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Caring for kids with leukemia, I did the nurse tech end of a lot of transfusions (vital signs). The exact procedures (tubing and all) are likely to vary from school to school and hospital to hospital. What matters most is to understand why each item in the procedure is done. That'll keep you from neglecting what matters. For instance, I wonder about checking the vital signs after 15 minutes and not checking vital signs until the end. Where I worked, we checked every 15 minutes for the first hour and, if necessary, every thirty minutes for the next hour. The one time I caught a reaction wasn't in that first 15 minutes. In that case, the temperature spike wasn't enough to stop the transfusion. Those kids absolutely had to have blood products. My experience was long ago, so others will know more up-to-date procedures. But the principle to know why you're doing something in addition to what always applies. Google 'reaction to transfusion' and you'll find links to numerous, credible sources. Here is what Mayo Clinic tells their patients: Blood transfusion Risks - Mayo Clinic --Mike

Take commuting into account, along with where you'd like to live. Seattle has one of the worst commutes in the country. Water on both sides force most commuting to be north/south and few arterial lanes have been added since the 1970s. Amazon's rapid growth at its South Lake Union location about two miles north of downtown is making matters far worse. Hating Amazon has become a new sport in the city. The city's traffic planners don't care about the traffic woes. Dominated by an ideology called 'traffic calming,' they want most people to use mass transit, however impractical that might be. Residential arterials, like the one I lived on, are getting cut back from four lanes to two to "calm" traffic, meaning make drivers angry. The city has blundered into light rail, wasting so much money that buses are starved for funding. When I moved away in August of 2012, some 175 bus routes were about to be removed or have their service cut back. That's despite the fact that the cost of bus tickets almost doubled during my last five years there. More and more bus commutes require at least one transfer which is really a pain in the damp, drizzly winters when it begins to get dark about 4:30. Bus service is so-so after the evening rush hour and ends almost completely after midnight, which can matter if you work odd hours like I did for a time. In short, wherever you work, make sure you have a sensible commute from where you live. Rent is rising rapidly in Seattle. That's one reason I left. When i worked at Seattle Children's in the 1980s, I had a nearby basement apartment. Commuting was a ten minute walk. That was nice. Seattle Children's is unusual for a hospital. It's in an upscale residential neighborhood. If you like kids, consider it. It's one of the top ten children's hospitals in the country. Most of the city's hospitals, clinics and the like are on Capitol Hill, just east of downtown. It's crowded, with dreadful parking and (I suspect) high rent. On the other hand, that's where top-notch care if given. If you love high-stress ER work, consider Harborview. It handles the city's major trauma. If you're interested in graduate work, look seriously into University Hospital. It's not only a part of the University of Washington campus, you can literally walk from the Health Science building where nursing is taught, into the hospital through a maze of corridors without going outside. No work/school commute. There's also a ring of suburban hospitals around the metropolitan area, so you might want to consider those. The Eastside (meaning east of Lake Washington) is more high tech. That's where Microsoft is. North of Seattle is more affluent and south is more blue-collar but that's a generalization. The really expensive homes are close to the water or at the top of hills. Take care where you live. Some neighborhoods, particularly those just south of Capitol Hill, have high crime rates. For all the hassles of living there, it's still an interesting place to be. In comparison, the small college town where I live now is boring. Nothing matters but football. Good luck with your job search. --Mike

Sounds like you're finding all that reading intimidating. Perhaps I should share an experience of mine from the tenth grade. There's been some confusion about which of our mid-year semester exams would come in the morning and which in the afternoon. I got it wrong and showed up prepared for a math test. With all my classmates pouring over their biology books, I realized I was in trouble. I hated biology so much, I'd planned to do my only studying between the two tests. Fortunately, one of my classmates came to my rescue. With but ten minutes until test time, she loaned my her handwritten notes and I began to read through them as fast as I could. They were absolutely marvelous, summarizing everything we'd covered that mattered. If she hadn't been the prettiest girl in the class, I'd have probably kissed her. I kept reading until our teacher dropped the test in front of me. Then I shifted into answer mode, blitzing through the test while my short-term memory still recalled what I'd just read and skipping when I didn't know an answer. When I finished, I returned to the start and managed recall some more answers. Last of all, I made educated guesses on what remained. When we got our tests back, I'd gotten a B grade for that ten minutes of study. I was quite happy. I would NOT recommend that as a study technique. What I would recommend is what my friend did when she prepared those notes. When you read those chapters, create handwritten notes of what matters. Do the same with your class notes. After each class, rework you notes into something more legible and complete. Study through those notes repeated throughout the semester. Don't be an idiot like me and put studying off until the last minute. Review, review and review. Each time you do, you'll learn a little more and move through the material a little faster. Then the night before your test, you won't be overwhelmed looking at those seven chapters. You'll simply review those already oft-reviewed notes. Also take note of what your professor said about 'critical thinking.' She doesn't want you to just spit back what is in those chapters. She wants you to look at the material from various angles so you really understand it. Test yourself on all those angles. Prepare for tests by giving yourself tests. That seems to be the real key. Here's an article based on studies about what techniques work and what don't. You probably don't have the time for all the techniques, so pick what works best with you: How To Study: The Best Ways To Get The Highest Grades based on this article: '+windowtitle+' Notice the additional links in that second article. My hunch is all that 'delayed retrieval practice' and self-quizzing (including answering questions in the textbook) primes our minds to see this material as important and thus makes us remember it better. Last minute cramming won't do that. Best of luck!

Ah, so it's the hospital lawyers who're interested in seeing how much harm or good you'll do their side. From your remarks, I gather you have no dogs in this fight, meaning that you don't care which side wins. That makes demands on your by either side all the more frustrating. In my one occasion testifying in traffic court, I was happy to be there because I wanted to help the defendant. I might offer one suggestion from someone who has been there not merely as a witness but as the plaintiff in a copyright dispute in a Seattle federal court that went on for some 16 months. Legal disputes can exhausting and include a lot of hassles that you dislike. You can be pushed about at the whim of lawyers and a judge. You may end up feeling used. A lot that happens may seem unnecessary or even unfair. Let that get under your skin and you'll get even more angry, frustrated, and exhausted. Don't let that control your emotions. Do what you have to do and let it go at that. In my case, the other side was hoping to win by exhausting and intimidating me. I could handle the intimidation. I knew how weak their case actually was. But I had to be careful not to be exhausted by the endless delays. You think you have problems, but they were nothing like mine, which costs hundreds of hours of my time. In my case, for much of the dispute I was representing myself and thus not getting a penny for the considerable time I was investing. (I do have some legal training, so the usual rule about not being your own lawyer did not apply.) In contrast, the Manhattan lawyer I was fighting was probably billing his client, the Tolkien estate, about $400 an hour. If I'd let my mind dwell on that, I would have gotten very angry. In the end, I won and one major factor was all the patience I'd shown. In your case, that exhaustion isn't about the legal dispute itself but in its impact on your present work and personal life. Testifying may mean lost income and missed sleep. But the principle is the same. Don't let this dispute wear you down. Resolve to do what you have to do and don't try to control what you can't control. Getting angry about this and how unfair it is for weeks and weeks will do you more harm than the mere time you spend giving testimony, should it even come to that. In short, don't dwell on this. Minimize the harm this does to your life.

Testifying is not up to you. As another poster has mentioned, you can be subpoenaed and forced to testify. If you were someone important, say a politician or rich, the judge might be differential about your time. But as a nurse, he's unlikely to care about the trouble you'll be caused, 60-hour weeks or not. That said, lawyers have a principle that they should only ask a witness a question when they know what the answer will be. That's to ensure that their client isn't hurt by testimony. That factors into who they call as witnesses. As RiskManager has noted, its rarely to your advantage to voluntarily meet with plaintiff lawyers. Don't talk with them, and bringing you in to testify is a risk. Do talk with them and you only increase your risk of being forced to testify. Even worse, having heard what you saw and heard outside the courtroom, they're likely ask questions in ways that distort what actually happened, leaving your frustrated and feeling used. Lawyers are often clever that way. I know one legal assistant who spends hours pouring over the other sides emails, looking for something that, rightly and wrongly, can be used to influence juries. If you're tired and sleepy, there's no need to hide that. But don't let that spill over into hostility. You could then be treated as a hostile witness and face a barrage questions phased in ways you won't like. Simply answer the questions as briefly and clearly as you can. The less you say, the sooner you'll be able to go home. If you don't remember, say so. Also, remember that if your nursing notes are a major factor in the lawsuit, you may be called on to testify about them. Be prepared for that. Court trials can move slowly, so if you are forced to testify, you might find yourself doing a lot of waiting around. Come prepared for that. You might call the court's clerk in advance to find out what you can and cannot do while you are waiting to testify. In your case, your first question might be, "Is there a nap room I can use?"

I loved pediatric oncology. The emotion risks were great, but there's no satisfaction like beating leukemia in a child and realizing that they've got a rich and full life before them. One patient I cared for as 10-month-old baby now runs three nail salons.

Thanks to Dr. Google: "The Material Services Department at UI Hospitals and Clinics provides a comprehensive selection of patient care products in a cost-effective, efficient and convenient manner..... Our four divisions include: Processed Stores, Mail Services, Shipping and Receiving, and Linen Services. Our 90 full-time employees include storekeepers, mail handlers, sewing machine operators, supervisors, and clerical staff." https://www.uihealthcare.org/materialservices/ ----- In general, it's the "material" a hospital needs apart from drugs and perhaps instruments. Think bed sheets, IV bags, patient gowns and, at that hospital, processing the mail. Hospitals vary in what they include. This could prove a good first job. They'll have starter positions where you'll be taught what you need to know. Work hard and stay with it and the job will look good on your resume. (In the cold, cruel world, you need to have had a job to get a job.) Show a willingness to learn and be flexible. If you do, you'll get the chance to move on to something that pays better and by the week rather than by the day. Some hospitals will even cover all or part of the costs of further education, such as LPN training, for their staff. Best of luck.

Stage actors have a similar rule. They don't wish someone good luck. They tell them, "Break a leg." Wishing bad luck is thought to bring good luck. There's a rationale reason. When others in a hospital, including Admitting and the ER, hear that a nurse has uttered the dread "Q" word, they set about to correct that deficiency. "Quiet huh, well we'll give them something to do."

From your remarks, there's a bit of uncertainty as to whether you're being asked to be family court to testify in some family dispute, to serve in some professional role as part of your work in family practice orthopedics, or to just do jury duty. If it's a family dispute, the the real issue may be whether you owe those involved your presence there, meaning can you help settle this dispute in a way that's good for your family. If so, you might ask yourself if that's more important than attending one class. Would not attending strain family relations for years in the future? If it's professional testimony, perhaps of something you have seen, then you have a professional responsibility to attend. And if that is the case, by all means tell your nursing professor. It'll impress her and show her you had a professional life before nursing school. Find some other way to make up for not being in class. If it's just jury duty, ask for a hardship exemption, include a note from your professor, and offer to serve at a later date. Whether you get that exemption depends on the court's ability to fill slots. When I tried to get one, pleading self-employment, I got nowhere. At that time, filling jury slots in Seattle/King County was so difficult, only being on my death bed in an ICU would have gotten me off. ----- One suggestion Courts move very slowly. if you have to go for whatever reason, bring school work with you because you're likely to spend quite a bit of time waiting. Also, if the judge won't let you study in his courtroom, ask to remain in the lobby and get called. If it's jury duty, you'll just have to grit your teeth, pay attention and hope the trial ends quickly. If you're there for testimony, it may be brief. The one time I appeared in court for testimony, my role took five seconds. I did it to lighten the traffic ticket of a guy who'd hit me. His life was falling apart. Out of work, his wife had left him, taking their baby. His brother had tossed him out. Getting him a fine reduction of $100 seemed the least I could do for him even though he'd hit me, being there took most of an afternoon, and paid only $10. Sometimes you just have to do what is right. Also don't forget the opportunity for a little income. When I did that jury duty, I was only paid $10 for each of two days even though each took up most of my day. The court did its best to get me to bus there, but I found out that if I drove I not only saved time, the court paid me car mileage, which was far more than the microscopic pay for jury duty. Good luck whatever happens.

You illustrate a point I try to drive home to young adults who have been indoctrinated with anti-car propaganda. Outside big cities, a reliable and inexpensive car is often a necessity. It saves you valuable time. It lets you live where the rent is cheap. It lets you shop where the prices are lowest. It lets you take jobs almost anywhere, including better paying ones that more than cover car costs. And it your case, I makes your clinical assignments far easier. Options: 1. You might spread the word about your situation among friends, family, and at church or like institutions. Lots of people today have older vehicles they hardly ever use. One might be happy to loan that spare car to you to tide you through to graduation. 2. Talk to your school advisors about your situation. It's unlikely that you are the only nursing student with this problem. Perhaps they can come up with a way to pair assignments, linking a student with a car with one without. Remember, there is a solution to your woes. so don't despair. Keeping plugging away until you find it.

Sorry, but good sense isn't discriminatory and any of us can spot the exceptional situation when a male nurse is a weakling and female nurse is strong. And if it's that easy, why walk on tippy-toes? Why regard being chosen for a job because you're best suited for it as bad? Why regard when someone else is chosen for that reason as bad? Why be blind to such obvious realities? When I worked nights at a children's hospital, the night supervisor would sometimes get me for a transport to the hospital's morgue. They were larger children, now wrapped in a shroud. She was six-inches shorter than me and had back issues. I didn't relish the actual task, but I was happy to help her. Lifting would put her back at risk. I could easily lift a child without straining. It didn't bother me in the slightest that she'd picked me because I was the only guy on night shift nursing. She'd also picked the most competent for the task. Unfortunately, in our poor, muddled society, we often confuse discernment, which means meaning making decisions that make sense, with discrimination, which draws lines that have no rational reason for them. The result is a lot of unnecessary anger that does no one any good. ---- One thing that men in nursing might teach the women is to not be so easily insulted. All Nurses is filled with examples of that. Try a website for mostly male professions and you'll find far less of that. Part of growing up as a male is learning to take criticism, laugh at it, and keep your cool. If you can do that, you get respect. If you can't, you don't. This funny scene from Gran Torino illustrates that perfectly: And it's a cultural thing. Badly reared, men are thugs. That's one reason why inner city minority males murder each other in such high numbers. They haven't had a Clint Eastwood as a father to teach them otherwise. At the slightest insult, they blow up. You see that in this scene from Grand Torino. If you haven't seen the movie, the plot centers around that Asian gang trying to recruit the boy and Clint's efforts to prevent that. It's a masterpiece, showing how a sensitive topic can be handled with humor.

Size and upper-body strength is perhaps the only differences that matter. When I worked on an adolescent unit, some of our patients were huge high school athletes in to get a mangled knee fixed. As a 5' 10' guy, I was nervous walking them to the toilet. I coped by being ready to stop their fall the instant it started. Once they were going down there was no way I could stop them. I can't imagine managing that as a 5' 2" and 110-pound nurse. That and perhaps embarrassment issues with some male patients. ------ Why were these interviewers asking this question anyway, much less expecting him to talk for 10 minutes on the topic? I can't imagine a guy who hates women choosing nursing as a profession. It'd be like someone who hates chocolate getting a job in a chocolate factory. I can imagine the opposite though. Were they looking for reasons to reject him?

You're right. Kids can be amazing. I once cared for a boy of about eight who'd saved his little brother from drowning in a lake. When he reached his little brother, he realized that he didn't know how to hold his brother and swim to shore. So he dove down, lifted his brother up on his shoulders, and walked to shore with his head beneath the water, leaving him unable to breathe. In the process, he swallowed some water and was in overnight for observation.

I wouldn't worry. What you experienced is so common, the Germans named an entire literary movement after it, Strum and Drang, meaning "storm and stress." In common use today it means a time of emotional turmoil. Sturm Und Drang | Definition of Sturm und Drang by Merriam-Webster Sounds like you're beyond all that now and should have easy coasting until perhaps many years from now when you hit the next common bump in the road, a mid-life crisis. I missed the first but did have the second. If this bouncing around comes up in an interview, call it what it is and tell them that you're beyond all that and eager to learn what they offer.

Discomfort is normal when you're dealing with a patient whose situation is new to you and whose troubles may be difficult to handle. That's not the time to panic. That's the time to be objective. Can you list actual situations that might arise with this toddler that you lack the training to handle? Take out a sheet of paper and create two columns. Head one, "Problems that might arise." Head the other, "What I would do." If for every problem, there's a response you have been trained to handle, there's no reason to fret. And if there is a problem for which you don't have a ready response, can you get the training to handle it ASAP? Only if there are issues that are beyond your training, should you be concerned. And even then are you should ask yourself if there would be enough time to summon medics who can handle those issues and transport this child to a hospital. You don't have to handle everything imaginable. Remember that in this case you've got two quite skilled parents to consult. Bring any questions you have to them and always keep handy a contact number for them. Remember too that you're new and establishing your first habits as an LPN. There's no more important habit to establish than a spirit of 'can do' confidence back up by an eagerness to learn what you need to know for each new situation. Run away this time, and you may find yourself running away again and again. Hang in there this time, and in six months you'll be surprised at all the hard stuff that's become easy.

Years ago, when I worked at Seattle Children's, the hospital supplied the nursing staff with a printed 4x6 card with places for a child's name, condition, and treatment. It was perfect. It was thick enough not to wear out over a single shift. Folded once, it fit well into a tunic pocket. In the hustle and bustle of caring for children with leukemia in the middle of the night, my handwritten notes were easier to consult and change than any smartphone app. It was, to use your term, my "brain sheet." I'd have never managed without it. You might check Google and see if anyone sells such cards or see if enough nurses are interested in using them that it'd make sense for your hospital to supply them. Avoiding a single medication screw-up could recoup the modest cost. Any print shop could do the work. ----- Failing that, you can create your own the same way that I print my own business cards. Go to a business supply store and find 8.5x11 card stock that's perforated for 4x6 cards. Here's an example of what you'd want: Amazon.com : Avery Postcards for Laser Printers, Uncoated, 4 x 6 Inches, White, Box of 100 (05389) : Blank Postcards : Office Products The price works out to about 7 cents each. Use a word processing program or a specialized Avery app to create a table with just the combination of lines and boxes to suit your needs. You can pick the right Avery app for you here: Free Online Templates | Labels, Business Cards, Greeting Cards, T-Shirt Transfers | Avery Design & P You might even adapt the content to the particular needs of your unit. If something is commonly done or not done, create a check box for it. Note too that laser printers and inkjet printers usually need a different card stock. ---- Or, if you want to be simpler, just get a box of sturdy, 8.5x11 card stock. Cut in half, it'll be 8.5 x 5.5 inches, Folded once, that should fit fine in a tunic pocket. If printing with a computer is a nuisance for you, create a master copy with a computer, then use a copy machine whenever you need more copies. That card is handy in another way. When I had a spare moment, I'd pull it out and review all I needed to do, even hours away. That provided a good memory refresher, especially when things got hectic or the night long. ---- You can see what my work at Seattle Children's was like in My Nights with Leukemia: Caring for Children with Cancer. Their care was very complex. Virtually every kid had two or three IV pumps and was getting multiple treatments at one time, some of them very nasty drugs. A card that could handle that can handle almost anything. Here's a Youtube lip-synch video done where I worked: ---- Oh, and if you find yourself forgetting things, make that card two-sided: one side for patients and the other for times. If you think you'll misplace it, get that card stock in a bright color. Finally, remembering routine times was easy: For example, 4 a.m always meant vital signs. But remembering out of the ordinary events was more iffy. Blood products meant checking a child every 15 minutes for the first hour, every 30 minutes for the second hour and then (if it mattered) every hour after that. To make sure I never failed, I got a small pocket alarm to serve as an extra "brain." A smartphone timer app would work as well, although it might not be quite as quick to set. What's quick is what you're more likely to do. You mentioned your smartphone. Developers are creating smartphone apps to replace these cards, but this may be one of those situations where it's hard to beat paper for ease of use.

Unfortunately, parental-leave pay isn't the real issue. Career advancement is. Drop out of a company's workforce for a year in a high-tech, rapidly changing field like that at Netflix, and you may never catch up. A few years down the line, that lack of advancement may become the rationale for a layoff. That's particularly true for the "best talent" Netflix is claims it wants to attract. ------ Most hospitals also lack the money for a year-long leave. A better solution lies in how hospital nursing is administered and in finding ways for nursing complaints to be heard and dealt with. In many hospitals, nursing staff fear that if they take their complaints to the higher levels of administration, those in the lower levels of that administration (who are causing the problems) will take revenge on them. This link offers a suggestion for dealing with that. https://indd.adobe.com/view/c1892142-ecf8-4621-a7a9-eee8f0ce19ab It's based on my experience at a top-ten children's hospital where the nursing morale got so bad, 20% of the nurses quit in a matter of weeks. And that figure understates the dissatisfaction. Many of the nurses I knew who stayed did so because they wouldn't let sick children suffer for the mistakes of adults. ----- There is one stress and burnout response that hospitals might consider that wouldn't cost much. Wars are far more brutal than many people realize, particularly fast-paced modern wars. If I recall correctly, in every extended modern war, more soldiers had to be removed from the fighting because of shell shock and PTSD than were killed in the fighting. Unlike with wounds, many of them never recover. Apparently, in the Iraqi War, the U.S. military dealt with that by spotting soldiers who'd almost reached their limit, pulling them out of action for a few days of rest and relaxation, and then sending the back in. Caught in time, even a few days can make a big difference. Hospitals might consider something similar. I know that when I've been under heavy stress, one major factor is that my troubles seem endless. A few days away would make a big difference. It'd break that "this will never end" loop in our heads.

Reading books by nurses about nursing is a good place to start. 1. Visit your local public library and search their catalog for "nurse" as the book's subject. 2. Go to Amazon or another online retailer and again search for "nurse" as the subject. ----- I checked Amazon and the first page of search results had six books on what it's like to be a nurse. If your budget is tight, look for used copies or buy several at once to get free shipping. ---- Perhaps best of all, look for volunteer opportunities or see if your local hospital has a "shadow a nurse" program: What is Shadow a Nurse Program? The longer you can shadow the better. That'll give you exposure to the real thing, which is almost always different from what you imagine.

One tip. Look at how long there's been between editions. If it's just a few years, they're probably almost the same and the publisher is just playing games. If there's been a substantial time, the new edition may be quite different, particularly in a fast-changing field. And if you can get a look at copies of both to see what's changed, that's even better. It'd be great if, when new editions come out, professors offered both the old and new as options when that's doable. Just because student loans are available, doesn't mean that nothing should be done to keep students from graduating deep in debt. Perhaps there's a student nursing website that could do reviews of changes and whether buying new makes sense. There's no need for everyone to do what one person could do with an online book review.

When I worked nights in pediatric oncology as a nurse tech, I remained in the position long enough to see two sets of new nurse hires made by the hospital to fill those critical positions. Filling nights meant hiring new graduates. The first set was a disaster, making numerous mistakes that I describe in both My Nights with Leukemia and Senior Nurse Mentor. Two of the three nurses had to repeat their orientation. It was terrible. With the next set of new hires, the hospital was more careful. Two of the three assigned to Hem-Onc nights were honors graduates and the third was quite capable. (In the books, I call her a "nurse's nurse.") I'm certain that being an honors grads got them those positions. The hospital did not want to take chances this time around. So, I'd say that, yes, having that having nursing honors will help you, particularly your first few years out of school. It may get you a job you otherwise wouldn't get. It will almost certainly mean you can get a more challenging position. Nursing honors doesn't necessarily mean you're a better nurse. But it does mean you're a good learner of the technical stuff and for more demanding nursing that's an important requirement. If you can manage the time and cost, I wouldn't see those added courses as wasted time, even if they aren't in nursing. That "honors" label that could make your nursing career far richer. This is your only shot at that. It's worth a bit of added trouble. Also, keep in mind that, since you'll be repeating these courses, they should be far easier.

It's not Montgomery, but if you don't mind a short move up the Interstate, there are such opportunities nearby in Auburn/Opelika at East Alabama Medical Center: East Alabama Medical Center You can see some of the benefits they offer employees on that page They include scholarships for various hospital-related degrees. Work there and they will cover the tuition for your CPA/LPN/RN or whatever. Both Auburn University and Southern Union Community College have nursing programs nearby. Overview - Health Sciences - Southern Union State Community College https://cws.auburn.edu/nursing I discovered that when I was hospitalized there last week. Below the nurse-level, almost every staff member I talked with was getting a scholarship. From what I could see from my bed, it also has excellent in-house training programs. Beyond that, you get all the benefits of a college town (Auburn) that's been repeatedly voted one of the best small towns in America. --Mike Perry

You've just found yourself in the middle of a minefield. There's a discussion of PBDS here: https://allnurses.com/nursing-educators-faculty/performance-based-development-393490.html That begins with this: You might also want to read this travel nurse website: The Performance Based Development System assessment tool affects travel nurses | Healthcare Traveler Google will show quite a few more links. The next might be relevant to your situation. Note the "most new graduates." That paper is from the creator of the test. An Error Occurred Setting Your User Cookie Del Bueno seems to be someone with a mission, one that could prove quite lucrative for her. That can be dangerous. ------- My next remark is a touchy one. Can you document this remark: "[COLOR=#000000]Behind the scenes, the hospital in question reported us (all that did not pass the PBDS) to the board of nursing, saying that we did not practice in a safe manner and are subject to disciplinary action."[/COLOR] [COLOR=#000000]If so, you might want to consult a lawyer, since that certainly seems to constitute a serious case of libel. Failing a test isn't a failure to "practice in a safe manner" nor does it seem you were "subject to disciplinary action" for anything you did. Go to court, and they'd have to deliver those documents.[/COLOR] [COLOR=#000000]For a parallel, imagine that you're home one evening and drinking a bit too much. There's a knock at the door and a state trooper proceeds to come in and administer the standard sobriety tests for drivers. Failing that test, he then writes you out a ticket as if you'd been driving. What you've described is a bit like that. No wrong deeds, just a failed test in a situation devoid of any harm done.[/COLOR] [COLOR=#000000]Just keep in mind that, as a nurse, suing a hospital might not be a good career move, so don't let a lawyer push you into it. It'd might be best done under the cover of a class action lawsuit that attempts to sign up all those who've been so treated this way back as far as the statue of limitations allows. Indeed, I did graduate work in medical ethics at the University of Washington medical school, and I'm left wondering why the hospital's lawyer would let the hospital put itself at risk by taking such measures. Not hiring/firing based on a failed test is the hospital's prerogative. Trying to wreck your nursing career is another matter. And any hospital that wants to make passing that test a requirement can administer the test. There's no need use the state board of nursing and deceptive accusations of "disciplinary action" as an end around that. [/COLOR] ----- [COLOR=#000000]One addition remark. Almost all tests can be gamed, including this one. A quick look suggests there are online resources to do that for this one. That'd probably be the least controversy-prone way to get past the hurdle. Learn the game, play the game, and laugh at it afterward. [/COLOR] --Michael W. Perry This is worth reading too, including the comments: In Our Own Words: The PBDS Test for Nurse Travelers The ones who really should be getting ticked off at the PBDS are nursing schools. They've just said someone is qualified to be a nurse and weeks later, a PBDS says that person isn't.

Dr Google offers an answer here: Nursing Diagnoses Overview of NANDA, Types, Structure, & Creation for Students @iStudentNurse #NurseHacks The writing there isn't nearly as clear as it might be. Read it several times and parts will start to make sense. Wikipedia is clearer: https://en.wikipedia.org/wiki/Nursing_diagnosis Essentially, medical diagnosis finds the underlying disease, while a nursing diagnosis focuses on the necessary nursing response. And if you're like me, you don't really want to call the latter diagnosis at all. It's more a nursing adaptation of what a physician would call treatment. To the extent that it's still looking at what's wrong with a patient, it's looking at secondary issues that impact nursing care. A child just diagnosed by physicians as having childhood leukemia, for instance, is also likely to be at risk for bleeding and infection. Those are a result of having leukemia, but in a sense can be treated separate diseases to be evaluated separately for their severity and with their own changing impact on patient care. And a nursing diagnosis can change. In the weeks of leukemia treatment that follow, chemotherapy will increase those risks for bleeding and infection, necessitating a revised nursing diagnosis and thus a change in nursing care. A child with leukemia AND a very low white count due to chemo, for instance, might be kept in his room to reduce his risk of catching an infection. Hopefully, the doctors will order that restriction, but even if they don't, the nurses should. -------- And no, four weeks after you learned to take a BP you shouldn't be making critical patient decisions. But remember this is school. You're learning to play a role not making actual decisions. Classes like these are intended to teach you to think like a nurse.

I've been there and done that and know it isn't fun. I live now as a writer and have even done three books on nursing topics. Once, a scientific publisher I'd done editorial work for (Wiley-Pearson—"Boo, Hiss") was several months late paying me, citing a change in corporate bookkeeping. Money got so tight, I was digging in the back of cabinets and eating cans so old, the food inside was almost petrified. Not an experience I like to recall. Nursing through an agency is probably out because, as others have noted, you lack any work experience. Agency work in general, however, is still a possibility, particularly if you're willing to any sort of work imaginable. I've done that from time to time to subsidize my writing. The work was often interesting, in my case including checking tickets for two marvelous, world-class art exhibitions. For such work, you need to prove you're dependable, flexible, and sensible. It won't pay like full-time nursing, but it will put food on the table and mean you won't have to sleep in your car. (Evening work will interfere less with your classes.) Since they're dealing with people who come and go anyway, the fact that you'll hope soon have a full-time nursing job will matter less. You might also call agencies to see what their policies are about hiring a nurse without work experience for positions such as a home care aide. Your clinical training in school should provide more than enough qualifications for that. At some point, that work may even evolve into something better. At any rate, it is income and, as nursing-like work, it'll look better on your resume than waiting tables. Look for a family needing someone to care for an elderly relative, perhaps as a live-in. In some cases, you'll get housing, food, and pay as well as practice your nursing skills. My sister hired people to do just that when my mother needed full-time care. There would, however, need to be an agreement that you might be leaving on short notice. In my sister's case, that mattered little. She had a number of other people she could call in. Call around, including to hospice services, and ask for recommendations. ------ Find ways to save money, so you can afford to travel for job interviews and dress well. 1. Look for a friend or family member you might stay with, perhaps exchanging housework or child care for rent. 2. Save on groceries by visiting local food banks and looking for free meal nights at churches and the like. Next to rent, food is probably your largest living expense. 3. Look for ways to cut back on other expenses. For many, the quickest way to save money is to convert an often pricey per-month cellular to a prepay plan where you only pay for your actual talk-time. Then slash the time you talk down as much as possible by using regular phones to talk with friends. That cell phone now exists only to get calls about job interviews. Even if you are caught in a two-year contract, you might try seeing if the cell company would work out an arrangement. They'd rather get some income from you than nothing. And as others have noted, take advantage of every nursing contact and connection you have. The key to getting a job is often knowing someone who can make sure your application stands out from the others. Remember, hang in there and the situation will get better. You're almost an RN and that is a big plus. Just a few more months and all these financial bumps will smooth out. --Michael W. Perry

Noise is the key issue. If you're both willing to be relatively quiet while the other sleeps, it'll work. If either wants to have friends over or do anything but tip-toe around, it won't. It also depends on how sound carries in your place and how sound a sleeper each of you is. Some people can adapt to a lot of noise. Running around Europe, I quickly adjusted to sleeping on night trains to save time and money. Not everyone can. You might want to conduct a short trial first.