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hmvassar

hmvassar ASN, RN

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hmvassar's Latest Activity

  1. hmvassar

    POTS emergency action plan or IHP?

    Thank you for the guidance!
  2. hmvassar

    Staff Training

    Thank you every one! I'll see where my teachers are doing the first aid/cpr as I know they do it and start there! Scuba Nurse - This is how it's been done in my district. Beginning of the year training for all staff on Epi/Auvi Q, Blood borne. I'm hoping to add all the other field trip stuff in there (action plans) so that I can make everyone's life easier including mine! So that way field trip medication pick up is a review not a rushed event!
  3. hmvassar

    POTS emergency action plan or IHP?

    What do you guys do for your students with POTS? I have a student with a POTS diagnosis. I have not received accommodations yet from the physician (1st time seeing a cardiologist is next week). But I was thinking she may need an emergency action plan due to the course of events since I've come on board at my school (like allergy/asthma/seizures). My department of education does not have one for this condition nor does my school health office. Does anyone have an action plan or an IHP they use (to be signed by parent and physician), that I can take to school health for review and put in place to keep her safe in school. Here's what I've found thus far: https://www.seattlechildrens.org/pdf/PE1792.pdf Also, I'm on month 2 of being a new school nurse! YAY!
  4. hmvassar

    Staff Training

    How does everyone go about staff training and documentation of staff training for: Blood borne, Epi, common illnesses/emergencies (seizures, asthma), inhaler I'm trying to find an easy way to institute this in my school and plan for next year since I'm starting in the middle of the year. I have heard of Safe Schools but I don't believe my school uses this. Is there any other online options for staff training to cover back to school?
  5. hmvassar

    Nurse legality issue, help

    If you are not comfortable with it, DO NOT DO IT. Stand your ground and state you are not comfortable doing so. I wish someone would of told me that. It is your license protect it.
  6. Can anyone recommend a good book or online resource that covers the following in a straight forward manner: Disease Disease patho and risk factors Assessment Treatment and interventionns Nursing interventions Patient education and LTC I got rid of all of my Nursing school books and Nclex prep books and now I'm looking for good resources. Thank you!
  7. hmvassar

    Hypertension Parameters

    Thank you! That's why I'm going back and forth. Because after being in the ER and seeing patients with a SPB in the 180's symptomatic and not receiving BP medications I was having a hard time with this number. Would it be appropriate to tell the patients call the PCP if your SBP is above 170 and are asymptomatic? And call 911 if your SBP is above 170 and you are symptomatic (chest pain, sob, weakness, severe HA, etc.). I just feel that if I'm consistently seeing a patient with a SBP in the 150's taking BP medications and they are following a low sodium diet, getting exercise, then their BP medications aren't working or they are continuing to retain fluid and need a med change and in that case I should use my judgment to contact the PCP even when the values are in parameters.
  8. hmvassar

    Hypertension Parameters

    Hi everyone, I'm on my 6th month as a new nurse and I'm working in home health after leaving the emergency room setting. I'd like some insight into some of the parameters in our plans of care. Many of our aging patients have hypertension, take blood pressure medications, and have multiple comorbidities. Our parameters read as following: RN and Pt will contact physician if SBP is above 170 or below 100 or DBP is above 90 or below 60. I feel that this blood pressure parameter is too high and the patient should be going to the ER if the BP is sustained above SBP 170 after taking blood pressure medications. So I'm trying to provide better values to educate my patients on when to call the doctor (while taking their home blood pressures) versus when to go to the emergency room. Every patient is different, this I know but I need a good starting place for advising. (I am teaching them the signs and symptoms to monitor for as well and tailoring it to each patient.) For example, one of my new patients SBP was 174 (can't remember diastolic off top of my head) HR 64, patient was asymptomatic. Called PCP, pcp stated to check it again next week at next visit. Educated patient on how to take BP and pulse and keep a log and check it first thing in the AM and then in the afternoon after BP meds have kicked in. Checked on patient today and her BPs were 154/68 and HR's were 54 1+ edema in calves, lungs clear, no other s/s of hypertension noted. Called PCP to report BP (even though it falls within parameters but outside of a healthy BP range) and PCP wants her to come in for an appt because the BP is too high. I don't feel that the parameters are fitting and the PCP made it more confusing considering the high reading that I took 3 times over the course of 45 minutes did not concern the PCP. So i'd like some better guidelines for myself and for patients to monitor for hypertension to prevent future complications. Thank you. Any resources for me or for patient education in relation to hypertension are warmly welcomed!
  9. hmvassar

    Mileage & Taxes

    Thank you so much, I guess my concern is the recent change of taxes.
  10. hmvassar

    Mileage & Taxes

    Thank you for explaining. I'm guessing now that the tax law has changed I wont be able to deduct this on my taxes. I plan to file as 1 (single) and have it balance out at the end of the year so I don't have to pay taxes. I just wanted to cross my T's and ensure I don't mess anything up for the end of 2018 for tax purposes. Hopefully, you can help me understand this too. My car gets 30 miles per gallon, a gallon of gas here is $2.34. If my employer is going to pay me .40 cent per mile I drive that's $12 for 30 miles. So in turn I'll be making money for my mileage, right? (I know that mileage doesn't start until I reach my first clients house or after the first 29 miles I have driven to a clients house). I just want to check to see if this math is correct?
  11. hmvassar

    NCLEX Resource Review - Kaplan, Hurst, UWorld

    One week after graduation.
  12. hmvassar

    NCLEX Resource Review - Kaplan, Hurst, UWorld

    Sorry it has taken me so long to respond, I used the Kaplan book that is provided with the online course. And I took notes from the Kaplan practice questions too.
  13. hmvassar

    Will this affect my future career as an RN?

    No it won't affect your future as a Nurse. Just ensure that you put in 2 weeks notice and tell them you are leaving due to finishing Nursing school and want to take time to focus on finishing and taking your NCLEX before you start your first Nursing job. Also, don't put the factory work on your resume as a new nursing job will not need to know about this. Just tell them that you left your last job to transition into the Nursing role and finish school.
  14. hmvassar

    Mileage & Taxes

    Hi Everyone! I was wondering at the end of the year how I will do taxes to get reimbursement/deductions for mileage if my new employer pays 40 cent per mile versus the federal 54.5 centper mile? Just curious how I need to keep track of my mileage so at the end ofyear I can easily do my taxes! Also, how would this affect my taxes? The company also will provide a company car and gas card if I drive more than 500 miles every 2 weeks for 3 months. How will that affect my taxes?
  15. I just finished Nursing School in July so I understand the confusion on how and what to study. Along with my anxiety-ridden journey here's what I found. I hope it helps someone! Let me start by explaining what works for me... I never learn by reading; med surg textbook with over complicated words and no way to establish priority? NOPE. Never helped me in school, not going to help me on the NCLEX. Old notes that I'm never going to look at again? Nope threw those out the day I finished Nursing school. Why? Because NCLEX isn't testing on patho. It wants application. It wants you to take simple concepts and be flexible with them. I learn best by hearing, seeing, doing, and WRITING. Concepts to me need to be broken down and simplified so that they stick. Example: magnesium and calcium are sedatives so their signs and symptoms will sedate you if you have too much of them. So far I've used UWorld, Kaplan, and Hurst. I did not pay for UWorld, my friend let me use hers. Kaplan was paid for with my tuition to school. And Hurst was my choice. Here's what I found on these websites... UWorld Great concept based questions with amazing rationales. But that's it, questions. Unorganized content review. The questions are harder than the NCLEX from what I have been told. My friend also used UWorld and failed NCLEX. Kaplan They offer a course that teaches you how to critically think through questions. Which I liked and found helpful in getting questions right on their website. It also allowed me to better understand the "Who do you see first questions". (The person with something going on RIGHT now. Not the potential for injury person). But the decision tree is not the end all be all. You have to have content to back it up. At times the decision tree will get you out of a bind and guess and other times it just doesn't. They have tons of questions in the Qbank (1800). And trainer tests that simulate NCLEX. The questions are more like the NCLEX than UWorld but they questions are still harder than NCLEX. The rationales are basic at best. Overall Kaplan is my choice for questions and practice because of its NCLEX like questions. They also offer videos for content review (300 of them) but they are at your own will to watch and are out of order so you can't build upon topics easily. A book also comes with their program which has tons of content including drugs. But the drugs don't differentiate between Side effects and Adverse effects. Remember side effects are bothersome. Adverse effects are never good. Hurst My savior at this point. I'm using the Hurst option that lets me move at my own pace. Hurst is content review and at the end, you get 4 practice tests. Hurst has videos that you watch in order and a (you print) study guide that you fill in as you watch the videos. At the end of the course, these study guides are your notes. There are options for closed captions that are accurate to what is being said. The content review videos are AMAZING. They break down confusing topics and giving the real explanation to WHY someone has these symptoms and why are we treating them without overcomplicating things. Hurst is allowing me to connect the dots between conditions and making feel like I will be a better Nurse. It's filling holes that I didn't fill in nursing school in a simplified way. Honestly, Hurst should have their own Nursing school. I have yet to do their practice tests but I'm over halfway done with the video content. They don't go over medications in detail in the videos but they bring them up and mention basic stuff about them enough for you to say hey I probably need to look more up about this medication but I'm glad it told me to check BP and HR before giving it and explained what it does. They have an Ebook that gives you the detailed information about the drugs they mention in the videos too. Also, the ebook includes content like infection control and giving blood which they don't go over in the videos. Hurst takes 5 days to watch the videos, but this doesn't include going over the ebook material and going back over your notes. They recommend you study the notes for 1-2 weeks and then coming back to do their tests. I also find myself crying laughing over some of the videos. The instructors are so funny! So which do you choose? If you feel like you don't know where to start and want the content review - choose Hurst. The Kaplan book that comes with the course is great with content but I can't sit around and read concepts and expect for them to stick. Especially when the book doesn't give rationales or priority or break down concepts to make the memorable. After content you need practice questions, it's a must. I pick Kaplan. Simply because of its a tried and true resource. And is similar to NCLEX questions. UWorld- Although I enjoyed the resource, I didn't feel it was necessary or as close to NCLEX as Kaplan. Books I'm using the Kaplan book for medications, you can also buy their companion drug book. Focus on medication stems and major drugs. Ex. lithium and digoxin, antithyroid medications, Synthroid, anti-infectives. I never got a great review of pharm either in school so it isn't my strong suit. Davis's Q&A also has 10k questions, it's sitting on my shelf and I haven't touched it yet. I plan to after I finish content videos. Prices Kaplan and Hurst are in the 300's. Hurst offers payment plans. Each site has a money back guarantee if you fail NCLEX, stipulations do apply. Read into these beforehand. Look for coupon codes online before purchasing. Sometimes you can find them on AllNurses. UWorld is 80 per month. When to study? I recommend 1 week after graduation/last day of class. Why? Are you really going to be focused on NCLEX when you are studying for your final exam? No, not really. Is the undue stress worth it? No. It's stressful enough. And you deserve a break after you finish Nursing School. It's an amazing accomplishment you deserve to celebrate it. Take time to reorganize life and do something you love. Then hop back into the "grind". You will feel refreshed and ready to take on the world. This is the confidence and energy I needed to face the NCLEX. How long to study? It's recommended you take 4-8 weeks to study for the NCLEX. Remember you want to pass the first time. So make it count and give yourself time. You never know when a family emergency will interrupt your studying, or when your internet will be out for an entire week because of your terrible internet service provider. Truly plan for these emergencies and give yourself time. TIPS: Do practice question sets 75 at a time and then go back and review all of them and read the rationale. This can be painstaking and boring, so if you aren't fond of doing this, you'll be glad you didn't schedule your test as soon as you graduated. Take notes of everything you didn't know or want to remember as you read the rationale. This will help it stick. Also about half of NCLEX is select all that apply questions. Also, check AllNurses for study guides others have made via the search bar! I hope this helps! Good luck on your NCLEX study journey!
  16. This is actually quite common for hospitals in my area. The best case scenario is to request training or at least a shadow day. I hope all works out!