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SaltySarcasticSally LPN, RN

Content by SaltySarcasticSally

  1. I spent years in grade school trying to figure out why I could never comprehend new material during class like other students could. I would take notes in every way possible, sit and intently listen, prepare before by reading the material to be presented the next class but to no avail. I never made a GPA over 2 point something in high school so when I decided to returnto a community college for my LPN to RN bridge program, I knew I had to find a different way. I had to start from step 1 since all of my post high school education was a one year LPN vocational program which meant no transfer credits.I faced classes in subject areas that I failed time and time again: math and science. To even apply to the program, I needed Chemistry, A+P 1 & 2, statistics, and Microbiology. I started with A+P 1, I knew I would do fine in the anatomy portion, one thing that has always been my strength is memorization.As for physiology, I knew it wouldn't just be memorization, it would be complete understanding of all the little parts that make the whole system work well. I went in for the first class as I had done many times before,my notebook (I even had a special note taking one) ready with the chapter we were covering that day at the heading, and I prepped the night before by reading the chapter. At the end of the class I was more confused than I was the previous evening. My professor had said the key for most students in physiology was learning the big picture before learning all the little pieces that put the picture together. That's when I finally got it and that is all it took to solve years of educational frustration. I just don't learn like that. It is impossible for me to understand the big picture before I fully understand the little pieces and lecture is set up directly opposite of that idea. As much as I tried during lectures, my mind always wandered. I have always been a reader even though I performed so poorly in school and I have always been a visual learner as well but it didn't translate well when sittingfor a traditional lecture I had been forcing myself to learn a way all these years that my brain just couldn't work with. With that realization, I began to study for my first test in a completely different way than I had before. I had five chapters on my first exam which equaled hundreds of text book pages. I am an avid reader, yes, but I also lack the ability to sit for hours at a time. I did some research online and found most of the information in textbooks are filler information. I read only the boxes, bolded words/sentences,and the first and last sentence of every paragraph. I made concept maps insteadof notes, graphs instead of flashcards, and for things I needed to memorize I utilized online flash cards to save time. When I didn't fully understand a concept, I went in search of reputable academic sites that provided videos, illustrations, and alternative ways of explaining a concept. I found I must talk difficult concepts out and I did this by either helping a fellow student or explaining it to my very loyal but bored dog who often sighed during my pseudo physiology lectures. I went to every lecture and did keep an ear out for any pertinent information but instead of forcing myself to focus on something I would not learn from, I sat in the back, quietly used my laptop and concept maps to review information, and to study for the anatomy portion (also very handy to use online flashcards for) so I could focus my study time at home on physiology. I blew through that first test. It was the first time in my life that I ever left a test knowing I just aced it. I had always told myself that it was OK I was not a super smart academic person, but I had wasted many years telling myself I could never succeed in educational pursuits when Iwas the one stopping myself this entire time. I continued studying in my new way and before I knew it I was applying to my bridge program with a 3.96 GPA. There were some definite bumps, I took Chemistry twice, had to study more for that class than NCLEX PN,and A+P 2 was one of the most difficult classes I have ever taken, the A minus I received as a final grade felt like an Olympic gold medal. I am someone who must study every day, as much as I wish I was one of those students that could read a chapter then pass a test without much effort, at least now I knew how to pass and gain knowledge at the same time. I am coming into my final semester of core nursing classes, I am due to graduate in April, and the study habits I developed for my firstA+P 1 test have changed some to meet the needs of those classes but my core study plan has stayed the same. I found I have had to study less in core nursing classes because I spent so much time on the foundational pre-requisites like anatomy and Chemistry. When a student who is about to start nursing school asks me what my best piece of advice is for them it is always find which way you learn best during pre-requisites. If it's not the standard way you have been taught is best, that's okay as long as your getting results and actually learning. Search the internet for different ideas, try out different things, use the strengths you already have! I am not a genius by any means and have done well even while working, having 3 kids, and a husband. I hope this helps some for students who struggle with traditional lecture formats and if anyone would like recommendations for websites that have helped me I would be glad to pass along the information. Good luck to everyone!
  2. SaltySarcasticSally

    Tips For LPNs Going For Their RN Degree

    I recently graduated from an LPN-RN bridge program and thought about all the things I wish I knew before I even started prerequisites. I often get questions from other LPN's about which programs are best, if it's easier to get through nursing school as an LPN, and tips for success. These are my top 6 steps that I think every LPN entering their bridge program may find helpful. STEP 1: Choosing A School This is one subject you're bound to have heard multiple opinions on as every potential nursing student has. I researched several popular for profit and local community colleges before I settled on a school. This is what I found: EVERY school will have faults, there is no escaping that. It IS important to review cost of the degree vs. what you will be making over your career. There are no bankruptcies for student loans so make sure you're not going to be broke after you graduate. For-profit vs. Nonprofit is a heated argument in the nursing community. I eventually settled into a nonprofit community college because it was worked best for my schedule. The negative for me on the for-profit college front was a few things 1) the expense was far more than community college 2) it was full time from day one and I needed to work 3) The online options for for-profit schools was limited compared to the community college because it was so accelerated and required in-person attendance 4) In my area the for-profit schools have trouble finding clinical sites in the hospital because there are so many nonprofits with contracts. The community college offered me more flexibility in terms of prerequisite scheduling. I took all of my non-science classes online which is a life saver if you have a full-time job, kids, a husband, etc. STEP 2: Tuition Reimbursement If you're an LPN, you most likely have a job and most companies now offer tuition reimbursement in exchange for time served. I ultimately decided not to take tuition reimbursement from my LPN job in a major medical network for a few reasons: The amount reimbursed was not enough that I was willing to limit my job opportunities after graduation I knew at some point I may have to drop to PRN status in the actual nursing program and that wasn't an option if I took tuition from the company I was not positive I wanted to work for the company after I graduated These are all points you should consider before committing yourself to a company after you get your RN. This can be a valuable monetary source but it can also hold you back if you have a hard time finding an RN job in the network or need to work less while in school. STEP 3: Prerequisites Vocational schooling for an LPN is often so structured and scheduled for you, prerequisites for college is a completely different experience. There are a few things to be aware before you starting choosing classes: DO your research. Have a plan, determine how many hours you can devote to classes that semester before you go all in. Repeating classes over and over again because you did not plan for what time that class would take is a time and money WASTER. DON'T take all of your hard classes together. If you know you're going to struggle in a particular subject, for example, chemistry was my school beast, please do not take that class with something like A+P 2 that will also need a lot of time devoted to it. Take it with a psychology class, a general prerequisite, something other than another hard/ time-consuming subject for you DO take as many bachelor prerequisites as possible in an ADN program. My program encouraged your associate prerequisites also be your BSN prerequisites. Yes, this means your prerequisites will be harder, for example, I took statistics for my ADN programs math requirement instead of the easier class you could take, but it also means you could have all of your bachelors prerequisites done when you graduate with your ADN. DON'T take your guidance counselor's word for it. College academic advisors look after multiple students in multiple programs. Yes, get their opinion on whether or not to take this class or that class but follow up on their suggestions by researching your college website to make sure you're getting the correct information. DO know you will have to study. It's time intensive, it's exhausting, and it gets old but you will be successful in the nursing program if you put time into the foundation of it. Also, figuring how you learn best needs to be figured out in pre-requisites NOT in the actual nursing program. DON'T take semesters off. I know things happen but the # 1 nursing school killer is that many students that take a break ultimately do not graduate with a degree. Barring any life-altering circumstances, attend school consecutively, even if you're taking one class at a time. When you take a break, you get out of rhythm, you lose focus, and you come up with a million excuses why you can't go back right now. STEP 4: Working while in school This is one of the top 2 questions I have gotten, whether you should work or not while in school. The answer is that it depends on multiple factors. I worked full time through my pre-requisites and then worked PRN during the nursing program because mine was only 12 months and accelerated after the pre-requisites were completed. It will depend on your support at home or if you have children, the intensity of your program, time management skills, and job flexibility. Most of the students in my bridge program worked full time and did graduate. I took 3 years to do prerequisites, I have 3 kids with one of those being born in the middle of a fall semester, but I planned for that going into it so it worked out fine. STEP 5: The Nursing Program You have finally made it into the program after the blood, sweat, and tears of pre-requisite courses. Your exhausted and over it but the hard part is just beginning: Get organized. Get a planner because it's essential if you want to succeed. Schedule the whole program out to pinning day if possible. This allows you to see ahead for any possible scheduling complications preventing any missed school or clinical days. Expect the unexpected. Nursing programs, no matter where you go, are notorious for last minute changes and general disarray. I am a person who likes to know what is going on ahead of time so this was hard for me but you need to learn to be flexible and roll with it. It will be easier if you devoted time to pre-requisites. I studied half the time of what some of my fellow students did in the actual program because I studied double what they did in pre-requisites. Save your pre-requisite notes, especially A+P classes, you will be glad you have them so you don't have to go back through your books. Don't get wrapped up in the drama. Nursing school is stressful, you're bound to have a few encounters with other students or professors that are tense. Please remember, you're an adult, stuff happens, you don't have to like/love every professor or student to have a good nursing school experience. DO NOT answer test questions like an LPN. I struggled with this in the beginning, I had 7 years LPN experience by the time I entered the program, test questions, modeled after NCLEX, boggled my mind at first because "THAT'S NOT WE DO IT IN THE REAL WORLD." NCLEX is a fantasy nursing world, everyone has appropriate staffing, enough resources, and the patients have expected disease progressions and outcomes. Use your valuable LPN experience in clinical, not in the classroom. Also, test questions are based on the assumption you're an RN, not an LPN. The test question answer that may have been correct in LPN school most likely will not be correct in RN school when it comes to things like delegation, assessment, etc. STEP 6: Clinical Experience While this is not the #1 question I get, this is the #1 subject I think LPNs need to think about before RN clinical rotations: DO utilize your LPN experience. We have basic nursing skills like wound care and PO medication administration down pat, utilize this to help the nurse you are training with to free up her time in order to learn things we may not know like IV medications and blood administration. (Disclaimer: this will depend on your school, we could give PO medications once checked off without our professor present but nothing that was out of our LPN scope of practice was to be done without our instructor. Reading your student handbook on these matters is essential). DON'T say you won't do "CNA work." I loathe this statement but understand the assumption when most of us come from LTC backgrounds. In LTC, we must depend on our CNAs for ADL care because we have so many patients. In the hospital, YOU as the RN are most times going to be doing all of that for your patient. Whether you work in LTC or not, separating yourself from "CNA work" puts a wall up between you and your co-workers. Remember, the CNAs in LTC and the techs in hospitals are not our subordinates, they are our co-workers, treat them as such. On one of my clinical days, the floor was so hectic, I did patient care all day. The nurses were so appreciative that next day I was there they grabbed me for every IV med, IV insertion, and anything else I wanted to get my hands on. DO hustle and make a good clinical experience for yourself. Your instructor can't be with you every minute of the day, don't stand around, find a tech or a phlebotomist, someone to help and observe! If my assigned nurse was busy, I would go find a PCA to help because I had never been in the hospital setting. I learned a lot from the PCAs and they were more than happy to fill me in on how things work once they saw I was willing to get my hands dirty. DON'T think yourself as an LPN in clinical (besides utilizing your skills), think of yourself as a student because you are. So many of fellow students got wrapped up in not being referred to as a nurse. We all experienced as LPNs the "so your not really a nurse" thing at least once in our careers. You need to move past that, it is what it is, don't get in a funk in clinical because you are referred to as a student nurse because that is what you are. DO treat the staff at clinical rotations with utmost appreciation. We as LPNs know how hard it is to train new nurses and do your job at the same time. The RN at the hospital is going through the same thing, use this to your advantage. One of our clinical rotations loved when they knew LPNs were coming for a clinical day because they knew we got what they were going through and didn't expect to be catered too at clinical. LPN programs are generally a year in length, going for your ADN/BSN is not. It's a marathon vs. a race and it's better to prepare yourself for the amount of time you will be in school than to try to rush through it. While I said not to take semesters off, DO give yourself days off. You need it for your mental health to stay in this long game Being an LPN while in RN school can be SO valuable but it also can be a big hindrance if you let. Use your experience but remember you are still there to learn.
  3. I live in a medium size city with several hospital networks and our area is short on nurses too. We have tons of nursing schools too but the networks are growing faster than the nurses coming out of school. I have started to see sign on bonuses for the first time in forever and "new grads welcome" job postings.
  4. SaltySarcasticSally

    What Else Can I Do For A Living?

    Are you sure you want to leave nursing because of the job itself or do you want to leave nursing because you struggling with those that work in it, your interactions with co-workers, and maybe personal issues? Nursing can be one of the best jobs and it can be the worst. When it's bad, sometimes it's the employer environment your in, it's you (general you) and your general outlook, or it its a combination of both. If your home life is stressful, your work life is stressful etc, it's easy to take it on and blame it on the job because that is the easiest factor to fix. From your responses, your defensive. And we all got like that, it's human nature. But it's when we are over-defensive that we can't see the whole picture KWIM? To answer your question though, there is school nursing, insurance company positions, safety nursing officers, infection control, research, etc. Many options that will have a different feel than the traditional nursing environment. But if you had a rough time in the last 7 years and haven't yet found the job that you feel is doable for a good length of time, it may not be the career choice that's the issue is what I am trying to kindly point out.
  5. SaltySarcasticSally

    Inappropriate Behavior?

    Ok, first, do not work with her. That's just ridiculous. Do not get involved in this. Let her make her FB comments, she just feels inferior. Unless you start to feel she is actually a danger, ignore this nonsense.
  6. SaltySarcasticSally

    Nursing and childcare poll

    I work every weekend and am off during the week while my spouse works. I have 2 in school, one not, so the daycare price was $1,500/mo for us since we needed before and after school care. We are young so our parents still work, no free childcare here. It stinks but it's temporary till I get my middle kid in full time school. My husband and I have always worked opposite shifts or schedules to cover the kids but still used daycare for the gaps. But once the third came, it was just too expensive.
  7. SaltySarcasticSally

    How late after your shift do you stay at work?

    10-15 mins after, usually no later. And that's just because of report taking a while. I have 6 months RN experience on Tele but I was an LPN in LTC before so charting wasn't new for me. We do not get admissions starting 30 min before and 30 min after shift change. If I get one at 1700 or later, I do everything I can before passing it off to the next shift.
  8. SaltySarcasticSally

    Ready to leave Med/Surg Tele, suggestions please?

    I'm in awe you made it 3 years lol. You can really go so many places with that experience. Tele is rough, I've been in 6 months. My manager told me if you can make it on Tele at least a year, you can make it on plenty of other units. I'm aiming for ER myself. I've learned I like have different patients every shift and I love in that in the ER (I did my capstone in the ER) that it's much, much easier to tolerate rude patients and family knowing you most likely won't see them again the next shift. See if you can shadow units your interested in! After 3 years on Tele, you deserve to be on a good unit with a good team. Maybe you will even land some where you can manage a 15 minute lunch break not charting at the same time lol. One can dream...
  9. SaltySarcasticSally

    Could not make it through the orientation of my first job, seeking advice.

    4 weeks isn't nearly long enough training for a new grad on an ICU floor. I got 8 weeks as a new grad on a Tele/MS floor with the option of 12 weeks if needed. And we do not take ICU overflow but we do manage lasix, cardizem, and heparin gtts. I was an LPN for 8 years before my RN and I really struggled in orientation the first 4 weeks. Mainly because I had a different preceptor every week and just because our floor is rough at times. Once I had a steady preceptor and had consistency, things got much better. I'm a person who likes variety but I need consistency during training when in a new environment. Having so many different people teach me in so many different ways the first 4 weeks was too much. It sounds like you had similar issues. I also did much better once I was on my own because it was then I could see the big picture of my whole routine. If you can't get back into a MS position any time soon then I would try a SNF. I worked in SNF as an LPN and many now are similar to MS units (sans a few things of course) because people get kicked outta the hospital so early now. It will build your skills and confidence plus the patoents will (hopefully) be less critical. The ratios can be high but the charting not as involved. You have the same residents weeks at a time so your not learning a new patient every shift. Try that, build your skills 6 months-1 yr and re-apply to acute care. I think yo7u will be surprised at how much more comfortable you will be in the hospital after some time in SNF.
  10. SaltySarcasticSally


    I'm a little confused, can you elaborate more? Are you practicing as a nurse in a different country? And are you a nursing student doing a capstone of sorts?
  11. SaltySarcasticSally

    Feel like a crap nurse. How do I become better?

    Your doing just fine. I've got my 6 month mark on a Tele floor, on my own for 3 months now. I just now feel like I can go into work and not feel overwhelmed. And I was an LPN for 8 years before and its still took me till now to feel comfortable. Always ask questions and keep marching ahead, it will feel less anxiety inducing soon.
  12. SaltySarcasticSally

    being called off..

    See they just limit all the call offs to our unit instead of rotating it through all similar units. It would be a lot easier if they did that. I had to take last Saturday with no pay since I have no PTO.
  13. SaltySarcasticSally

    being called off..

    How often is normal? On my floor, 1-3 nurses are called off mostly every shift. I've been there 6 months. Called off once due to stomach flu, have taken no other PTO but I'm out due to using it to cover the frequent call offs due to over staffing. And they are still hiring nurses...not sure why. Is this common? Its been going on for 3 months now. I do not have any more PTO to cover it and I need to pay my bills...
  14. SaltySarcasticSally

    Outpatient Clinic Nurse Patient Ratios

    Are we talking case management or being on the floor? I worked on the floor for years as an LPN in a variety of offices, we never had any set # of patients we could see in a day. Sometimes we had 45 patients in 4 hour or only 45 patients in 8 hours, just depends on the day/season. It never bothered me to have a lot of patients in one day but I could see how too many patients in case management may be hard to handle.
  15. SaltySarcasticSally

    Going to color coded scrubs.

    We have to buy our own at a particular shop because of the embroidery. Its silly because transport wears the same color as nurses so it really does nothing.
  16. SaltySarcasticSally

    being called off..

    We aren't union so no go there. Curious, why would a hospital about to close hire too many nurses?
  17. SaltySarcasticSally

    being called off..

    I'm honestly not sure why they are over staffing. I think its mainly for an occasional overflow unit but its hardly ever open. I am a new grad RN so can't do specialized roles yet but will be trying to transfer as I don't think this occurring on other units. I'm also floated often so I've seen its not as common on other floors...
  18. SaltySarcasticSally

    What do you wear under your scrub pants in winter?

    Nothing. I walk really fast from the parking lot lol
  19. SaltySarcasticSally

    Quitting a job after a short time

    Honestly, there really is no good advice for staying in that particular hospital if you want off the unit. You can try to transfer but I wouldn't hold your breath. You will likely have to find a new employer. I think what your looking for is an oncology office or chemo nurse. Our onc floor is also MS, I think many are like that. Besides that, any MS floor stinks. I'm 5 months in and while its gotten easier, I can't say its a job I enjoy.
  20. SaltySarcasticSally

    Normal Saline Shortage

    Having same problem at our hospital too. Many of our ATB are coming in syringes now that we push over 5 minutes or more.
  21. SaltySarcasticSally

    Be honest, what pt behaviors do you find annoying?

    Oh man, I get tired of when is the doctor coming? Now I just say it varies but I would happy to give you the patient advocate # if you feel something isn't happening the way you feel it should. I'm done being asked a thousand times when the Dr will be here. No matter how much I explain it will vary most days depending on their patient load. If your one of the last to be rounded on, it means your doing pretty darn well usually, so be happy with that.
  22. SaltySarcasticSally

    Be honest, what pt behaviors do you find annoying?

    Omg I needed this thread in my life!! 1) when patients who who are ill but ill because they have DM and CHF and ignore their fluid restrictions and sneak out to the vending machine for sugary pop and snacks complain constantly about being in the hospital. Listen, its your life, you destroy your health as you please. But don't come make my shift hell because you put yourself here. It drives me nuts because these are super entitled people who lack any self reflection skills. 2) patients that want to know the second they will be discharged when the Dr mentions it to them. Even when I say over and over, the doc will get the orders in and then I can do my part. No, for the 50th time, I don't know when the doc will do that, if it were my choice I would have discharged you yesterday. 3) family members that are MIA for their loved ones entire hospital stay but then come the last day and raise hell about nothing. Like what is up with that?!? Clearly you weren't concerned 1 week ago when this patient was declining and no one could get a hold of you.
  23. SaltySarcasticSally

    Putting in a year.

    I'm currently 5 months into my year on a Tele/MS floor. I would like to be in the ER and had the chance to as a new grad but I knew as a former LPN for several years before my RN, that a solid foundation in fundamentals would do me well in the end. I didn't get that in my first year as an LPN and it took me some time to become "good" as a result. Let's be real though, MS/Tele is rough as they say which is why less new nurses actually want to do it. I don't stop in 12 hours, have 5 patients every shift, and its constant discharges/admissions. I actually just started to not dislike it because up until this point its been just trying to keep my head above water. I'm not a cryer but I cried in my car 3x during my 8 week orientation, its just so much coming at ya at one time. Many days I thought there is no way I'm coming back next shift. BUT I have seen a lot already. I have been shoved out of my comfort zone, even more so when I float. I'm learning prioritization and utilization. And most important of all, I have learned how to get a handle on feeling like a tidal wave is coming at me and instead of internally spazzing, I'm finding my stride. I still have a lot I need to learn but I see the benefit of being on a MS/Tele floor already, much to my surprise. Will I eventually love MS? No lol but I do see the benefit of a year in it. I've taken care of everything from CHF, sepsis, withdrawal, cancer, pancreatitis, post op, chest tubes, NG tubes, TPN, central lines, MI, stroke, and all kinds of drips. And that's just in 5 months. I don't think its essential per say but very beneficial.
  24. SaltySarcasticSally

    F Grade Hospital

    I signed a contract as a new grad in May with a hospital not that know to me but now I know it doesn't have a great rep. There is a reason why they make us new grads sign a contract -- because they couldn't keep people to stay. Its the only reason why I've stayed at my current employer, the contract, because that place is a hot mess. Point of lesson --- do NOT sign unless your very, very sure.
  25. SaltySarcasticSally

    Acquity of tele patients

    Lol! No, I appreciate it. I admit spelling is not my strength and I even spell checked that word, just picked the wrong one it seems. But I didn't even notice so good to keep in mind for the future.