, it will likely just grow bacteria within the yankauer itself, or in the little ridge where yankauer meets suction tubing. The research makes sense if you don't change it or rinse it. And having it secured near the bed is better than finding it on the floor when you suddenly need it.

"After that I came back into the back room and I got an attitude with the lady who flipped out and did i forget to mention... TOLD THE WHOLE CLINICAL GROUP about what I did. I told her that it was my business and I'll do what I want.\\" I was willing to give you some error of margin until I read this comment-why would you 'get an attitude' with a nurse while you are in clinicals? She was right; you were wrong. You'll "do what you want?" You likely would of had more success by stating "Wow, I don't know why I did that, I wasn't thinking-you're right that IS a dangerous thing to do." After reading the rest of your post, I sense some attitude issues-you seem to think that since you BELIEVE that the instructor "is out to get you" that you're excused from being respectful. Sorry, most people at some point are completely sure that at least one of their instructors 'have it out' for them. They are not there to be your buddy; they are there to make you a competent and safe nurse. Period. Using the fact that you have ADD to excuse your mistakes is not acceptable; "but judge, I have ADD, so it's okay for me to make a med error, I 'm not responsible" just won't cut it. If you were to ask, everyone has some kind of issue while in school-problems studying/clinicals due to the need to work, or childcare, or dyslexia, or money problems, ADD, OCD most people just deal with it and suceed; some use it as an excuse to fail. I am not lightly suggesting that it is easy to do, but you have to, as blue eyes put it, buckle down, and you need to lose the attitude and all of the drama. When a preceptor, instructor, or another nurse corrects you, or gives you a pointer, you don't "[get]an attitude with the lady who flipped out ... I told her that it was my business and I'll do what I want." (what? you wanted to get stuck by an old, used, dirty needle?)not a way to win points or become a respected member of any unit team. Sorry, I know I sound harsh; and I'll likely get flamed; but you made a mistake and then, instead of trying to amend the situation, you copped an attitude-the nurse who said something to you probably would not of reported you if you had not "got an attitude"-you asked to be reported with that move.

Do any of you have migraines or do you work with someone who does? How do you work around these? I don't want to just have to give up everything because of something that happens a couple of times a month (I do actually have some months where I get away with having none). Cara I have had migraines since I was 14. They wax and wane in frequency, some are "triggered", some are idiopathic and some are peri-menstrual. I have a prescription for Relpax-which I haven't used in a couple of years, because I hate the way it makes me feel. I have found that making sure I get decent sleep, exercise at least 4 times a week (usually walking), and avoid triggers-chocolate, ETOH, sugar, and staying hydrated helps. I also read an article in Natural Health Magazine that discussed that there are some docs/studies that link hypocalcemia to migraine, as well as low magnesium levels; it was a great article and made sense. Since then, I have doubled my calcium and upped my mag intake-it really seems to make a big difference for me, my frequency has dropped to one or two much less severe ones a month at most. Here is a link for a product that I have not tried, but have heard some positive things about (from people as well as Natural Health magazine): http://www.gelstat.com My migraines range from pro-dromal for days to severe (N/V, light/sound sensitivity etc)-I work in an ICU, so the consant "DING DING DING" of alarms is like torture. But I don't take anything more than ibuprofen when working-I don't like to feel "medicated"- all of the migraine meds I have been given make me feel spacey and tired; everyone reacts differntly-I don't tolerate them well. I can generally stay focused during a migraine; I have had them so long that sometimes it is just "normal" functioning to have one-the same way you keep going even though your back may be "killing" you-working three 12s helps decrease the chance of migraine and work coinciding. But I just tough it out-coffee, water, gingerale, saltines and motrin. You can do it-don't let this stop you-the first step is to be aware if you have any triggers, or to get extra rest and hydration as you close in on your period. Good luck.

Maybe see if you can get a PRN or Per Diem position at the hospital-just to see what it is like. I really understand your fear of "losing" your skills. But you also need to be where you feel happiest-A few women that I graduated with went right to a doc's office-they knew that they would be happy there-you need to follow your gut instinct, weigh the pros and cons; and finally, remember, no decision HAS to be permanent-if you want to change your mind 6mos down the road, you can-the jobs are out there. Best of Luck.

I work in a 26-bed Adult critical care unit-Our staff looks like the UN-Over 50% of our staff is "non-white" (whatever that remark means-personally, I'm kind of peachy-tan)-and we have quite a few men (of all nationalities)-it is really wonderful to be around so many different cultures and ways of thinking. I guess it depends on where you work, live, opportunities and peoples' career choices. I feel uncomfortable about this because I have never seen people as a "race" or "minority" or anything other than-"Hey, there's Dahlia, she's really nice" or "Hey there's Tom, he's not very friendly, but whatever."

But also think-you are walking down the street of your town, and even after you've explained to your son not to, he shouts out suddenly "look, mom, there's that lady who was at the hospital" or "look, there's the man who had the operation"-oops, Hippa violation.

Having had the crap beat out of me, I am not sure what I think-but to classify what the doc did as "not liking" the pt would be incorrect.....

I was a certified surgical tech before I was an RN; I use sterile technique because it is necessary to protect the health of my patient, and because after 15 years, it is a reflexive habit. For some dressings, clean technique will do; but for other dressings, for central line dressing changes and such you have to use sterile technique-or if you are assisting a central line, A-Line, etc., placement-you need to know sterile technique. It is a necessary nursing skill-just keep practicing, and don't think "oh why bother, this isn't really important" because one day it will be. Track down someone you think has good skills,a nd ask them for pointers-or just watch people when you can. What can't you "get right"? Good luck!

Most of our ACCU pt's are sedated to a RAMSAY scale of III-moderate sedation; the only time I have noted sluggish, or a lack of pupillary response is when there was something neurologic going on with the pt separate from the sedation. Good luck on the NCLEX-just remember to breathe ( iam not kidding!)

We generally use SCD's and/or Lovenox, unless the pt is already heparinized or on coumadin-in our ACCU