At my new place, the nurses put in IV’s!!!!! And pull out PICC lines, etc! I’m so excited! Get to practice and insert IV’s now :).
Old place-not allowed. Boo!
Finished with general orientation. Going to Disney for a few days soon, when I get back, I can start orientating on the unit. :)
Went to old work to get my check and visited some of the staff. All the hugs!!!!!! They all said they missed me. I miss them too. My favorite Cnas were there. ☺️ residents (alert and oriented ones) even missed me and hugged me. 😊
Making a difference in people’s lives feels good.
Just gave my 2 weeks notice to the DON. She was like “is this what I think it is” and in my head I was like YASSSSSS!!!! I’m leaving this place!!!
But I said yup, got offered a position somewhere else. And she said ‘sorry to see you go’.
Now I’m on my 2 weeks vacation from there because I didn’t want to lose it.
Just had an interview at another skilled nursing facility since no hospitals have been calling me back. Got offered a job!
I’m glad to be leaving the place I currently work at. I’ll be on a short term unit at the new place!
Your blog is awesome👍 thanks for the posts. I have a question. I'm a RN from the Philippines but right now im working as a nanny in KSA, i will go home in 9mos & im planning to take NCLEX. I just want to ask whether its possible to pass it doing self-study? Cuz i have 9mos free to study so im wondering if thats enough with the right materials or do i need to go to a review center? Im worried cuz since i passed last 2011 i didnt do anything thats nsg related. Thanks.
Hi. I self studied. If you look through one of my posts where I explained what I used to study and how I studied, that should help. after I graduated, I took a vacation and didn’t study for a month, then when I came back, all I did was study. And passed the first time. I think you should study the most for a month and no longer. Because you really can’t remember everything, and the nclex tests you on anything and everything. A lot of the things I was tested on, I barely remembered it. They don’t test you on simple questions and answers. They make you think critically and test you in the “nclex world not the real world” as my professors would tell us all the time.
I had Friday the 13th off which was also a full moon.
I worked last night which was Saturday the 14th and a leftover full moon.
OMG it felt like Friday the 13th/full moon. IT WAS CRAZY.
Nursing home residents all went crazy after dinner time. Major major sun downing.
I wanted to go home so bad it was horrible.
How was fundamentals and foundation class? Any tips?
Fundamentals class is basically the introduction to nursing. I had a class called ‘Heath assessment’ and in that class, I learned how to take vitals, assessments, etc. The classes are the beginning of your nursing education. It’s a lot of information, as is every class.
Tips: Just make sure you take notes and ask questions. If your professors have power points, print them out before class. Even look them over if you want. Take notes on the side, highlight, etc. Anything the professor says ‘you should remember this’ (which my professor’s all said to hint it was on the exam), highlight/ underline/ star it!
Some professors teach at a fast pace, or talk really fast. Don’t be afraid to ask them to repeat what they said. If they allow you to voice record them, do that if you want. I personally just took notes. If you missed something, ask another student to borrow their notes or take a few minutes after class and ask the professor to go over something that you need clarification of.
Hope that helped!
Hey! What would you tell those who are balancing nursing school and work?
Hi! Thanks for the message.
When I was in nursing school, I worked at the school’s library during days I had classes (which was everyday). I didn’t have a outside job because I thought it would be hard with studying for exams and staying focused. I worked between classes and after classes. I was lucky enough that my boss understood the stress that nursing students had while studying that she would sometimes let us bring study materials if we had downtime while working.
I think it’s really up to the person on how they are while working and going to school full time.
I knew a lot of nursing students who worked part time while going to school, and they all did well.
Just be sure you don’t over work. You need the time to study and rest your body. Maybe just work on weekends and spend the weekdays focused on school. The days you don’t have classes, you can pick up a shift or just spend time with yourself/relax/ or be with friends.
It was my first time orientating a nurse. It also was a really busy night. Already had a resident fall at the beginning of the shift. ugh.
A per diem nurse was also working with me who has never worked on the unit before. There are 20 residents (patients) on my side of the unit (39) total for the floor. The 7-3pm nurses left us (aka me) all the orders to do because ‘I was the only full time nurse on the unit’ said my nurse manager.
So it was sort of hard to teach the orientee how to do everything since it was so busy. But I did it! I asked if she was comfortable with passing bedtime meds as I watch over her and if she was comfortable to do some simple orders in the chart, and she said yes. So she good for her first time. She asked questions as we went along and I showed her the steps to do a physicians order. I told her she will learn as she goes and don’t be afraid to ask questions.
If felt nice teaching/helping a fellow nurse. Hope to work with her when she’s off orientation :)
Also, towards the end of the shift, my supervisor came to me and said “you did a really good job today,” yay!
Hi there! Do you work in the US? I'm really intrigued that as an RN, you can't start IVs in your facility.
Hi! Yes, I work in the US. At the skilled nursing facility that I work at, there were a lot of nurses (RNs and LPNs) who worked there for many many years who have never been IV certified. The facility and director of nursing (DON) never certified them. I asked the previous and current DON many times when were they going to send me to IV certification class and they just put it off. I think it’s because it costs the facility a lot of money to train/certify us.
I had always had to call another nurse who was IV certified to come hang my IV meds, flush them, change the dressings, etc. But finally, I can start to do them myself. I wish the previous DON certified me when I first started working there.
Hopefully in the near future: I get a job in a hospital, learn more & gain more experience as a nurse, and also put IV’s in. :)
Had my first IV class at the facility (skilled nursing facility) I work at. Been working there for a while and finally got certified today to hang IV’s and flush IV’s. Each facility has their own rules on IV’s and policies/procedures and mine is strict even though I’m an RN.
Best part of the class was inserting an IV in a practice arm. We can’t insert IV’s where I work but now I can hang and flush them. :)
At the end of class, the instructor recommended feeling and finding/looking at veins. I want to practice inserting IV’s allll the time now!! I wish I had this experience earlier in my career. Hope I can further my practice/experience in inserting IV’s in the near future.
Veins veins veins!!
Also, I had asked the current director of nursing (DON) and previous DON’s to be IV certified and they all put it off. Many of the nurses who have been working there for many years aren’t certified because the company didn’t want to pay for us to be certified. So I’m thankful to the current DON that she got us all certified today.
(I’m posting this in general med-surg and pediatrics. I remember for studying the nclex, had to know the risk factors of ear infections in children.)
An ear infection (acute otitis media) is most often a bacterial or viral infection that affects the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. Children are more likely than adults to get ear infections.
Age. Children between the ages of 6 months and 2 years are more susceptible to ear infections because of the size and shape of the eustachian tubes and because of their poorly developed immune systems.
Group child care. Children cared for in group settings are more likely to get colds and ear infections than are children who stay home because they’re exposed to more infections, such as the common cold.
Infant feeding. Babies who drink from a bottle, especially while lying down, tend to have more ear infections than do babies who are breast-fed.
Seasonal factors. Ear infections are most common during the fall and winter when colds and flu are prevalent. People with seasonal allergies may have a greater risk of ear infections during seasonal high pollen counts.
Poor air quality. Exposure to tobacco smoke or high levels of air pollution can increase the risk of ear infection.
Thank you to all of Boston’s finest for protecting our city and its citizens and keeping us safe!!! THANK YOU! Thank you for risking your lives for us!!! I LOVE BOSTON! This is our city!!!!! Boston strong!
I can now sleep with a sense of relief. Going to try to make it to downtown Boston to pay my respects to the victims and families who were affected and injured from the bombings from Monday very soon. As a nurse, medical volunteer at the marathon, and citizen of Massachusetts, I want to thank all the medical volunteers, police, EMTs, doctors and nurses, marathon volunteers, who were all involved in this weeks tragic events. You all are heroes!!! Thank you!
I was there, just 2 blocks away from tent A. An hour earlier, I was near the finish line to get mylar blankets for the runners who were in my zone who were freezing cold after finishing the race. I heard the explosions. The memory of running to tent A with a wheelchair and not knowing what to expect or see. The scenes I saw were like from a horror movie. Ambulances, sirens, police, screaming, and yelling we’re all I could hear. I wish I could of done more. :(
My heart and prayers to those who were killed and injured and their families. And to those who couldn’t finish the race. :( :( :(
Extravasation, the leaking of vesicant drugs (such as antineoplastics) into surrounding tissue, can cause severe local tissue damage, resulting in delayed healing, infection, tissue necrosis, disfigurement, loss of function, and even amputation.
Signs and symptoms of extravasation:
blanching, burning, or discomfort at the I.V. site
cool skin around the I.V. site
swelling at or above the I.V. site.
If you suspect extravasation, follow your facility’s protocol. Take these essential steps:
Stop the I.V. flow and remove the I.V. line, unless the catheter should remain in place to administer the antidote.
Estimate the amount of extravasated solution and notify the health care provider.
Instill the appropriate antidote according to your facility’s protocol.
Elevate the extremity.
Record the extravasation site, your patient’s symptoms, the estimated amount of extravasated solution, and the treatment.
Infiltration occurs when I.V. fluid leaks into surrounding tissue. It’s commonly caused by improper placement or dislodgment of the catheter. When the tip of the catheter is positioned near a flexion area, patient movement may cause the catheter to slip out or through the lumen of the vessel. The risk of infiltration increases in older patients because their veins are thin and fragile.
Signs and symptoms of infiltration include:
If infiltration occurs, follow your facility’s protocol:
Stop the infusion and remove the device (unless the medication is a vesicant; consult the health care provider and pharmacy).
Elevate the limb to increase patient comfort.
Check the patient’s pulse and capillary refill time.
Counteract the effects of the drug as ordered.
Perform venipuncture in a different location and restart the infusion.
Check the site frequently.
Document your findings using the infiltration scale
*Need to know in nursing, not just in school. Especially as a nurse.** (You’ll study it in pharmacology class too.)
What is Vancomycin?
"Vancomycin is an antimicrobial drug that is used to treat serious infections caused by Gram-positive bacteria." (Usually through IV administration but can be by mouth (PO)).
Understand peak and troughs and the difference between them.
How is it used?
"This test is used to monitor levels of the antimicrobial drug vancomycin in the blood. When a vancomycin dose is given, its concentration rises in the blood, peaks, and then falls. The next dose is timed to be given in anticipation of the falling level. The goal is to overlap the doses enough so that a minimum concentration is always maintained in the blood.
Measurement of blood levels are ordered at times to reflect the lowest concentration (trough) and the highest concentration (peak) to evaluate the adequacy of dosing and adequacy of clearance of the drug.
Trough levels are collected just prior to a person’s next vancomycin dose.
Peak levels are collected 1 to 2 hours (varies, could be 30-60 min) after the completion of the intravenous vancomycin dose.
The trough and peak values are used by clinical pharmacists and doctors to calculate rates of absorption and clearance of the drug. These results are then used to determine the appropriate amount of drug and the appropriate timing between doses to assure that the blood concentration remains in the therapeutic range.”
Someone had sent me an ask and I thought it was a great question that I should share.
"Hey there! I was just wondering when you started applying for RN positions. While still in school or did you wait until the summer?"
I started applying for jobs right after I passed my nclex-RN exam. I focused on school and studying for exams before even thinking about a job. Many places will only hire you only if you pass the nclex. Some places, if you already work there as CNA or something else, they will probably rehire you as an RN. During school, we had to have a résumé finished before graduating.
I never had a nursing job or any health related jobs during high school or college. My current job is my first nursing/health related job ever. I had jobs in retail and food during high school and college.
My advice: focus on school and graduating, then focus on studying and passing the exam, then focus on applying for jobs right afterward. But I know some people who started applying during the last few months of senior year in college. Do what you think is best for you :)
Don’t stress out! Some of your classmates might be applying for jobs sooner than others.
I remember freaking out because I hadn’t even thought about a RN job during senior year while every one was applying and studying early for the nclex. Move at your own pace.
It took me about 2 months to finally have a RN job. Some people get hired sooner than others, some later than others. Don’t give up. Keep trying and applying.
For those of you who are nurses (RNs or lpns):
how many patients are you assigned a shift?
And do you work at a hospital or rehab/nursing center/ or other?
Me…. 20. Yup, 18-20 patients at a rehab/ nursing center.
Only 2 nurses on each shift and each with 18-20 patients. Too large of a patient load for one nurse. In clinical, we only had 2-4 the most, now I have 5 times more.
I know in hospitals, nurses only have like 3-5 and in acute settings.
I float from short term unit to long term care unit and the patient load is the same. But the short term unit has all alert patients, super fast paced, super busy, and super stressful.
Hoping to get a hospital job after a year of experience.
/end mini rant.
Nursing jobs are difficult to get after the nclex especially as a new grad.
Hi! Works going good. Still on orientation. Passing meds by myself, nursing notes, documenting, and taking care of lots of patients. It’s going well though. Still learning how to do things and how this place functions…no computers! I’m so used to documenting on computers, using automatic vital sign machines, electronic beds, monitors, and etc! Everything is on paper…everything is…different than what we’re all used to-no electronic machines.
Sorry haven’t updated, but I do check my tumblr everyday when I get home. When I do have some free time, I’ll post some nursing material for you guys!
Working full time is a lot of work, but it’s going great. :)
& Thanks for the messages you guys have been sending me. Glad my tumblr and material can help!
Also, good luck on finals! Study hard! Don’t get too stressed out! You know the material!!!! BREATHE!!!
What are you guys studying right now in your nursing classes? Or what’s on your next nursing exam?
If people are learning/studying for a certain topic right now, I’ll dig through my nursing notes from school and post some thing’s that may be helpful :)
Let me know by replying to this post.
Also, you can let me know if this ‘what is everyone studying right now…’ is useful, and I can do this like once or twice a week depending on everyone’s responses to this post. Like and/or comment and/or message if you’d like this to happen :)
Example: Say if many of you are studying for cardiac…I’ll post cardiac notes, or pedi/etc/etc/etc.