thebeccalc

Short answer - yes, it is 100% doable. I'm starting my transition program in a few weeks (online except Clinical, awesome), and I have no intention of cutting back on work. Like you, I can't afford to. Also like you, I was in an RN program and failed my third semester. I shot myself in the foot by working nights and then trying to be focused in class the next day. Didn't work out for obvious reasons. Now, in preparation, I've been working with my director to rearrange my schedule so I can be successful. She needs me to get my RN, I need my RN, and her accommodation will only benefit the hospital, especially since I'm getting tuition reimbursement and so will be contractually obligated to them for two years after graduation. Everyone benefits. For context, I'm also a fairly new (one year-ish liscenced) TX LVN. Good luck! :)

Look into bullet journaling. The system allows you to create the type of planner setup that works for you, and only takes as much work as you're willing to put in to it. bulletjournal.com :)

The best piece of advice I was ever given, and one I will take into my LVN-RN transition program in a few weeks, came from a Clinical instructor: Study and learn the material in order to take care of your patients. Don't study to pass a test, don't study to make a grade. Study the material with the understanding that what you are learning will assist you in saving lives. Once I was able to do that, the grades just fell into place for me. Good luck!

This sounds like my facility. One unit is like your old one, constantly busy, possibility of up to ten patients in a shift between admits, discharges, and transfers, and people just work from clock in to clock out with no time to think, let alone complain or stir drama. Then there's my home unit, much lower acuity, typical patient load of 3-4 per nurse, no Tele to futz with, and tons of downtime. Being on nights, my crew gets along great, and we're all fairly positive folks so we use our time the best we can (hello Netflix and study time!). However, the day crews, both of them, walk in the door complaining and are still complaining when I get back the next night. They're too busy, they have too many patients, they need more help, and gossip, drama, gossip. Bleh. Let's not even get into the fact that days have a unit clerk and a CNA, neither of which nights have unless we're just totally full.

We have Alaris pumps at my facility as well, and I've seen this happen a LOT. I was having a hard time remembering to unclamp piggybacks as well so now, when I hang a secondary, I always back prime the tubing so it's already unclamped when I set the pump. It's been a lifesaver.

I tend to have a basic template for my notes. At my facility, we note by exception, except ICU/Stepdown, where we note q2h. With noting by exception, I typically have an opening note and, if I think about it, a closing note. In my opening note, I document the patient's diagnosis/reason for hospitalization, and dressings or drains in place and their status, Foley, NGT, PEG, and then what I think of as the close-up: alertness and orientation, V/S stable/guarded, bed low, side rails, call light accessible, and I always note to see assessment for any further detail. The only time I always make sure to do a closing note is to if I float to tele because I have to note end-of-shift tele readings on all my patients. My opening note, since I'm on a predominately post-op unit, goes along these lines: Assumed care of [age]yo [m/f] pt of Dr [Name], S/P [Procedure], site covered with [Dressing], [any drainage/inflammation/etc noted]. [Any drains, Foley, other uniqueness if applicable]. AAOx4, VSS, bed in low position call light in reach, side rails up x2, no s/s distress. Denies needs at this time, see shift assessment for further detail, will continue to monitor. Assuming all goes well, that may end up being my only note of the shift. If I talk to a doctor, my note included why I spoke to the doctor, and if any new orders were received: Spoke to Dr [Name] re: [issue], new orders received and carried out. Will contribute to monitor. I don't list the new orders in the notes because they've already been entered as orders. Avoid double-documenting as much as possible because the more you document, the more you open yourself up for error. Anywho, hope that helps!

It's absolutely doable! I have a coworker who works two shifts per week and is in an online MSN program and has two children under the age of ten, and she's killing it at every turn. I totally understand wanting to get underway with school first though to see how your life needs to be scheduled.

Is your A&P in two parts or just one? I ask because, at least in my neck of the woods, A&P I was all basic memorization and regurgitation of various body system functions. I think the most complicated concept we learned was protein synthesis which, looking back on it, was a total cakewalk but was absolute hell at the time. A&P II went more in-depth, almost like a Pathophys Lite class so, while there was still memorization and regurgitation, it was more about disease process and the why and wherefore, rather than just the how. For the first part, I studied by labeling and re-labeling diagrams of whatever we were learning at the time - bones, skeletal muscles, the basic cell, and by reviewing vocabulary - abduction/adduction, flexion/extension, anterior/posterior, etc. For the second, I drew a lot of diagrams of body systems. What path does a drop of blood take through the circulatory system? How does the lymphatic system work? What does gas exchange in the lungs look like? A&P isn't a class that works well with flash cards except maybe for vocabulary. I only say that because there's a LOT to learn so you'd be carrying around a ton of cards. I hope this helps! Good luck! It'll seem difficult until you're eyebrows-deep into your first semester of nursing school. Then you'll look back on A&P with wistful fondness, lol.

MedSurg/Ortho here... Percocet Norco Morphine Lovenox Zosyn, so much Zosyn, at 25mL/hr...ugh

My hospital will do this sometimes when census is high and the "call-in happy" rotation is working. I don't have a problem with it generally speaking, but the idea leaves a slightly bad taste in my mouth for the following reason... When I got my LVN license and began orientation, easily half of my orientation shifts were still aide shifts. It felt like House just took a while to see me as a nurse instead of an aide playing nurse, which kinda irked me. I didn't feel I got the full benefit of orientation because of the lack of consistency, so I don't think a new nurse should be shifted in this way.

Agree with everyone else about buying, especially MedSurg and Pharm, and *especially* especially if you're a highlighter/underliner type. Also, with technology always evolving, your books may, like mine did, come with digital copies and supplemental goodies that renting won't give you access to, some of which were actually part of the required class materials for me. So yes, TL;DR: buy, don't rent. And good luck! :)

In Texas, the line is extremely thin so this conversation has become a hot topic down here. Just for example... I've seen posts regarding an LPN's inability to push IV meds or even start IVs, both things LVNs do in Texas except for very specific drugs (and truth be told, those very specific drugs also tend to be facility-dependent and based on previous negative incidents). We can't spike a blood bag or do the first 15 minutes of monitoring, but everything else wrt blood transfusions is within our scope. We (well, any facility employee) can receive blood from the lab, monitor vitals, and complete the documentation. We can't do an initial admission or post-op assessment, but we can do the interview and history. We can't pull blood from a PICC line/midline or access/de-access a port-a-cath, but we can administer meds and fluids through both. Hospitals around here have started phasing out hiring LVNs altogether and actually hiring RNs at a lower pay rate, which is pretty awful IMHO. I was one of the last LVNs to come up, and that was mainly because I was already an aide at my facility. The major issue with LVNs now is that the state has started placing a higher level of liability on having them in specialty areas so a 20-year LVN can no longer work in the nursery she essentially helped to create. A coworker of mine was an ICU nurse for years before LVNs were removed from critical care. The pediatricians aren't comfortable with LVNs caring for their kiddos even though we're all PALS certified. It's all become a matter of liability, which I understand in this highly litigious society we live in. I would never say I do the same job as an RN, but here at least, it's a very thin line between the two.

I took Micro my first semester of nursing school (so Fundamentals, Assessment, and Clinical of course), and it was rough. I got through it, but I wish I'd been able to really focus on that class as I was very fascinated by the subject matter, to the point that I'd like to study immunology further. My college had a Micro section that was set aside specifically for nursing students so it would fit with our other nursing classes, which was fabulous. It was an incredibly challenging semester, I won't lie, but if you have good study habits, it's possible. If you're able to find a way to pay for the summer class, though, I'd definitely try to make that happen.

I LOVE night shift! I worked nights as an aide; I work them now as a nurse. It's the only shift I work, both NH (10p-6a) and hospital (7p-7a). I've always slept better during the day and functioned better at night so it really is an idea shift for me. While the activity level *can* be lower at night, it really depends on the unit, census, and patient acuity level. I've absolutely had nights that dragged (thank the gods for Netflix), but I've also had nights when I didn't even think about charting until 3am because I was running nonstop, just like on day shift. As far as pay, our shift diff works out to +$1 from 7p-11p and then +&2 11p-7a for LVN's. I believe it's about $2 higher for RN's. I think it's a flat +$3 for weekends (Friday-Sunday), plus $100 shift bonus for working additional shift (regardless of day/night). Some things to consider: 1) Are you comfortable calling a doctor at 3am for any reason, a doctor who will usually not be your patient's doctor but merely the one on-call for his/her group? 2) How do you feel about the idea of not having management around to answer questions? 3) Do you prefer autonomy in your daily routine, or are you someone who needs more guidance from management? 4) Does the idea of attending a 1pm "mandatory unit meeting" when you've worked the night before and will be returning that night make you want to rip someone's face off? (Totally rhetorical, of course it does.) Night shift is a different world at the hospital. In my experience, the staff is a closer-knit group that tends to work very well as a team because we're, quite literally, all we have. I'm about to have to switch to days to better accommodate my school schedule, and I'm seriously dreading it. I love my night shift.

No CNA task is below your pay grade once you get your license so yes, it's absolutely okay to do bedside care when you have the time. As you said, it's an opportunity for a fuller assessment, especially skin checks, plus your aides will love you for it. Having worked as an aide for about two years before "movin' on up," I try to never forget where I came from and help out where I can when I can. As previously stated though, don't allow your nursing tasks to be neglected for tasks that are easily delegated.