Building Your Portfolio

The process of building your portfolio can start when you are in nursing school. Participation in extracurricular service activities, especially when they are related to nursing, is one way to boost your marketability after graduation. Community service activities (CSER), for example, is a great opportunity to use your skills to benefit others as well as a great addition to your resume. When I was sophomore nursing student, I taught a class on the effects of drug addiction on the brain to a group of women recovering from various addictions at a local Teen Challenge. Other great opportunities to serve and simultaneously hone nursing skills and expand your knowledge base is volunteering in the nursing skills lab and tutoring student nurses in nursing courses, such as Patho, Med/Surg, and pharmacology. I did both of these when I was an upperclassman, and there is so much truth in the old adage that the teacher learns more than the student.

You also don't have to wait until you pass your boards to start attending continuing education (CE) activities such as professional conferences. There are usually plenty of offerings for local CE opportunities. Honors students might be interested in petitioning critical care as this involved attending a single critical care conference when I attended LUSON. See your instructor for current petitioning requirements.

Nursing Undergraduate Honors Thesis

Your Honors Thesis will likely be one of the more challenging writing projects of your undergraduate studies, but it can be very interesting and rewarding if you pick a topic that has the potential to contribute to the body of nursing knowledge and is something you are passionate about. Writing your Honors Thesis does not have to be a dry and dreary task, although it can be at times. For me it was a scholastic adventure that took me down a road I did not expect. I discovered pieces of evidence I was not looking for, and it took on a shape that I had not anticipated. But that is the wonder of nursing. God's creation is so complex we are continuously surprised and delighted by the mysteries of His handiwork. Our earthly bodies daily testify to the glory of our King and tell of His wondrous deeds (Psalm 78:4).

If you are a sophomore or a junior nursing student figuring out your thesis topic, I suggest looking in and looking around; look in to find what is really important to you or what interests you, and look around to find out what is going on in nursing and medicine. Once you pick a topic, find a mentor, this will usually be your thesis chair, to help you to find a searchable question to answer in your thesis. Formulating a question using Patient Intervention Comparison Outcome (PICO) can help you narrow down your search.

Using your resources is also important. Even though I used to work in the Library, I still sought input from the nursing librarian when I was writing my thesis. Another resource I wish I had used when I was an undergraduate was the residential writing center. As a grad student, I have used the graduate writing center multiple times and found their feedback very helpful and informative.

Finally, have the grit to stick with your thesis topic when you get tired and bored. If you pick a topic meaningful to nursing and yourself, the laborious process will be well worth the effort.

Perfect Peace

How many of us wish we lived in "perfect peace" all the time? I know I do. Isaiah 26:3 says, "You keep him in perfect peace whose mind is stayed on You, because he trusts in You." Now that's a promise! Over the past few days the Lord has been convicting me that I often allow myself to become distracted by the "cares of this world" (Mark 4:19) that easily crowd out thoughts of my Savior. Instead of continually renewing my focus on Him and devoting myself to Him "in body and spirit" (1 Cor. 7:34), I all too easily allow my focus to drift away from Him to things like homework, clinicals, and grades. 

I know that it the middle of the semester, and that this can be a difficult time with Mid-Terms and exams that just don't seem to end in Nursing School, but I want to challenge you, as I am challenging myself, to remain focused on the Lord. I was reading in My Utmost for His Highest by Oswald Chambers this morning, and Chambers challenged his readers to "use your imagination to put yourself before God" (p. 42). What he meant by that was to use your imagination (your thoughts) in a way worthy of the Lord (Phil. 4:8-9). Instead of our imagination living in a starved state because it is set on thinking about whatever our empty impulses desire, we can instead set our thoughts to contemplate the majesty and the wonder of God. Where can we look for our inspiration? The beauty of sunsets artfully painted by God, the trickling or thundering waterfall pouring over the side of a cliff, the majestic scene of mountains overlaid with clouds of water vapor, the starry host of heaven twinkling in an inky sky--these are all launching boards for our imaginations to imagine God--to consider and meditate on His power, majesty, and grace in saving us mere humans. 

When setting our mind on Christ our King and Creator, we have no reason to fear the future, to worry about what will come our way, or to think for a moment that He might not come through for us this time. Instead we can rejoice with the psalmist who realized the majesty and the wonder of God and found "perfect peace" in Him. Psalm 8:1-4, 9: "O Lord, our Lord, how majestic is your name in all the earth! You have set your glory above the heavens. Out of the mouth of babies and infants, you have established strength because of your foes, to still the enemy and the avenger. When I look at your heavens, the work of your fingers, the moon and the stars, which you have set in place, what is man that you are mindful of him, and the son of man that you care for him? . . . O Lord, our Lord, how majestic is your name in all the earth!"

 

Maternal Child Critical Care Program:Perspective of a Graduate

Warning: to all readers, if you are reading this I assume that you understand that you are about to enter the nerd-dom of Maternal Child Critical Care Certificate Program (MC-CCCP) NOT the original of adults in CCCP. This is the world of patients the size of teacup poodle puppies. This is NOT the world of ER re-runs and those ever-popular shots of scrub-bedecked heroes running down endless halls and pumping with all their might on the chests of unresponsive patients. This is the world of two-finger compressions, micro-changes in IV calculations, tiny bodies that require exquisitely careful care and much peace and quiet, inexpressible joy, broken hearts and messed-up homes. Welcome to MC-CCCP.

As noted, this is not adult CCCP. When I took it last year, we did not operate or run codes like the CCCP students. We spent more time in lecture and with guest speakers and less time running mock codes than our “adult” neighbors last year. Most of our practice was self-taught, with us designing and running our own scenarios. Considering the feedback we got from instructors after we all passed NRP and PALS, we were a pretty demanding set of self-teachers! All that to say, if you take MC-CCCP, you need to be motivated to learn. Like all of the nursing program, you get results in proportion to the effort you make.

If you do persevere and learn, it is a program you will never forget. I had the incredible privilege of working in a NICU. It was a small one and by weekend #2, my instructors were turning me loose to do basics on my own (with them only a few feet away in the tiny department). By the last weekend I was essentially put in charge of the patients assigned to my instructor and myself. I had the joy of watching the light bulb come on in a tiny child’s mind as he finally understood the idea of nursing from a special preemie bottle and took a giant step toward going home. I got to share that joy when his mom came to see him. My heart broke as I cared for and loved on babies only to meet their families, people unprepared for this responsibility. One had not even wanted the babies in the first place and could not make it into the department without crying. Then there was the one father who could win a smile from his tiny daughter and make her calm down and go to sleep against his chest, staying as long as he could just to be with her. Above all was the wonder and joy of working with some of the most beautiful creations God ever designed and sent to give us a taste of what unconditional love is and demands.

        

Fun epilogue: I do not currently work with any of the patient populations we covered in MC-CCCP. God has placed me for a time in long-term care and rehab. However, the skills of MC-CCCP have shown up here too! I was trained to face the worst, which makes it easier to prioritize and keep a levelheaded approach to a constant deluge of problems of all sizes. There are also basic concepts that apply to everyone: everyone must breathe, their hearts must pump and blood must circulate. And everyone is hungry for unconditional love. 

The above post was written by Elizabeth Houser, RN and graduate of the MC-CCCP

Critical Care Certificate Program

Over the past year I have received numerous questions regarding the Critical Care Certificate Program (CCCP) from nursing students at Liberty University. Most often these questions revolve around what the program is and how it benefits students interested in critical care nursing.

The Critical Care Certificate Program gives students the advantage of taking three American Heart Association tests that nurses normally will not take until they have already graduated. These three tests are Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Neonatal Resuscitation Program (NRP). Taking these tests before graduation allows Liberty Nursing students to achieve more qualifications for a nursing job than most new nursing grads, in effect, giving students an extra advantage. This is particularly helpful for positions, such as those in an intensive care unit (ICU) or emergency department (ED), that require these certifications be acquired soon after being hired.

Another advantage of the CCCP is the numerous hours that are spent in simulation, running code blues, interpreting EKGs, selecting and administering the appropriate drugs to the simulation patients, performing CPR, delivering breaths with an Ambu bag, and practicing recording drugs and interventions given during a response to cardiopulmonary arrest. This provides the opportunity to learn in a low-stress environment by working through real-life scenarios that allow you and your peers to learn from your and others' mistakes as well as successes.

I am currently in the Adult CCCP and loving it! We start each NURS 465 class with two hours of lecture, break for lunch, then come back and run mock codes for three hours. An added benefit is NURS 465 (for the Adult CCCP) counts for the nursing elective required to graduate from Liberty's Nursing Program.

Another advantage of being a part of the CCCP (both Maternal/Child and Adult) is you will be given preference during selection for Leadership. This means that your requests for Leadership clinicals will be looked at first before your peers who are not in the program. The reason for this is that you will need to complete 140 hours of Leadership (NURS 490) clinicals in a critical care setting, such as an ICU or ED, which is greater than the 90 hours of Leadership required of your peers. If you get into the Adult CCCP, you will also have the opportunity to shadow in a critical care setting of interest to you such as the CVOR, flight nursing, EMS/fire department, etc. These are great observational opportunities that you may never have again after graduation.  

Relationships in Nursing School

I often am asked by other nursing students my opinion on relationships in nursing school and whether it’s possible to have a boyfriend while in enrolled in such a rigorous program such as Liberty’s. My response in the past was to smile and remind the nursing student who asked the question that God is in control of everything, including her love story. While I used to point out that I knew several nursing students who had boyfriends, were engaged or even married, now I can testify from personal experience that it is possible to have a boyfriend and still be a successful nursing student, which was the real issue my nursing friends were getting at with their questions.

Desire for companionship and love is a natural longing deep-seated within the heart of a woman; nevertheless, it is dangerous to want a boyfriend just for the sake of having one. One of my friends told me recently that her goal for the year was to “get a boyfriend”. The problem with this thinking is that if you seek to make something happen—like getting a boyfriend—you may miss out on a better plan that God has for you. Solomon shares some insight into this in Ecclesiastes; “For everything there is a season, and a time for every matter under heaven: . . . a time to embrace, and a time to refrain from embracing;

a time to seek, and a time to lose; . . . a time to love, and a time to hate” (3:1, 5b, 6a, & 8a). The Song of  Solomon also speaks about waiting on God’s timing in your life; “I adjure you, O daughters of Jerusalem, by the gazelles or the does of the field, that you not stir up or awaken love until it pleases” (3:5).

To all the single nursing students, guys and girls, this is just a reminder to let God write your love story. Seek the Lord in prayer before entering any romantic relationship—just like I hope you do with every other decision you make. If there is no one in your life right now, do not be discouraged. Jesus is your Bridegroom King (Isaiah 54:5, 10), and He loves you with a love no other human being on this planet could ever match (Jeremiah 31:3). Rejoice in His love for you, and be content in waiting (Phil 4:4, 12).

When that special person does come into your life, be sure to have good time management. I used to joke before I was courting that I was dating my textbooks—not really an exaggeration for how much time I spent with them. Since I still study a lot, I have to be intentional about taking time to just be with my boyfriend and talk or do something fun. (Yes, having fun is important for single nursing students too! You should try it sometime). When the time comes, remember you can—and I often do—spend time with your significant other while studying. You both have to be able to stay focused, but it is possible to get a lot done and still be in the same room.

On a final note, I want to remind you all not to fall for the nasty Liberty rumor that you have to meet your spouse at Liberty University or you will never find anybody. One of my friends graduated from the nursing program single and unattached over a year ago...she's getting married this Saturday to the man of her dreams, who she met after graduation! So, if you graduate with no one in the romantic sphere of your life, trust the Lord. He may have a surprise waiting on the other side of graduation.

   

Join the Liberty Nursing Journal Club

As many of you know a few senior nursing students founded the first Liberty Nursing Journal Club for our Department last semester. As the Club's President, I would like to invite you all to join the Liberty Nursing Journal Club for an exciting time of learning from each other about the latest research in fields like Cardiology, Neurology, Trauma Nursing, and Critical Care. Participating in this student-led group will give you the opportunity to explore ground-breaking research in nursing and discuss how this information applies to you and your future practice with your peers.

The LU Nursing Journal Club meets once monthly for about one hour. Dates will be advertised in the Nursing Department Office on the Department's kiosk. You can also check out the Liberty Nursing Journal Club Facebook page. 

I Shall Fear No Evil

This morning I undertook the task of re-memorizing Psalm 23, a chapter I learned when I was 6. After reading it a few times, I decided to turn it into a prayer of thanksgiving to God. It was only after doing this that my heart was impacted by the magnitude of His love and grace toward me, His child.

The LORD, the Great I AM, the Lord of Angel Armies, is my Shepherd, and He takes care of my needs so that I do not lack anything (Psalm 23:1). He not only gives me the peace I need to rest (John 14:27), but He makes me take a break and lie down like sheep in green pastures (Psalm 23:2a). He leads His sheep, His Church, by still waters--waters I can drink from and not be swept away (Psalm 23:2b). He again is protecting me from danger as a Good Shepherd would. He restores my soul when my spirit is weak and exhausted (Psalm 23:3a); He imparts new joy. I am continually able to rejoice in His mercies, which are new every morning (Lamentations 3:22-24)! 

Even though I do not know the future or the path that my feet will take, I can trust that God will lead me in the path of righteousness in order to bring His name honor and glory (Psalm 23:3b). And even if the path I take brings me right into the valley of death, I shall fear no evil because my God--who created the valley--is with me and will lead me through to the other side in safety (Psalm 23:4). I know that God is my Salvation; I will trust Him (Isaiah 12:2) and not fear the enemy who stalks in darkness (Psalm 91:6). In fact, the Lord blesses me even when I am in the presence of my enemies (Psalm 23:5).

Truly, it is good to follow the Lord! He takes such great care of His people, the sheep of His pasture (Psalm 100:3). He causes us to experience His goodness and mercy every day of our lives (Psalm 23:6). And when our time on earth is fulfilled, we will dwell with Christ in the house He has prepared for us forever (John 14:3). Praise the Lord for His continual faithfulness and mercy!    

10 Suggestions for Writing a Solid Patho Paper

1.      Figure out the main problem/diagnosis. The main medical diagnosis is usually what brought them into the hospital or it could be the root cause of their visit. For example, a patient who had a heart attack two weeks ago may present to the hospital with dyspnea and new onset heart failure. While dyspnea is their main complaint, the main problem is heart failure since it is the root cause of their difficulty breathing.

2.      Clearly structure your paper. This stems from a good outline. Before I ever sit down to write the Pathophysiology portion of my profile, I figure out what the main diagnosis/problem my patient is facing. Once you know the top problem, write down the various other issues that your patient is dealing with and then arrange your patho in a way that organizes the information in a logical fashion. For example, if your patient’s primary diagnosis is heart failure (HF) secondary to a recent myocardial infarction (MI) complicated by renal failure (RF), I would outline the paper like this: Hx of present illness, patho of HF (from macro to micro level, i.e. down to the cellular level) and how the diagnosis of HF was made (echocardiogram, BNP, etc.), patho of MI in relation to the development of HF, patho of RF which was caused by insufficient perfusion secondary to the decreased cardiac output associated with HF, discuss the patient’s current status (edema from fluid overload secondary to HF and RF, dyspnea secondary to fluid overload leading to pulmonary edema, etc.), and conclude with a paragraph discussing patient education (e.g. call the doctor about significant weight gain in short period of time) and follow-up care (nutritional consults, congestive heart failure out-patient clinic).    

3.      Spend sufficient time discussing the pathophysiology of the primary diagnosis. Write as much as you need to sufficiently cover the topic, including the normal anatomy and function, the pathophysiology of the disease, and the manifestations of the illness and what causes each of them. When discussing acute kidney injury (AKI), for instance, discuss the normal anatomy and function of the kidneys (nephrons, tubules, glomeruli and how they are involved in filtering urine and regulating fluid status), the original insult to the kidneys (e.g. decreased perfusion from low cardiac output associated with HF), the stages of renal failure, and the stage the patient is currently in and how each manifestation (peripheral edema, hypertension, and decreased urinary output) relates to the diagnosis of AKI.

4.      Be sure to include procedures and studies related to your patient’s diagnoses. If your patient has HF, discuss how it was diagnosis such as by Transesophageal echocardiogram (TEE) and BNP values. Discuss how this procedure, TEE, is performed and the physician’s interpretation of the results (ejection fraction, hypertrophy of ventricles, etc.).   

5.      Write at least one paragraph or more on the other diagnoses related to your patient’s primary condition. For instance, if the patient has HF, RF, and past MI. Discuss how the MI led to his HF, the patho of MI, and how it is currently affecting the patient (this could easily be three paragraphs). Also, discuss the patho of RF and why it resulted from HF and how it manifests in the patient.

6.      Relate the information to your patient in each paragraph. At the very minimum, include your patient (e.g. their presentation, diagnosis, etc.) in the topic sentence (usually the first sentence in a paragraph), and in the last sentence of the paragraph.

7.      Integrate your patient’s labs into your paper. This is one of the best ways to relate your topic to your patient (#3). Whenever you give your patient’s labs don’t just list their lab values, include the normal ranges (specific to age and gender) and the correct interpretation of the labs (low/high/normal). Then apply this information to the patient and their diagnosis and prognosis. For example, your patient has low hemoglobin, hematocrit, and red blood cell count; you know this because these values are lower than the normal levels for an adult male, indicating that he is anemic. After explaining this, address the reason for his anemia. For example, he could be anemic as a result of insufficient production of erythropoietin secondary to his renal failure.

8.      Integrate your patient’s medications into your patho. This shows your understanding of your patient’s condition as well as the indication for the medications which they are prescribed. For example, your patient is on a statin, ACE-inhibitor, aspirin, and beta-blocker; these are all standard medications prescribed to a patient post MI. Don’t just list the medications; instead, talk about the specific medication your patient is prescribed, its drug category, mechanism of action, and indication for your patient. For example, your patient is prescribed metoprolol (Lopressor), a cardioselective beta-blocker, which decreases heart rate and blood pressure by blocking the beta-1 adrenergic receptors in the heart. This medication is given to treat hypertension by lowering this patient’s blood pressure.

9.      Read before your write. It is so much easier to write a patho if you’ve read about the diagnosis and the related issues in your Med Surg and patho textbooks and journal articles before you start writing. By doing this, you can avoid the risk of plagiarism that arises from writing as you read. You also are able to demonstrate your understanding by writing the information in your own words.  

10.  Read your patho before submitting it. The flurry of patho writing it is easy to miss grammatical mistakes and spelling errors that you will be able to catch on your final pass over your paper. I usually like to read a paper out loud before submitting; this keeps me from just skimming the content. Remember to use spell check and Google the spelling of words you are not sure how to spell. Finally, the undergraduate writing center at Liberty University is another great resource. They usually take a few days to review your paper, so start working on your patho and send it to them early if you want to be able to update your paper based on their comments before the deadline. 

The Waters Shall Not Drown You

I know last year when I was a junior, there were times when I felt like I was treading water, trying my very hardest just to keep my head above water…and there were other times when my own strength failed me, and I felt myself sinking. It was in those times that I threw myself before the Lord and cried out for His mercy. I was like Peter who got out of the boat in faith, but then when he saw the wind and the waves, he was afraid. In his fear, he began to sink; he cried out “Lord save me” (Matthew 14:30), and Jesus reached out His hand and brought him up (See Matthew 14:22-32).  

You all have got out of the boat. You took a leap of faith and signed yourself up for nursing school, but you don’t have to wait until you’re drowning to cry out to God for His help. James says,“You do not have, because you do not ask” (James 4:2c). Ask for God’s aid; He is waiting for your call, and once you ask, have faith—trust Him that He will do it (1 Thessalonians 5:24).

2 Peter 1:3-4 “His divine power has granted to us all things that pertain to life and godliness, through the knowledge of him who called us to his own glory and excellence, by which he has granted to us his precious and very great promises, so that through them you may become partakers of the divine nature, having escaped from the corruption that is in the world because of sinful desire.”

Isaiah 43:2-3 “When you pass through the waters, I will be with you; and through the rivers, they shall not overwhelm you; when you walk through fire you shall not be burned, and the flame shall not consume you. For I am the LORD your God, the Holy One of Israel, your Savior.”

Seek 1st

Over and over again in both the New and the Old Testament the Lord emphasizes the need for us to make Him our first priority. We all understand why it's important to place Christ at the center of our lives (because He is God and is worthy of our all), but how many times do we push Him to the background of our attentions? I know I am guilty of allowing other things (grades, work, people, even family) to become such a focus of mine that I lose sight of what is really important—Christ and Him only. This is the point when I allow things to become idols in my life.

The only way I have found to keep competing attentions from stealing away my focus on the Lord is putting Him first in my life. It takes intentionality. For me I know this summer I allowed myself to get in a morning routine of checking my Facebook before I had my devotions. The problem I found was that I would get engrossed in Facebook and would forget until later that I still hadn’t spent time with God. The time I had wasted on Facebook forced me to cut short the time I would have liked to spend with the Lord.  

The solution I found for my predicament is not getting on my computer until after I’ve spent time with the Lord. The Old Testament speaks of offering the Lord the first fruits of the harvest (Nehemiah 10:35), but couldn’t we apply the same principle of offering the Lord the BEST of our time? Whether your best time is early in the morning or late at night, let’s all choose to give the Lord our best.   

“But SEEK FIRST the kingdom of God and his righteousness, and all these things will be added to you” (Matthew 6:33, emphasis mine).

God Our Provider Will Meet All Our Needs

Recently I’ve allowed myself to worry about life after college, paying off my loans, taking care of all my own bills, buying a car, and providing for myself. Even though I was fully aware of Who my God is—that He is Jehovah Jireh, “The Lord will provide”—and that He is faithful to His Word, I still allowed myself to worry about the things Jesus says in Matthew 6 only the Gentiles worry about (vv. 31-32).

This morning as I was giving God all my anxieties in prayer (1 Peter 5:7; Psalm 55:22), the Lord reminded me of His promise in Matthew 6: “Look at the birds of the air: they neither sow nor reap nor gather into barns, and yet your heavenly Father feeds them. Are you not of more value than they? And which of you by being anxious can add a single hour to his span of life? And why are you anxious about clothing? Consider the lilies of the field, how they grow: they neither toil nor spin, yet I tell you, even Solomon in all his glory was not arrayed like one of these. But if God so clothes the grass of the field, which today is alive and tomorrow is thrown into the oven, will he not much more clothe you, O you of little faith?” (vv. 26-30).

As I read the whole sixth chapter of Matthew and looked at these verses in their context, the Lord dissipated my fears and anxieties that I had allowed to creep into my mind. Over and over again, Jesus speaks of our “Father” in this chapter of Matthew, conveying the message that I have a “Father” in Heaven who cares for me and wants me to ask for Him to meet my needs and then trust Him that He will take care of me (Matthew 6:11, 25, 31-34).

I have discovered that worries about the future not only rob me of my joy from the Lord but also distract me from the real task at hand—seeking first the kingdom of God. “Therefore do not be anxious, saying, ‘What shall we eat?’ or ‘What shall we drink?’ or ‘What shall we wear?’ For the Gentiles seek after all these things, and your heavenly Father knows that you need them all. But seek first the kingdom of God and his righteousness, and all these things will be added to you” (Matthew 6:31-33).

Will I consider myself a living sacrifice unto the Lord and give my life to Him, allowing my time and resources to be spent for Him as I seek first His kingdom and His righteousness? Will I choose to be broken bread and poured out wine for my King’s glory? Will I cast all my cares on Him knowing that He cares for me and will meet all of my needs as He promised? 

What Every Junior Needs to Know

Juniors, welcome to the year of greatest learning and your greatest gain in competency. This year you will learn each body system in detail, beyond your previous knowledge from Patho and A & P. Never stop being amazed at God’s masterpiece—the human body—or be so caught up in the exam in front of you that you forget to stop and marvel at the beauty and intricacy of God’s creation. There is so much you have learned so far, and, yet, there is so much waiting around the corner for your inquisitive minds to discover.

There are several things I would like to share with you before you begin your journey. To begin with, I would like to encourage you to put the Lord FIRST in everything. Give Him first priority in your time. I would never have been able to meet all the demands of Junior year if God had not been holding me up, strengthening my weak body when I grew weary, and giving me hope of success when my fears of failure overwhelmed me.  

Do not derive your sense of success or worth from grades or by comparing yourself with others. If you do, you will find yourself in a world of disappointment. No one is perfect. By all means, shoot for an A on every exam, but if you fall short, do not despair. I remember a time last year when I received a certain grade that left me feeling defeated. I saw one of my senior friends in the hallway of the Nursing Office, and, when I told her about my grade with tears streaming down my face, she reminded me that God’s love for me does not change. God’s love is not based on any merit I could earn by high achievements, and His love for me will not change when I fall short of my aspirations.  My worth is found in who Christ has made me to be—His Beloved Bride.

Remember to take time each week or, if you are able, every day to allow yourself some mental solace. Do whatever you find relaxing. Exercising was one of the outlets I used Junior year to alleviate stress. Do whatever makes you forget about your work, even if only for a little while, and take a break from studying and enjoy yourself.

Be balanced. Realize your limits. Assess your assets. I may never have earned the poor grade I mentioned earlier if I had been more balanced in the way I spent my time. One of my greatest weaknesses as a new Junior was perfectionism. My first clinical assignment required me to write all my profile information post-clinical. Because I was fixated on writing a good paper, I spent the greater portion of my time writing my profile than on studying for the exam that was approaching. This cost me the A on the test, which was my aim. Looking back, it would have been better for me to set a time limit for my profile writing and set a specific time for when I was to concentrate completely on studying for my exam.  Please, learn from my example; know your time limits and plan accordingly.

My last piece of advice is to use your resources. Your teachers, senior tutors, online Evolve practice questions, and ATI books are all resources intended for your benefit. Ask your instructors for clarification if you don’t understand something you’re learning. Engage your senior tutors with questions you have from studying the material. Determine areas in which you need to spend more time studying by taking practice quizzes. All this will help you be better prepared for exams and, ultimately, make you a more knowledgeable nurse. 

My Experience As An Extern

I'd like to take a moment if I can and talk about how wonderful my experience as a nurse extern at Wake Forest Baptist Medical Center was in hopes that it will encourage many of you juniors to apply this fall when the application opens up.

A typical week as an extern included working three 12-hour shifts in my home department and shadowing for four hours on another unit. My externship allowed me to rotate through two different units. I started in the Emergency Department (ED) where I learned about triage, prioritization, focused assessments, and caring for high-acuity patients. As a Nurse Aide (NA) II in the ED, I was able to sharpen my skills base and grow in knowledge about how trauma, sepsis, burns, strokes, and MIs are treated.  

During my second rotation on the General Medicine unit, I was able to care for four to six patients at a time as their primary NA. This opportunity refined my ability to prioritize, multitask, communicate, and perform NA I and II skills. Because I was often able to care for the same patients two or three days in a row, I had the opportunity to get to know my patients as well as see them improve from one day to the next. 

During my externship I was also able to shadow nurses in the Trauma Intensive Care Unit (TICU), Pediatric ED, Cath Lab, AirCare, Medical Intensive Care Unit (MICU), Rapid Response Team, Cardiac Care Unit (CCU), and Hospitalist Service. Each opportunity taught me something new about nursing and gave me new knowledge about disease processes and treatment pathways. 

I cannot express in one post the magnitude of all that I learned as a nurse extern nor express my gratitude for the friendships I developed with my coworkers. I can only encourage the next class to apply to the nurse externships in your area. If you have specific questions, please leave a comment. I'd love to aid you on your journey to success as a nursing student and a future nurse!

Books on Facebook?

As the fall semester draws close, we all start looking for the textbooks we'll need to succeed in our nursing classes.

I would like to spread the word about two sites on Facebook which will help connect you with buyers and sellers of nursing books. The first is the "Liberty Book Exchange", which is a venue for Liberty students to sell their books to other LU students. It allows you to get the most out of your books by cutting out the middle guy.

"Nursing" is another page within Facebook Groups at Liberty that serves the same function while catering to specific nursing classes. The Nursing page also allows students to post questions about classes and get advice from fellow classmates as well as upperclassmen, even LU nursing graduates.  

Work Experience Builds Confidence

I cannot overemphasize how important it is to gain experience in healthcare before graduating from nursing school. Many nursing schools require some sort of experience as a nurse's aide (NA) at either a I or II level. These schools require this experience from their students because they know that students will learn lessons at work that they may not learn while in nursing school.

I know for me personally working as a nurse extern at Wake Forest Baptist Medical Center has been a great opportunity to learn many skills that are vital to success as a nurse. Working in a hospital as a nurse extern (NA I and II) has taught me time management skills, prioritization, effective communication, and people skills.

My responsibilities do not end with the basic duties I perform as a NA; they go much farther and encompass communicating patient and family concerns with nurses, doctors, nutritionists, medical and PA students, and physical, occupational, and speech therapists.

These are life experiences for which I wouldn't trade the whole world because they have prepared me for my future vocation as a nurse, a job that will put me in the position to deal with issues with both people and equipment. I now have confidence when I walk into a patient's room--confidence that I can get the job done in a timely manner and take care of all the patients I am assigned. This confidence was born first in the amazing clinical experiences we have at Liberty University, but it has matured and grown as I have worked in the hospital setting as an employee with coworkers I have an opportunity to get to know and patients I get to see more than one day a week.

Nurse Aide Daily Task Checklist

Recently as I've been working as a nurse extern, I've created a checklist that helps me stay organized and make sure I complete the numerous tasks I am responsible for throughout the day. This is a tool I wish I had used while I was a sophomore and junior nursing student. I hope that you will find it to be useful to you during your time serving patients in the hospital. Feel free to use it and edit it any way you wish to best serve your needs as nursing students. 

Nurse Aide Daily Tasks Checklist by Elisabeth Campbell

Filled in NA Daily Task Checklist by Elisabeth Campbell

Guide to Writing an Integrative Review

I know that recently the Nursing Department has shifted their research focus for Honors Theses toward Integrative Reviews. If you're like me, you only vaguely remember all the different types of research we learned about in Nursing Research (NURS 225). So, if you're writing your thesis following an integrative review model, The integrative review: Updated methodology by Whittemore and Knafl is a great resource to help you understand what an integrative review is and how to write one. The article is available free through LU's library website.

Nurse Aide Level I

If you live in North Carolina and have completed the Fundamentals of Nursing class at Liberty University, you have the skills and knowledge necessary to challenge the Nurse Aide I test proctored by Pearson Education. For information about testing sites and what information you should study for your written and skills tests, click on the following link: http://www.pearsonvue.com/nc/nurseaides/

I took my CNA examination last year after studying the booklet provided online and reviewing the skills we were taught in "Fundies". Becoming Nursing Aide I certified was very advantageous for me because it allowed me to become Nurse Aide II certified half-way through my first semester of Junior year. In addition, having these two certifications qualified me to apply to the nursing externship I am now participating in her in NC.

If you have any questions about how to become Nurse Aide I or II certified, feel free to leave a comment. I will do my best to direct you to the resources best suited to meet your needs.

Email Subscription Box Fixed

It was recently brought to my attention that the email subscription box on the left-hand side of the screen was not enabled. The problem has been fixed, and those who are interested should be able to sign up for email notification of new posts. If there are any more difficulties, feel free to leave a comment, and the problem should be rectified as soon as possible.