KaliNurse

A-fib, for sure....A-flutter is REGULAR, a-fib is IRREGULAR. That's one good way to distinguish between the two....and of course, flutter shows the saw-tooth waves:-)

I think the question/order could have been worded better than that, but it sounds like the forst 3 should be given STAT.

Hospitals choosing the BSN RN's over the ADN RN's started because of Magnet accreditation. Many more hospitals are starting to apply for Magnet status (nursing excellence award). Having BSN's on board looks more favorable when facilities are applying for Magnet recognition. Honestly, in my opinion, hospitals are interested in your RN license....more so than the schooling. But, because of Magnet, they are trying to hire bachelor's-prepared RN's. (Wait til the nursing shortage catches up to them!!!!!!) lol...... You can always enroll into an RN to BSN program. The best part of the ADN is that you can allow your employer to pay for your BSN!!! If that particular hospital is going thru the "Magnet Journey", chances are, they will have some kind of tuition reimbursement waiting for you to use because that makes the hospital look good with Magnet:-) Take it from me....the "Magnet Ambassador"

I believe that hospitals are currently in a position to hire only BSN's. However, we will see that change once the economic situation lifts. It does look good for hospitals to hire nurses with higher levels of education. After all, most other professions are at least entry-level bachelor's anyway (ex.... physical therapists = masters degrees; pharmacists = doctoral degrees). However, once the economy turns around, hospitals may not be in that same position to be so "choosy" with their nursing levels of education. There are simply not enough BSN's to care for the additional 26 million people that will be insured once our new healthcare plan goes through. So, I don't think this is going to be a permanent thing. You should further your education because you WANT to, not necessarily because you HAVE to. Magnet does have alot to do with this whole BSN thing. Many hopsitals aren't quite ready to get their Magnet status as of yet. If this is going to continue to be a strong recommendation from Magnet, then hospitals may eventually start providing more tuition reimbursement for higher education. There's nothing wrong with getting an ADN, and then making your employer to pay for your BSN, if that's an option for you...... Hang in there!!

DCCC Marple students......Some clinical sites are: Mercy Fitz, Paoli, Crozer & Lankenau. DCCC Chesco Students.....clinicals are at CCH for the first 2 semesters (First Year).

Kaplan and Mosby's Comprehensive have all the questions broken down into systems (resp, cardiac, GI...etc)

You CAN do it. Forst of all, you got the right idea (in my opinion) with the Kaplan QBank. The NCLEX set up is extremely similar to the Kaplan set up. Keep practcing computerized questions, since that will be the format of your exam. Review all rationales...even if you get the answer right. Kaplan wants you to pass as much as you do, so keep doing their questions! You have a few weeks to keep at it. Good luck!!!

Stacey, Make sure your read your contract BEFORE you sign it! Know what your facility is asking of you, prior to committing! Also, it is good to ask about their requirements for passing the NCLEX. Jumping into a contractual agreement prior to graduation can be shady if you don't consider what they want in return. It may also be helpful if you could talk to another person who contracted with the same facility and went through the same ordeal. You can ask anyone in HR if they could refer you to someone who went through it so you can ask them personally..... prior to signing the contract! Good luck with your decision.:wink2:

Yes. You really should check prior to administering meds. Even though some patients have been on those same meds at home for the last 20 years and don't check their own blood pressure prior to giving themselves their meds.....you should still check because the patient is in YOUR care now! When talking about parameters...you should know whether you are giving a beta blocker versus an ACE inhibitor. ACE's won't affect the heart rate...they only affect the BP. Beta blockers will affect both. So, you need to pay attention to what you are supposed to be giving, and as well as the parameters. If the patient's heart rate is 50, and their BP is 180/90, then call the MD and let him know about it since he is the one who ordered parameters. Most likely, he/she will change the classification of the drug ordered in order to lower the BP without affecting the HR. By the way....pay close attention to your diuretics as the others have told you! Lasix or Aldactone in combination with a blood pressure medication, could certainly "bottom out" your patient.

Hang in there, ehlay! You'll get through it! You've come this far!! Best of luck to you!:up:

Patient Safety!!!......Patient Safety!!!....Patient Safety!!!..... You cannot go wrong with those words. Also, the Joint Commission knows that you simply cannot know all the answers. So, if they ask you something that you aren't too sure of.....you should say something like...."I would ask my nurse manager first", or "I would refer to the Policy Manual for that". Believe it or not, they are more interested in safety than anything else. I think most people would agree......

That's correct. You need to go to your family physician and have titers drawn for Chicken Pox. This will tell how high/low your titer levels are for chicken pox. If you still have a decent level, you may not need to get the Varivax vaccine.

I know what you mean....you mean like aesthetics or administering botox injections for a spa or salon....etc.....The answer is YES. I have a friend that does it with a BSN and malpractice insurance. You also need an MD to partner with. He needs to review your charts and order your botox and restalin (I think that's what it's called). Anyway, I think this is what you are asking...... If it is the answer is YES you can. I'm sure there are alot of other things involved in getting it started. You'll have to check with the nursing board in your state to see what the regulations are. That would be a good start if you are serious about considering it.

Well, I guess I wouldn't take that for granted either. But, think about it....that makes NO sense. Why would the facility require a double RN signature on a heparin gtt and NOT on an insulin gtt???? I can see why you are questioning it!!

Yeah I guess everyone has their own "method to their madness" when it somes to studying. I think all of you have great studying ideas. I also agree with the fact that studying a little every night will help. You cannot cram this information in. Some people are procrastinators and believe that they can cram all the info in the night before, and then pass the test. That is usually not possible. However, now that I said that.....someone is gonna reply to my post and say that they waitied til the last night to study and passed their test...blah...blah...blah. So, here's the deal....if you wait til the last night to study for a nursing test and you pass it, you simply got lucky. Yeah, that's right...lucky! But, guaranteed....you will not remember ANY of that information when you need to actually use it in future practice. So don't listen to the procrastinators on that one. Remember...nursing is a PROCESS. It takes time to develop and build. Study a little each night and continue to ask questions. That should take you a long way!!!! Also, I agree with Lauren too about PRIORITIZATION. You have to know what to do first. But, since you are a first year student, you have to get the basics down first. Then, you can build on the original knowledge taught to you first year. Best of luck:)

Ehlay, Just out of curiosity....Is there a reason why you are waiting until October to take the exam????? If you graduated in May or sometime over this summer, you really should schedule your exam within a few weeks, if possible. Waiting a while post-graduation is not a good thing to do. But, maybe you have your reasons....... If its possible, try to take your exam earlier while the material is still fresh in your head!!!! My advice is to use your Kaplan strategies. If you are taking the exam via computer, use the Kaplan. That's my opinion.....If you are taking a computer-generated NCLEX, it would be more helpful for your to practice (at least 100 questions/day) on the computer. Kaplan has a great "Q-Bank" which gives you about 1000 or more questions WITH rationales. The setup of the NCLEX is also the same as the setup of the Kaplan questions. The answer to passing the NCLEX is questions...questions...and more questions!!!! Keep on doing them! Do not go over your nursing school content. You will get overwhelmed. I picked a few areas that I needed to brush up on before I started to study. For example, psych meds and their possible side effects, and popular meds such as lasix and digoxin are almost always on an important exam. But, I just kept doing the questions and reading the rationales. That's what will help you. Again, this is only my opinion. But, it worked for our class.....all of them passed. Best of luck!

These stories, once again, reiterate the overwhelming responsibilities of the RN. Considering the status of the current healthcare situation, I don't see very much changing in the very near future. Hospitals are downsizing staff to save $$, and nurses are becoming more and more responsible for these kinds of issues. Unfortunately, liabilities such as these stories continue to plague our healthcare system. Hopefully, I am wrong, and we will see some needed changes down the road!

Billythekid, It seems like you are talking about a Heparin drip, not Heparin SQ. A double RN signature is a mandatory policy in each facility because Heparin is considered a "high-risk" medication when given via IV route......just as an insulin drip would require a double RN signature as well. I have never heard of a facility not mandating a double RN signature for Heparin IV. It should be mandatory in each facility. Hope that helps!

En1024, I don't believe you will have to report in unform until you are on the floor. Chances are that if you are having difficulty getting your uniform, some others may be having the same issues. Keep trying! You can personal message me if I can help you with anything else. :wink2:

Tiff, You are right. The first clinical day on the hospital floor is 9/20. But, technically Sim Lab on 9/12 is considered a clinical day as well (even though you aren't technically "in the hospital"). Hope that clears things up!

FYI...Clinicals for evening/weekends at CCH starts on 9/12/09, not 9/20. And also....CH does not teach clinicals for Chester Co Hosp. She teaches classroom for senior students (N210).:wink2:

You are sooo funny. In fact you sounded like me at one point in time!! Here's the deal.....hospitals are now turning to plum pumps for calculations in order to avoid IV medication/drip errors. The pump will tell the nurse if an "unsafe" dosage is programmed into the pump prior to administration. However, it is still imperative that you know how to do it for the Boards and in real life! In reality, there will always be someone there to help you with a given calculation. But is important that you know HOW to do that particular calculation because it will be part of your practice at some point. Yes, Pharmacy can help you. Yes, another nurse who is more seasoned than you can help you....etc. But ultimately, you SHOULD know how to calculate so you can check things for yourself. Here's a good example.....In the hospital you will see heparin drips all the time! It is the MD's responsibility to figure out how many units/hour that patient will receive based on the patient's diagnosis and weight. It is the pharmacy's responsibility to see that the correct amount of heparin goes into each bag for that patient. It is YOUR responsibility to see that the MD came to that dosage correctly. Did he know how much the patient weighed at the time he prescribed the drip, or did he just guess? (Yes, I said "guess"). Sometimes, doctors are as busy as nurses. Did I just say that??!! Anyway, orders are written in a hurry sometimes, and despite popular opinion.....doctors make mistakes!!! So, here's just a glimpse of why you should know how to manually calculate when necessary. Don't fret...when in doubt just ask! Kali, RN, MSN

WOW! I'm glad that HESI's were not in existence when I took my Boards!!! Here's something the nursing schools should be asking.......HESI always talks about its "pass rate" for the NCLEX. Well, has anyone asked them what their rate of "failure" is?? Hmmmm......I wonder..... Don't be discouraged. Keep on and continue to hit the books. It will all be over soon enough!!! Best of luck to all of you....... Kali, MSN, RN

Hi E.R. Rookie, Here's some words of wisdom.....Do as many questions as you can PRIOR to taking your boards. It is probably best to do your practice questions in the on-line format. That is a good way to get used to the way the questions are posed on the actual NCLEX. Focus on categories and classifications as opposed to content. There is simply NO WAY you can go over all of your nursing content! However, you can review things by classification and categorization. For example, know your cardiac drugs by categories.....beta-blockers, ACE inhibitors....etc. Know your psych drugs by classification.....MAOI's, Anti-Depressants, Anti-Psychotics....etc.... Also keep this in mind.....The state boards are an indication of how SAFE you are to practice.....It is not necessarily how SMART you are to practice. Many people think because they got 75 questions, they are really smart nurses. This may be true in some cases. However, a minimum of 75 questions proves that the state board of nursing has deemed you "safe to practice" at the minimal required amount of questions. Hope this helps!

There are many different reasons for the "nursing shortage". Peter Buerhaus is the expert!! I would refer to any of his research studies. They are all good and relate well to your topic. I do agree that lack of faculty is a HUGE issue and will be one of the biggest issues over the next few years when many of them retire!! Here's a bit of advice....Alot of research regarding the nursing shortage is derived from nursing labor unions. This may be represent a biased opinion when doing your paper, unless there is research to back it up. I have nothing against nursing labor unions. In fact, I'm in one. They really bring the topic of the shortage and better ratios to the forefront. But, in order to keep your paper balanced, I would use a little bit of both (union and non-union) types of research. Be careful when choosing your references. REMEMBER THIS....There is NOT a shortage of nurses!!!!! There is a shortage of PRACTICING nurses!!! This is one of the big misconceptions out there today. People believe when they hear that there is a "nursing shortage", that there is not enough nurses in the country. This is simply not true!!! The shortage is the lack of PRACTICING nurses! Hope this helps a bit! :nuke: