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.

Gee, I think you may need to cut yourself some slack! You're very young and have accomplished SO much already---all with the major strain of a chronic conditon. I went back to school & chipped away at pre-reqs when my second child was 5. It took me nearly 5 years to get into our local community college nursing program and I graduated just after turning 50. NOT to imply you'll wait that long, but try to be patient with yourself and enjoy your family and raise your kids w/o the pressure of nursing school looming when they're so very young. You've already got a good job and are gaining so much experience that will be applicable to nursing school & your future as an RN. I too had no family or people to watch our kids---I took one class a semester. When nursing school started our kids were a bit older so we were able to juggle them & our lives around the chaos that ensues with homework, play dates, sports etc. Oh! & a side note---I feel like I can relate to you b/c I too carry the burden of a chronic condition too (Type I diabetes). It NEVER completely leaves your mind and needs near constant attention, but you know what? It absolutely lends to the position of being a nurse in regard to having patience, not only for the patients you serve, but with yourself and remembering the importance of taking care of yourself. You also have the 'gift' of being able to relate to others with ailments--be they acute or chronic.

I believe if you have the desire to be successful, the enthusiasm to pursue what you ultimately want to do with your life, then YES! you can overcome this difficulty with math---no doubt! Just start training yourself like an athelete would do for their sport. They often practice "muscle memory"---not to imply our brains are muscles, but repition is key in this instance. Start by practicing and reviewing either on a daily basis or every other day or a chapter a week. (Or whatever regime you can fit into your current schedule- you get the picture). What you learn in high school is only a base, but not what you'll use as an RN. It's kind of "specialized" type of math you use as an RN. You'll end up learning ways to calculate meds, amounts and applying them to your patient's needs. You can learn this with practice, memorization and rote learning. There's books available that specifically train RN's all they need to know to safely administer meds. One I used was called "Calculate with Confidence" and before I started nursing school, I went through it from cover to cover. I spent extra time on sections that stumped me. Now, granted I never had much trouble with math but I did have a bit of a mind block with standard vs. metric conversions and had that to overcome---which this text certainly helped to do. Don't let the fear of math, or thinking you "can't get it" stop you. I had a fear of taking an anatomy class and dealing with cadavers. My husband would say "how are you going to be a nurse if you have that fear?"---I said that I planned on working with live people and not in a morgue! (Anyway, that's another story). Fear put me back a few years in achieving my nursing degree. Sometimes, it takes time before you realize in order to get what you want out of life, you have to do some things you don't want to do, but you grow from pushing forward and the struggle helps you gain confidence. That confidence will come in time for you too.

I attended a 5 day KAPLAN course and did ALL the Q-banks. Re-read SAUNDERS (I had used it a lot as a reference throughtout school to help before exams), although I felt Saunders was too 'rudementary' and the practice NCLEX-like exam in the back of the book seemed much easier than Kaplan, but nevertheless it was good content review. Also, I listened to HURST Audios that a classmate forwarded to me. Graduated end of Dec. 2014, scheduled for NCLEX Jan. 26, 2015. I studied EVERY day for 4 weeks. I really didn't want to wait too long because I didn't want to be studying endlessly AND I was concerned that I'd have to review things I studied weeks before, so unlike most of my classmates, I decided to prepare myself as best as possible and JUST DO IT! To prevent getting that bogged-down feeling, I rotated reading, listening & taking the practice tests. I made sure to change the routine of studying too. I'd go for long walks with our dog while listening to Hurst. Come home, take a break and do something else for awhile. I'd have the Saunder's book in the living room so when I was in that room it was on my lap and I could actively read it or just hope it would somehow 'seep' into my psyche ;o) I had Kaplan in the dining room & would make practice tests for myself and scrutinize the rationales on the one's I missed (mind you, I often didn't agree with their rationales!). Also, I would take & re-take & re-take the questions that I missed. I would make practice tests of ONLY the quesitons I missed....that was tortuous. I didn't study the day before exam. My appointment was for 8 a.m., about a 45 minute drive from home. In order to make certain I was on time & early, I got up about 5 a.m. and left home at 6. I was the second person in line, signed in and went for it. One VERY important thing I think everyone should do is to KEEP it PRIVATE---don't tell a soul! You'll have enough pressure that day and it's really a much more free & relaxing feeling than to think everyone knows and they're all waiting to call or text you. Believe me you won't want to talk to anyone that day especially if they're asking you "did you pass?" or "What was it like?--do you think you Passed?" I felt like the first 75 questions were easy and I was kinda' even laughing to myself imaging telling friends that it was 'easy'. It was only when the test didn't stop and kept spewing out question after question that I realized...hmmmm, maybe I've been too cocky here. Guess I oughta' slow down and be more serious. So, to make a long story short here, I ended up with 259 questions and left the testing sight wondering "what the heck just happened?"----why didn't it make me go to 265? Well, I'll never find out because within 48 hours I was licensed on the BRN site. And, yes! I did do the Pearson Vue Trick after 24 hours because from what I understood (from painstakingly researching the topic on this site ALL NURSES) it takes that long for the test to be processed by the BRN. Good luck to you and thanks for reading! PS Praying like hell didn't hurt either ;o)

I'm afraid I "jumped the gun" on the position I accepted at an LTC & couldn't agree more with what you wrote. I graduated in Dec, 2014 took NCLEX in Jan & started working in Feb 2015. Hmmmm....maybe I should've been a bit more choosey, but I didn't want to pass up this job and end up with NO job. In the meantime, I struggle with all the issues listed not only in your comments, but in the comments of others. I too will never be able to become accustomed to calling people by #'s instead of by their name. The buck is passed my way when I'm told by the DON & the administratorto "control" the CNA's---to "babysit them" and make sure they do their jobs. Half the time it's as though we find ourselves basically begging these fellow employees to simply DO their job! It's insane. For instance, they'll walk past you when you need help scooting a patient up in their bed and by the end of the shift you wanna' know what rings in my ear nearly as much as all the ignored alarms, not to mention the ignored call lights (?), is hearing the CNA's say "that's not MY patient".....holy God! The administration/management is crippled by the Union and can't dismiss these cretins. In the meantime, you leave the facility each day with a heartache for the poor unfortunate creatures that call this dump home, asking yourself, should I stay to make a difference for these folks or give notice and start my career with a clean slate? It's torture to have such a lack of support not only from the "team", but from management that lacks backbone. Thanks for reading---this is such a great place for us to commisserate!

Brenda Johnson: Yes! Couldn't agree more. Putting yourself in the patient's predicament truly helps remind us of the importance of our care and what it means to their recovery/experience. I also like to think of the person as a close family member and ask myself "what would I do for them"....

Snorkledorf: So nice to read your comment about "Pt in room 222". I, too am entering late in the game. Just graduated at age 50 and it's reasons such as given in this story to why I did it. It just occurred to me that this is exactly what it's all about---making the most of ourselves while we're here ;O)

Thank you for writing that VERY inspirational story. It was certainly hard to read at first, but well worth how it left me----with a strong sense of "what it's all about" you know? I'm a newly licensed RN and this is the absolute reason that I pursued the profession. Having spent some lengthy time in a hospital bed when I was much younger and understanding how rotten & helpless one can feel it's a huge comfort to know there's this kind of love in the world..... Thank You! Thank you!

63Tedbear: I can only tell you what I did and I had success when NCLEX day came. I really feel like I went overboard and probably could have done less, but here it is: I took an in-person Kaplan class which was 4 days, about 6 hours a day ($400, but I figured I'll re-coop that investment with my new job), also listened to Hurst Audios and used the Saunders book. I'd flip-flop between these to help "mix it up". I graduated on Dec 19, 2014 and began reviewing right away, took the Kaplan 1st week of Jan., and the NCLEX on Jan. 26. I basically dedicated as much time as humanly possible to all the above mentioned tools. I made sure to maintain sanity and took walks and breathers every hour or so, which really helps me to retain the oodles of info. Bottom line with all this?---No one can retain the amount of info that they can potentially ask you about so you just prepare yourself as good as possible in order to have the confidence needed to get through that one last hoop. Practicing really hard, mind warping (Kaplan) questions trains the ole brain and I highly recommend that! Good luck to you! If I did it ANYONE can ;o)

XNavy corpsman What a great feeling, eh? Such a relief! I've been on cloud 9 all day....need to get ready for an ACLS class, then resume & job hunting!! All sounds easy after what we've been through! Congrats to you too!

It's official! I passed! My RN license # from the BRN just appeared... (tested on Tuesday and it's Friday morning....so, approx. 48 hours here in CA.) He-he-he. Thanks to everyone on this site for their words of encouragement, it really helped me calm down and have more patience........