OFFICIAL: Health Care Thread. Health Care Crew Unite!

[yowtfisthis]

I studied in total for about 12-15 hours (srs) and even that wasn't enough. I'm starting to think i need to just study/workout/sleep for the next 3 months to even get back on track. Is this how you guys do it? During these last 3 weeks i've been kinda wasting time hanging out w/ friends and playing videogames/misc. I think i need to cut all 3.

Brah just go over the test and figure out if the questions come from just lecture, just the book or a mixture. My chemistry class is STRAIGHT out of the book, so I study that and I'm golden. My AP1 and Micro class both have the test on JUST what we cover in lecture. Make sure you take good notes and pay attention in class. If you have to go, you might as well try to get the most out of it.

Also, when studying for the exams it REALLY helps to find random funny things to help you remember things. Like for remembering the 5 layers of the epidermis, I just remembered "Bishes suck giant luscious cawks". Then today on my exam, it was a question to label them in order and match the characteristics with them. AP is just memorizing man, you just need to know what you need to memorize then spend time doing that. Note cards REALLY helps me. I'll also just start telling my girlfriend things that I need to know. It drives her nuts, but trying to talk/teach the material is a great way to learn it and understand concepts better.


EDIT: ^^^^ For patients, he's right. Walk in and act confident like you're doing your normal routine, even if you have no idea wtf you're doing. Think about it, you wouldn't want somebody coming in nervous as hell to be taking care of you. You except healthcare professionals to be confident and proficient at their job, even though you're still a student. They're people just like us, and let's face it if you are having a nurse take care of you then you're not going to be 100% comfortable regardless of the situation.

Anddddd sometimes you get patients that don't like the idea of students at all and there's not too much you can do about it, just act confident and always be nice. It gets hard to be mean to somebody that has been nothing but extremely nice to you. Just can't ever take things personally and just realize that they might be seeing things from a completely different perspective.

[LongLong89]

You just gotta show em your confident side. If you walk in and you look clueless then they'll start giving you problems. Usually that first impression is vital with these types of pts.

true that, you gotta grab ya balls and go in there and be a boss. You are only there to help and you gotta show them, in a confident and leading way, almost as if you are telling them what to do not asking.

[iBrooklyn]

Brah just go over the test and figure out if the questions come from just lecture, just the book or a mixture. My chemistry class is STRAIGHT out of the book, so I study that and I'm golden. My AP1 and Micro class both have the test on JUST what we cover in lecture. Make sure you take good notes and pay attention in class. If you have to go, you might as well try to get the most out of it.

Also, when studying for the exams it REALLY helps to find random funny things to help you remember things. Like for remembering the 5 layers of the epidermis, I just remembered "Bishes suck giant luscious cawks". Then today on my exam, it was a question to label them in order and match the characteristics with them. AP is just memorizing man, you just need to know what you need to memorize then spend time doing that. Note cards REALLY helps me. I'll also just start telling my girlfriend things that I need to know. It drives her nuts, but trying to talk/teach the material is a great way to learn it and understand concepts better.

Thanks

And omfg yes i did the same thing for the epdermis layers.
Boys Suck Girls Love Cock

I lold so hard. repped

[DrFeeIGood]

any RN brahs in CO, MO, or AL? I'm looking for a few good RNs in these states for contract/consulting work, PM me if interested

[fedekx]

I'm always interested at what other healthcare providers are doing so ell us more (of course while respecting HIPPA lol)!

Well what do you want to know brah? I'm an NREMT-P (which is basically the national, uniform certifying agency ... a few states don't use it like Tennessee and others). Last year I cleared about $80k after taxes, I worked a lot and I work at one of the few agencies where you make a lot of money. I work a night shift, and all our shifts are 12 hours. We do whats called a "2-2-3" schedule, which means you work 2 days, off 2 days, work 3 days (the weekend), then off 2, etc.... you get every other weekend off. Usually run about 10-18 calls in a 12 hr shift, all 911 and no transfers or anything. Where I work is urban in a very large city, so our transport and response times are less than 8 minutes. We transport everything code 2 or 3 to the scene, and to the hospital, regardless of patient condition (ie lights and sirens for everyone). We have semi progressive protocols.

Since this is primarily nurses it appears, I'll give you a run down on the differences between the two. I have a list of preset protocols which set by our medical director (an MD) and are treatment "guidelines" that I'm "encouraged" (pretty much forced) to follow for each patient presentation. I work with just an emt-basic which is basically the equivilant to a CNA in terms of what they can do, so I'm "in charge" of all patient care. You can decide what medications are appropriate to use in a situation, and the decision is all on you. For example, I can decide whether I want to give someone Atropine or go straight to pacing depending on the condition, whereas nurses usually have to run everything by the doctor, and the doctor has to put in orders for x and y before it can get done, or even get accessed in the medication systems in most ERs (i.e. pixis). In terms of airway, we have surgical crics, rescue airways (King LT, and combitube, we have both), and just the standard endotrachael tubes. So we can decide if we want to do an advanced airway, and which one. We have Rapid Sequence Intubation (RSI), and we carry etomidate, versed, succinylcholine (paralytic), and rocuronium (paralytic) - we RSI people who need to be intubated, but have a gag reflex or are conscious but need to be intubated (bad CHF for example). We carry pain medication on our person, we have fentenyl, and morphone for our narcotics, and then we have toradol as our non narcotic pain reliever - we never use it because it doesn't work too well in my opinion. We have regular EKG (4 lead), and 12 lead ekg that we interpret ourselves, and we can transmit it to the receiving facility if it's something important (like a stemi, or just something that makes us say wtf is that).

In tactical medicine (TEMS = Tactical Emergency Medical Support, where you support Special Response Teams, or SWAT teams) it's much more limited to what you can carry in your vest if your in the stack. Usually just a bunch of tourniquets, surgical cric kit, bvm, chest seals, small IV kit with fluids only, decompression needles, and a small amount of bandages ... and maybe some extrication devices if no one else on your team has them (fancy short ropes with hooks on it to hook into other peoples vest to drag them out). Nothing fancy like oxygen, or cardiac monitor unless your in the "warm" zone.


Not sure if I answered your question, I just like explaining what paramedics can do, because most people think were just a taxi cab ride.

If you have any other questions just let me know.

[.:Chris:.]

Wow that was amazing. That was a good read, thanks for sharing man.

[stronguy91]

Well what do you want to know brah? I'm an NREMT-P (which is basically the national, uniform certifying agency ... a few states don't use it like Tennessee and others). Last year I cleared about $80k after taxes, I worked a lot and I work at one of the few agencies where you make a lot of money. I work a night shift, and all our shifts are 12 hours. We do whats called a "2-2-3" schedule, which means you work 2 days, off 2 days, work 3 days (the weekend), then off 2, etc.... you get every other weekend off. Usually run about 10-18 calls in a 12 hr shift, all 911 and no transfers or anything. Where I work is urban in a very large city, so our transport and response times are less than 8 minutes. We transport everything code 2 or 3 to the scene, and to the hospital, regardless of patient condition (ie lights and sirens for everyone). We have semi progressive protocols.

Since this is primarily nurses it appears, I'll give you a run down on the differences between the two. I have a list of preset protocols which set by our medical director (an MD) and are treatment "guidelines" that I'm "encouraged" (pretty much forced) to follow for each patient presentation. I work with just an emt-basic which is basically the equivilant to a CNA in terms of what they can do, so I'm "in charge" of all patient care. You can decide what medications are appropriate to use in a situation, and the decision is all on you. For example, I can decide whether I want to give someone Atropine or go straight to pacing depending on the condition, whereas nurses usually have to run everything by the doctor, and the doctor has to put in orders for x and y before it can get done, or even get accessed in the medication systems in most ERs (i.e. pixis). In terms of airway, we have surgical crics, rescue airways (King LT, and combitube, we have both), and just the standard endotrachael tubes. So we can decide if we want to do an advanced airway, and which one. We have Rapid Sequence Intubation (RSI), and we carry etomidate, versed, succinylcholine (paralytic), and rocuronium (paralytic) - we RSI people who need to be intubated, but have a gag reflex or are conscious but need to be intubated (bad CHF for example). We carry pain medication on our person, we have fentenyl, and morphone for our narcotics, and then we have toradol as our non narcotic pain reliever - we never use it because it doesn't work too well in my opinion. We have regular EKG (4 lead), and 12 lead ekg that we interpret ourselves, and we can transmit it to the receiving facility if it's something important (like a stemi, or just something that makes us say wtf is that).

In tactical medicine (TEMS = Tactical Emergency Medical Support, where you support Special Response Teams, or SWAT teams) it's much more limited to what you can carry in your vest if your in the stack. Usually just a bunch of tourniquets, surgical cric kit, bvm, chest seals, small IV kit with fluids only, decompression needles, and a small amount of bandages ... and maybe some extrication devices if no one else on your team has them (fancy short ropes with hooks on it to hook into other peoples vest to drag them out). Nothing fancy like oxygen, or cardiac monitor unless your in the "warm" zone.


Not sure if I answered your question, I just like explaining what paramedics can do, because most people think were just a taxi cab ride.

If you have any other questions just let me know.

cool, i'm looking into the emt basic program at my school and will probably do it next semester...according to some emt's i know there's always jobs out there, can you back this up? heard you can get massive overtime too

[Soullus794]

Lots of good information in this thread. Surgical RN (38hrs) and pretty much Pediatric RN (as i pick up 18-24hrs every week PRN for the last 4 months). Let me know if anyone needs any tips ! Been working for 7 months now

[Rabbitw00t]

Lots of good information in this thread. Surgical RN (38hrs) and pretty much Pediatric RN (as i pick up 18-24hrs every week PRN for the last 4 months). Let me know if anyone needs any tips ! Been working for 7 months now

I respect those that are diverse in patient populations regardless of skill level. You can easily transition into an ER environment where I'm sure you'll have a lot more action and fun.

[Voidofhope]

First year nursing student reporting in. Starting my hospital internship on the 15th. 2 weeks in geriatrics and 1 week in surgery.
The starting salary for a nurse here is something like €1500 a month but I'm not in it for the money at all. Mind blown at how much American nurses apparently make.

Class schedule:
Monday to Friday:
8:15 AM-9:55 AM
10:10 AM-11:50 AM
12:40 PM-2:20 PM
2:35 PM-4:15 PM

(wednesday afternoon off)

[LongLong89]

Question - In hospitals, what happens to the patients "home" meds they are taking? I know most of them are on it during their hospital stay but I am not too sure how the med reconciliation process works. I know there is a list in the system, of all the meds the pt was taking previously at home. So are all "home" meds essentially re-ordered by the physician, depending if he/she wants to change the type,dosage,route etc or if allowed, does the patient just takes them regularly on his own time in the hospital along with the other meds we give out.

What happens if the medication they are taking at home doesn't need to be changed, for example a beta-blocker, is this med listed to be given out by the nurse, or is the pt supposed to continue how he was taking them before?

[Rabbitw00t]

Question - In hospitals, what happens to the patients "home" meds they are taking? I know most of them are on it during their hospital stay but I am not too sure how the med reconciliation process works. I know there is a list in the system, of all the meds the pt was taking previously at home. So are all "home" meds essentially re-ordered by the physician, depending if he/she wants to change the type,dosage,route etc or if allowed, does the patient just takes them regularly on his own time in the hospital along with the other meds we give out.

What happens if the medication they are taking at home doesn't need to be changed, for example a beta-blocker, is this med listed to be given out by the nurse, or is the pt supposed to continue how he was taking them before?

Scenarios vary. If a patient comes in and gives the nurse a list of meds that they take, the nurse would input the medication, confirming / dose/ frequency / last time taken with the patient and chart it. Physicians will look over that medication and reorder / modify what they see fit. If a patient is normally on a beta blocker for htn and they're admitted for sepsis, the beta blocker obviously won't be ordered. If the patient is quite sick, many meds that the patient takes won't be ordered because they are not life saving. There are exceptions of course like seizure medications, ssri's or even glaucoma medication since a decrease in vision as a result of not taking the medication would impact ADL. It's no big deal to administer some drops.

If the patient is well enough, most home meds will generally be incorporated into the medlist. You'll have old patients that take nightly *****...unless contraindicated, you want to get that ***** ordered or you'll have a mean restless granny.

Let's face it, most patients are dumb, but they know well enough to bring the physical medications in. It's funny to see duplicates, with the patient saying "ah yeah, i take both" Herp. Polypharmacy is a problem, especially in the elderly. A connected system where all patients meds can be retrieved by other physicians would be ideal. Anyway, after you chart all the home meds they brought it, we generally gave them back to a close relative to take back home with them...unless there were narcotics. Those were counted and sent down to the pharmacy.

[LongLong89]

If the patient is well enough, most home meds will generally be incorporated into the medlist....Anyway, after you chart all the home meds they brought it, we generally gave them back to a close relative to take back home with them...unless there were narcotics. Those were counted and sent down to the pharmacy.

Okay I see, so for an example i'm going to use recent pt. Guy comes in with diagnosis of paralytic illeus with unrelated hx of htn, cad, s/p avr, afib. He's been taking beta blockers, coumadin, plavix etc...So all these meds he was already taking at home (barring any contraindications) is just incorporated with any new meds that were ordered for his diagnosis and any other problems that developed during the stay...and thus making up the medication task list I see when I log on to system.

And were things can go wrong is where you mentioned im guessing, pts take their own medications as well as the same thing provided by the hospital.

[Rabbitw00t]

Okay I see, so for an example i'm going to use recent pt. Guy comes in with diagnosis of paralytic illeus with unrelated hx of htn, cad, s/p avr, afib. He's been taking beta blockers, coumadin, plavix etc...So all these meds he was already taking at home (barring any contraindications) is just incorporated with any new meds that were ordered for his diagnosis and any other problems that developed during the stay...and thus making up the medication task list I see when I log on to system.

And were things can go wrong is where you mentioned im guessing, pts take their own medications as well as the same thing provided by the hospital.

Patients are not supposed to take any of their home meds in the hospital. All meds they take are from the hospital's pharmacy. Just making that clear. (With the exception of glaucoma medication sometimes) I just let family members drop those in when they usually do it. Technically this is not what you're supposed to do. For clarification, I enter the home into the chart, but, I let the doc know that family will do it and they're often cool w/ it. If for some sneaking suspicion you don't trust them, then go through the whole ordering shabang. It also depends on how long you think they're going to be admitted. Short stays, no big deal. But if they were in a trauma and intubated, you'll have the med ordered to do it on your own. This is something you'll figure out when you're on your own

When a meds are entered an ordered, there may be slight changes to the med. Coumadin is the brand name, whereas warfarin is generic. For the sake of cost, you may see hospitals using generic.

[LongLong89]

...

Yeah you were clear, I prob just phrased it weird, but it makes sense now thanks.

[captain_marvel]

in for later

[Ivan7x]

wtf do u get tested on in labs? not sure wtf im suppose to be studying

[.:Chris:.]

wtf do u get tested on in labs? not sure wtf im suppose to be studying

Lab practicals? Mine you just wrote what the body parts were. Theres models on stations and numbers on the models. Then you gotta know the body part and write it down with the corresponding number. Double check with your professor though just in case your college is different.

[Rabbitw00t]

wtf do u get tested on in labs? not sure wtf im suppose to be studying

...what class? What does it say on the syllabus? If you are graded, it must say something in syllabus. Will it be in a simulation center?

edit: A&P. sometimes it's examining a cadaver.

[Ivan7x]

...what class? What does it say on the syllabus? If you are graded, it must say something in syllabus. Will it be in a simulation center?

edit: A&P. sometimes it's examining a cadaver.

it says units 1-4

Miscroscope
Anatomical Terminology
Cellular Rep. Mitosis
And Tissues

i mean i know most of all that **** but if im gonna be having to identify tissue im fuked

Lab practicals? Mine you just wrote what the body parts were. Theres models on stations and numbers on the models. Then you gotta know the body part and write it down with the corresponding number. Double check with your professor though just in case your college is different.

well the lab exam is tomorrow so cant really ask anymore brah and i skipped monday cause lecture is boring as fuk

[Rabbitw00t]

it says units 1-4

Miscroscope
Anatomical Terminology
Cellular Rep. Mitosis
And Tissues

i mean i know most of all that **** but if im gonna be having to identify tissue im fuked

well the lab exam is tomorrow so cant really ask anymore brah and i skipped monday cause lecture is boring as fuk

Sounds likely you will need to identify specific tissues. Pepper your angus.

[Ivan7x]

Sounds likely you will need to identify specific tissues. Pepper your angus.

welliguessthatsthat.jpg

[carrrlitosWHEY]

PACU here. I studied for most of tests using NCLEX questions. If I didn't know an answer using kaplans desicion tree, I'd review my notes and books.

- Stay thirsty to learn, complacency is never an option.
- Real world nursing is different than NCLEX nursing. Know when to separate the two.
- Listen to experienced nurses rationales for their practices and take what works for you.
- Time management is a big deal.
- Network.

[Rabbitw00t]

PACU here. I studied for most of tests using NCLEX questions. If I didn't know an answer using kaplans desicion tree, I'd review my notes and books.

- Stay thirsty to learn, complacency is never an option.
- Real world nursing is different than NCLEX nursing. Know when to separate the two.
- Listen to experienced nurses rationales for their practices and take what works for you.
- Time management is a big deal.
- Network.

Good synopsis. I wouldn't mind handing my patients off to you

[bbkonmai]

1st semester nursing student here. anyone have recommendations for books, videos, etc...? got a C on my first exam in fundamentals. feelsbadman.

[Rabbitw00t]

1st semester nursing student here. anyone have recommendations for books, videos, etc...? got a C on my first exam in fundamentals. feelsbadman.

Focus on passing your exams with the material they give you. Google search topics you're covering w/ video to get a better understanding.

[yup123]

welliguessthatsthat.jpg

you talking bout epitethelial/squamous/stratified type ****?

[.:Chris:.]

Miscroscope
Anatomical Terminology
Cellular Rep. Mitosis
And Tissues

Just a heads up, we had to label all four of those. You shouldnt get Cell Rep. Mitosis wrong lol..I used IPMAT to remember it. Good luck!

[stronguy91]

it says units 1-4

Miscroscope
Anatomical Terminology
Cellular Rep. Mitosis
And Tissues

i mean i know most of all that **** but if im gonna be having to identify tissue im fuked

well the lab exam is tomorrow so cant really ask anymore brah and i skipped monday cause lecture is boring as fuk

lol the histology practicum was dumb...mine was bones and 20slides of tissues together and the slides fuked my sh*t up...still got a B on it though, next practicum is the muscles and that sh*t is going to be easy as fawk, my angus is peppered

[Ivan7x]

you talking bout epitethelial/squamous/stratified type ****?

yes brah. i can probably identify those (epi,squam,strat.) but not the different kinds of connective tissue FUK THAT ****

Just a heads up, we had to label all four of those. You shouldnt get Cell Rep. Mitosis wrong lol..I used IPMAT to remember it. Good luck!

yea i use P-mat 2 brah

and i know each stage of Interphase 2 g0, g1, s and all that bs ill probably just do a lil bad on the tissues

lol the histology practicum was dumb...mine was bones and 20slides of tissues together and the slides fuked my sh*t up...still got a B on it though, next practicum is the muscles and that sh*t is going to be easy as fawk, my angus is peppered

lulz thats what im saying ill probably get my angus raped if theres slides