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Quest5 BSN, MSN, RN

Nursing Student Retention
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Quest5 has 24 years experience as a BSN, MSN, RN and specializes in Nursing Student Retention.

Quest5's Latest Activity

  1. Quest5

    Quitting tomorrow, in panic

    I'm glad to hear that you will get some help. Remember, the good things, i.e.the critical thinking skills you learned, will always be yours, no matter what your career choice. I do hope you will stay in nursing. It is no longer an absolute requirement that your first job in nursing is in an acute care setting; many nursing articles have been published about alternative pathways. So take heart, you need not give up nursing and healthcare. As part of your plan, please investigate these other options. You are clearly courageous enough to make a difficult personal decision, so I'm sure that with a little more time and less pressure you will find the setting that is absolutely right for you.
  2. Thank you, TheCommuter, for the WGU update! I'm delighted to hear they've made it easier for the ADN RNs to make use of this great opportunity. I've been recommending WGU for years. This will eliminate one of the main reasons I've heard in return for not enrolling.
  3. Quest5

    Quitting tomorrow, in panic

    Whatever your decision, and only you can make it, please consider getting some help recovering from the stress. It sounds as if you have been through an emotional wringer, something intense enough to leave scars. If that is so, simply changing careers or jobs won't null the effects of this experience. It need not involve medication or a long time, perhaps just someone unrelated to you in any way, to listen to all the details in a safe place where you can disclose the full scope of what happened, without anxiety or worries about judgment. Plan to take care of your mind as well as your career/ employment. Not doing so can result in a obviously inappropriately intense response the next time one is subjected to major stress, the level that can happen in any job. Take it from someone who saw a close friend hit full meltdown without warning. Prevention is always easier than belated cures.
  4. Quest5

    Scared about mentorship in the ED/ER

    A mentor ship in the ED can be a fantastic opportunity to work on assessment skills, to use non-medication comfort measures and to participate in interventions with a wide range of patients in a comparatively short time. Be prepared to be on your feet the entire period, so show up well rested and no yawns, or complaints. Have all the necessary paperwork available for your mentor. Technology is great but any personal cell phone use is inappropriate; HIPPA regulations can be a challenge in an ED, so if you see people you know at all, respect their privacy without exception. No names, no photos, no recordings, no matter how spectacular or news-worthy. Try to act as a professional at all times. The schedule in many EDs is usually unpredictable but there are some generalities. Some days and times are usually busy, so if you're worried, try to arrange to start on a less active time but remember, chances are you will need to follow your mentor's schedule, one that may have been set a month or more ago. If you have contact information, try to call your preceptor before your first shift to confirm what is expected of you and some minor administrative details, like whether you will have a secure place for your things, meal breaks, etc. If you are allowed to do so, ask to visit the ED in advance or to arrive early, just as you would to get a clinical assignment during other semesters, to find who is who and out where everything is located, including the small things like bedpans, urinals, linen, portable ECG, crash carts, etc. Should your first hours be hectic you will feel less lost if you have a clue where to find things and who does what. Until you really have a sense of what is expected of you, stay out of the way during emergent care of critically ill patients. Don't take it personally if you are spoken to sharply in the heat of a moment. The ED can be highly stressful even for experienced staff. Asking questions will be expected, but pick your time and place. Especially if the ED has curtained cubicles, remember that sound carries, so be cautious about discussing anything where you may be overheard. Patients in the ED are often frightened so simple things, even a warm blanket or a pillow, if you can find one, mean a lot. Don't offer false reassurances and don't assume that a patient wants you to discuss anything about anything with anyone, family included. Make the most of the many learning aspects available in an ED, including triage, urgent care, pediatric emergencies, communication with inbound ambulances, cardiac/ respiratory emergencies, etc. The variety can be amazing. In the unlikely event that things are slow for more than 15 min., resist the temptation to sit down. If there is nothing you'd like to discuss with your preceptor, volunteer for tasks. Simple things like ensuring all cubicles are ready for patients, including the code/ trauma rooms is a chance to become more at ease in the ED. Checking supplies on code/ crash carts will teach you the variety of supplies required rapidly. Learn to use the equipment, especially portable ECG and cardiac monitoring; even if you have some experience with these, there are always opportunities to become more adept. Stay awake, attentive, and professional. It is acceptable to be anxious, but not to be frozen with fear. When in doubt ask if you can assist. If confronted with the horrific, keep control of your emotions and your face by remembering that the patients/ family/ friends are far more scared than you and are watching to see their worst fears confirmed! Should you feel faint or about to vomit, get out of the patient care area or anywhere you might obstruct movement. Of course, if you must leave the unit, let someone know and come back without delay. Lastly, bring your sense of humor. ED humor is sometimes a little off-beat but it cuts the stressors to manageable size. Don't consider telling any stories or jokes to your class mates later, as chances are they will seem inappropriate or unfunny. You may feel you are there purely by chance, but that is rarely so. You are nearing the end of your entry-level education so you have the knowledge to be successful during this mentorship. Make the most of the experience. It may lead you to a career in the ED, or not, but at the very least it will give you greater confidence in your abilities and skills. 'Best wishes for a great time! (By the way, my senior practicum in the ED some years ago led to my selection as one of only two new RNs in the department's first new grad program. I felt empowered, confident and blessed that I had that experience my final semester.)
  5. Quest5

    stinky patient pet peeve

    I'm saddened to think that you missed the lessons inherent in your clinical assignment. Yes, you are a nursing student but the fundamental lesson any healthcare student must learn is that it is a team effort. There is no description in a nursing report at change of shift of who did what. You made assumptions, but others have commented on the possible reasons for what you saw. As others have commented, many diseases will cause the sufferer to have an odor, including renal, liver, advanced cancer and psychiatric disease as well as medication side effects. Experience of these odors teaches us to recognize disease, sometimes before it is clinically evident in laboratory results. Bathing a patient goes beyond removing sweat and grime, as it teaches us to respect the skin, to see telltale signs of pressure before it becomes a decubitus, to check for perfusion and healing. Such experience relates directly to learning the skills of assessment, the RN's first responsibility in the nursing process. When you get to your class on leadership you will learn that as someone in a position to delegate care to others, you must be able to evaluate whether or not the person to whom you have assigned the task can do it correctly. You are indeed a nursing student and as such you are in a position, through lectures and very limited clinical exposures, to learn what it takes to deliver and delegate care properly. Without personal experience of what is involved in a full bed bath, you cannot expect to effectively delegate these tasks. It surprises many new RNs that a correct full patient bath and full bed linen change can be done by an experienced CNA in an amazingly short time. By learning that level of care, what it entails, and what is involved is a critical lesson for every future RN. Experiences providing the simplest care are not a waste of your clinical time; it directly teaches the knowledge and skills needed by the RN to effectively plan care and ensure its efficient delivery. What grieves me most is however, is that the patient's bath was a not fully appreciated by you as an opportunity to learn gentleness of touch and the use of self in the nursing process. You did not realize, assuming you did bathe the patient, the subtle effect of a task intended not only to clean the patient, but to promote patient comfort. Patients who cannot communicate openly will often settle and sleep after a bath. It has benefits for both the caregiver and the recipient. Ask any experienced RN if s/he recalls the first, and most recent time, a patient expressed gratitude for the simple act of bringing true comfort just by touch. It is a powerful experience and the bath provides the opportunity. The next time a clinical patient needs a bath, accept the chance to learn from the experience, keeping in mind the bath is not about your comfort, but your patient's. Your nursing education will have greater depth and meaning if you can learn to connect to patients through comfort measures and ultimately, your delegation decisions, when you begin professional practice, will be rooted in reality.
  6. I completed my MSN at WGU in 2013. Cost was of tremendous importance to me and the tuition, charged at 6-month intervals, amounted to less than an online hybrid graduate program at my state university. Of greatest value was my program mentor, a feature of both undergraduate and graduate degree programs at WGU. The program mentor is an experienced RN with a degree at the level of your program who guides you through your program for as long as it takes. Course faculty/ course mentors change with each course, but your program mentor is with you throughout as a coach, a motivator, and a shoulder to cry on those times when you begin to doubt you'll manage work and school. Mine was a gem, someone I respect and regard with deep affection. To my knowledge, only WGU has developed this feature to they extent they have. I referred an acquaintance to the RN-to-BSN program when she was completing her Associate degree and now, a year into her BSN coursework, she loves it and her program mentor. Granted, a competency-based program is not for everyone. WGU is not about profit and applicants must pass an entry assessment and an orientation course, an actual course, before full acceptance. If you are looking only for an easy grade or must have a transcript loaded with honors, WGU may not be for you. Successful course completion is a demonstration of your competency in a subject and is equivalent to a grade of B/ 3.0, a policy well explained on your transcript and the website. Your work is your own, a reality those who like to be carried by the efforts of a group won't enjoy. With WGU you control your tuition by completing as many or as few courses as you can or want to finish every 6 months. I've heard of some WGU students who by careful choice of projects have completed graduate degrees in nursing administration in a year, but that's not the rule, especially in nursing education. Bottom line, check out both programs thoroughly. WGU advisement staff talked with me regularly for a year, at my request, discussing the many obstacles I expected, long before I enrolled something no one from any for-profit program I contacted was willing to do. To my mind, that fact separated the institution interested in my education from those interested only in my wallet!
  7. Quest5

    Trauma and Employment

    'Glad to hear you are proactive about these issues, but in agreement with the first poster, please consider a behavioral therapist with experience with PTSD, possibly someone with experience with fire or police agencies where the disorder is an occupational hazard. PTSD treatment has come along way in 20+ years and need not be medication-dependent, expensive or prolonged. If your local fire/ police department has a professional advisor to a CISM team, they may be able to provide a name and contact information. These advisors are often volunteers who have private practices and are available to the public.
  8. Quest5

    Confidence shaken/looking 4 a new job

    I agree with the other posters but suggest in future situations I you can comment on your need to take notes as a personal preference rather than as a limitation. The wording is different ...something like "to ensure accuracy, I prefer to take notes when complex information is involved". In today's environment almost everyone acknowledges the necessity for documentation so make it into a positive attribute, not a negative limitation. My mum used to say "never give anyone a stick to beat you with" although her grammar was usually more precise!
  9. Quest5

    Back Injuries

    Cynt87, you didn't mention how much the accident has affected your back. If it is a muscle-related injury, and does not involve a vertebral fracture or major nerve damage, you may find that long term it will not affect becoming a RN. That said, as you are a LPN you may need to do all you can, first, to recover completely before doing any heavy lifting, and then, to build strength in your core: abdominal, back and upper leg muscles. Some recent clinical RN positions list lifting/ positioning weight requirements up to 250 lbs. This may not mean every lifting/ shifting movement would be this great but it does reflect the realities for many bedside nurses. Any certified fitness trainer or physical therapist can describe the best exercises for rebuilding back strength after an injury. Take it slow but be faithful to your exercise regimen; it will take more time than you think. Most RN programs, even "bridge" programs, will require clinicals as part of your course work so you may face some lifting in your RN training. Be honest with your clinical instructors about any lifting limits and make sure you have enough help to perform lifts safely. When I was in my program I was recovering from a neck injury involving my right arm; my instructors cut my limit to half of what the MD recommended. Yes, I did encounter one faculty member with a very negative attitude, but she was the only one. I had had some years of experience as a CNA and EMT, so most faculty told me they were sure I knew how to lift and that being a RN was more about brain than strain. Once you have your degree and license you can decide on a career path that reflects the limitations of your back or the concerns you have about possible re-injury. If your injury is major and a permanent one, be sure to discuss disability accommodations with the college/ university admissions representative when you apply for entry to the RN program. You may need to submit documentation substantiating any disability, but nursing schools/ departments are required to comply with federal law just as the rest of the institution must. Reasonable accommodations at clinical sites are usually negotiable as long as your condition does not limit the majority of essential job functions or compromise safety. 'Best wishes for your progress healing; be patient and keep moving towards your goal!