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LJR89

LJR89

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LJR89's Latest Activity

  1. LJR89

    First combative pt

    Hi all. Im feeling a little burnt out. I work in a small tcu and have been dealing with my first combative patient. They are only only in my care for about half of my shifts, but I still go home wondering what else I could have done going home to prevent their behavior even when they are not my patient. We work hard to make sure their needs are met, and they're not in pain but atleast twice a shift they become so agitated they are grabbing, pulling, swinging, kicking, and spitting at staff. this pt does have some Nuero/cognition issues. When they are calm they can answer questions and make eye contact. But during these episodes they can't make eye contact and aren't verbal. Does anybody have any tips on how to avoid these types of behaviors? They tend to happen around the same time. So we know when to look out for them but haven't figured out if there are triggers to address. Weve tried making sure basic needs are met (hungry? Thirsty? Bathroom? Pain? Tired?)but they still seem to occur regularly. Most of us our staff are fairly new to the unit and many of us new nurses, so some advice from those experienced with combative patients would be so helpful. Sometimes i I wonder if the sounds of all the call lights and noises just get too stimulating. Would headphones/music be relaxing or is that just sensory deprivation? They don't have the cognitive function or the dexterity to perform simple tasks to keep them occupied currently. So those kinds of activity's have just lead to more frustration for them. I just want want to help them so much but I have less and less patience each shift. I feel awful having such a poor attitude but I'm so stumped and frankly exhausted at the idea they'll be assigned to me before I even get to work. Just wishing I knew how to keep him and all of the staff safe.
  2. LJR89

    Staffing and Change of Shift

    Hello all! I currently work in a 24 bed TCU and we've been having some staffing issues. Let me first start by saying that we have pretty awesome ratios compared to most of you out there in rehab/TCU Nursing. We have 8:1 for nurses and 12:1 for our nurse assistants. so I really feel for those of you that have worse ratios. But we've also have been taking higher acuity patients as of late and are now approved to take more memory care patients some of which require 1:1 attention for large portions of the shift. My first question is... um how do you even do it with even less staff? Shifts feel out of control so any tips or tricks are appreciated. Second, we have a serious teamwork problem on our unit. Any ideas that have helped your units with teamwork and team accountability would be helpful! finally. On the team work note, I know some of my nursing friends participate in a short unit wide report. Where they can talk about census and admits and any issues that would help the group to know. Even if it's not their patient, things they could help keep an eye out for or even know that there coworkers might run into problems with? Or offer input if someone has had that patient or similar problems in previous shifts and might be able to offer ideas? Has anybody done this system and think it's worth the time? In my mind are unit is small enough that it would help with accountability and teamwork but I could see my coworkers not being as enthused. Thoughts?
  3. Hello all! I currently work in a 24 bed TCU and we've been having some staffing issues. Let me first start by saying that we have pretty awesome ratios compared to most of you out there in rehab/TCU Nursing. We have 8:1 for nurses and 12:1 for our nurse assistants. so I really feel for those of you that have worse ratios. But we've also have been taking higher acuity patients as of late and are now approved to take more memory care patients some of which require 1:1 attention for large portions of the shift. My first question is... um how do you even do it with even less staff? Shifts feel out of control so any tips or tricks are appreciated. Second, we have a serious teamwork problem on our unit. Any ideas that have helped your units with teamwork and team accountability would be helpful! finally. On the team work note, I know some of my nursing friends participate in a short unit wide report. Where they can talk about census and admits and any issues that would help the group to know. Even if it's not their patient, things they could help keep an eye out for or even know that there coworkers might run into problems with? Or offer input if someone has had that patient or similar problems in previous shifts and might be able to offer ideas? Has anybody done this system and think it's worth the time? In my mind are unit is small enough that it would help with accountability and teamwork but I could see my coworkers not being as enthused. Thoughts? (also sorry this thread got so long, I'm kinda rambling, a bit exhausted and frustrated! )
  4. LJR89

    When do give up?

    Thanks for all the great advice. Got offered a position at a TCU where I think I will learn a ton and get some great experience! I appreciate the help!
  5. LJR89

    When do give up?

    Hi, This is my first time getting to post on the general nursing board!ive spent a lot of time on the pre-nursing and student boards, but now I need advice on fully entering the the profession! I am a new graduate and just passed the NCLEX a couple weeks ago! ive been riding the high of "officially" being a nurse but had a pretty big reality check today. Ive worked in the restaurant industry for the last 10 years. With 1 year as a Nurse assistant in an ER. But tonight I found out that my place of employment for the last 5 is shutting down. Of course I was already pursuing nursing jobs since January, but I wasn't too stressed out about not getting one yet, since I had a job that paid the bills. But now I only have 1 month to find a new one. My question is, since I only have about a 1 month cushion once the restaurant closes, at what point should I start applying for non-RN jobs to make sure I still have money flowing in. I have an ADN and am currently in an RN-BSN program which I will graduate from May 2018. I have my heart set on working in an acute setting, but only a few of my classmates have gotten jobs in a hospital with a ADN. so I feel like my options are: 1)start also pursuing TCUs or LTC 2)get another resturaunt job while I'm waiting for a hospital position 3)try to get hired as a Nurse Assistant somewhere and hope it leads to an RN gig in the future. Im worried about starting some place new and then needing to leave right away, I know I need to prioritize meeting my own needs, but don't want to be inconsiderate either. So when do I start looking for non-RN jobs and what kind of job is the smartest idea? Or perhaps there's other options I haven't thought of yet too. Thanks for your help! I know that was a long (grammatically challenged) story
  6. LJR89

    Inver Hills MANE Fall 2017

    They try to limit the amount of hours are spent in class during the Metro portion because they know students want to work, so it's kind of a hybrid thing going on. So, at the campus I'm at we only meet thursdays, and only a handful of times this semester. but you got plenty of time before you got to worry about metro :) good luck! I really enjoyed my CC in the MANE program, hope y'all do too!
  7. LJR89

    Pharm distress!

    My school used ATI and also Pharmacology: A Patient Centered Nursing-Process Approach (Kee) And surprisingly enough I liked it a lot. I wouldn't suggest dropping a lot of money on it, but if you can find it for cheap it might be worth a look, because I thought it did a decent job of explaining both the drugs and the pathophys they are treating in normal human words. to study for exams I would first read the section on the drug in my text book (short sections about 5 minutes per drug to read), compare it to ATI while fast forwarding through the module. And then glance at my Davis DrugGuide and Mosbeys Flash cards. My whole process Was admittedly time consuming, but pharm became one of my strongest subjects!
  8. I also found out I passed this morning! What a relief :)
  9. Do you need a cheat sheet? If your not wanting to make one as a learning tool then I guess i would say I never needed to look them up at clinicals. When I would check lab results in the chart it would highlight any out of range and if I just wanted to see what the range was I just had to hover over or select the lab value I was having trouble remembering the range for. As far as signs/symptoms/causes I think it's worth your time learning those rather than just referencing a cheat sheet. Lab values are important to know too obviously, but can be tough to keep them all straight so I get why people want a reference but I'm not about spending even more money on materials I don't need lol
  10. Alright folks, since I was constantly on this site comparing my scores to those who had passed, I figured it was only fair to leave mine here as well. I passed the NCLEX-RN yesterday in 75 questions. All I did was most of virtual ATI (did not complete the final comprehensive practice exam so I did not get the green light) and the NCLEX Mastery app. Mastery: (ordered strongest to weakest) Overall- 63% Labs- 76 Fundamentals- 74 Mental Health-67 Maternal- 66 Peds- 63 Med/Surg- 58 Pharm- 53 Virtual ATI scores: Fundamentals- 86.7 Pharmacology- 73.3 Med/Surg- 57.8 Maternal/Newborn- 78.3 Children- 61.7 (not gonna lie I ended up googling for answers on this one because I knew I was gonna fail and didn't want to remediate, so my score should be lower) Mental Health- 71.7 Leadership- 78.3 And like I said, I didn't end up taking the comprehensive predictor on virtual ATI to get the green light, but my school gave us the proctored one in December and I got 78.7 which was pretty good. Hope this helps ease a mind or two, especially the mastery scores since they are harder to find on here. Good luck!
  11. LJR89

    When should I begin studying for the NCLEX-RN?

    Does your school do any sort of comprehensive predictor? Finding out your strengths and weaknesses is the best place to start to figure out how, what, and for how long you should be studying. everyone on here studies and learns differently so you first need to figure out what your unique needs are. After all the first step in the nursing process is to assess right?
  12. Took it this morning too and i only got SATA and standard questions. Mine was pretty OB heavy too! I'm sure we did just fine!
  13. LJR89

    Just took the NCLEX. Terrified I failed.

    This was so calming for me to read at this time. I've been out of the test for about 3 hours now and I've been getting more and more worked up. But my test experience sounds pretty similar to yours. Turned off at 75, about 25-30 SATA,no other alternative formats, didn't feel super confident in any of the questions except for maybe 1 or 2. can breathe a little now :)
  14. LJR89

    Best Way to Remember Side Effects

    Well for starters, darn near every drug is gonna have GI upset as a common side effect (except maybe drugs to treat n/v/d obviously) so I never wasted time taking notes/flashcards with that info. I did the same thing as Ruby Vee... what does the drug do/what is it for? Well then the side effects is probably related to that. And then highlight the 'weird' side effects. I also had to resist the urge to just memorize drugs, didn't start doing well on my pharm exams until I really started to take the time to understand the patho/action etc
  15. LJR89

    Is nursing school as bad as they say?

    I feel like nursing school is one of those things that while you're in the thick of it, you couldn't imagine anything harder or more time consuming. Then you graduate and it doesn't seem like it was all that bad lol. I even miss it a bit now that I'm a couple months out (well the structure and my classmates anyway)
  16. LJR89

    New grad hiring

    It goes faster than you think! We/you have amazing instructors at Normandale! the best (unsolicited) advice I can give you for the program is to really appreciate your instructors and the amazing resources they can be. It can feel like they they are trying to make your life difficult, but Normandale has a reputation for producing very strong new grads and it's all thanks to them. They know what they are doing and we are so fortunate to matriculate from there.