chill1121

So let me start off that I'm overly critical of myself. I do it to help me figure out what I could of done differently. So my story goes like this. Im a new grad working in critical care for about six months. I always wanted to do critical care and or trauma so it's exciting and I learn something new a least once a week. I also know because it's s tough unit, the learning curve is steep. I had a patient who was transferred from a cardiac floor for a rapid response. She was dx with a NonSTEMI and her BNP sky rocketed. Doctors related her increase with her MI and previous CHF issues. Patent was alert and oriented but forgetful all day. She was in a first degree HB, sounded slightly coorifice, BP was in the low 100s. Her MAP was borderline and so was her urine output. Cardiology saw her and increased her lasix, put her on looted and aspirin. Typical MI protocol. Her temp gradually climbed so I got an order for Tylenol. Her white count was 15 and was on daily rocephin. I iced her up and took the blanket off her. Temp didn't move. She was on 60 percent heated high flow all day. She sat around mid 90s until she would take the cannula off. Respiratory talked to her about it and so did I a number of times. She did that all day. She only desat when she removed the cannula. Her son comes in around the end of my shift and he talk. Her urine is now cloudy and output is pour. I page the doctor after I get report about her urinr and her desat issues and her temp. They talk about rethinking her code status because they don't think she should be a full code. She's 85 years old and her recovery wouldn't be that great. The son was receptive but wanted to talk to his sister before they made any decisions. So so I go to leave and all the sudden she is very restless. At this point it's almost 2 hours after my shift and I've clocked out. I stop in because I felt she was off compared to her mental status all day. I call respiratory and tell them she's not sating well and is anxious. They tell me they were just there and weren't concerned but I convince them to come anyway. I stay with her until they come and I head out once they charge nurse told me to leave. I had a bad feeling but I knew she was in good hands. Well about two hours later I get a text from my friend saying she died. I was dumbfounded. She went into PEA was intubated got a rhythm but Brady down and the son said to stop efforts. I feel horrible. So now I'm thinking about my day and how I could of prevented this. I'm kind of brainstorming here so next time I can be more in tune with this. So maybe her desat was hypoxia? Maybe her cloudy urine with poor output with her temp and being tachycardic was sepsis instead? Maybe pay more attn to her MAP? Maybe this just happens with a NonSTEMI and heart failure in an 85 year old with co morbidities? Im new so I really don't know. I know what's done is done but I want to know for next time what to look for. Of of course I'm convinced I'm losing my job. Probably doesnt help I'm 6 months pregnant either. I know if she had that change of mental status on my actual shift I would of rapid response her. I know change in mentation is a first sign of crap hitting the fan. I'm looking for some input to help me be a better nurse. I know I can't prevent everything. This could of been inevitable. I just want to think of things I could of done differently. Sorry it is so long but thank you for advance for your input. I'll be impatiently waiting.

Hey everyone I need some preliminary career advice. I'm a new grad and newly licensed from an ADN program and have been offered a job....in long term care. I want to go into trauma as a long term goal and I know I need a lot of hospital experience in my area (MD) to do that. It pays well and it is only part time. They want an answer soon do they can get me into orientation soon. At first I was thrilled because I got a job offer days after I was licensed but then I started to think. Should I? 1. Wait and not commit to the job for a hospital job 2. Take the job and keep applying and give my two weeks if I find something in a hospital even if I'm only two weeks into working I'm trying to decide what's the best career move. I don't want to jump at the first opportunity but I really need to work. Any advice would be appreciated! Thanks!

Just an update....I passed! Good Luck to everyone testing!

I think nursing programs could benefit from a pre entry psych evaluation but that may just be my experience in nursing school. ??

Hello everyone! I wanted to give a congrats to everyone that has passed the NCLEX and for the future first time test takers and retesters that will also pass the test! That is no easy feat and you deserve a pat on the back! ?? So what's my deal? I took my NCLEX RN for the first time this morning (September, 3rd) bright and early at 8am. My last day of school was August 12th so I am roughly 3 weeks out. Anyone who knows me knows that I'm not a morning person and I rather not be talked to until 9am so it's a wonder I managed to get through it. I stopped at 75 questions which let me just say: getting to question 75 is very daunting. It either means I did sooooo poorly that there is no way for me to redeem myself in the next 190 questions or they grilled me just well enough to let me pass. And why I say grill me, I mean hit me with every bit of material I didn't look at in my years of nursing school and weeks of studying. I swear there's a little NCLEX camera up there in the sky that had been following me around and knew that. ?. Anyways I finished in about 80 minutes and got in my car, blasted some music and wept softly to myself. A few hours later a tried the trick. Now I know a few people are annoyed with the posts and honestly I was at one point but I feel like I have to tell you so we can at some point get a consensus on whether or not the new one works. I know it's impatient I get that but as along as people know the risks they are taking, then they should be able to sign the consent form. I HIGHLY recommend that if you do try the new trick, you should use a prepaid card with a few dollars on it or an old non expired card. I used an old non expired card, closed my eyes and got the good pop up. Even if it's wrong, I can go about the next few days with a decreased amount of anxiety. My BON in Maryland does participate in quick results so that's fantastic. However they do not post licenses any quicker than quick results and they will post your name regardless if you pass or fail, there just isn't a number next to it until a week later if you indeed pass. So here's my magically elixir to pass or at least allegedly pass: I took a deep breath in and out about every 20 questions to gather my thoughts and get some much needed oxygen to my brain. I prayed all throughout my exam and did a lot of internal self talk (sounds like nursing Dx interventions). It helped me keep control of my situation and rebelieve in myself. I did not do a review course simply because I was tight on money but if I had to recommend one, I would say take one that focuses on strategy then find a book or app to do a bunch of questions. I ran into a lot of content I didn't even know so this is very much a strategy test. Being able to eliminate answers and use the context of the question will allow you to pass the test. I used the Saunders Comprehensive, NCLEX 3500 RN which is free btw, I joined a Facebook group that every minute of the day people post questions and answers with rationales which btw also free and a very expensive iPhone app called the NCLEX Mastery (30 bucks!) that was by far worth the investment. I did about 100 questions a day and did not study the night before. I'm not going to learn anything new hours before the test. My advice since I know everyone is just on the edge of their seats dying to know? Do a ton of SATA. I had at least 30. I feel like the more you do them, the more comfortable you feel going into an already increased anxiety ridden test. Even if you don't know the content, at least you are less likely to freak out when you see your 1000th SATA. I also recommend looking at rationales while you are studying and not just the content part of the rationales but the strategy part of the rationales. For example in the Saunders book they talk a pig eliminating answers not just because they are wrong but there are key words that make an answer wrong like ALL NEVER ANY and so on. Balancing content and strategy will go a long way on this test. Also KNOW YOUR GENERIC DRUGS. My school told me they were fading away to oblivion but I didn't think so soon and completely. None of my drug questions were obvious ones either like -lol or -sone. In conclusion, I wanted to give my experience to help put some stuff in perspective because the rumors about this test are numerous and are enough to drive a future test taker mad. There is a great post that I think is 2 parts that break down the FACTS of the NCLEX to correlate to the official makers of the NCLEX. READ THAT! Even if the pop up is wrong and I don't end up passing at least you guys know what to look forward to and that it proves whether or not the new PVT is effective or a bunch of bologna. Thanks for reading and I hope this helps even if it's just one person! I will update with my unofficial results the moment I get them and I stop sobbing in the corner or dancing in the streets!

The new pop up comes up when you actually put your info into pay. During step two it doesn't let you pay and the pop up is on the top of the screen I took a screen cap of it but this site won't allow me to post it. Sorry. I hope that helps though.

Thank you for posting a picture of your pop up. When I took the PN exam this past January, the good pop talked about contacting your BON so I see that the pop up has changed in wording although it conveys the same message. Congrats on passing!