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Things Every Nursing Student Should Have: Part II, Palm Pilots and Programs

I left a cliffhanger of a post in Part I of this article. This section of the article will focus more on things to help you be successful and knowledgeable in your clinical skills as a student nurse, even if you do decide to go further for your master's or doctorate degree in nursing. Palm Pilots As I mentioned in the previous article, buying a palm pilot was the smartest thing that I ever did. Going on many websites, your head may swoon when thinking of all that you have to consider when buying a Palm Pilot. There are only three things that you need to worry about: price, compatibility, and memory. Price Most good palm pilots (PDAs) start at a range of $199 and can go as far as $499 or higher. I am not a rich person at all. The Palm Pilots (yes, plural...see below) I have bought took months for me to save up for. In my humble opinion, I would have to say that a PDA for $199-299 might be all that you need. Before you tsk, tsk me, there are several things working for you as a student nurse. The first is that you're a student, a poor, poor student who needs help financially. Most companies offer some kind of student discount if you order PDAs from their website like Skyscape and Epocrates. These two websites offer bundles in which you buy PDAs and medical programs together at a discounted price. There might be more sites out there, but these are the two big sites that I deal with when shopping for medical stuff for my PDA. Secondly, as I said in the last section of this article, you can always hit all of the relatives up for some palm pilot lovin' during Christmas/Hanukkah/birthday or whatever time. Compatibility I have had 4 Palm Pilots in my whole life. The first was lost by family members. Number two was tossed out due to the power button breaking...that was the Tungsten E, which I guess was on the list of many repairs and updates leading to Tungsten E2. The third was a Tungsten E2 that ran out of memory. Epocrates is a memory hog...more on this below. Currently I have a Palm TX, one of the few loves of my life. I only know Palm OS (operating system) as opposed to Windows Mobile. Most of the PDA programs that you're going to buy are going to be Palm OS compatible, so it can work on both a Mac or a PC. The PDAs that are only Windows Mobile compatible can only work with programs built for Windows, not for Macs. There are not many Windows only programs, so you're best bet is buying a PDA that is Palm OS compatible. Memory You want to have at least 32 megabytes of memory on the actual device. Palm's Tungsten E2 has this much memory and did very well for me. Most nurse practitioners (and nurses) who I have seen with a PDA have a Tungsten E2. If you choose to shower your palm with a good reference guide, medical dictionary, and drug book, then you will definitely need a memory card. A memory card with 1 gigabyte should be enough. I'm kind of obsessive about new and cool medical books available on PDAs, and I have a 1 gigabyte memory card. Be sure to know which major programs you would want to buy before buying a PDA. Some software requires a certain amount of memory to be on the actual PDA device, even if you have a huge amount of memory on your memory card. Programs Here's the fun part. The inner nerd in me loves nothing more than to break open a new PDA box or play with a new medical e-book found on the internet. You will find this to be true, too,or maybe I am a freak. Student Nurse Must Haves: 1. Epocrates Essentials Pros:
  • Keeps you up to date on current research (depending on how much you update Epocrates)
  • A 5-minute Clinical Consult in which you type in symptoms and it gives you the most likely diagnoses and treatment modalities
  • You can look up different labs and what they mean, different medical diagnoses/diseases, different drugs different medical math formulas i.e. body mass index, creatinine clearance, and pediatric maintenance fluids.
  • Epocrates = memory hog. Get a memory card to save you the trouble and heartache
  • It sometimes has trouble updating and gives you corrupt files. If you have a PDA with WiFi, like the Palm TX, then do the auto update wirelessly instead of using your hotsync cable. This will save you 5 months of constantly calling Epocrates tech support. You'll know exactly what all this mumbo-jumbo is when you actually have a PDA, I promise.
2. Taber's Cyclopedic Medical Dictionary Pros:
  • A full 2439 pages all wrapped up in 10966 kilobytes of memory.  It may sound like a lot of memory, but it's still not as much as Epocrates.
  • web access to the dictionary with illustrations.
  • No illustrations for the PDA version.
3. Lexi Comp Drugs International Pros:
  • In-depth description of tons of drugs...far better than Epocrates.
  • Many international drugs used in Canada and Europe listed.
  • Patient education and monitoring parameters are really spelled out well.
  • It is a bear to download and update. They are based in Hudson, OH, but their books are used all over. I'm really surprised that they haven't made their website more user-friendly.
Grad Nursing Student Must Haves: 1. Washington Manual Outpatient Medical Survival Guide 2. Washington Manual Internship Survival Guide These two books saved my life a few times when doing my clinical rotations. As student NP, you are basically treated as a resident because many people don't know what your training exactly is. This experience was bittersweet...maybe more sweet in hindsight, because I trained myself to not only think on an advance practice nurse's level, but also on medical level along with all of the residents and docs. Studying many sections of these two books also had prepared me for seeing common problems in all of my rotations that NPs and docs have to deal with all the time. I know it is the end of the school year for many and maybe soon to be the beginning of the school year for some. I get asked these questions all the time from classmates, so I figured if that many people wanted to know about PDAs and medical software, then there has to be hundreds more people out there who haven't even started nursing school, yet. I hope this article has helped you. If you have any questions, post them in the comments section below and I will try to answer or add additional parts to this article. Feedback is always greatly appreciated. Good luck in your future studies!

Nurse Practitioners…Groveling Every Step of the Way

For those who don't know, I am a student nurse practitioner (NP). This is the main reason as to why I am not able to post as much to support my husband's website. The other reason is partially due to the fact that nursing school has sucked the creativity out of me so much so to the point that the only creative juices I am able to produce are through the means of a power point presentation. But, I digress. The point of this article was for me to point out how hard NPs have it in the healthcare field. It does not start in practice, but rather, in school. Since I am in the Family Nurse Practitioner (FNP) program, I am required to complete a total of 750 practicum hours before I graduate. Practicum is basically where I practice in a clinical setting (with real patients and real problems) as a student NP underneath the direction of another NP or MD. This amount of hours is fine with me since I am going to be working with other NPs and MDs who will consider me to be their colleague. Also, I will be making important life and health decisions with many families which requires much training. However, in the program that I am in, I have to find people who will be willing to precept/take me under their wing in this process. My practicum placements are totally made up by me in my free time between going to school full-time and working my 3 separate part-time jobs. This results in several rejections from people (because a student would decrease their productivity) and many calls and e-mails that are unanswered (they are too busy to call me back or they just don't have the time). I can understand why some NPs do not want to get back with me for one reason or the other, though. NPs are not paid extra to precept student NPs. So this means that their productivity decreases AND they are not paid extra. On the other hand, MDs are paid extra to precept physician assistants (PAs). PAs do essentially the same duties as an NP does. It's just a different discipline of thought when it comes down to it (medical vs. nursing). Okay. So now I'm a bright-eyed and bushy tailed NP in the world excited to conquer new things. I accept the first job that comes my way. A PA who has just graduated from a 2-year community college with an associate's degree (vs. me, who has graduated with BA and 2-years of masters training) has also just landed a job in my same place of work. This person, on average, is going to be making at least $20,000 more than I am based on the fact that 1) he/she was physician-trained and 2) this person is most likely male (I'm not even going to go there at this present time.). It's bad enough that NPs have been around for over 100 years and they're just starting to get recognized in 2006. Next year will officially only mark the 40th anniversary of PAs. Unfortunately, the reason that NPs are more recognized now, is not because MDs want to promote collegiality, but rather, because MDs want to specialize. They are willing to pass many of their regular patients on to NPs now in order to make more money for themselves in specialization. This is not the case for all MDs...but they all know who they are. It saddens me when a patient demands to see an MD. Then when he/she is told that the MD is unavailable, they'd rather settle for the PA than the NP. These patients freely admit that they would rather see a PA opposed to an NP just because of the name "physician" in "physician assistant." They claim that they have got to be the next best thing to doctors. Haven't us nurses paid our dues already? We're not in the old-school days of hospitals being places to go and die and the healthcare professionals they label as "nurses" are really the town prostitutes. Do your research. It's true. I just feel that for a profession that has been around for so many years, I don't feel I should fight for everything that I've already worked so damn hard for. It's just ridiculous.