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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!

Things Every Nursing Student Should Have…Even Through Grad School: Part I

I have stewed over this topic for several months as I am finishing up my second to last semester of my Family Nurse Practitioner (FNP) program. I do not consider myself an expert on this issue; however, there were several things that got me through nursing school that I could not survive without. The following stuff is mainly for an undergrad nursing student. Part II (coming soon) will be more for a nursing student in grad school. 1. A cheap watch that tells military time I am a cheap watch girl because, working with the pediatric population ( & going through 6 watches in 5 years), I have learned that it is not worth it to get an expensive watch. Also, the amount of lifting, moving, bending, carrying, etc. that a nurse (especially the average nursing student, since the nurses on the floors are happy to have students do the grunt work) does makes for a broken watch every 5 months or so. These watches are so cheap, $9.99 at Target. Military time watches saved my life. My husband always makes fun of me for having a military time watch, but it's truly a lifesaver. I never got used to adding or subtracting twelve hours to regular time. This watch made my life so much easier and my documentation much more accurate as a student and nurse. The first time I was truly grateful for having a military time watch was during my first job straight out of nursing school in the PICU (pediatric intensive care unit). It was during my first real code (code blue) ever and I was the recorder. When you watch ER or something, it amazes me that they never show the recorder who has to write down every single thing done to a patient during a code. 2. A good stethoscope I started out with a Prestige Medical sprague stethoscope. I remember an instructor telling us that we should buy a stethoscope with both a diaphragm and a bell in order to hear both high and low pitched sounds. This will be helpful for you distinguishing different breath sounds (rales, rhonchi, wheezing) and heart sounds (gallops, rubs, murmurs). I also (vaguely) remember being told that the shorter the tubing for the stethoscope, the better. This basically has to do with the physics of it all. You'll be able to hear the sound more clear the shorter the tubing is. My prestige stethoscope was a great starter. Once I was able to save up enough money, I got the a Littmann stethoscope. I made the upgrade to the Cardiology II because the difference in my ability to auscultate faint adventitious sounds of the body and checking NG (nasogastric) placement improved 20 times. Well, I was unable to actually measure the difference, but there was a definite difference. If you're the kind of student who feels that you need to have something like this early on (like now), hit those loved ones up, all of them at the same time. My Littmann is approximately 4 years old and still working very well. This is another very good investment for nursing school. 3. Comfortable nursing shoes I was never a trendy "croc" aficionado. Many hospitals don't even let you wear them. I'm a New Balance girl, myself. From working anywhere from 4 to 16-hour shifts, these babies keep you comfy. 4. Pocket protector filled with bandage scissors, many packets of rubbing alcohol, a permanent marker, a highlighter, and (at least) two 4-colored pens This is also something my husband makes fun of me about. It may seem nerdy, but it's going to save you the ink stains. Plus, it acts as a very handy storage area in your pocket. You'll learn to stuff unimaginable things in your pocket just to avoid an extra bag or trip. It's all about the multi-tasking. highlighter- Just highlight the important stuff for patient/family education. The patient is already overloaded. bandage scissors- I'm asked every single day for my scissors. rubbing alcohol- This is for a quick clean of almost any surface...also, those bandage scissors are going to end up in some pretty gross places permanent marker- Labeling meds/IV bags/anything really two 4-colored pens- You'll be surprised how much you might need red ink for taking off orders...depending on your institution. You'll learn that the piece of paper that you have all of your activities recorded for the day (tube feeds vs. PO meds vs. IV meds vs. I's & O's ) will need some color coding. This is pretty anal, but it helps map out your day. I've done this ever since junior high, and it has made me more organized in my thought process. You'll need at least two pens because us nurses are all filthy pen thieves. 5. Mosby's Drug Guide This book was a good starter for me. It has all the info that you will need for when your instructor grills you. The language is easy to understand. The part of the book that I really like (I'm sure it's even better now because I only have the 4th edition from 2002) were the pictures of how to give different kinds of injections. It also gave pictures of different common drugs used in the general population. This is helpful for that those cute little old people taking 15 different kinds of medications per day, don't know what they're for, but can tell you the color of the pill. 6. A PDA Know these initials and know them well. PDA stands for personal digital assistant (for those who always wondered, but felt too dumb to ask), otherwise known as a palm pilot. In nursing school, one thing I hated was carrying around 5 different books to get me through clinicals. After biting the $200 bullet, I got hip to my first palm pilot. The greatest thing about these little devices is that you can carry 10 or more different medical books all on this little device. One thing you may be thinking is, "I can't afford this. She's out of her mind." Believe me, I couldn't afford it, either; however, it has proven to be the best investment (besides becoming a nurse) that I have made for myself financially and medically. This is what you can do. Again, tell all of your family members...I mean all of them, to not get you anything else for your birthday/Christmas except a palm pilot. You will have a vast array of knowledge at your fingertips, your backaches will go away, and people in the hospital (doctors, nurses, patients) will be impressed. Plus, every palm pilot comes with some kind of built-in calculator (another nursing school must), calendar to schedule appointments/meetings, and an address book to help you manage your hectic life. See Part II of this post (will be posted soon) on what to look for when buying a palm pilot and programs/books to put on it. 7. The knowledge that things will get better and that you will overcome this. I didn't want to have to be all preachy, but I wanted to include this because I think it's important. The decision to become a nurse is a very important one. You will hold people's lives in your hands, literally. The pressure between nursing school, your job to make ends meet, possibly kids/family can all seem like it's just too much...not to mention all the blood, vomit, mucous, urine, and poop that you're going to have to put up with. There is something to be said about those nurses that tend to eat their young. It seems like they use you as their own little "fresh blood" punching bag. Someone probably did the same thing to him/her in nursing school or his/her first job, so they feel like they need to pass on the tradition. I don't believe is this bs. This is part of the reason that there is such a shortage, because even some nurses can't appreciate each other and stop the cycle of hate. You need to take it upon yourself to kill that person with kindness and do your job 150%. If you are still thinking of quitting nursing school/nursing in general, speak to a nurse who has been around the block a few times (not sexually) and that truly loves what he/she does. You may not find many nurses that like where they work, but you should find nurses that love what they do. No nurse should be in this profession that is burned out and/or hates what he/she does. When a person comes to this point, this is when they should leave nursing, even if there is a shortage. It's just not fair to the patients. Coming Soon: Things Every Nursing Student Should Have...Even Through Grad School: Part II---palm pilots, programs, books, and websites. Oh My!