FutureRNArk

Yup. I was just talking to someone about this the other day. I've only been a nurse 8 months, all in the same unit, and it just feels like we hold on to these patients way too long, providing care that is futile. And I'm already starting to get burned out on it. We're a 20 bed Coronary Care Unit in a 450 bed hospital in the south, about the same size city as yours. We also get overflow from our MICU/SICU and Neuro ICU. We've had patients in the unit for months, one particular that's been here since I started. These patients need to go to step-down or LTAC, but often, these are Medicaid patients or uninsured, and we can't get them anywhere, and so we sit on them forever.

We do not do CHG baths at my facility, except for patients who are expected to have an orthopedic surgery or CABG, or with known colonization with MRSA or VRE. Studies have actually been mixed on whether there are any benefits of using CHG baths compared to regular baths. There have been studies that show that CHG baths cause resistant bacteria that are harder to treat. So at my facility, we still do the soap and water bed bath. All patients in the units get a bath once a day unless they refuse. Vented patients are bathed at night, non-vented are bathed during the day.

I work in an ICU and have seen it given as well. I had a fresh CABG patient come out with orders for beer with dinner and 30ml of brandy HS. The beer was sent up from the kitchen with his dinner tray (who knew we had beer on premises - might need to raid the fridge on my way out!!) and the family brought the brandy and we kept it in the med room, slapped a patient sticker on it and what not. There was no point in detoxing him, he was in his 70's, and had no intention of doing away with his beer or nightcap. Don't blame him either - you've lived that long, enjoy yourself! On an aside, my mother is a nurse trained in Ireland, and they used to give the patients a pint of Guinness every night, as it contained vitamins. Probably didn't hurt for an easier night for the nurses either!

I am so sorry that you had this experience, however, there are a couple of flags for me as far as your manager being correct in that maybe ICU was not the best fit for you. I may get some negative flack for this post, but I feel it needs to be pointed out. First, you admit to being a passive person, and your actions with numerous preceptors highlights this fact. But working in an ICU, you can't be passive. Passive nurses tend to get eaten up in that setting, both by other nurses, doctors, and patients. The worst patients and situations are thrown at you, and you have to be able to speak up and be heard above the fray. It seems like your preceptors and peers picked up on this passivity early on, and jumped at it. I am not one of those people who thinks that lateral aggression/bullying doesn't exist - it absolutely does. And in this case, it seems you were a victim because you were too passive. As a relatively new grad myself in an ICU setting, I have been fortunate to not have experienced that myself, but I have seen others fall victim. The second flag for me was the levophed gtt. You stated that at that point in your orientation, you were already taking the full patient load of 2/3 patients each shift. I'm assuming taking on the full workload, this should mean management of critical gtts. You went back in the next paragraph and seemed to blame the preceptor for the gtt running out. If those patients were your responsibility, you should have noted the volume of the gtt, rate of infusion, etc, and anticipated the need for another bag. At that point in your orientation, you may not have known the exact pharmacology of the gtt, but you should know the basics - it's a pressor to keep BP up, and it's important to not let run dry! They are critical gtts for a reason. Even if it wasn't a critical gtt, you shouldn't have infusions running dry anyway, whether it be fluids or antibiotics. Part of the assessment of a critical patient should include an assessment of the IV medications/fluids, pump settings, etc. What this highlights to me is you aren't accepting responsibility and that you may not have the critical thinking part of assessing a patient down yet. You seem to mention numerous times in your post how good you were at tasks and charting, but critical care is measures beyond just task-oriented nursing. You have to assess the situation, anticipate interventions and responses, know medications and what they are for, etc. You can't just approach it from a task-based front. Accepting responsibility is also important. You have to own your mistakes and shortcomings. In this situation, things certainly seemed stacked against you, based on your view, but that doesn't necessarily mean you were without fault. Having said all of that, that does not mean you aren't a good nurse, just that ICU is not the right fit. And that doesn't mean ICU won't be a good fit forever, but right now, it just doesn't seem to be a good fit. You mentioned several times in your post that you felt that your skills weren't up to par or were behind others. Find a position and facility where you can get those skills up to par. Look into hospitals with a residency program for new grads. They tend to offer classes and longer orientations with weekly feedback reports, as well as mentoring. Best of luck to you in finding your fit!

I work at St. Vincent (SVI). It's a level 2 trauma center. UAMS is the only level 1, but they both see high acuity patients. SVI is the only Magnet hospital in the state. It's LGBT friendly, and the insurance covers domestic partners/spouses (it's actually really nice in that you can cover any one adult living in the same household as you no matter marital status, so like an adult dependent child that's past age 26), and our hiring policy protects against sexual orientation discrimination. SVI also has a nursing union. Pay is good, probably some of the better pay in the area plus they are offering sign-on bonuses. I'm not sure how Baptist is as far as being LGBT friendly. They are a level 2 trauma center as well. I've known several nurses at Baptist and they like working there. Every hospital has it's ups and downs, but people seem to like working for each of the hospital systems, so I think anyone is a safe bet. You might also look at AR Heart Hospital. I don't know much about them, but I've heard good things.

UAMS has the more specific pre-reqs like Development Psychology and Nutrition that other nursing programs don't tend to require prior to starting. It used to have a more difficult Chemistry requirement as well when I was evaluating school choices, but looks like they've dropped that to match other schools and only require Fundamentals of Chem w/ Lab. Also, for anyone comparing schools, I've heard that Baptist now requires students to sign an agreement stating that they will not work during the program. So if you work, you should keep that in mind.

They do not have an RN to BSN option, only diploma. For the BSN, you would have to transfer to either UALR or AR Tech I believe.

Every class contains dosage calculations, including drips and critical drips, and pharmacology.

Classes are difficult. There is a lot of material and a very short amount of time to cover it. Once you get past the summer class and first semester, you pretty much have a test every other week. You have to be dedicated and flexible. I haven't seen anyone get dropped from the program for minor mistakes, but a lot of people don't make it through due to grades. As far as retention, they usually start the summer with approx. 260, and end up graduating approx 150, which includes the LPN transition class of approx 30-40. So out of the 260 who start, around 120 will graduate on time. This may sound like a lot of people failing, but think about if you want that "F" nurse caring for your family member. Nursing school is hard because you will have someone's life in your hands, and you need to know how to take care of them.

This class is exactly that. It is designed to weed out those who aren't committed to putting in the hours of study, or practicing of clinical skills. A good number of people don't pass the class. It's pretty basic information, at least compared to what you get in later courses, but it is a lot of material. You also have clinical skills and check-offs in order to pass the summer course.

Y'all should really get a Facebook group started for your class. We have one for our class and it has been super helpful as we post questions and get answers, share study materials, reminders about deadlines. We have a few of the upperclassmen in the group that help answer questions about future classes and share their experiences. I know that your summer class is starting soon and you'll definitely want to get that started before class starts.

UAMS is the only program in the LR area that offers a BSN only program, so if that's your main goal, then UAMS would probably be the best program for you. However, getting an ADN and then doing the one year RN to BSN option online allows you to work while finishing the bachelors. It's really a personal preference.

It is not the same as a rejection letter. They do flat out reject some people, while some get wait listed. Here's how that process works: within the next couple of weeks, they will accept some wait list students based on the number of people who accepted. Then they will admit a second round of students for the last summer class based on the number who fail out of the first one. My class had 30 or so fail out. So they then admitted 60 for the second summer session and roughly half of those failed out. So it's really a wait and see based on the numbers of who accepts and who passes the May/June fundamentals course.

I was wondering how your UR department was set up at other hospitals. In our hospital, we have a team of five RN's who do the Milliman reviews for all inpatients and OBS. Then we have 2 payor specialists (that's my position) who interact with the insurance companies faxing clinical information or doing telephone reviews for auths. We just started using Milliman at the first of the year (we used InterQual before) and they want us to begin only sending the MCG reviews to insurance companies as our clinical review. Does anyone else's hospital do this and is it successful? We are worried that it won't be enough for most of our payers, and additionally, that the reviews are usually not completed within 24hrs of admission and so we wouldn't have anything to send. I'm just wondering how your hospitals work this side of the UR piece.

My schedule does allow me to work. I work full time (40 hrs a week) and still attend school as well. It's difficult, but doable. My schedule this semester includes class for 2 hrs on Monday and Friday and then I have 2 6hr clinical rotations each week on Wed/Thurs nights. My employer is flexible so I'm able to come in and work around that schedule. Flexibility is definitely key in working through nursing school.

Have you been to the department advising for applicants yet? They explain there how they rank you for acceptance. Pretty much, they are only looking at how well you have done in your pre-requisite coursework that they require for the program. So Math, A&P, Micro, Chem, Writing, etc. You have to have above a 2.0 overall per UALR standards, but as far as admission into the program, they assign points based on your grade in those classes. Then, once they assign you a point total, they begin admitting from the top of the list, so highest points get admitted first. After that, some people are waitlisted, and others are denied. They give you a very limited window of time to respond to their offer (something like 2 weeks if I recall), and those spots where students didn't accept admission are given to those waitlisted. BUT, I will say that even if you aren't selected in the first round, they admit a second set of students for the second summer class based on how many people didn't make it through Fundamentals (We lost roughly 30 from our first summer session). So there's always hope. ALSO, be sure to get your application in by the priority deadline. they consider those students first. If you don't get it in on time theres a good chance you will end up waitlisted especially if they've filled their spots, even if you had a high ranking. I'm sure the elimination of the HESI may change the number of applicants. But in reality, you're pretty much ranked the same way. The HESI was just supplemental and if I recall, didn't have a high value towards the points ranking. That may be why they got rid of it. I know the wait is hard, but you just have to try and calm your nerves until then. I'm sure you will get in!

Hi everyone. I am currently in the UALR program, and I started last summer. The application is somewhat comeptitive, as only about half of those who apply are selected into the program. The program is very challenging, but if you commit to doing well, you will be ok. As far as fexible, it is flexible to the extent that you aren't in class or clinicals every day. However, you don't always get the choice of when your clinicals or classes are. Even when you know your schedule, tests or skills labs or sim labs may occur outside of those time frames. So you would need an employer who is EXTREMELY flexible if you want to work. I still work 40hrs a week and have been doing well in all of the classes that I've had so far. The program is hard work. They expect a lot from their students. A lot of students don't make it through the program. But, I've learned a lot, and I feel like I am being prepared well for the nursing field. The teachers are there to help you and want you to succeed. If y'all have any more questions, I'll try to answer them!

The Little Rock area hospitals start their new grad nurses off around $20-$22/hr. I'm not sure exactly how much it would be in NWA, but I imagine it's similar.

I am currently in the UALR program and I love it. It is a lot of hard work, but you learn everything you need to be an excellent nurse. UALR has it set up so that you can get your ADN in 1.5/2years, then begin working and do the extra year of BSN coursework work totally online. They have a partnership with St. Vincent that includes scholarships. Also, the UALR NCLEX pass rates are some of the highest in the state, so it's a good program. As far as the Baptist program, I have heard that it is an easier program (which may account for it's NCLEX pass rates only in the 80's). It is a diploma program so you don't get any degree with the program, but you're still eligible to sit for the NCLEX and can do an RN-BSN program online in the future. UAMS has a good program as well with high NCLEX pass rates but it is a full-time, 3 year program. They have more pre-requisites than any of the other nursing programs, so that may need to be taken into consideration. All of them have their pros and cons. I chose UALR because of the short program time, variety in clinical rotation sites (SVI, VA, Baptist, Saline, Bridgeway, Birchtree, State Hospital, UAMS), less pre-requisites, and because I am still able to work full time while attending. Your personal decision will need to take all of these things into account. What kind of degree do you want? What pre-reqs do you have? Do you work?

I don't feel as if it is disorganized, but just rushed. There's not a lot of time between when Spring semester ends and Summer starts. Couple that with trying to coordinate paperwork and information for 200 plus students, and I'm sure it is difficult for the department. The syllabus/course manual should be available this week. The policy and procedure manual and textbook is currently available.Below is a comprehensive list of things we need to buy (as best as I can remember). As as far as housing goes, I would contact housing and see if they can make arrangements so that you can move in earlier or if they can make any other accommodation. I will say that when I got my first bachelors at another institution, the college didn't let us move in until the Sunday before classes started Monday. So I don't know that it's so unusual. I would encourage you to stick with the program. It is an excellent program with one of the highest NCLEX pass rates in the state (if not the highest). Don't be discouraged by the rushed nature of what has happened this far. I think part of this is to test your flexibility, adaptability, and time management as well. I work at a hospital with many UALR graduates, and they all told me that this first class is really meant to play mind games with you, weed out the people who signed up for wrong reasons (only for money), see if you're dedicated and willing to put in the study time. Supply List: To buy now: Keizer and Erb's Fundamentals - $50 on Amazon Policy and Procedure Manual - $35 Course Handbook/Syllabus - $?? Skills Kit - $100 Stethoscope - $30-$200 BP Kit - $25 Pocket Kit (Bandage Scissors, Pen Light) - $15 Optional: Clipboard with storage - $25 SNA Membership - $35 To buy over summer: Background check - $120 Uniforms - $??? Books/Syllabus for Fall Classes - $??? Skills Kit for Fall - $??

@NutriRX we need a sphygmomanometer and a stethoscope. The stethoscope doesn't have to be a Littman. They were recommending them at orientation. But all the nurses I talked to at the hospital I worked at said that other stethoscopes were just as good and cheaper and would work well for clinicals. I would recommend looking at Amazon to read reviews. I got an ADC after doing some research and reading many reviews. It was $50 on Amazon with free shipping and I am liking it so far! The uniform store recommended the basic MDF ones they sell since they're inexpensive and work well for student nurses. We also need to purchase a skills kit from the book store (not yet available for purchase) and they recommended a clipboard with storage and a calculator, and a pocket kit thing that has bandage scissors, a pen light, and some kind of pen that they said wasn't as important with electronic charting.

If you do get a Littman, get it engraved. They have a tendency to "walk off" in the hospital setting. Allheart will engrave it for you cheap if you buy from them.

If you go to Griffey's Uniform Store on Markham, they have the sphygmomanometers for $23. They have stethoscopes starting at $30. I got an ADC 615 stethoscope off Amazon for $50, and it works really well. I didn't like that they made it seem like you had to have a littman. Amazon has a bunch for cheaper with free shipping with good reviews, so check those out if you don't already have one. I am super excited! When is y'all's clinical day? Mine is Wednesday.

@urmandyjoy there wasn't a CD/DVD that I know of. The 4 skills that we will be tested on from what I understand are vital signs (BP, pulse, respiratory rate, temp), Foley catheter insertion, sterile dressing change, and medication administration. There are some good videos on YouTube. Search for 'hawknurse' as I found her videos particularly helpful for the skills. I also believe that we get 3 chances at each of the skills. For the lecture portion of class, there are 4 tests and 4 quizzes. (This information may have changed since the last entering class, so don't quote me on it!) I am both really excited and terribly nervous about starting the program!

@NutriRX the chapters weren't listed in the Policy manual. I am guessing they are in the course manual, and the bookstore told me they didn't have those yet. I will check with them later in the week to see if they've gotten them.