HESI Smesi

It’s that time again—maternity HESI in T-minus 9 hours. For those unfamiliar with this particular form of headache, HESI is yet another test we take in addition to our regular exams/quizzes. I like to think of it as nursing SAT’s. It’s not quite the NCLEX but it’s supposedly a pretty good indicator of how well you’ll do on the real thing. In our program it doesn’t figure directly into your actual class grade (so depending on if you do well or poor on it, it may feel like a waste or a relief) but they’re currently giving us a few points (on a sliding scale) towards our final exam depending on how well we do.

So I’ve been up to my eyeballs in case studies, practice questions, and reviews/rationales most of this week in preparation (I don’t throw away any free points!). And for some reason, one concept that really gets my panties all in a twist is GTPAL, which basically gives you a summary of a woman’s obstetrical history. I wish they would just do away with that mess and write it the hell out. Damn, you don’t have to abbreviate everything!

Here’s a little scenario from one of my case studies I did last night: Jane Doe, who is currently pregnant, has previously given birth twice, twins born at 35 weeks and a singleton born at 39 weeks. All of these children are alive. She also has a history of having had one miscarriage (the more medicalese term would be “spontaneous abortion”) at 9 weeks into the pregnancy. What is her GTPAL?

Well first a refresher on the acronym/abbreviation itself. Gravidity is the number of times pregnant, including the current pregnancy (which is what I always forget to count). Term is any birth after the end of the 37th week, and Preterm is any birth between 20 and 37 weeks. Both term and preterm include live and stillborn babies. Abortion is any fetal loss, whether spontaneous or elective, up to 20 weeks gestation. Living refers to all children who are living (duh). Multiple fetuses (twins, triplets, etc.) are treated as one pregnancy and one birth. It’s just too many variables and parameters and whatnot…it makes me cross-eyed. So…Jane’s GTPAL is 4-1-1-1-3—four pregnancies including the current one; one baby born at 39 weeks; one set of twins born at 35 weeks; one miscarriage/spontaneous abortion at 9-weeks; three living children.

Well I don’t know about you, but I’m spent…

Spring Break!!

Health Assessment is over. Finished. Finito. We took our final exam last night and now have to wait 48 long hours for our grades (probably even longer for our final course grades). I actually didn’t think the test was that bad. And since I made benchmark on the HESI I already have an extra 10-point cushion. There were a lot of questions that looked let’s just say “familiar” and I found myself thinking “ooh! I know that!” throughout most of the exam. There were 70 questions total and I was done in about 35 minutes. My professor hesitantly took my scantron—“Are you sure???” I just smiled and shrugged. You know my motto—“Either you know it or you don’t.” I have never been one to sit and stare at test questions as if the answers are going to magically pop out all of a sudden. I have also made it my policy to never change my answers on exams. Most of the time when people change their answers they had it right the first time.

My interview for the nurse extern program was today—I think it went pretty well. It was initially a group info session and then we broke out to tour and interview with the managers of our preferred units. They received almost 600 applications for the program and can only take 32-34 externs so my fingers are crossed—matter of fact while we’re at it, cross yours too! My only concern is the scheduling of it all. They would like for you to work as an extern fulltime—which of course I can’t do or I’ll lose my benefits. So I would have to work my extern schedule around dropping down to a 0.5 FTE at my “real job” (*smirk*), plus my lectures and clinicals since my nursing program runs all year round. Not an easy task, but it can be done!

And so spring break it is—sadly there will not be any sandy beaches in my forecast. I will say it is starting to warm up a little since that record-breaking snow we got but it’s still probably only about 45 degrees on a good day. But at least I’ll get to go to sleep at a normal hour for a few days…

Buh-bye Health Assessment

Health Assessment is just about coming to a close—thank goodness. For a minute there I thought I wasn’t going to make it–my hair even started falling out again. But I’m still here, balding and all lol. We had our clinical final exam/check-offs this past Saturday. You have to do an assessment of one major system (Neurological, Thorax & Lungs, or Abdominal) and two minor systems (CN 1-6, CN 7-12, Cardiac & Peripheral Vascular, or Head/Neck/Face/Ears)—which you basically pick out of a hat. Since you don’t know which ones you’re going to get until that morning you have to know ALL of them perfectly—or at least sufficiently well as clinical is pass/fail. With so many minor details within each system I must have studied for it for a week straight—I even slept with my notes the night before. Instead of visions of sugar-plums dancing in my head I was having nightmares about cranial nerves, diaphragmatic expansion, and liver spans. But it actually turned out ok. My major system was abdominal—which of course was one of my least favorites. I’m just not comfortable with the percussion aspect of it. Liver spans, splenic dullness, tympany over the gastric bubble—most of the time it all sounds like the same ol’ shit to me. And how many nurses really percuss in their daily practice? I am almost 29-years-old and I don’t remember ever being percussed. For my minor systems I had Head/Face/Neck/Ears (and I remembered to hold the otoscope upside down!) and Cranial Nerves 7-12—piece of cake.

We still have to take the HESI tomorrow night and our final exam on Thursday. If we make benchmark on the HESI (we’ll see how that goes), we get 10 points added to our final exam grade. Now I wouldn’t mind that at all…

Up next, Maternity/OB. But first, spring break here I come! Of course it won’t be a full week of pure unproductive bliss since we’re expected to have read the first five chapters in our maternity textbook for the first day of class—oy!

In other exciting news, I have an interview scheduled for the 2010 Nurse Extern Program at the #1 pediatric hospital in the nation! Go me! And from what I’ve heard, due to the economy they’ve had to cut the number of spots in the program in half, so I would just about pee myself if I actually get a spot. It is such a great opportunity—clinicals are such a tease to me at this point! If I’m selected I’ll get to do more hands-on direct care, and in peds at that! For those of you looking for a similar opportunity check out the 2010 U.S. Summer Externship and Opportunity Resource Guide. UPenn puts this out every year; it was recently updated so it should be pretty accurate. Good luck!

Slow and Steady Wins The Race!

So it’s a wrap! At times I wasn’t sure that I would be able to do it (or that I even wanted to anymore), but I made it through my first semester of nursing school! I also got my first B in about eight years—damn philosophy/ethics! It was a high B at that—like an 88.5—so close and yet not close enough. But I’m actually okay with it. My primary focus was on nursing and I did extremely well. Finals were not as bad as I expected them to be; neither was the dreaded HESI. For anyone planning/needing to take it, what I found to be really helpful were the case studies and practice quizzes/tests on Evolve. I also liked that they gave you the rationales for the correct and incorrect answers—it really helps you learn to critically think through the scenarios. I’m not saying the HESI was a breeze because it wasn’t, but it was manageable. Some of my classmates may not agree with me seeing as though the class average on the exam was a 613. But I got a 1033—not too shabby. So I’m feeling pretty good—and it was comforting to know that all of the stress, the meltdowns, and the hair loss were actually turning out to be worth it.

But now when I get home from work I find myself totally stupefied. No chapters to read, no care plans or concept maps to develop, no exams to study for—what in the world am I supposed to do with myself for an entire month? And has cable always been this crappy?—there isn’t anything good to watch that I haven’t seen enough times to be able to recite the script on my own. I will get to spend more quality time with my family though. It gets so hectic during the semester that sometimes I feel like I’m just a family member visiting from out of town. Even my son has said a couple times—“it seems like I haven’t seen you for three days!” Between getting up at the butt crack of dawn to go to work, not getting home from class until after they’re asleep, and then tiptoeing out to clinical like a thief in the night on the weekends—sadly, sometimes that’s almost true. In order to pull this off everyone is making a few sacrifices—not just me.

During the break I’ll also have a little time to work on a few scholarship applications (times is hard, lol)—I know for one the deadline for the FNSNA scholarship is coming up in mid-January. Join me for a little friendly competition?  

But before I know it I’ll be bored out of my mind and ready to go back to school (and back to bedlam). Spring semester I’ll be taking Health Assessment and Maternity—maybe I’ll get to catch a baby or something 🙂

Happy Holidays and New Year to all—I’ll see you in 2010!

Ready, Set…

It’s been a month since my last post so I felt the need to check in. I actually wrote a quite lengthy post about the whole Creative Steps / Valley Swim Club incident but to be honest I am really tired of talking about it—Yes, we went to Disney World; Yes, we met Tyler Perry; Yes we had fun except for the fact that we were stalked by paparazzi and random people would stop us on the street because they’d seen us on television (I mean honestly how could you ever miss those bright orange shirts??). Thanks but enough already. Besides I think people have become so swept up in the hype that they’ve forgotten what this is really about and why this is all happening—that unfortunately, racism is not dead as some naïve folks would like to believe…  

Anyway, back to the next phase in my life—nursing school. I know I will regret saying this but—I cannot wait to go back to school. First of all, because I don’t know what to do with myself when I’m not overextended with work and school and home and so I’ve been sleeping to the point where my body is no longer absorbing it and I still wake up exhausted. Secondly, because I will finally get to do real nursing stuff! No more art history and world civ and pottery classes in an effort to make sure I’m one of those “well-rounded” students—bring on the pharmacology and starting IVs! Okay so this semester I’m just taking Intro to Nursing and Foundations so no IVs quite yet but I’m excited anyway. And I do realize that along with all this “fun” stuff there is a dark side—body fluids and poop to name a few, but hey somebody’s gotta do it…

We finally had orientation which gave me a little taste of what I should expect for the next two and a half years—total and complete information overload. You cannot even imagine all of the information that we were infused with in those four (short) hours. This included but was not limited to the bare essentials such as attendance and dress code, and professional comportment (“you don’t have to like everyone but you do have to get along”—trust me I get plenty of practice with this at work…). If you didn’t already know the grading system is a little different in nursing school. For instance in the real world a C ranges from 70-79, but in nursing school (or at least at mine) it’s a 75-77. There is no C-. Get a 74 and you just got an F. Get two of those and you’re sent packing. Talk about pressure! And let’s not forget the dreaded math policy–you must make a 90% within three tries on the math exams or you fail. I have long heard moans and groans about various nursing program’s math policies—“but I had the right answer, I just put the decimal point in the wrong spot”. Well, HELLO. Let’s face it, the difference between giving a patient 1mL of a drug and 10mL a drug may very well kill them.

We were informed of yet more stuff we needed to buy—such as a nursing lab kit filled with all kinds of goodies–BP cuff, IV set,  tracheostomy care kit, ostomy wafer and bag (I told you there was a dark side) and so on. They even threw in 10 whole alcohol prep pads (like those’ll last long). We talked about clinical compliance and all the reasons why former victims students were failed and/or kicked out—mostly HIPAA slipups. There was one girl who decided to get into an argument with a surgeon during an operating room experience (because of course she was so much more knowledgeable than he was)—so we’re no longer allowed to go to that facility. And lastly—the big kahuna—NCLEX-RN prep. So my school’s NCLEX pass rate hasn’t been so hot these past few years so of course they need to put in supports to help get that up. And guess who’s in the guinea pig class?—yours truly. So now we will have to take a HESI exam (which is supposed to predict NCLEX success) after each subject in order to continue on in the program. This is actually not a new concept. Other schools have already been using this method to weed out the poor achievers—and this is how they keep their pass rates higher. Basically you have to obtain a certain score on the HESI or you can’t continue in the program. At the end of the program you have to take the HESI “exit” exam and pass with a certain score otherwise the school won’t sign off on you taking the NCLEX-RN. So basically the school gets to make their pass/fail rates look great because if you don’t pass the HESI to their satisfaction you never get to take the NCLEX. Oh, and I almost forgot—we also have to do (and show proof that we did) 3000 NCLEX practice questions before it’s all said and done…so I guess I’d better get started now.

In other news my uniforms finally arrived and the pants are just as horrible as I remember them the day of the fitting. They are about three shades darker than the shirt but after an hour of retail therapy they had been replaced with some pants that I could actually live with (shhh…I don’t need the uniform police citing me for being out of uniform). And I know I live under a rock sometimes but when exactly did Baby Phat start making scrubs???—Kimora Lee Simmons definitely stays on her grind.  I am also now armed with my engraved Littmann stethoscope and some white Dansko clogs I got off eBay for peanuts compared to what they cost in the store. As soon as I knock off this $1000 book list I should be ready for nursing school. But the real question is—is nursing school ready for me??? Till next time…