whew almost done!

Enough ranting about MyNursingLab.  I have decided that the topic now bores me.  It's obvious that whoever created it has no desire to fix whatever is broken. They only want to make the new version and charge people even more money for garbage.   Unless students wise up and do anything about it, they will simply have to consent to their money being taken by people who provide sub-standard quality.  If that's the way the students want it, that's how it's going to stay.

On to better things... today marks the last Performance Checklist in my Nursing Assessment Class.
It is a LONG checklist, but it's good to know that by tonight I will be free to just study for the final which is a month away.

For those interested in the checklists that we use in the head to toe assessment, I've provided links below. Ask me for stuff if you are interested.

I would post my video here, but for purposes of maintaining confidentiality, I will only provide it to students who want to see it.  A password will be required to view the video and I will only post it temporarily.

I did manage to find some good websites and youtube videos about nursing assessments: I will provide links here in the near future (translation: maybe next week or so).

So far, this has been an overall positive experience, occasionally, I have enjoyed it, except for the griping about MyNursingLab.  I might even have to consider taking a real pharmacology class because now I am really confused with this darn Adams book.  And to think that I expected and really wanted it to be a good experience, it has left a bad taste in my mouth.  I love pharmacology and really enjoy learning about drugs and their effects on physiology, since after all, I am a physio major and immensely enjoyed physiology.  If I had the money and didn't have to earn a living, I would get my PhD in Physiology except you can't make $$ on that these days unless you have published a zillion papers and become someone's research slave for about 6-10 yrs.    If money were no object, that's what I would do, but then reality kicks in... I want my kids to go to college, be high achievers in high school and also be responsible, caring and thoughtful individuals, so it is no longer about what I want.

I would give anything to be able to also stay home w/ the kids and teach them things and devote a lot of time to developing their science knowledge, encouraging math skills and also encouraging reading.  I try to do what I can, and have to rely on school to do the rest.  Once again, if money were no object -- I'd spend most of my life doing just that.

The distance learning program at Indiana State University is not as good as actually attending classes, but given my situation, it is a darn good program that I think has the potential to help many LVNs get their BSN degrees.  In so many ways, I am thankful to have found this program.  I hope I will be able to finish the 11 classes that I need to finish.

My Nursing Lab - the saga continues

I received an email last week from My Nursing Lab. I just about fell over in my chair when I read the email. They addressed me as "Professor", and asked if I would be interested in reviewing the next version of My Nursing Lab.

Is this a joke? I thought...I was even madder than I could ever imagine myself to be.  The only thing I had done was try to contact them several times through the feedback link of their website, and now suddenly I am a professor?  LOL

Anyway, I responded that I was not a professor -- just a student who had access to more than one textbook, hence being able to pinpoint which part of their textbook & accompanying software was incorrect.  It certainly wasn't that hard.

Then it turned into a business proposition -- except I could not accept the offer because no way was I going to spend time looking at that stuff when I know that it makes me sooooo mad to think that they would be selling a product that had more errors than swiss cheese has holes.

HA!

Oh well -- I pointed out their errors, told them to go fix it and not be in such a rush to charge money next time.  We'll see if they listen...

oh joy

More chapters to deal with in this Pharmacology for Nurses 2nd edition book by Adams, Holland and Bostwick.   If this is truly the quality of the textbooks these days, heaven help us all. No wonder health care is in such disarray.

I read another article, which is even scarier -- it talks about all the flawed statistics that scientists use.  Mind you, the method that ALL of the so-called "Evidence-Based" medicine appears to be banking on is based on hypothesis testing.

What if all the stuff that is being propagated as "good medicine" is all wrong.

???more mind-boggling stuff from Pearson/Prentice Hall...

You be the judge...here's another classic faux pas from Pearson/My Nursing Lab

I don't know about you, but if I had Alzheimer's, I would definitely NOT want improvement in my memory loss....  I woud only want improvement in my memory, but not my memory loss.    I would like for my memory loss to stay lost...

Chap 20 page 270 says:

"Donepezil and memantine are approved for the treatment of progressive AD and are marketed under the brand name Aricept."

Uh....sorry, but Aricept is made by Eisai, marketed by Pfizer.  Memantine is made by Forest Pharmaceuticals.  But only in the world of Pearson and Prentice Hall is there a combination drug of these 2, marketed under the trade name Aricept, and I bet they will improve your memory loss. 

Good grief -- this next one has 3 typos in the same question:

The best part was reading "I should not take this drug if YOU have liver disease"....! 

And yet another:

I suppose nobody could decide about the ibuprofen.

DKBP96ERPQEK

MyNursingLab rant

Over the past few weeks, I have been using the book Pharmacology for Nurses, 2nd edition by Adams, Holland & Bostwick.  For $117, this book comes w/ a subscription to a website called My Nursing Lab.

By itself, the subscription to My Nursing Lab costs $75. 



I ran into a problem w/ My Nursing Lab one of the first few times that I used it.  Over time, as I have used it more and more, I have found errors in the pretest and post-test questions.  Mind you, this pre-test and post-test are supposed to be tools to measure your progress.  In theory, you take a pre-test that tells you which parts of the book or which sections you need to review or work on.  Then, you take a post-test which hopefully shows that you learned something. 



Except -- if you find a bunch of errors...you just learn that the thing is not worth the $75 out of the $117 that you paid for it.



OK, so maybe I'm a little harsh -- everybody makes mistakes... everybody has those days (as Hannah Montana says!).   But gee -- if I find a problem w/ several chapters, I think I have a right to be a tad annoyed.  Can you imagine reading a Harry Potter book and finding out that they omitted one of every 5 pages?   How about watching a movie and finding out that they forgot to put the ending in?  Or better yet -- how about getting a house built and finding out that the pipes are missing? How about a teacher teaching you chapter 5 and giving an exam on Chapter 6?  Does that still fall under "everybody makes mistakes"?  How about the DMV failing you on a driving test because they had the wrong answer key? Mistakes? Hmmmmm.

OK, so you be the judge - I am posting the errors for all to see.

Chapter 5 had this as an exercise.  Check out the 3rd question in the series:

??? How did we get 24 as the correct answer?  The correct answer is 18.0 (3 half lives) but the system marks that answer as wrong and it lists the correct answer as 24.0 hrs.    Mindboggling, I know.



And that's not it .  Below is another moment of brilliance. The question isn't even all there. (Saliva isn't an effect, last time I checked!)

And it goes on...

Yet another is error below.  You will see that even though the thing marked my answer incorrectly, the Rationale is exactly the same as my answer and anyone w/ half a brain knows that none of the other anwers make sense.

I know there are more. But these are the ones I've found and so far I am already too mad to worry about the others. I didn't even bother to review anything else.

I want my money back. I really do.
I hope nobody else has to endure this kind of silliness. For $75 they should invest in a proofreader.

Neuro

Soooo tedious. How am I going to get all of this in my head?

Seriously, I must not have been paying attention in class because even though I majored in Neurobiology, I don't remember the abdominal reflex?

Ugh. I can trace neural pathways but never heard of abdominal reflex ? I suck!

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Neuro & Cardio assessments

OK, so I went and watched a bunch of videos on how to do neuro assessments.  I get it (sort of).
Of course, testing the 12 cranial nerves are quite simple. It's the reflexes that I'm not so sure about.  Nevertheless, with my trusty Buck hammer and reflex hammer that came w/ my stethoscope -- I should be all set.  Sort of.

On Old Olympus Towering Tops a Finn and German Viewed Some Hops
Those are the 12 cranial nerves.

I   olfactory
II optic
III oculomotor
IV trochlear
V trigeminal
VI abducens
VII facial
VIII auditory
IX glossopharyngeal
X vagus
XI spinal accessory
XII hypoglossal

How to test them?  I dunno. Haven't read the book yet -- just watched the videos.  Stay tuned.
Neuro Assessment Video 1

Neuro Assessment Video 2

Starting to feel better about this program -- after last night's major coup, I am feeling kinda good about this.

Cardiac assessments
Clear as mud. I must admit that a regular S1 sound and a split S1 sound and an abnormal S1 split sound all sound kinda alike.  I'm not sure I could actually picked the right one if you mixed it up.  Sad part is -- I actually am interested in this topic so I hope I can be good at it.

Total bum

I wasted an entire evening. I could have read something but I am so burned out from homework and picking on the typos in MyNursingLab.



Gotta work on the careplan AND the test. :(


Post-test update:  98 out of 100 possible points.
:)



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Care plan

My first official care plan is currently about halfway through. The bad part is that it cost me $60 for the darn book. I didn't think I needed one but the care plan needed to have references. And so, in my rush to get things done, I bought a book so I could say I used one and cite references from it. In reality, 3 pages out of a few hundred. I should really just borrow a book from the library, but I just wanted to get this over with right now.

I need to identify 2 nursing diagnoses and a bunch of interventions. The truth is, it's not a hard assignment. It's just darn expensive and tedious. You would think that for $60 it would write itself.

Another thing-- It says in the requirements that the student has to provide an assessment as to whether or not the outcomes were met. Here's the actual text:


VII. Evaluation
1. Include the date of the evaluation.
2. Make an entry discussing where the client is at this time in relation to EACH desired outcome.
3. Then, identify if the goal has been:
MET
NOT MET
Or
PARTIALLY MET
(this is based upon your discussion of the desired outcomes)
4. Then, identify what you will do with the plan of care:
CONTINUE THE PLAN
DISCONTINUE THE PLAN
Or
REVISE THE PLAN

VIII. Documentation
1. Make a charting entry that includes each of the interventions in the plan.
2. Chart how the intervention was performed for your client.
3. If you did not perform the intervention for the client, then chart how you would have performed the intervention.
4. Include the date, time, the entry and your signature.



Go figure- do they think anyone with half a brain would write an intervention or outcome that could not be met on an imaginary subject? And what do we really write ? Are we supposed to make up the assessment? I dunno -- I think I'll go to bed.

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Significant milestone

I finally am sort of halfway through the health assessment class. Today I managed to demonstrate knowledge in assessing the head and neck region, skin, eyes, ears, nose mouth and throat and even breath sounds.

After an hour and a half of demonstrating and explaining, the task was completed.

Next, on to neuro assessment and then heart and peripheral vessels, musculoskeletal and abdomen.

Yay me!

Typos in Textbooks

I never noticed before but these days I'm finding a few more errors in textbooks and so called websites that are suppposed to help you study and learn things.

Here's an example of a silly question

"The nurse has administered a drug that is highly protein-bound and unerstands wich effect will occur?"
Select all that apply:

Saliva
Bile
Feces
Sweat
Breast milk.

HUH??? I paid $75 for access to this?


Another example:

History of Ethics as discussed in a nursing textbook:

400-300 BC - Plato, Aristotle, Early Christians
400-300 BC - Hippocrates

??? Last time I checked, there were no Early Christians in 300 BC because Jesus hadn't been born yet.


A third example of an NCLEX-RN problem (!)

An appropriately stated goal for a client w/ Type 1 diabetes mellitus is:
1. The nurse will teach the client to recognize & respond to signs and symptoms of hypoglycemia prior to discharge.
2. The client will demonstrate self-injection of insulin, using a preloaded syringe, into the subcutaneous tissue of the thigh prior to discharge.
3. The nurse will teach the client to accurately draw up the insulin dose in a syringe.
4. The client will be able to self-manage his diabetic diet and medications.

Answer: 2
Rationale: Clients must be able to swallow without difficulty to take pills, capsules, and enteric-coated tablets. Clients should be able to sit up to swallow medications Enteral drugs are not added to IV fluid. Cognitive Level: Analysis. Nursing Process: Assessment Client Need: Physiological Integrity.


HUH?

Health Assessment -- aaaarrrrgh

Health Assessment class -- the one class that strikes fear into every nursing student. In my case, I am in a distance learning program through Indiana State University. Trying to do this as a nursing student is already hard enough. Trying to do this online is like navigating a maze in the dark, with only glow in the dark stickers at every turn.

Of course I already know how to do a head to toe assessment. I went through it in LVN school. I partnered up w/ a fellow student nurse ( in my case, enlisted soldier) and we poked and prodded each other while observed by our clinical instructor/ Staff Sergeant G/ Sergeant First Class P. and Capt. S. I did it lots of times on fellow students, patients young and old, and yes, as an LVN working for a major hospital.

So why does it strike fear in my heart in a BSN program?

Because I'm rusty. LVN school and my LVN career was a LOONG time ago. Almost 17 to be exact.
Yes, I know all the steps. Yes, I know the rationales. Yes, I know how to do things.
But no -- I can't really "do" it. That means -- I don't really think that I can be relied upon to give an accurate assessment.
I mean really -- breath sounds? high pitch, low pitch -- HA! I don't know how high is high and how low is low.

Hyperresonance? How does one know (after not listening and percussing chests for 17 yrs) what hyperresonance is if you don't even know what the regular sound should sound like?

And how do I know how decreased breath sounds should sound when it has been years since I've heard one. And besides -- decreased is only decreased if you know that it should be as loud as it should be...except -- how loud SHOULD it really be?

Palpation of lymph nodes ---- hahaha. Yeah right....I couldn't find an enlarged lymph node till the person told me it was there. So much for finding them.

Vital signs - uh...yeah right. Nope -- you can't just stare at the bouncing needle. (come on, you know you've done it!).
Pulse -- yeah, you have to feel the pulse for 30 seconds and then seamlessly switch to counting respirations for the next 30 while concentrating on remembering the first number and then counting the person's chest rise and fall for the next 30 seconds. When it's done -- uh...what number was that again? LOL

Countless hours spent practicing on a willing subject -- hoping that the 'willing subject' doesn't get tired of being poked, prodded, palpated, auscultated and percussed to death.

So this coming Tuesday -- I am asked to demonstrate to a preceptor the follwing assessments:
Skin, Hair & Nails
Eyes
Ears
Nose Mouth & Throat
Thorax and Lungs