Friday, November 30, 2007
Thursday, November 29, 2007
Wednesday, November 28, 2007
Tuesday, November 27, 2007
Monday, November 26, 2007
OK, so yeah, I am tooting my own horn. I don't do it often, so that makes it ok!
I won a scholarship from school, from the nursing department. It was a fun night, though after an 8 hr shift and being up since 5AM I was a little tired. I got my second (or third) wind and made it through the ceremony. My two best nursing school friends came with me and I saw the other nursing students and friends/family. We made up the largest group, as our dept has the most awards/scholarships to give out.
The awards I won is called the Gail Hodson Award.
His wife had slept on the pull out bed in his hospital room the night before my shift and was giving him a sponge bath when I first visited his room. Later she spoon fed him breakfast and lunch even though he was able to feed himself. After spending the entire day waiting on him I heard her say she needed to go home to fix dinner for the kids. I can only assume she meant THEIR kids. Although appearances can often be misleading, she seemed to really love her husband and when she left I thought to myself "what a wonderful relationship they have."
About thirty minutes after his wife left I overheard him on the phone telling someone "She left already. Come on up." As I walked out of his room ten minutes later I passed a skanky dressed woman walking in. On my next visit to the room the woman was sitting on the bed next to my patient with her hand in his lap. The man didn't even seem a little embarassed by the fact that I knew his little secret.
Maybe his wife knows about his mistress. Although I usually try not to make judment calls about my patients, it sure was hard to look at him the same way after finding out about the other woman.
As my shift came to an end the two asked me if I wanted to use some tickets they no longer needed to a show at the Civic Center that night. I took the tickets, but I still don't approve of their relationship.
Sunday, November 25, 2007
Friday, November 23, 2007
It is easy to find travel nurse jobs on the internet, as sites such as MyNurseJob.com accept online applications.
Let me start by saying I am currently registered with more than a dozen travel nursing agencies although I have used only two or three of them during the last year or so. I keep my paperwork up to date with all of the agencies. This allows me to receive e-mails from all of the agencies detailing the available travel nursing assignments . I have previously posted one of the e-mails I received last summer with a listing of assignments on it here. That e-mail is typical of all of the agencies.
Select Your Location First
The first thing I do is select where I want to take an assignment. Being registered with so many travel nursing agencies increases the likelihood of finding an assignment in any location I choose. So far the only difficulty I have had in finding an assignment has been when I have wanted to work in smaller towns with smaller facilities. I have never had a problem finding assignments in cities with more than 30,000 people.
My husband and I have used a number of methods to choose a location. We have picked some locations after visiting them on vacation (Knoxville, TN), some because we just wanted to see what it would be like to live there (Bellingham, WA), some to be near relatives for the holidays (Jacksonville, FL) and some for the money (Orange County, CA). It has been my experience that anywhere you choose there will be at least one medical facility that hires travel nurses.
If you are not sure you will like the location you have chosen ask your agency for a shorter 3-4 week assignment. It is my understanding that some agencies will work with you on the length of the assignment. Most assignments I have taken have been 6 weeks or longer.
Select An Agency
You do not have to limit yourself to one agency. I have come up with several checklists I use when registering with an agency. The checklists deal with Contract Terms, Housing Stipends, Medical Facilities, Benefits and Insurance.
I hope this e-mail has answered the e-mails I have received this week.
Wednesday, November 21, 2007
Tuesday, November 20, 2007
Monday, November 19, 2007
Sunday, November 18, 2007
I had an admission at 2100 so I start handing over at 2115. The oncoming nurse cannot touch a patient until she gets report and knows about them. Doing that is begging for litigation. We really need to get started with this handover.
I start handing over at 2115, at 2116 a patient requests pain meds so I administer them, on the way back to handover a patient requests the commode so I help her with that. Phone call comes in from lab that new admit has an HB of 6. Eek. Call doctor. He orders a group and save...to have blood tonight etc etc. It will take a lot of time in itself between getting the blood from path lab, setting it up, moniter for transfusion reactions etc.
take patient off the commode and settle her into bed. She asks for a drink, my HCA's are tied up with a confused patient so I get this lady her drink. Can't handle complaints from patients saying that the nurse couldn't even be bothered to get someone a cuppa.
back to handover room. I was halfway through the first patient so I continue. I am in here and there is no RN to care for my patients whilst I am handing over.
phone rings. Angry relative wanting to know if the nurses "bothered" to change mum's nightgown today. He gets nasty. He obviously is in a bad mood and wants to kick out. Probably a regular reader of The Times who thinks there are lots of nurses up here eating the patients food and discussing politics since we are too academic now to wash and don't care about patients.
back to handover. we tick on nicely until...
I realise that patient who has an infusion of IV insulin is way over due to have her sugar checked. This is not something you can put off until later. It will need checking again in an hour. HCA's are still tied up so I do the BM. She asks for commode while I am there. I am useless at saying no.
back to handover.
I am just in the middle of telling on coming nurse what we need to do for a patient that has a drip with a med that she has never seen before....explain what we need to watch for, labs that are getting drawn in the night that she needs to stay on top of...
Visitor (who shouldn't be there at this time but has special permission) bursts into handover room. Demands that I get up off my ass and clean his mother up.
I am concerned with time at this point as it is way past the time that the night nurse should have started her assesments and drug rounds. Lateness could fuck things up royally for these 18 patients. 9PM meds have not been started yet. I see the HCA getting someone a pillow. I point her out to the visitor and say that I'm sorry cannot help you now...can you ask that young lady over there. He tells me that he didn't ask her because "that nurse looks busy meanwhile you nurses are sitting in here chatting" I resist the urge to punch his ignorant face.
It takes less time to sort out patient than to argue and explain to the visitor why I can't so I go to help her with assistance of oncoming nurse. It takes 5 minutes to clean her up and 20 minutes listening to the visitor and patient tell us what useless slags we are for not being at her bedside all the time, all shift. Arguing back is pointless.
Back to handover. Ten call bells are ringing throughout the rest of handover. This is more than 2 HCA's can handle. If we go out there we will never get through this. Ever. Things are getting desperate now. I fly through the rest and say a silent prayer that I am not forgeting anything critical.
Phone call from patient's cousin who wants to know the ins and out of everything we are doing for his loved one. I have no choice but to be abrupt with him.
I finish handover and realize that the hourly blood sugar check for the IV insulin patient is a little overdue as well as 100 other such things. I go to check it so night nurse can get started. Get stopped for 3 commodes on the way back to nurses station. The night nurse and HCA are tied up. One patient starts telling me off as she has been ringing for 15 minutes and asked why we couldn't be bothered to see to her.
Path lab has blood ready. That was fast.
Head Home. I have been here since 0715 this morning and have been unpaid since 2130. I WILL be deducted on hours pay for lunch breaks I didn't have. Phone call comes in. I let night nurse get it. It is a relative screaming because their loved one was left to starve yesterday. Patient was NBM for an operation. Don't these people have anything better to do at this time of night other than stopping nurses from seeing their patients and interrupting them whenever they try to hand over critical info to the oncoming shift? WTF? During the day the phone never stops ringing due to this shit. At least there are less calls at this time.
I am going home. I am tired. Fuck the paperwork I haven't done. They can pull my registration for all I care at this point.
Wake up to see what why my baby is crying and it suddenly occurs to me that I forgot to tell oncoming nurse about a patient who should be NBM from midnight for a FBS test in the AM. Call work since she probably won't have time to look at the charts causing the patient to get breakfast. I am not the only nurse who calls in the middle of the night with this kind of stuff. There is way too much info to keep track up and no time to stop and review and take stock. At least this was relatively minor.
How different would things be if there was at least one other RN on duty with me to cover problems while I was handing over? You should see what it is like when we are one RN to 35. There was another RN on duty on the ward but she was even busier with her 18 patients. I don't know what time she got out. Her patients were on the other end and we didn't really see eachother.
Saturday, November 17, 2007
Friday, November 16, 2007
Thursday, November 15, 2007
A traveling nurse is a registered nurse who contracts for short term nursing assignments in locations that are usually far from home. The assignments are typically 90 days to one year, but arrangements can vary and shorter term assignments are also occasionally available.
Wednesday, November 14, 2007
Tuesday, November 13, 2007
Salary: $NZ50,000 median
Hospital Type: Public Sector
Location: New Zealand
NZ's capital city is looking for experienced ICU nurses. If you have 2 years ICU experience we would love to hear from you. In 2008 the brand new state -of- the- art hospital will be opened, it is 5 minutes from the heart of Wellington, the cafe capital of New Zealand! The lifestyle in NZ is one to be envied by other countries, you are never far from the sea, adventure sports abound we have areas just like Switzerland, great skiing yet we also have long sandy pristine beaches with long warm summers.
RN1 NMC Registered Post grad ICU course very desirable
2 years ICU experience
pls email: email@example.com
Monday, November 12, 2007
Sunday, November 11, 2007
Saturday, November 10, 2007
Friday, November 9, 2007
Thursday, November 8, 2007
1. Advance nursing research
2. Promote dissemination and utilization of research findings
3. Facilitate the career development of nurses and nursing students as researchers
4. Enhance communication among members
5. Promote the image of nursing as a scientific discipline
Visit the website.
Wednesday, November 7, 2007
Check out these "picks" from recent articles dealing with nursing research or evidence based nursing.
1. Wilhelmsson S. Lindberg M. Prevention and health promotion and evidence-based fields of nursing -- a literature review. International Journal of Nursing Practice. 2007 Aug; 13(4): 254-65. (27 ref) Burlew has some online access, no print issues. AN: 2009640528 NLM Unique Identifier: 17640247.
NLM Serial ID Number9613615
2. Matchim Y. Armer JM. Measuring the psychological impact of mindfulness meditation on health among patients with cancer: a literature review. Oncology Nursing Forum. 2007 Sep; 34(5): 1059-66. (41 ref) Burlew carries this journal AN: 2009667780 NLM Unique Identifier: 17878133.
NLM Serial ID Number7809033
3. Rawson KM. Newburn-Cook CV. The use of low-dose warfarin as prophylaxis for central venous catheter thrombosis in patients with cancer: a meta-analysis. Oncology Nursing Forum. 2007 Sep; 34(5): 1037-43. (30 ref) Burlew carries this journal AN: 2009667778 NLM Unique Identifier: 17878131.
NLM Serial ID Number7809033
4. Jansen CE. Miaskowski CA. Dodd MJ. Dowling GA. A meta-analysis of the sensitivity of various neuropsychological tests used to detect chemotherapy-induced cognitive impairment in patients with breast cancer. Oncology Nursing Forum. 2007 Sep; 34(5): 997-1005. (35 ref) Burlew carries this journal AN: 2009667775 NLM Unique Identifier: 17878128.
NLM Serial ID Number7809033
5. Delgado-Passler P. McCaffrey R. The influences of postdischarge management by nurse practitioners on hospital readmission for heart failure. Journal of the American Academy of Nurse Practitioners. 2006 Apr; 18(4): 154-60. (17 ref) AN: 2009153576 NLM Unique Identifier: 16573728.
NLM Serial ID Number8916634
6. Mickle J. Reinke D. A review of anemia management in the oncology setting: a focus on implementing standing orders. Clinical Journal of Oncology Nursing. 2007 Aug; 11(4): 534-9, 590-4. (19 ref) Burlew has some years. AN: 2009646490 NLM Unique Identifier: 17723966.
NLM Serial ID Number9705336
7. Moore SM. Duffy E. Maintaining vigilance to promote best outcomes for hospitalized elders. Critical Care Nursing Clinics of North America. 2007 Sep; 19(3): 313-9. (40 ref) Burlew carries this journal AN: 2009660369 NLM Unique Identifier: 17697952.
NLM Serial ID Number8912620
8. Kelly T. Howie L. Working with stories in nursing research: Procedures used in narrative analysis. International Journal of Mental Health Nursing. 2007 Apr; 16(2): 136-44. (37 ref) AN: 2009544947 NLM Unique Identifier: 17348965.
NLM Serial ID Number101140527
9. Closs SJ. Postoperative ibuprofen increased bleeding complications in hospital and did not improve pain or physical function at 6-12 months after total hip replacement. Evidence-Based Nursing. 2007 Apr; 10(2): 57. (5 ref) Burlew has some online access, no print issues. AN: 2009552902 NLM Unique Identifier: 17384109.
NLM Serial ID Number9815947
10. Stone C. Rowles CJ. Nursing students can help support evidence-based practice on clinical nursing units. Journal of Nursing Management. 2007 Apr; 15(3): 367-70. (13 ref) Burlew has some online access, no print issues. AN: 2009546843 NLM Unique Identifier: 17359437.
NLM Serial ID Number9306050
11. Garbett R. Hardy S. Manley K. Titchen A. McCormack B. Developing a qualitative approach to 360-degree feedback to aid understanding and development of clinical expertise. Journal of Nursing Management. 2007 Apr; 15(3): 342-7. (23 ref) Burlew has some online access, no print issues. AN: 2009546840 NLM Unique Identifier: 17359434.
NLM Serial ID Number9306050
12. Jansen J. van Weert J. van Dulmen S. Heeren T. Bensing J. Patient education about treatment in cancer care: an overview of the literature on older patients' needs. Cancer Nursing. 2007 Jul-Aug; 30(4): 251-60. (35 ref) Burlew carries this journal AN: 2009646256 NLM Unique Identifier: 17666973.
NLM Serial ID Number7805358
13. Dunne M. Kelvin J. Derby S. Montefusco M. Cawley K. Lucas J. Gilman J. Bringing the evidence to practice: development of guidelines for mucositis prevention and management in patients receiving cancer therapies. Oncology Nursing Forum. 2006 Mar; 33(2): 396-7. Burlew carries this journal AN: 2009169830.
NLM Serial ID Number7809033
14. Baldwin KM. A case for using evidence-based assessment scales. American Journal of Critical Care. 2007 Jul; 16(4): 394-5. (10 ref) Burlew carries this journal AN: 2009616894 NLM Unique Identifier: 17595372.
NLM Serial ID Number9211547
15. Labeau S. Vandijck DM. Claes B. van Aken P. Blot SI. Critical care nurses' knowledge of evidence-based guidelines for preventing ventilator-associated pneumonia: an evaluation questionnaire. American Journal of Critical Care. 2007 Jul; 16(4): 371-7. (32 ref) Burlew carries this journal AN: 2009637067 NLM Unique Identifier: 17595369.
NLM Serial ID Number
16. James V. Clark JM. Focus. Benchmarking research development in nursing: Curran's competitive advantage as a framework for excellence. Journal of Research in Nursing. 2007; 12(3): 269-87. (34 ref) AN: 2009645900.
NLM Serial ID Number101234311
17. Woodward V. Webb C. Prowse M. Focus. The perceptions and experiences of nurses undertaking research in the clinical setting. Journal of Research in Nursing. 2007; 12(3): 227-44. (67 ref) AN: 2009645892.
NLM Serial ID Number101234311
Tuesday, November 6, 2007
Monday, November 5, 2007
I purchased the Kaplan Online Complete package for far too much money. The online course was soooo boring, but had some nice ideas and flowcharts and such. The online question bank was the best investment in the package, however. Answering several hundred questions really got my brain into NCLEX mode. I highly recommend the Qbank, but can take or leave the rest of the course.
My classmates went to the Hurst Review. I flipped through their book and listened to their stories after the course was over. Apparently it was hilarious and awesome and useful because the crazy jokes and anecdotes caused all the review points to stick well in your mind. The book was much simpler and digestible than my own Kaplan book, but it lacked the review questions I found so useful. So I recommend the Hurst Review as well, though only if you're able to attend a live class.
On the whole, I recommend you do any review course, period. They help refresh your brain, and statistically those candidates do better. Which kind you pick really depends on your style.
I arrived early to the small testing facility. I opened the door to find a gentlemen seated attentively and upright behind a desk. He stared at me as I entered and sat. After I'd arranged myself in the chair, he asked if he could help me. Yes, I explained, I'm taking NCLEX.
"Your authorization to test, please. Thank you. Please take this paper and read it. Let me know when you have finished." He was a very formal guy, whose tone was as crisp as his pristinely ironed shirt. I sat and read the paper. When I came back I had to give him my ID, sign my name, let him scan my finger 5 times, get my photo taken, sign my name again, lock up my things, on and on and on. Finally he gathered my papers, scanned my finger one last time, and walked with me two steps into the hallway.
There was a woman seated in the monitoring station, watching the test takers. Though calling it a monitoring station is a kind of visual understatement. It might be better described as a space pod, since it's sphere of glass looked down upon so many screens I felt certain that touching one of them would surely cause the entire thing to blast off.
She took my ID as well, scanned my fingerprint, activated my test in the computer, and escorted me inside to my terminal. I noted that I was seated at computer #7, and hoped it was a lucky omen.
There were a tiny pair of earplugs before the monitor that I didn't use. I started clicking at the tutorial pretest questions and reading yet more rules and warnings. When the test finally began, it looked exactly like the review books describe them. I didn't feel nervous at that time. I felt like I had a really good chance.
Every time I answered a question and clicked "Next", I checked the counter at the corner of the screen. I've heard people say that they were never more terrified than when the cutoff screen popped up and ended the test. I was actually the opposite. I was terrified when I hit Next on question 75, because if it didn't cut off then that would mean that I still hadn't passed. At least I'd know it was over if it cut off at 75. If I had to keep answering questions after that, I would have been terrified.
Thankfully, it did cut off at 75. They scanned my fingerprint again when I left. As I understand it, they scan your fingerprint if you so much as get up to go pee. I was glad to be out of there.
I didn't check exactly 48 hours later. I spent the day working, then spent the evening at a friend's house soothing his grief over his recent breakup. So when I finally got around to checking the site in the middle of the night, I was somewhat disgruntled when I was greeted with only a few lines of text saying my name, number, and the word PASS.
I blinked heavily. Where were the trumpets??? At the very least couldn't they have included an animated gif? Or perhaps the word "Congratulations"? Make no mistake, I was thrilled. But it seemed almost an anticlimax to these years of struggling and studying. I printed out a screenshot to keep with my other school momentos. And then I went to bed, and didn't dream at all.
I'm now a full time RN in a Cardiac Care Unit, and almost finished with orientation. And I have to say, I love it. I absolutely love it. While I found my experiences as a nurse tech extremely beneficial while in college, I cannot tell you how physically demanding it could be on me sometimes. This job is so much better, and I don't feel like a zombie all the time from having to balance work and school.
CCU is all about bypass patients and other thoracic surgeries, though we get other intensive care patients from time to time. I've been learning so much every day, and feel like I'm almost ready to do the job all by myself. I hope to work back here for a year or more, then perhaps for a while in the ER too before I eventually go back to grad school. What do I want to be? Probably an NP, though I'm not sure yet! I have lots of time to think.
This is my last entry, and I will not be posting in this blog anymore. I have to concentrate on my career and starting my new life. I considered writing another blog for a while called "I Am No Longer a Nursing Student"... but realized how silly that statement is. I will always be a student. I feel like I'm growing and learning all the time.
Studying nursing has been good for me in so many ways. Certain parts of my personality were already predisposed to this kind of work, but other parts of me were not at all suited to the task. For example, when I began clinicals I was a very shy person. That might not have come out in my posts so much, but I had a hard time talking to new people. As little as 6 months ago I still had a phobia about calling people on the phone. But by working as a tech and working with my classmates, I've grown past those anxieties and gained a measure of self-confidence. The changes were subtle and slow, but when I look back, I'm amazed at how far I've come.
I think that finding a path in life that both complements and challenges you is precious. I think that, in this culture full of disillusionment, I was lucky that college "worked" for me. It actually helped me in the classical sense by shaping my identity and strengthening my character. Of course, it was tedious and taxing. And in the years before I transferred and changed majors, it was downright depressing. But here I am now, with a degree on my wall and initials after my name. After all of it... after everything... I made it.
You can make it too. Hang in there. <3
Thanks for reading.
Sunday, November 4, 2007
Saturday, November 3, 2007
Friday, November 2, 2007
Yesterday was a lot of fun. I took a day off work and traveled with my oldest son and two 5th Grade classes to the Little Grand Canyon on a geology field trip. Don't worry. I didn't make him sit with me on the way up. I really don't think he would have minded, but I remember when I was that age what it was like to have a parent chaperone school activities.
I rode on the bus on the way up because one of the kids has juvenile onset diabetes and another severe ADD. The child with diabetes had to have a specific low calorie meal and diet drinks and had to check his blood sugar periodically. The child with ADD needed medication. Nothing a concerned mom could not handle but the school wanted someone with medical training. I also brought along inhalers and epi pens just in case. We didn't need them.
The Canyon was beautiful. There were a ton of dogwoods, chestnut oaks, hickory, wax myrtle and magnolia trees. Their leaves were turning red with the change of seasons and the acorns on the chestnut oaks were huge. The soil was a combination of red Georgia clay, sand and lava rock. I still don't know where the lava rock came from as Georgia is not really known for its volcanic activity.
One of the kids found a perfectly intact arrowhead made out of Kaolin (I think that is how it is spelled) which is the main ingredient in Kaopectate and cat litter. I wonder if the Native Americans of yesteryear knew about its medicinal properties. They probably did. In any case, the State Park would not let the kid take the arrowhead out of the park. Instead, they took a picture of the kid holding the arrowhead and they are going to mount the arrowhead on a plaque with his picture and put it on the wall at the visitors center. The arrowhead was apparently a rare find given the park ranger's reaction to it.
Well, it is back to work today. My shift starts at 2:00 p.m.
1. The Précis Blog Précis starts with the idea that any good paper can be summarised in one sentence. That sentence may sometimes be complex, and should normally leave you wanting to know more, but it will contain the core of what the paper is about. This is, by its nature, idiosyncratic, and hopefully sometimes controversial. The blog focuses on the online first part of ADC:
2. The Archimedes Blog You'll be familiar with Archimedes, the bimonthly section of evidence-based questions and answers, and with the Archimedes blog you: Get to see the questions as they are being asked, and can comment on the answer you expect to see. Can argue about the interpretation of evidence from the published topic report. Can add new information to older reports. There are also teaching tips, bite-sized explanations of EBM concepts and links to other places where the practice of evidence-based child health can be discussed.The bloggers explain why they think this is important in an editorial in the November issue of ADC.
Don't forget to sign up for the Blog RSS feeds so you don't miss anything.
Thursday, November 1, 2007
12 month contracts
free flights at start and end
mid year flight home after 6 months with 10 days leave
over 50 days annual leave
free modern accommodation
end of contract cash bonus
tax free salaries around $60000 Aust a year for Australian or New Zealand trained staff nurses with 2 or more years experience.
higher salaries for senior and management grades
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roles across all areas at the present time
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