startingnw

My new life is starting now

Many FIRSTS as a New grad pediatric nurse

Two days later, many firsts, lots of new information, skills and just the beginning of my o crap moments. I first day ever as a home health pediatric LPN, my nursing director meets me at the house, introduces me to the kid and parents. Hands me a binder with plan of care, and random instructions and information…then leaves. After she leaves, the parent asks if I mind if she goes out for breakfast….sure? O btw he will need his meds within the next hours, they are in the drawer and fridge. Bye! Here I am a new grad nurse, 2 semesters of college, 22 individual days of shadowing a nurse in the hospital, all alone with a child who has an artificial airway, feeds from a hole in his stomach and too little to communicate anything to me. I got this right? Wait how do I give meds through a gtube, I watched a video on this in class about 9 months ago, and did it ONCE in the hospital setting. Do I mix them all up, can I do that? Will they interact with anything? Am I going to kill the kid?? Ok I looked up a few things, I got this. Meds are ready,just gotta connect the tubing to the gtube. I can’t get it to stay, im goingto pull the tube out. I really can’t get the tube to connect, the kid is thrashing around,wants to get down, has his blankie in the way of my vision ahhh I need help. Google somemore…alright I got it. Finished the messy task, spilled the water, but hey he got his meds right? I am so proud and excited. I just gave my first medication administration by my self, no teacher over me, no nurse watching me, I just did it!! The first of firsts. After playing and messing with the kid, its time for trach tie changing. Well I’ve been around trachs in the hospital and have helped changed countless trachs and trach ties. I’ve suctioned ONCE before in my entire life, I got this. Well wait, Im used to in the hospital there are two people always incase we need to bag the kiddo or anything happens to the airway. Your telling me I have to do this ALONE, BY MYSELF, for the second time ever, an hour away from any hospital, and good20 minutes away from civilization. I have to mess with this kids airway ALONE? Time goes by, Im very slow, the kid is fantastically patient for me, I only pinch him once, super nervous, but gosh dang it I GOT IT. Another first..my first trach care alone. First day goes great otherwise.
Second day has more firsts than the first day. Second day family asks me for “advice” The last five years as a tech I’ve been asked a lot of questions, I answer them the best of my ability but I ALWAYS finish with ( in the acute care I can say this) “ but be sure to talk to your nurse or doctor about it”. I almost say those words today to my patients family, then I remember I AM THE NURSE. Now its no longer advice, but its PATIENT EDUCATION and its my OBLIGATION as a NURSE. Alright, get through medication administration again , piece of cake this time. Well I notice my kid has a bit of secretions, working a little hard to breathe. Hey I can problem solve, this is easy…lets just hook him up to the pulse ox, double check hes fine. WRONG…his stats are dangerously low. WTH, WTF do I do. Quick call respiratory, grab the nurse and stand by to help as needed ( that’s what I’ve done the last five years of my life) NOPE..megan you are the nurse, you are the respiratory therapist in this position . I have to act, and I have to act fast.Ok I make sure my ambu bag and vent is near by and okay..but I don’t want to use them as ive never EVER initiated vent use. Problem solve and QUICK…oxygen and breathing treatment…( my phone is next to me incase I give up and call 911 and introduce myself as a new grad nurse) After breathing treatment stats go up..but not much, quick suction….alright stats go right back down . More oxygen and some puffs. Alright stats are up…I saved him, he didn’t die….I got this. Yet the entire time this is going on the kid is looking at me “screaming” for help, choking on secretions, I want to call the mom and 911, I need backup I have no idea what im doing. Deff doubting myself. “ O shit this is me, I have to do something NOW” went through my mind a few times during that episode. After all was situated I even thought..” I don’t want to be a nurse, its just too stressful, peoples LIVES directly are in my hands” After it was all done I really just wanted to cry, it was a scary first, a stressful first, but with the fabulous education I received I was able to handle the situation. Here I think..I am the nurse hear me roar. The other first I had was with feeding rates. Again more doubt. I am grateful for nurse friends I can call for advice in times of struggle. Order was for one amount at one rate. Patients having feeding intolerance and mom request I change the rate. BUT WAIT..am I allowed? Will I LOSE my nursing license..Am I GOING AGAINST DOCTORS ORDERS. Nope! I am THE NURSE, I can assess the situation and my kid will be getting the ORDERED AMOUNT. At a SLOWER rate..in the PATIENTS BEST INTEREST. I WILL DOCUMENT reason for CHANGE, and be JUST FINE. Again, I AM THE NURSE , and my judgment is needed to ensure the patient will be okay. Five years of being a tech in the hospitals has given me incredible learning experience, I’ve seen it all, helped with it all, and heard it all. But I have always worked under the nurse and doctor, they have always been a resource for me. They have always covered my butt. Now this new range of responsibilities, obligations and requirements is overwhelming. In the home health setting I am everything I have. I know I am skilled and competent, I need to stop doubting myself, I need to trust my instinct. I am a skilled damn good nurse, and I know I will have many more first, and many more o shit moments, but I will get through them successfully and learn ongoing. I got this ( fake it till you make it right?? ) My one goal will be not to kill anyone…all new grads have that common goal right?

Leave a comment »

Well worth it

I know alot of people are weary about becoming an LPN these days. They are getting phased out, not getting paid well, or whatever else crap you can come up with. I too didn’t want to an LPN program, I thought It wasn’t worth it. Boy was I wrong. I applied and got accepted into Gateway Community College LPN fast track program in Phoenix Arizona. It was a nine month program , with amazing clinical experience in great facilities . They taught us very well and got us very prepared for HESI, and NCLEX. I passed everything with flying colors.I am now eligable to transfer into third block of the RN program and finish fourth block there after. In the time I would of spent waiting on an RN program waiting list at this same college, I can have my RN. I took my NCLEX, and am now a state licensed LPN. I paid out of pocket for my education, book and and all. I am a single mother working two jobs. I got hired as a pediatric home health LPN making in the 90th percent of the national average LPN salary. Pretty darn good! In my first two paychecks I will get back every penny I put into my education.That seems worth it doesnt it? I have worked in the ER and hospitals for a long time, so i have experience, but nonetheless the LPN program has allowed to be secure a well paying job as a LPN, while working towards my RN. I will be an experienced nurse when i get my first RN job. I will know what I am doing, and how I am going to do it.I will be confident, skilled and desired.An LPN is a respected member of the healthcare team and we should remember that when we dress our confidence for the day . I am a success story, I am a single young mother who attained her LPN in 9 months, passed the NCLEX on the first try, secured a job I wanted ( got many calls for jobs I didn’t want) within two months, and will have a very well paying job while I am finishing my RN in 9 more months. Tell me that isn’t worth it…I deff recommend becoming an LPN prior to RN. I am a CNA, with phlebotomy and EKG certification, now I am a new grad LPN and soon will be an RN. Just the first of my life long career path. I want the old me to read this post..the old me who almost went to a 90k private college to avoid a 2 yr waiting list for the RN program. This route is just as fast, financially smart and well worth it.

2 Comments »

Life goes on

We are now in Late July and life has gone on . Two of my classmates did 3rd block in the summer block, and the majority of the rest of them start August 27th for third block in the fall. So if your ready, have your hesi scores utd and ready to go, you can go into third block right after. I will be applying for third block in the spring due to life, and I am okay with that now. I’ve had some legal issues and can’t leave arizona until June of 2015, so I guess I am stuck here now.

In the last month I’ve applied for some LPN jobs, have gotten quite a bit of response back from Skilled nursing facilities, doctor offices, home health and even corrections. I have given careful though to where I want to work, what environment and I’ve decided and taken a job as a home health pediatric nurse. I am sad leaving my emergency room positions right now, but taking a leap of faith that this is where I need to be. The position is with a great pediatric company that I’ve always wanted to work with as an LPN. I am very blessed to have gotten the position I’ve wanted. The pay rate is good as well. I’ve looked up the average LPN rate in the nation, and I will be getting paid in the 90th % , I am satisfied with that.

Honesty time…. I am scared to be a nurse on my own. I am scared to be in charge of the daily life of a two yr old with chronic health issues. What if i get the medication mixed up, what if I don’t do the feeding pump correctly, or if I freak out with the trach/vent. I know I will be fine, I know I am competent to do such, but it still makes me nervous thinking about the responsibility I will be having. I’ve been around vents/trachs/feeding tubes for many years, and have been in life threatening positions with them and have been fine. But I’ve had my nurse close by, a call away…now I am the NURSE. I am the NURSE…….

Leave a comment »

NCLEX PN

I took my NCLEX, and passed. My experience was pretty positive. I had 85 questions, as well as three other people in my class. Our college has a 98% first time NCLEX pass rate which was reassuring. I used the Saunders NCLEX study guide, as well as the study guide I got from our NCLEX live review . I had ZERO medication math, Zero regarding lab values, about 12 SATA, two drag to order, zero diagrams, and a ton , ton of education and delegation..assigning to UAP. My appointment was a 2pm, I got in at 1pm after they scanned my fingerprints/palms. And I was out and walking out by 2.07pm. I checked the “trick” to try to resign up for the exam, and it told me I couldn’t due to recently signing up for it. I woke up the next day, and by 8:04 AM my license was up on the AZ BON website , and stated I had passed my NCLEX PN. Super easy, don’t freak yourself out about it. I didn’t start studying until four days prior, and the day of I just read over the 33 page study guide I previously posted the link for. Dress comfy, I came in a sweatshirt and jeans. It got to be a little toasty after, but when I am nervous I get cold so it was okay. The morning of the test I went to the movies with my son and our friends, then I went to dunkin donuts , had tea and donuts before heading to the testing center. Our testing center let me in right away even an hour before my appointment. I put my purse in a locker, and my cell phone in a locked bag which also went into the locker. After the fingerprints/palm prints I went to another desk that was right outside the actual computer lab we used. There she rechecked my palm prints, checked my wrists/arms/pockets for any cheating material. She gave me a white board with a marker, and ear plugs . Explained the rules, and emphasized for me to raise my hand when i needed anything. Then i got to the computer and she signed me on. I did a practice thing that was like 8 questions long, then my test started.There were headphones that i placed on top of my earbuds to help me focus. As stated above i had no lab values, no electrolyte questions, no medication math , no heart/lung sounds or anything else that they really drilled into us in nursing school. I thought it was okay, just don’t stress over it, stay busy to keep your mind off it. If you’ve gotten to the point of taking the NCLEX (Passing nursing school), then you will be successful . You got this!!

Leave a comment »

Results are in…

I passed my NCLEX!!!!

 

Last day of school was May 9th.

Applied to the state May 6th

My fingerprints came back 13th of May

 I got my ATT ( authorization to test ) on May 27th

Took my NCLEX June 5th at 1pm. My test shut off at 85 questions, forty five minutes after I started.

June 6th 8:15am the State board of nursing stated i passed my NCLEX .

Leave a comment »

A good NCLEX review/study guide

http://allnurses.com/attachment.php?…7&d=1310076980 

This is 35 pages of review. Print off, and read in your spare time, I truly find it beneficial. I haven’t taken my NCLEX yet, but have used it to pass my HESI, and practice exams.

3 Comments »

Block Two Clnicals

My block two clinicals were phenomenal . We did 8 weeks at a local hospital for twelve hours, once a week . We were able to do everything except for blood products, PICC lines, and push meds directly through the IV. We were able to start IVS, do blood draws, do EKG, give meds, trach care, central line dressing changes, dressing changes in general, catheters, NG tubes, and everything else nurses do. My class mates were broken up, two to each section. We went to various places such L&D, NICU, PICU, the burn Center, surgery, the ER, regular med/surg floor, oncology, ICU, and gosh Just about it all. My day in surgery was in the Burn OR with the burn center patients . Out of the entire LPN nursing school going to the burn OR was the first time I saw something new, and something I was just amazed by. In my entire medical career I have never been inside the OR while an active surgery was going on, so it deff was super interesting to see and be there for. It was interesting to see how they prep the patient,and how the multiple medical teams are there such as respiratory,anesthesia, the attending, students, nurses, and regular docs. They had pandora going, and the mood was very relaxed and I thoroughly enjoyed it.Besides all the medical floors and stuff the only other thing I found kind of interesting was going to endoscopy for the day. I started IVS all day, and watched a few endo procedures such as colonoscopies and endoscopies. Four our LPN program we had to have a minimum of five successful IV starts to pass the course. In endoscopy alone I got my minimum and plenty more.

As stated above the rules for block two were we couldn’t do any blood products, chemo, push IV meds directly, or  mess with PICC lines. We also had to have our instructor with us for the first time we did ANYTHING, and once she was comfortable with us being independent we were able to do stuff at the discretion of the nurse we were following.We are not allowed per the state board of nursing to give push IV meds. That means we can’t give meds directly into the IV such as morphine or zofran. We can hang meds that are premixed from pharmacy , fluids and such, just no IV push meds. The best experience I had was with a nurse who let me do everything the entire day from start to finish and she was there to verbally guide me and reassure me. I really enjoyed that. That specific day was on medical oncology unit, and was just fantastic to do what a nurse does the entire day.  The bad day was when I had a nurse who didn’t want to be bothered by a nursing student and didn’t let me do too much stuff.If we do something without letting our instructor know the first time..we can get in serious trouble with the potential to get kicked out of the program.

We did a few days in the women, infant services section. I was in post par tum /couplet care. My classmates went to NICU, L&D as well as post par tum as well. A few saw some  deliveries and cool stuff. The two highlights of my L&D was going around with the lactation consultant and learning her tricks, and seeing how she helps the women and babies establish positive breastfeeding routines. The other highlight was shadowing a pediatrician doing his rounds on the newborns and what to look for in words of anomalies. He told me some tricks and good advice as i continue my way into the pediatric nursing world.

From block one to two the only differences of our allowed compentencies was Phlebotomy, IV , trach and central lines. Block one of course was slower and we didn’t get opportunity for much simply because we were in a long term care facility and the skills just weren’t there. Block two I had a clinical instructor from HELL, who made my entire time at the hospital HELL, and made my life HELL,. I cried driving home after her, and wanted to quite nursing school at gateway because of her. She was a rude, spiteful, God forsaken fucking  bitch . Besides her I really loved my second block clinicals and the experiences I got to participate in. I learned more in block two than i did in block one, and retained so much due to the clinical experiences.

Leave a comment »

Finishing up

Second week of May, one week post last day of class. We had our pinning ceremony last Friday, and it was very nice. It incorporated the entire nursing class of RN’s and LPNs. This week we had two (8 ) hour days of live NCLEX review. The school pays for us to attend this class, its not mandatory but its helpful. We received NCLEX PN review books that will be a good study guide to help us. I know three students in our class got offered and accepted summer third block RN spots, a they start next week. I am hoping to get in , in the fall. So far noone has gotten the ATT letter or email from Pearson. That is the Authorization To Test email/letter is sent from pearson and gives us a code and dates to test for the NCLEX.

I turned my application to the state board of nursing On Tuesday May 6th, and today the 13th I come up  on the state board website (online verfication ) It also states my fingerprints are on file as of today May 13th. So now all I am waiting on for complete Arizona state board of licensure is to pass the actual NCLEX. I do plan on taking the NCLEX asap, as soon as I get my letter to test, I will be signing up and taking the exam. Its very exciting to look up LPN jobs and the future opportunities for us. God willing this time next year I will be looking up RN jobs. Again I stress that the LPN program has been wonderful, besides block two’s issues with my horrible clinical instructor, I have loved the program and learned so much . I am confident to take my NCLEX, and confident to become a prudent and capable nurse.  

Leave a comment »

HESI EXIT PN

28351573901142120326HJuEnMc

I just finished my HESI PN exit. It was definately not as bad as I thought, and I passed pretty well.The exam is off the evolve website, the teacher will give you instructions to log on. We were all in a computer room, and were allowed to bring a drink . I also recommend bringing your own headphones as there are questions you will need it to hear the question, and will have to use a random pair the school provides…and who knows what was in your classmates ears prior. The exam itself is 110 questions and you are given two hours and 45 minutes to complete it. Upon completion it will give you your score overall and it will then allow you to review your rationales. I finished the exam in 40 minutes, with plenty of time to spare. Most of my classmates that i know of did well, and I can only hope everyone did well. Today we were allowed to turn in our block three applications for advanced placement into the RN block three program.We should know in the next few days who is getting in and such. It is said that the HESI exit is a predictor for the NCELX. If you can score an 850 or higher on the HESI you should be able to pass the NCLEX the first time. I used multiple various NCLEX review books to study..and that is what I will use to study for the NCLEX as well.

>950 – OUTSTANDING probability of passing
900-940 – EXCELLENT probability of passing
850-899 – AVERAGE probability of passing
800-849 – BELOW AVERAGE probability of passing
750-799 – Additional preparation needed
700-749 – Serious preparation needed
650-699 – Grave danger of failing
<649 – Poor performance expected.

Leave a comment »

Week 15

We are in week 15 of the second block. We did exam 8 on Tuesday, and this thursday will be an online day. It wasn’t suppose to be an online day but due to the teacher having some home issues we are doing it online. We started our short stent on Pediatrics this Tuesday. Pediatrics is my favorite , my passion. We have an exam next Thursday, then the HESI exit next week, and the final exam the week after. I look forward to being done! The HESI exit is on the fifth and they will be taking our application for advance placement at that time and hopefully placing us within the month. I am super excited. I won’t be turning my application in at that time due to some life issues, But nonetheless they are taking our apps and hopefully placing my class mates that will be going into third block in the fall. The next stage of our journey. As I’ve stated in earlier posts, the school pays for us to attend a NCLEX live review for two days, and we just got the dates for that finally. May 12 and May 13th from 9am to 4pm and it will help us pass the NCLEX. They have a 99.78 pass rate and money back guarantee. Even though we wont be paying for it , but still that shows how confident they are in their work. Ill be taking my NCLEX in June and I will be PASSING THE FIRST TIME. So far we haven’t lost any more of our day cohort students. Total we have lost 7, six the first round and one the second block. 

Leave a comment »