THE NIGHT NURSE

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Aw, nutella93, I’m flattered!  It’s an honor to be followed by you as well.  I shall try my best to continue supplying useful clinical information, my own experiences, and a bit of humor to my fellow new and student nurses. Thanks for reading!

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Thanks very much, iamheretoworship!  Without getting too specific, I’m 23 and studied in the Western New York area.  Thanks again for the love, and thanks for reading :)

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My pleasure, kittenzrule!

Thanks for reading, I hope this blog helps student nurses and new nurses out… I’ve been there, and I’m still making the transition from student to novice.  I know as well as anyone that once in a while you just need a good laugh or a prod in the right direction!

I’m a fledgling critical care nurse in the Surgical ICU.  It’s my first job out of nursing school (I just started in January) and so far I love it!  I’m learning so much and every day is something new and challenging.  What about you?  Any ideas about specialties yet?

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Thanks for the question, gingaaaaa!

My suggestion to you would be to make the most out of this summer.  Call up some hospitals ASAP, tell them you are a student nurse and when your anticipated graduation date is, and ask if there are any opportunities available for you.  Paid or unpaid.  See if you can volunteer somewhere or shadow a nurse, especially if you can find an opportunity in the clinical area you’re interested in.  Or look for a position as a nurse’s aid that you could possibly continue into next semester.  I did a summer externship, and the skills and concepts we were taught reinforced things I’d already learned in school… Externships are valuable because they expose you to the nursing environment, and steer you towards connections and contacts that may benefit you later.  These are things you can certainly accomplish without the official title!

In terms of finding a job, it all depends on where you live.  I live in New York City, and it was hard enough to get anyone to read far enough into my resume to find out I’d even done an externship.  In the end, the thing that got my resume noticed was not my summer externship, but my GPA… and of all things, the format.  When I interviewed with my current nurse manager, she complimented me on the way my resume was put together and barely even asked about my externship.  Meh, c’est la vie.  But job hunting and interviews are another entry entirely, gingaaaaa my friend.

Good luck to you!

There are few words in the English language that adequately express my loathing for writing Nursing Care Plans— at least the ones we had to make in school.  Even the simplest of interventions required peer-reviewed validation.  I’m pretty sure it’s common sense that if someone is dehydrated, you give them water to drink… but you wouldn’t be able to write that down on a care plan without someone doing research on the relationship between dehydration and drinking water in the acute care setting.  Bleh.

That being said, invest in a good care plan book!  I waited one whole semester to get one, and once I did it was like learning how to do long division and then buying a calculator.  When choosing a care plan book, make sure it is up-to-date and evidence based— this way, you can use it as a source for all of the common-sense interventions it dishes out.  As a bonus, a good care plan book will also cite its own sources, pointing you in the direction of additional reading material.

Individualization is the difference between copying a page out of a care plan book word for word and actually doing what is expected of you as an RN or student nurse.  Make sure your goals and interventions are realistic, appropriate, and acceptable to both you and your patient.  Ask your patient what he or she wants to achieve, both in the short term and long after discharge— their answers can be used as direct quotes to form a highly individualized plan of care.

When planning care for your patients, always prioritize.  Actual problems take precedence over risks, and as our friend Maslow reminds us, physiological issues trump emotional needs.

When I first read through the NANDA list of official nursing diagnoses, I was like, “you’ve got to be joking.”  Someone in my class muttered that we were dealing exclusively with “the fluffy stuff,” and that’s certainly what it seemed like to me.  All those arguments defending myself against idiots that asked me why I had to go to school to learn to give sponge baths came crashing down on my head.  But once you start putting your care plans into action, you see that there’s more substance and purpose to it all.  Even the simple act of turning and positioning a patient diligently can prevent a pressure ulcer that could cause infection, then sepsis, then death.  What you do matters— that’s why nursing care plans are so important.  As annoying as they are to write, they supply evidence that the choices we make as nurses, both innovative and derived from common sense, can improve someone’s quality of life.

Thanks for the question, mother-father!

My first suggestion to you, dear Anon, is to be well prepared.  Give yourself at least a week and a half, depending on the amount of material, and DO NOT TRY TO MEMORIZE THE TEXTBOOK.  There are a million ways to study, and one of them works the best for you.  Find it.  My technique was to make a standardized flashcard (diagnosis, risk factors, signs and symptoms, diagnostics, treatment, possible complications, related nursing diagnoses, nursing interventions), print out a few dozen copies of it, and fill one out for each diagnosis or surgery as I read through my notes and books.

My next word of advice is to try to recreate your studying conditions for the test.  Do you wear sweatpants, a t-shirt, and sneakers to the library?  Don’t doll yourself up in tight clothes and heels for the test.  Do you like to study by yourself and avoid crowded places?  Try sitting in the back of the classroom.  Do you like to snack while you study?  If your professor allows, bring something to munch on (but nothing too noisy! ;) ).  Make yourself as comfortable as possible.

During the test, read through each question, and stay calm.  If you have no clue, skip the question and come back to it.  If the material sounds familiar, try to muscle your way through it using critical thinking and memory association (can you remember what the page of your textbook looks like that contains the information?  When did you read it and where were you?  What were you eating at the time?….. it’s weird, but it works for me.  Maybe it will work for you, too.).  If you know the answer without even reading the choices, let yourself be happy about it!  Save up that energy, and call upon it when you have to skip three questions in a row and start to feel nauseous.

My last word of advice is something I say everytime I see people frantically sifting through their notes, asking their neighbors obscure questions two minutes before the test is distributed.  Put it away!!!!  First of all, you are making me nervous.  Second of all, if you have followed my first suggestion to be prepared, these last thirty seconds will make little, if any difference.  Take a deep breath.  Close your eyes.  Relax, and whether or not it’s true, believe you can ace this test!

Good luck, Anon!  I believe in you :)

I’m assuming urinary catheter?

I don’t know how your school works, but for mine, one of our 5-6 teaching assistants (usually an RN from the school’s NP program) would demonstrate a procedure during lab using SimMan.  Then, each of us would have an individual appointment to perform this procedure for a pass or fail.  The problem was, each TA usually had a different method which he or she used to grade us.  The lesson I learned from all the hoopla was not to get caught up in the procedure itself, but just to get the job done safely in whatever way made sense to me.

Practice setting up your sterile field!  If you will be catheterizing SimMan (hopefully they don’t have you catheterizing each other…), this will be the most difficult part of the comp.  If you have an extra kit, practice opening it up, putting on your sterile gloves, setting up while maintaining sterility, and fold everything up again so you can repeat the process.

Once you’ve mastered setting up the sterile field, take a look at all the equipment you have.  What is each item used for?  It’s hard to forget a step in the process if you take a deep breath and realize all the steps are staring you in the face.  Identify them all, and then do them in whatever order you please, as long as you work from most sterile (working on the field: test the balloon, open up your sterile packets of lube and antiseptic) to least sterile (touch the patient: remember to keep one hand sterile once you reach this step!)

***Remember the principles of a sterile field!  Before you even open up the kit, make sure it is in a clean, dry, convenient place— once you open it up, it will be near impossible to move it.  Avoid reaching over the field, turning your back on the field, or placing your hands below the level of the field once you don your sterile gloves. 

A general tip that I have for any comp is to talk your way through it!  I’m a nervous person myself, and describing what I was doing through each part of the process helped my nerves, as well as helped me realize if I was forgetting something.

Hope this helps!  GOOD LUCK!!!

My pleasure, my fellow night-shifter!  Ditto, you have such a cute layout.

No problem at all, childxofxgrace, thanks for the love.  If you ever encounter anything as a new nurse that you’d want to write about and submit here, I think that would be fabulous!

Yup!  I grew up in NY though, so when my parents speak Tagalog to me I usually answer in English.  Hahaha ask away…  I just started my first job as an RN in Surgical ICU, so I’m still learning myself and I still remember a thing or two about the horrors of nursing school.  Good luck with your summer classes!

Thank you, twistedsatisfaction!  I’m a big fan of nursing diagnoses about nursing students.  I’m gonna follow you back, it’ll give me a chance to brush up on my Tagalog ;)

Thanks, sugaryspiced— Nursing is serious business, but that doesn’t mean there’s no room for a couple of laughs here and there!