sestelle

I have never done this but at this point I feel like I need feedback from other nurses. I got hired as a MedSurg Float before I even graduate school. I worked in that field for about a year and a half and then there was an opening in the ICU and I always wanted to work in the ICU, during my time I had floated there several times as helping hands. So 10 weeks ago I started orientation to ICU, I already had all the training/certificates I needed. I had my ACLS, I had CAPD before, I just had to do this online ECCO modules which was fine, I finished that with no problem. The first 6 weeks felt like a piece of cake for ICU, I didn't really have critically crashing patients. I did express this to my manager several times when we had our every 2 week meeting. She told me not worry and that I would get the experience and that I'm doing well and everyone has nothing but good things to say about me. Week 8 comes by and I have an arctic sun and a major trauma admission who I also have to set up for ICP monitoring which I've never done so that week was extremely overwhelming. So because of that they wanted to give me an extra day on the day shift, because I'm going to be working nights. Since my preceptor felt that I need more time during the day to listen to rounds with the MD's, communicate with them more, get more admissions, have more things to do during the day basically. Also at this point, I ended up having to have 3 preceptors because the "main preceptor" ended up with a back injury so part way through my orientation I had to switch so the preceptor that wanted me to have more time on days was a preceptor that I only worked with for 4 days. I didn't think have the extra week on days was going to be a huge blow to me. But I guess that may have been what made my manager start thinking that she didn't want me to stay in the ICU. Because by the end of week 10 I felt like things were going fine, I was on top of everything, sure I forget to change my limits of the alarm but once I remembered I went and did it, It's not like I didn't realize a patient was crashing or anything. I had a patient transfer from the floor that was intubated and every hour I would have to sedate her even in wrist restraints but it would tank her pressure and the MD's didn't want to put her on pressors and just wanted to use fluids, so most of my time was in there with that patient. So 4 hours into the shift my preceptor said to me, "Why haven't you titrated the levo on your other patient? Her pressure is 130/70? Because I am kind of a wuss, I responded with, "I was going to. I'm going to do it now." I should have explained that because I was in with the other patient I didn't have a chance to go in and titrate the levo down and really be able to keep a close eye on that patient because I was occupied with the other patient. So my manager brought this up as one of the reasons why I am not a "good fit" for the ICU. Another reason was because a pt's BP was 40/30 and I didn't tell anyone. Which wasn't true. When I saw that BP, I went into the room, recycled the BP and waited to see if it was "real" or not. And then went and told the MD first but I guess I was supposed to tell the preceptor first. Am I completely crazy? Did I do all of these things wrong? This morning felt like the worst morning of my life because I was completely blindsided when my manager said that she had to make a decision that it wasn't safe for me to keep working in the ICU. She didn't think that in 4 weeks I could handle things on my own. This has never happened to me before. I feel like crap. Does stuff like this happen? All of my coworkers are now going to know that I "couldn't make it in ICU" once they see me in another position. And that is another thing I'm not going to want to deal with.

I am in my 2nd semester ADN. I have not changed anything different about my study habits but I am doing very poorly compared to last semester. I don't know what to do. My first semester I was getting 90s and 85s on all my tests. This semester I got a 77.5 and a 75. The third exam I orginally got an 85 but the instructors decided to throw the exam out and retest it because there was a fire alarm in the middle of the exam. I thought that it wasn't a big deal because it would be my chance to get in the 90s. The test was 25 questions worth 4 points each. That started giving me a panic attack and the test questions were harder. I ended up with a 76. I was angry and upset and I still am. I read all of the chapter before class, I record the lectures and listen to them over when I'm driving or at the gym, I make note cards on the power point and go over those. I make a study guide based on the objectives and I take practice tests from the Saunder's nclex review and I do the questions in the back of the book. I have a lot of stress in my life but it's always been that way and I deal with it. what can I do to get back to the grades I was getting last semester?

They don't call it the PAX. This exam is specific to Goodwin College. I've applied to many schools and each school had their own entrance exam. For this one they said it's the NLN A&P. These items were on the website for what they test on A&P. Should I just not worry about it? And why should I change my picture? What's wrong with it? Because my hair fell over my face a little? I just wanted a head shot of me smiling.

I thought it was specifically just on A&P too but when I signed up for the exam they gave me a piece of paper and told me to go online to NLN website and look at the item descriptors for A&P and these types of topics were under that. I never learned anything about assessing patients for specific things in my A&P class so I don't know how to really study for that section.

This isn't really an NCLEX question. I am studying for the NLN specific to Goodwin College's nursing entrance exam. In the item descriptors that I was given a lot of the items are "assessing a client" for something. For example, "Assessing a client who is scheduled for an MRI." I don't know what that means exactly. Does is mean checking the patient's medical records? Making sure they haven't had any metal inserted during a surgery or that they aren't allergic to the contrast IV, things like that. Some other examples are, "assessing a client who is receiving patient controlled analgesia," assessing a client's response to sublingual nifedipine," assessing a client who has ulcerative colitis." I know what all of these topics are but I don't know that they are looking for in terms of assessing a client. Can anyone help me? Thank you.