Kpholland

Honestly, if you don't know the material enough to pass the tests you shouldn't be able to pass the level. It's more than just passing a class. It's preparing you for nclex and for when you're the one keeping a person alive. Since tests are the biggest part of your grade, if you can't pass them, you shouldn't pass at all.

Does anyone know of a current CEN review course that is available by cd so I can listen to it in the car instead of attending a class? I have two kiddos under 3 years old and it would be easier for childcare purposes not to travel to attend a class. It makes sense to me that it'd be out there but I just can't find it!

My understanding is that you cannot withhold medication that is physically safe for the patient to take and is ordered by the physician. And you cannot hold the patient there against their will after giving said medication if they don't have a ride (that's called false imprisonment and I don't feel like going to jail anytime soon). But, if I feel that the patient is going to be unsafe in the car I immediately call the police on that patient's departure from the ED (the police aren't far from us and we always have an officer stationed in the hospital). They can then do a sobriety test and take it from there. Of course I also document the hell out of the entire encounter.

Last summer I had a patient come in for high blood sugar. She had run out of her diabetes meds because she couldn't afford them (though she could afford her cigarettes) and now she was in DKA. She was all set to be admitted to the icu when she told me she wanted to go home. She said she needed to be with her kid. I explained to her how important it was for her to stay (she was super acidotic and her sugars were in the 800s) and asked if there was anyone else to watch her child. It took some convincing but she ended up deciding to stay. I got her up to the icu so impressed with myself for explaining effectively to her the importance of her remaining in the hospital to continue her treatment. Four hours later, we had a 7 year old boy come in for a drowning. They were at a pool party and everyone just assumed he could swim. Turns out, that was her kid. The boyfriend was her option for childcare and he didn't know the boy couldn't swim and just stopped watching him. We lost that little boy. I will never again question a patient's reason for leaving AMA. You never know what their reasons for leaving really are.