Always Learning, RN

received im vaccine yesterday pm, no side affects at all, not even a sore arm. both teen daughters received nasal mist 2 weeks ago, oldest one got nauseated that pm but ate from football concession stand prior to nausea, and all kids who ate same item got ill, so there you go. other teen no issues and she is quick to complain about everything. anecdotally, to looks as if soreness at injection site is related more to who is delivering the injection? my seasonal flu shot given by rn who took a 3 foot running start (really drew back the full length of her arm!) and i was sore for days not to mention bad bruise, others had from same lot by another nurse who injected correctly and had no issues at all. just my

As this thread is over 1 year old you have probably already found out about these but: Arthrex or Dyonics shoulder holders, same people that make the yellow fins/allen stirrups. They are foam padded U shaped supports that attach to the bed at the shoulders. We use extra foam at the shoulders as well as pad the stirrups. I pad the bed with eggcrate foam under the blanket and use the lumbar laminectomy (pink foam) arm cradles to tuck the arms at the side taking care to pad the IV hub sites and keep the fingers wrapped with towels and away from the bed break. I also make sure that the bed is not moved unless I have my hands over the patients hands when the tailgate is being moved. Any tips you have learned about improving turnovers or have you found any particularly useful equipment, supplies, techniques? Thanks, Always Learning, RN

Hi all, I see that this thread is quite old, but as the new RC for robotic surgery at my facility I am interested in improving turnover times. Curious as to what type of turnover times you have at your facility if the same surgeon, team and robot follow themselves in the same room. No additional help for set-up, 1-SCT and 1 circulating RN. Until this week we only had 1 surgeon doing 2 cases per day, which are colpopexy's. Our turn over for those is around 1 hour but we have 3 back tables for him (1 clean for robotics, 1 dirty for lady partsl work and 1 cysto -- LOTS of instruments!!!). We now have one of our urologist who is going to do 2 prostates in a day and I am hoping for a MUCH faster turnover (less stuff to open). How does your facility do on turnovers on these types of procedures and do you have any tips that might help? Thanks AlwaysLearning, RN

WOW, I am a new grad working PCU/Tele and our ratio is 5/1! It is extremely overwhelming for me, even though I worked this floor as a student. I would love the 2/1 or even 3/1 ratios mentioned above. We are also VERY fast paced, no vents but do have bi-pap and c-pap as well as lots of drips. We are full feed, that is our patients come from ICU, CCU, Neuro ICU, ED, transfer from Med/Surg when they start declining, or are direct admit, so I see it all, Ortho, GI, Pulmonary, Infectious Dz, you name it, although I much prefer the cardiac patients. I found this floor a wonderful training grounds for life as an RN, when the nurses I was working with when I was a tech found out I was in school, they often pulled me in to see stuff that was neat and offered their wisdom, which I will always be grateful for. The diversity of conditions that I saw on the floor helped me tremendously on NCLEX because I was exposed to so many different conditions. Best of luck, and I hope you get and enjoy the job. Always Learning

I AM PROUD OF YOU!:icon_hug: And you should be proud too. Jealousy is an evil green monster that rears it's ugly head at times of great accomplishment. Your mom and brother should be ashamed of their behavior. Oh, and they may need an education on the fact that NURSING is an important job too, Doc's could NOT do their job without us and we are every bit as intelligent as they are! Geez, you can't be dumb and make it in to, much less through nursing school! I too was the first to graduate in mine and my husbands families. My hubby too planned a huge party, only for my mom to call the day before graduation and say "you won't be upset if your dad goes and plays golf instead of going to your graduation, would you?" :angryfire My hubby made a couple of phone calls and dad showed up (aggrivated and with a sour look on his face the whole time). My sister did not show up at all, and my brother in law showed up for the free food afterwards. But guess what I realize now -- I am just as pinned, graduated, and licensed witout them as I would have been with them. The people who supported me the most, my hubby and 2 kids, were there and I would rather share the day with the three of them than anyone else. I am sorry you are having to deal with this at this time, graduation is a stressful time (at least was for me) and the added stress is just not needed. Just know that you don't have the only dysfunctional family out there. Know that you went to school to improve things for yourself and your family and you are far better off for your efforts. Congratulations again on your accomplishments!:ancong!: Always Learning

Hey futurecnm, I was taught the same info as Jedi both in nursing school, and in the NCLEX review class (big name one) that I took through my employer. 51% to pass, but the 51% must be above the minimum confidence line, which is a standard level of test question. It starts off at mid level questions, as you answer correctly it progresses to harder questions. If you answer incorrectly it will keep you at the same level as the question you missed for several questions if you continue to miss THEN it drops the lower level, which is below the confidence line. You then must answer correctly to bring your self ABOVE the line again, which means you will answer MORE than 51% correct because the questions at the lower level do NOT count for the % needed above the line. So yes you can fail at 75 questions, but the chances of you progressing to higher level questions, (reasoning and nursing judgment) is very unlikely. 51% is not at all unreasonable considering the progression of the level of questions. Two different instructors, one in my school and one from half way across the country (review course) said the same thing and both have written questions for NCLEX, so their info is most likely reliable. As far as finding out your results, it depends on your state. Some states do not have rapid results at all, my state does but it varies in how long it takes to get the results, just says to wait at least 48 business hours before trying to obtain the results. Hope this answers your questions, Be Well, Always Learning

Hey There, From what I was taught in school and in the review I took, the test gives you every chance to pass, so unless you were missing very very basic questions the computer would have kept giving you more questions until it was convinced you passed or you reached the maximum number of questions. If you were doing horribly, you would have never progressed to the higher level questions, from what I was taught. It is perfectly natural and normal to leave boards feeling like you did horrible. I left in tears after the machine cut off at 75 and I passed. Try to put boards out of your mind and enjoy your weekend. Best of luck, Always Learning

Hey All, I have to agree, very unprofessional to ask over the phone or show up in person days later. You did just the right thing IMHO. Not that I don't respect what the medics do, I have the highest regard for what they do, its a tough job. I have several family members who are EMT's and paramedics and I was a first responder prior to becoming a nurse, so I have an idea of what they do. As a side note, about 13 years ago now, I was transported by squad to the ED from my doc's office. I was 6 mos preggers and experiencing severe stomach pain. The medics came to my room the next day and asked how the baby (fetus) and I were doing. I had just had emergency surgery and my husband and I were VERY impressed that they cared enough to check on us. It let us know that they cared about their patients beyond dropping them off at the back door. My point being that there are ways to find out through proper channels, in this case asking the patient directly. As I gave the hospital permission to release my room number, they had easy and legal access to my room number even IF HIPPA had been around then. Just my take on the matter, Always Learning

:yeahthat: I agree 110% with ann945n. NCLEX is NOT reality! Go with what you feel you would be interested in, not based on another persons opinion -- especially those with no more experience than you have in the matter (meaning your classmates). Trust yourself to make your own career decisions and remember your boards will be based on what you learned in class not on what you see in clinical. Best of luck! Always Learning

We are color coded, but it is up to each department to determine their color code. As it happens, the Tech colors for some of the med/surg floors are the RN color for other areas, like the ICU, surgery and the ED etc... . Very confusing for the patients.

Not at all impossible, although not the norm. I just graduated this past semester and have just started my first RN position on days, or course I teched on this floor for a long time prior to graduation. You may want to consider some areas that are primarily day in nature such as day surgery or OR -- keeping in mind that the OR does run 24/7 but most of the nights and weekends are 'on-call' or at least in my facility. Good luck, Always Learning

Finally Got My ATT! Testing on Valentines Day - First Available Date!

Waiting Anxiously! Graduated Dec. 8th. School did not send packet off until JAN 4th -- Nearly ONE MONTH later! ARGGGGG!!!!!!!:angryfire Checking my e-mail about every 15 minutes when home. I guess I will be lucky to test by the end of MARCH! My state will not even show you the test dates and sites available until you get your ATT so I can't even plan work around potential test dates! OK Rant Over! Congratulations to everyone who has their letter. Good Luck to US ALL on the test! Career Student

:roll Too Funny! My hubby says the same thing, as evidenced by the screen name! Just graduated with my BSN in December and if it were not for the NCLEX review course I just took, I think I would be going through D/T's about right now!:grn: One of the things I like most about this field is there is ALWAYS lots to learn, I have already signed up for all sorts of classes through the hospital and I am still waiting for my authorization to test! I think that an assertiveness class would be an EXCELLENT choice for an elective, I can think of so many times that I wish I were able to communicate more assertively that was also tactful. I can imagine countless situations in the clinical setting that this would be so much benefit! Good luck with school, like someone else stated there are MUCH worse things to be addicted to. _______________________________ :stdy:Anxiously Awaiting NCLEX!

With all due respect I must inform you that you are making an incorrect assumption. I am a tech on a very busy telemetry floor and I frequently have two halls (10 patients per hall) all alone all night (1900 - 0700)! I am responsible for VS, OTBS, Labs, EKG's, Standing Weights (with a huge scale that has to be drug around) Baths, ice pass, stocking the nursing stations, stocking linen carts, keeping up with I/O's, toileting needs of patients and answering call bells (even the walkie talkies who just got up to use the restroom and forgot to turn off the light or wants me to adjust the head of the bed; like it takes more effort to hit the button for the bed than for the call bell -- yes they are all taught to use the controls when they are admitted). It is very overwhelming, especially when there are usually 3 day time techs and there is always trash left in the rooms, usually two or three food trays and many times I find Foley's so full that they look like they will pop if I touch the bag (so I have to get the I/O's for the day too - don't know how the day nurses are charting it). The only time I sit is while I am charting, I often do not even take a lunch (but believe me I have learned to file a time adjustment!) When I get home, I feel as if every muscle in my body is on strike, after being on the go and so busy for 12 1/2 hours (required to clock in 15 min early and stay 15 min late for report) sitting in my car driving home causes me to stiffen up and can barely get out of the car when I get home. It took several months of working but I finally found my groove. I learned how to cluster tasks, learned to set priorities, learned what could be done in advance and what could wait. But am still dog tired, because I refuse to compromise patient care just because of staffing issues. I feel that this job has prepared me very well, as I will graduate on Dec. 8 of this year and hopefully be an RN by Feb or Mar. Yes -- this is a true account of my responsibilities and is the norm on my floor! This is why I will only work 1 night each week while I am in school. To the OP -- I am sorry for what you went through, I know how difficult 20 patients are and can only imagine what 29 would be like. Just know that if you can handle the patient load of a tech you can easily handle the smaller load of a nurse. Please no flames -- I did my preceptorship on the floor where I work and was required to handle the 4 patient load the same as the RN's -- yes I had an RN to back me up but I still did the work myself and still was not dead to the world when I left there. -------------------------- :mortarboard:Graduating Dec. 8, 2007 NCLEX - Here I Come!

yes! yes! yes! -- but whatever you do -- hang in there! :icon_hug: the first few weeks are brutal at best, but it is all worth it. i actually quit every afternoon on the way home, then got back up and went at it again the next day. talk with classmates, form support groups. i know it sounds silly, but my class did, and i am proud to say that out of my support group of 10, all of us except 1 will graduate this december, and that one will be just one semester behind the rest of us. while we did loose a substantial portion of our class, the vast majority that participated in these informal groups are still with us! take a few lunches together, blow off steam -- spend some time complaining about the program, crying on each others shoulders and then put it behind you and spend the rest of the time just enjoying each others company. i had one meltdown around mid-term first semester, ended up crying in the women's restroom room during morning break. at lunch, my support system went out and bought chocolate and brought it to me. chocolate makes everything better! they helped me refocus and i survived another day. thing is, i was able to repay this debt in kind as we all have had those days. this will be one of the wildest journeys you could ever embark on, but it does get better, and is well worth the effort. the first semester can be considered a weeding process, and a building of character -- sorta like the military so i have been told by classmates with that experience. so, don't quit, things can only get better. hope this helps, career student _____________________________ graduating december 2007 :monkeydance:

Same Here! Way down south, where I am, you are EXPECTED to join in. I try to avoid them (prayer circles) whenever possible, but when in the room when it is initiated, I'm just stuck. And I agree, I leave my beliefs concerning religion at the hospital doors. I do feel however, that if my participation fulfills the clients spiritual needs, then it is one step closer to recovery -- be it a physical and emotional recovery for the patient, or an emotional recovery for the family of a dying patient. It's all about the patient's needs, and yes, I do offer to have a minister of the patients faith come visit, some patients accept, others just want a quick prayer with the family. I see it as a comfort measure, and a basic element of nursing, regardless of whether on not their beliefs on religion conflict with mine or not.

:balloons::balloons: congratulations! hope to join your ranks soon! ___________________________ class of december '07

I will also graduate in December '07, and we have used ATI from the start, even our entrance exam was ATI. I find the tests to be very challenging, but so far have scored quite well on the national percentile rankings - which is what my program uses for your score, not the actual percent of questions correct. The school tells us that the NPR is an accurate predictor of NCLEX, but then they say a lot of things, so it is reassuring to hear that someone other than our administrators are confident in this program. _______________________________ Graduating December '07 :monkeydance:

MIKOo14, As a student who just started my preceptorship this week, "THANK YOU!" It was very difficult for the faculty and staff to find preceptors for my entire class (actually only half of the class at a time) and we really do appreciate your willingness to share your knowledge with us. Please know that most any student that you get will be nervous and scared, some are good at covering it up and others not. To some extent, we want to impress you enough that you will allow us to do as many skills and take on as much responsibility for managing the patient as possible (after all we learn by doing), but this can easily come across as arrogance if not done very carefully. Each of the students in my class are at different skill levels, due to our individual clinical experiences, clinical instructors and patients we have had the opportunity to work with. Many in my class have never started an IV, most of my class have never given an IM injection. It is nice when a nurse says "What have you had the opportunity to do so far?" Yes, there are a few know-it-alls but for the most part we all want to learn. I know that the floor gets busy, and nurses don't always have time to explain every procedure, but it sure is wonderful when the time allows. Most of us appreciate the "see-one; do-one" approach. Ask your student what the school allows students to do, and if at all possible, let them do as much of it as he/she can. Example, my program allows students to push IV meds as long as an RN is in the room, when my preceptor asked me to go push a med while she checked on another pt, I explained an RN had to be present, she rolled her eyes and said she might as well go do it herself, took the meds and sent me to get vitals on a third patient. This is a missed learning experience for me. I have to look up the meds if I give them, find the push times, compatibility, reactions, adverse effects before I give the meds (regardless of how well we know the med), and I cannot give them if I did not see the order and draw the med. So it does take a while for a student to do what it would take an RN only seconds, but if an instructor walked in on a student who did not have this info or the RN not present when pushing the med, they would be dismissed from the program. Not trying to vent with my experience, just an example of how a simple request can put a student in a very precarious situation. I know how busy she was, had 5 patients and a student at the time, but I can't risk being kicked out of school and never receiving a license. When we ask questions, it is not to put you on the spot, it is to learn how and why. Be patient with us, we want to learn! And don't be too critical if we were taught things a little differently than you were. I was once reamed because I was taught to add an equal amount of air in a vial before extracting the med. The nurse said it was a waste of time (among other things), but this is how we were taught in lab, so this is how I preformed the task. As long as it is good technique and does not break sterile field or pose risk to the patient, it is most likely just the method the student was taught. The fact that you are concerned about this tells me you will be a wonderful preceptor! Best Wishes, and thank you again! ____________________________ Graduating in December '07 Excited, and scared all at the same time! :monkeydance::chair:

:yeahthat: Ditto! -- I trip over my own two feet, even if I am bare footed, so yes, I have stumbled (not fallen) in my Crocks, and also in my Red Wing Worx shoes, which are made for people who work on their feet all day (marketed mostly to wait-staff) as well as every other type shoe I have owned. Since going to Crocks I can't imagine a 12 1/2 hour shift without them! ______________________________ Graduating December 2007:monkeydance:

in a operation i had, i heard oh $***! just before i went under -- but i think it was more related to the fact that i was thrashing around like a fish on the table because the regional block did not work! procedure went fine thereafter -- at least i think it did! _________________ graduating december 2007!

in my recent or rotation i thought i would have a temporary reprieve from the poop - until we got a pt with a perforated bowel that had been stewing for several days - yuk! :barf02:this was the first time i have ever been nauseous from something that come out of another person! poop - it's everywhere! ___________________ graduating december 2007! :cheers:

congratulations on starting nursing school! :balloons:getting accepted is half the battle! (well, maybe a little less than half!) the previous posters have given some great advice. check with your school though, mine strictly regulates everything! can not touch collar, no excessive accessories, all hair accessories must be a neutral color to blend in with natural hair tone (no kidding - specified in our hand book under dress code). i had mid back length hair when i started and have recently cut it to a few inches below the shoulders and i wear mine in a bun. i know, i look like an old maid with it in a bun, but it does stay out of the bed pans, emesis basins, and wounds! good luck in school! _________________ graduating in december 2007!

mil called me, up set because her doctor called her an "idiot and said she had throbbing cystic pen-nas." she also wanted to know where and what her pen-nas was. finally, after some questioning i figured out idiopathic thrombocytopenia. i swear that woman is wonderful practice for figuring out supposed ailments and medication names! wish i could remember them all. ___________________ graduate this december! woo-hoo!