Ruadh

I wholeheartedly agree with “Everline”—-nursing is stressful and at times exhausting, as are most jobs. One aspect that sets nursing apart from other careers is the satisfaction you gain from helping another person. When you put their mind at ease or relieve their pain or help them understand a new diagnosis....the list goes on. Doesn't mean we won’t find ourselves dreaming of maybe scooping ice cream or waitressing instead when we have tough days—-I’m afraid that’s just part of being human. Go easy on yourself. Good luck navigating & hopefully finding a niche in nursing!

To Aleonard13: I don’t think the 2 comments given knew the actual med you were referring to...Vivitrol does NOT come as a “prefilled syringe”, cannot be drawn with a filter needle and ideally should be placed in the ventrogluteal muscle. I’ve been administering this med frequently for over two years and unfortunately it is known to ‘jam or clog’ on occasion. I contacted the manufacturer (Alkermes) about this and their rep came to our clinic—-her advice was this: -Tap powder in vial in order to loosen -Inject diluent into powder vial -Shake vigoursly for precisely one min (use a timer) -Turn bottle up-side-down and wait until you see med separate from top of bottle -Draw med out, switch to needle for injection, tap out all bubbles and administer ASAP! PLEASE note that even after following the manufacturers advice precisely (as listed above) the syringe will STILL, on occasion LOCK. When this happens you must remove, change needle, prime again & retry :o( It’s such a nuisance and causes not only the patient an additional ‘stick’ & stress, but it is also very stressful for the nurse! I only hope improvements are made to thin the med out (w/thinner diluent) so not only could we use a thinner gauge (20 gauge), but so this doesn’t ever happen! (Just happened to me AGAIN today—-I’m sure I hate when it happens even more than the patient!).

I recently began working in our county clinic and am giving many IM injections. Not only in the deltoid, but for meds that require injection into a larger muscle & instruct either dorsogluteal or ventrogluteal placement. Of course, we were always told to aspirate when injecting in the dorsogluteal b/c of the dangers of hitting the bloodstream (and there's PLENTY of talk about that when you research it). But when I research injecting in the ventrogluteal, I not only find the latest research showing it to be a superior injection site b/c for one thing, NO aspiration required (no fear for patient to need additional poke either!), but we are completely able to avoid some anatomical areas that exist near the dorsogluteal that could cause the patient injury---possibly permanent. Whew! Now that I've described all that---I'm perplexed by WHY there is such LITTLE talk about this? And why do meds like Aristada & bicillin continue to include instructions to inject into the dorsogluteal only & neglect to mention ventrogluteal (?)----has not the research caught up with EBR? Just hoping for others input here. Thank you for reading and for responding! How to give VENTROGLUTEAL injections. – theNursePath

Thank you for that great suggestion, 'Canoehead'. It is a little awkward for sure, although we gotta' do what's right now don't we? Currently, there is no other RN on the floor so at the time, I couldn't ask another colleague AND I didn't want to contradict her in front of the patient. I plan to show her what I looked up in a nursing text and I have a great on-line site with some good visuals..... Wish me luck! ;o/

Need some advice on PPD reading. I've placed 100's of PPD's in LTC with most having been negative---some with minimal redness, but rarely induration. Fast forward to my new job in a public health clinic. I'm working with my supervisor who has many years experience in Behavioral Health, although little in the way of clinic nursing. We have numerous PPD testing w/subsequent interpretations nearly everyday. So, here's my dilemma: she claimed a 'read' as positive today and sent the patient for an x-ray. I disagreed. There was NO induration, only redness. The supervisor pressed on patient's arm and could "feel a palpable bump" and proceeded to grasp & measure this area. I felt the patient's arm too. I believe my co-worker was really "reaching" by categorizing this as a positive result. Again, the site was completely flat with zero induration. I know what a positive looks like & this was NOT.....am I missing something obvious here? What do you all think out there? I researched on-line & in texts & found only the same documentation: INDURATION is what indicates +.

Hey All! I'm here working on my C229 (WGU's Community Field Work) and would like to know if anyone out there has ever be "audited" by their course mentor and what that entails. Some of the phone #'s I have to supply are somewhat generic and I'm not sure they'd ever reach the person that I had contact with...I suppose they could ask me in the long run and I could help them verify or they could ask my preceptor (?)-----anyone experience this after submitting their paper?

Thank you, "BUYER BEWARE': I needed a good laugh today. "I never feel smart enough to be a nurse, only dumb enough. Sorry if not right answer". .....Ha Ha Ha, ain't that the truth!!!!!!!!!!!!

(In regards to Kimdesiree's message): I really think at times we can all say we've had moments of self doubt. I've been an RN for only 2 years and had that creeping feeling on & off through nursing school and beyond. But, I must tell you that I know I'm in the right profession, when I help people each day accept the hand they've been dealt and make the best of what they DO have. As far as knowing enough for exams, sometimes when I didn't do as well as I would have liked I would tell myself that I simply mustn't have tried hard enough and that would help give me the determination to push through (and, of course, try harder!). Make certain you join a good, reliable study group. If it's truly something you feel a "calling" to do, then you can pull it off. Don't let anyone discourage you from reaching and attaining that goal---including yourself and that creeping self-doubt. One thing that helped me too was asking my higher power each day for guidance and inspiration. Good luck to you, future RN ;o)

Ten times! You must have nerves of steel. I did Kaplan, Saunders & Hurst prior to NCLEX. Try different angles. Kaplan was classroom, Saunders was practice questions and I listened to Hurst audio as I'd go on long walks. Kinda' drummed it into my head from many angles. Ended up w/180 questions, but passed that stinker....you can too, it's just a matter of being in "the zone" on test day....good luck on #11

As a 'second career nurse' I spent about 1 1/2 years in LTC. You learn prioritizing, juggling, multi-tasking and consistency, all of which are attributes you'll need as a nurse wherever you go. You learn to manage your time and ways to NOT forget that such & such patient needs an IV infusion started at 1300, as do 4 of your 40+ patients need their breathing treatments at that same time. I'm in Home Health now and the pace is sooooo completely different. Although, between family members and their questions, phone calls, changes of conditions, falls, new dx's, paperwork etc., there are days when it's nothing but chaotic. Just as Nurse Beth quoted above, finding your niche is the true key to success. Keep chopping away at it, "Terminated"....you'll find it!!

Well, that's the trick "Samari2"....there is NO sample paper. Unless you have a Facebook account (which I don't)---then I believe you can join WGU on Facebook and supposedly there's a sample paper there.... good luck!

I finished it last month and even though it seemed endless, when I look back it was just time consuming--oh! and confusing as heck at times too. But, basically what you want to do is go through the assignment step-by-step and answer each area to the best of your ability. Some areas require your own observations and those are fairly easy. You simply write what you observe. I think my paper was too long (23 pgs. including citations) so, don't go overboard like that. Also, when you cite your last section (the one that leads to the last paper you'll write during the "preceptorship") make sure you have several references. I was told to have ONE by my mentor and my paper got rejected! I re-submitted with 5 or 6 references and satisfied the requirement. You will too! Just keep plugging away at it, literally "plug" in the required information one piece at a time. Good luck!

Thank you for your insight, "TheCommuter". The cheating angle didn't actually occur to me. When I did my ADN program they always supplied an example paper for us to get a better idea of the format they wanted used. This WGU project has extensive, albeit vague directions. Either way, it looks like I'll be filling in their blanks and crossing my fingers.

Anyone out there willing to forward the Task 1 from Facebook for WGU's "Community Health & Population" class ? I know it's lame, but I've been living without Facebook this long and would REALLY like to keep it that way---all except for getting a glimpse of an example for this project. When I asked in course chatter the Course Mentor blocked my request! WOW! top secret, I suppose. Not sure why they don't supply an example for us to get a proper idea of what they want on the paper. The directions are vague as well as confusing. Input on this matter would be much appreciated----that example paper would be a blessing ;o) Thanks!

I know just how you feel. At least about the "conditon" rearing it's ugly head when you least expect it. It certainly nerve wracking, no doubt. I try to take one day at a time, sometimes one moment at a time. You mentioned that you feel your epilepsy is worsening---could it be time for a med adjustment? Even with diabetes, you have to adjust often. Sometimes you get it wrong, but that's where you learn what works and what doesn't. My oldest brother had grand mal epilepsy, but never took proper care of it. I know of 3 people now who have the same condition and are all in good control w/o active, regular seizures so I know "good control" is a possibility. I do understand we're all different, so maybe what works for them won't work the same for you but....just saying, maybe it's time to revisit the ole med amount or combo you're taking. And, you're right....school can wait. You're already most of the way there with a great, well paying career as an LVN. Additionally, you'll be able to enter an ADN program in the second year (or 3rd semester) with your current license, so that's comforting! Having an RN license only opens up the possiblity of expanding further into other nursing avenues (in CA. there are few restrictions on LVN's---they can't run/start IV drip/antibiotics etc., hang blood and can't be left "in charge" of a floor w/o access to an RN.