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[nurselydia]

Officially graduated from nursing school!!! Final grades are in and I’m already feeling guilty for not logging in to look at assignments/study. woo hoo!!!!! Nclex bound!!! 

[nurselydia]

I graduate nursing school in 3 weeks!!!!!!!!

[nurselydia]

Really late reblog but thank you so much <3 

Studying for the NCLEX blows 😒

[nurselydia]

New nurses, student nurses

I need you to know these things.

This job is hard. It’s hard as a student, learning things most people will never understand. It’s hard as a brand new nurse; no patient or seasoned nurse truly has faith in you.

You want to learn. You want to know things. You want to get to the point in your job where you are comfortable in your skills, the patients trust you, and the doctors start to know your name and believe in your abilities.

It takes time. The first year of nursing will be the hardest year of your life and you will find yourself truly doubting your intelligence and intellect for the first time ever. You will make mistakes, second guess yourself, cry after work, cry during work, cry before work. You will triumph, and you will fail miserably.

But with literally every single moment of every single day, you will learn so much more than you’ve ever learned in your entire life combined. You will learn about human suffering, joy, love, sorrow, insanity, and pain. You will experience moments that will haunt you forever. Moments you will bury down deep inside because the people closest to you could never understand.

Student nurses, stay with it. You aren’t there yet. School is hard. It does get harder. But it also gets better.

I was a student. Nursing school was the hardest thing I had ever done up to that point. I will not downplay that. Ever. It is so hard.

But then I was a new nurse. And it was harder. I experienced things that will haunt me to the grave. I was bullied by patients, doctors, and nurses.

I’m still learning. I’m still a baby nurse. But I’ve got a bit of time and a little experience under my belt now. I’ve been a nurse in the burn ICU, a med-surg nurse, and now a bone marrow transplant/oncology nurse. I’ve dealt with nurse bullies, bully doctors, and abusive patients and families. I’ve seen all kinds of sickness, I’ve welcomed new life, and I’ve held countless hands as their pulses faded away.

I’m here to tell you, student nurses, new nurses, that this job is hard. It is cruel and unforgiving at times.

But it is so worth it. It may get harder, but it will get easier as time goes on. The bonds you form with patients, doctors, and fellow nurses will bring you through it.

You knew it would be difficult when you chose such a selfless profession. This job takes heart. It takes a special kind of person that was meant to heal this harsh world.

Stay with it. It gets so much better. It is rewarding. We are here and we want you to succeed. Forget the nurse bullies, forget the bad. You are a guardian angel and you chose this noble path.

Thank you student nurses, thank you new nurses. I was there, not long ago. If I could go back and do it again, I would in a heartbeat. Because I am right where I want to be.

[nurselydia]

yes ma'am it doo :(

Studying for the NCLEX blows 😒

[nurselydia]

when you study for hours and still can’t answer NCLEX questions

[nurselydia]

Every UWorld question...

Start reading question, where they describe symptoms and I think “I actually know the answer!!”

Then they continue with : *so the patient has X disease*

And I’m like “okay okay, that’s cool… I know what the treatment for this is, so I should be good!”

Then they continue with : “so they treated the patient with X treatment”

And I’m like “Okay… Deep breath…You knew everything from the question up to now, you’ll be okay!”

Then the question is something like : “Which vitamin could have prevented this?” 

[nurselydia]

[nurselydia]

Maybe if I had this kind of study buddy I’d be more motivated :(

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Study buddy

(via)

[nurselydia]

I Can’t Tell Whether My Dark Circles Are From Nursing School Or This Morning’s Mascara: A Memoir.

[nurselydia]

yessss just what I needed 

How to remember the Glasgow Coma Scale index numbers

Eyes = 4

Verbal response = 5

Motor response = 6

…

4 eyes 🤓

Roman numeral for 5 is V (verbal) 🗡

A 6-cylinder motor 🚘

[nurselydia]

Hi, I'm a nursing student about to start a 5 week placement in my hospitals ICU and I'm wondering if you could tell me some things to read/brush up on? I want to be prepared so any help would be greatly appreciated. Thank you :)

Dear Anon,

Ah, the ICU. A lot depends on what type of ICU you’re in, but I’ll try to hit the highlights.

Lab Values - Especially your electrolytes (Mg and K), kidney function (BUN, Cr), and liver function (AST, ALT, bilirubin).

Ventilator Settings - Most common are A/C (assist-control), SIMV (synchronized intermittent-mandatory ventilation), and spontaneous. A/C is the most frequently used setting on my unit. It guarantees a set number of breaths for the patient. For example, the patient’s vent settings may be A/C, rate of 14, Tv 450, PEEP of 5, FiO2 40%. This means the patient is getting a minimum of 14 breaths per minute with a minimum Tidal Volume (Tv) of 450mL, positive end expiratory pressure of 5 (the lowest setting, max is about 18, which isn’t typically a good thing), and fraction (or percentage) of inspired O2. Room air is 21% oxygen, so patient’s on a ventilator can have anywhere from 35% to 100% FiO2 to help improve their PaO2 saturation.

At my facility, the pulmonologist’s personal preference determines the vent settings in most cases. We have one that prefers SIMV and another that prefers AC. In some case, however, one is necessary over the other. For example, generally speaking, if a patient is breathing fast, then they would probably do better on SIMV mode. Conversely, if a patient has weak respiratory muscles or left ventricular dysfunction, they should probably be on AC mode.

ABGs and ROME - While we’re on the topic of ventilators, you’ll come across ABG (arterial blood gasses) values. These include pH, pCO2, pO2, HCO3 (bicarb), and base excess. When in nursing school we learned the ROME acronym to determine if a patient was in respiratory or metabolic acidosis or alkalosis. 

Respiratory = OppositeIf the pH is low (7.45) and the pCO2 is low, then the patient is in respiratory alkalosis.

Metabolic = EqualIf the pH is low and the HCO3 is low, the patient is in metabolic acidosis and should probably get some Sodium Bicarbonate (either an “amp” or a gtt, or both). If the pH is high and the HCO3 is high, it’s called metabolic alkolosis.

EKG Rhythms - All of the patients in your ICU should be on continuous telemetry and Q1H vitals (unless otherwise ordered). This means you’ll see a variety of heart rhythms. You’ll see a lot of Afib, Aflutter, runs of VTach, bigeminy, PVCs, PACs, and everything inbetween. Here’s a good overview of heart rhythms from Duke’s Nursing School. You’ll also want to brush up (or take a crash course) on EKG lead placement.

Common ICU Medications - In the ICU you will see a lot of medications. Patient’s on ventilators will have some type of sedative like Propofol, Precedex, and/or Versed. They may also be on a Fentanyl drip (gtt) for pain control.

Another common medication is Toradol (Ketorolac), but always know the patient’s kidney function lab results before giving Toradol, because while it’s metabolized by the liver, it is excreted by and very hard on the kidneys.

Morphine is another common pain medication you’ll see in the ICU, typically in the IV form. Remember that morphine can cause burning in the veins, so just give the patient a heads up and don’t push it too fast. Also, check the patient’s blood pressure and respiratory rate before giving morphine as it will depress the respiratory system and can drop a patient’s blood pressure.

You’ll also see potassium chloride given a LOT in the ICU. That’s because altered potassium levels (hyper- and hypokalemia) can cause cardiac arrhythmias, so maintaining proper levels is important. At my facility, potassium chloride (KCl) can be given in 10 mEq bags (we call them K-riders) through peripheral IVs. Anything stronger (20 mEq or 40 mEq) needs to go through a central venous catheter (CVC). Refer to your facility’s policy. KCl can burn, so that’s why we limit the concentration in the PIVs.

These are just a few of the topics I would brush up on before you begin your ICU rotation. Obviously there are so many other things I could mention, but I could honestly write a book and no one wants to read that on Tumblr.

One last suggestion: visit https://www.nrsng.com/cheat-sheets/ and download their free cheatsheets. You gotta give up and email address, but they’re worth it. You can also get their app for $9.99 on either Android or iOS. I bought it and I use it all the time. There are 72 cheat sheets in total.

Oh my gosh! I could go on forever about the ICU, but I’ll stop there and hopefully I haven’t overwhelmed you. Make the most of your time there. Learn as much as you can. Ask questions. Do as much as your instructor and preceptor will let you do! Practice your assessments and before you give any medications, know the common side effects and why you are giving it. The worst feeling is when a patient asks you what you are giving them and you don’t know the answer. It was one of the biggest pains of nursing school, but it is a good habit to get into. Eventually, you’ll become so familiar with your medications that you will rarely have to look them up. But, I still come across new meds or rarely given meds that I have to look up.

OK, good luck! And thanks for the question.

Sincerely,Mursenary Gary

[nurselydia]

Hahah...very important.

Fun nursing fact for ya.

Did you know Nitroglycerin lowers blood pressure? Sometimes it’s in creams and what not.

Did you know if you don’t wear gloves you can pass out while applying it? Because a certain classmate of mine DID NOT. (Hint- MEANING THEY PASSED OUT DURING THE PROCEDURE)

-Mommabean

[nurselydia]

I suck at it, but looove it 

Who else sucks at cardiology? 🙋🏼‍♀️ I promise the more you look at these things the easier it gets!

[nurselydia]

Last semester of nursing school online be like 

Or an accurate depiction of nursing school…!