melissamabd

Hi-- I'm a nursing professor with 40 years of nursing experience. I teach pharmacology, fundamentals, med-surg, and psychiatric nursing. I'm not sure why any RN would state they don't need chemistry to function; makes me wonder what they do at work. Here are some places where chemistry is used in nursing: fluid and electrolytes-- basically applied chemistry in the human body. You will need to understand Na+ and K+; ionization, movement across membranes and factors which influence the process-- which are virtually all biologic processes. renal function-- great deal of chemistry there.respiratory function-- again, chemistry of gases/movement and how it goes awry. pharmacology-- all chemistry; it's the use of chemicals to influence s/s/health. GI processes-- chemistry in effect once again; for instance, the use of hypertonic fluids to move fluid into the bowel (FLeets enema) and how this works. metabolic disorders such as diabetic ketoacidosis, rhabdomyolosis are also chemistry-related illnesses. It's the nurse's responsibility to understand all this and more-- and apply the nursing process of assessment/intervention/evaluation to the same. This is true in all settings, for all patients, all disorders. I think you may find some concepts unfamiliar during school; be mindful of this and prepare to get tutoring as needed. Last thing: of course you are no less capable than anyone else. That's rubbish. However, practical experience as a nurse's aide, while helpful with comfort in clinical settings, does not prepare RNs. Nursing school does; and in that clinical environment, you will assess patients, teach them about their disorders and treatments; and intervene as a nurse. You will also be expected to abstain from carrying out orders if they're not safe. That's quite a judgment to make-- not the judgment of a tech. It's quite different from helping with ADLs.

Hi-- my research is about medication errors. I am not convinced this was an error; and actually, nursing needs to change its culture. We are not perfect, never will be, just as we're not perfect in other areas of life. The edict that we should be perfect is abusive/in my opinion a woman's issue. Anyway, I wanted to express my support. You are a second victim of this incident- it's traumatizing you. As a seasoned instructor, I would use this as a teaching moment and discuss the critical thinking needed to make that decision. It sounds like you did the right thing by going to your instructor... and that someone sabotaged you, a form of horizontal violence. If you need more support, reach out to me at [email protected] Melissa Davis DNP RN

This question speaks to the very basic one: what do you want to do in life? If you want to be a physician, you want to diagnose and treat illness on a tertiary preventive basis. Nursing, on the other hand, is not at all like medicine. Nursing deals with primary prevention, teaching, and treatment of actual or potential human responses to illness. It is a holistic endeavor which could almost be likened to "medical social work," or advocacy for individuals' optimum physical, mental, emotional, spiritual, cultural, developmental, and vocational health. Although the two professions share situation in the realm of health vs. illness, they are VERY different. Be sure to understand the nature of each profession so you can make an optimally effective choice.

Pathology is the study of sickness; kind of a general concept. I am guessing they're asking you for pathological consequences of this disorder; in other words, what could happen? how serious is it? How likely is it? What would make these possibilities more likely, more dangerous? For instance, is this patient on anticoagulants? Lastly, how would you apply the nursing process to all this? What would you assess for, and how? How would you know if your findings are normal or not? Nursing diagnoses? Interventions? And all the holistic factors which affect all of this... culture, cognitition, sensory deficits, socioeconomic status and its effects, etc. This is a quick and dirty summary of what nurses are expected to know, do, prevent, etc. Hope it helps.

OK... But think of the possible consequences. Were anything to go wrong, the first question from an adversarial attorney would be what was assessed and known prior to acting. I hear your real-time world perspective. So many things go into whether or not it's safe to act. For this nurse, I recommend revisiting those old rules.

It's true... there are a few ways to fail. Is it theory, skills validations, clinical time? If it's theory, there are a few things that may help. You need to do more than master what the book, lectures, and powerpoints say... you then need to be able to explain them to someone else (accurately) and show how you would apply them to your work. Next, you need to be able to analyze situations which depend on these concepts. For instance, if you're studying pressure changes due to ACE inhibitors, you need to analyze all the ways things could go, predict them accurately, and know your rationales. Beyond that... I know, it's huge, this endeavor... you need to be able to write a piece about this concept (think care plan, brochure, article). AND THEN, evaluate someone else's doing all these things we've talked about accurately. WHEW. Nursing is about going FAR beyond mastering the book's content. You then have to make it three-dimensional. This fosters critical thinking and eventually (years later), expertise. Ways to accomplish all this: 1. do your reading. all of it. know it cold. 2. study with other people. if a concept is hard, read it from 2-3 sources. 3. do NCLEX questions, case studies to flesh out how things are applied. 4. follow all that practical advice about resources offered by someone else here (above). GOOD LUCK TO YOU!

It's time to use these two episodes as learning experiences. You need to go back to nursing fundamentals and the rules of proper medication administration, and there are many. To give medications safely, you need to have an assessment on your patient. Why would you just go give meds to some other nurse's patient? Also, you need to read orders for yourself. We never take orders from each other and frankly, I think both of you are at fault there. Do you not have to scan medications into the system prior to administration? Lastly, there are required components to every order. You do not have an order if any of these are missing. Period. No one should give you grief for insisting on safe medication practices; if they do, time to work elsewhere. Last thing... are you working agency? Why did you not have much orientation in this environment? I don't think it's safe, whether it's them or you. If you are inexperienced, agency is deadly unsafe. I have 37 years' experience and I STILL would feel unsafe just waltzing into a new environment without much orientation. I tell this to all my students; please heed. Good luck to you.

How about weekend track? It's the most efficient use of your time; work your 24 hours, be paid full-time, with benefits, and have all week to do your schoolwork.

Yes, it's an unparalleled experience and whatever you do afterward, your experience (or the lack thereof) will always be evident to those of us who have done this. I know several APRNs with little to no experience and it's obvious they are missing a great deal, including the nurse's role and professional identity.

I think this is akin to marrying someone because he/she is an honest person with a job who doesn't hit you. It will become very difficult to negotiate the waters if you have no passion for this cause, it isn't your calling/vocation. Actually, it's hard to do both when those factors are indeed present. Compassion for the patient is utmost and is the basis for professionalism, putting the patient and his needs before your own. I would get out now and find something which suits you better.

As a community health nurse of 31 years, I have to disagree with the idea that home care is a great last resort for new grads without experience. How can you make critical decisions alone in a house with no experience? Example: you are reassessing an infant's respiratory status for adequacy and stability after a questionable visit yesterday. That's a LOT of responsibility and takes skill. Not unusual in thdaera of 23 hour hospitalizations.

I think you would do well to ask yourself additional questions here. This is far more than blue collar training for a "job". It's a profession, which is nearly the opposite. Will you be furthering your education? It won't be too long before a doctorate is the competitive preparation. Will you be assuming leadership positions on your hospital board? Helping to direct the ANA, NANDA, NLN? Will you be teaching one day? Or pursuing a position at a major teaching and research institution? These are likely factors as your career progresses, so you may need the best possible preparation. I cannot make that judgment for you, but I think price is an overly simple factor. It's time to start thinking about what you want in broader terms. At your level, you will want as much preparation, professional affiliation, mentoring, and credibility as you can get. Use your vision and reach as high as possible!

I think you need to reflect on why you have a 2.98, because nursing school is completely different and more difficult than the average prerequisite course. Many nursing students drop a grade or two once they matriculate in nursing courses because the ability to reason critically is required, both with patients and on all exams. There is very little learning of facts and spitting them back to the instructor. The learning levels quickly escalate to comprehension, application, and analysis levels (think "select all that apply" questions routinely). If your current GPA is average due to a lack of effort or time invested, you will need to face the reality of needing to ramp up to pass nursing courses, even Fundamentals. Those who make it through nursing school are able, committed, and responsible both academically and ethically. This is an enormous challenge. I wish you luck in your endeavor.

I'm going to ask you to critically think about your questioning your educator. Does he/she have credentials such as a master's degree, R.N. licensure, and experience? What would enable you to reason about nursing issues more ably than this person? I'm a little confused about the need to compete with the instructor. Generally, we respect that authority. Unless you are able to readily furnish material contradicting the instructor's input, which does happen as we have ever-changing evidence, it's more likely your instructor, who has more education, experience, and a license to practice, is correct.

I'm sorry you're having a hard time. As a nursing instructor, I do expect students to show the ability to read and learn accordingly, because that's a requirement for ongoing competency in the profession. However, you need a great deal of support as you work. I would approach this instructor with your listed concerns, then go over her head if you don't get satisfaction. Good luck to you. I will be here if you have questions.