The Dog Ate My Care Plan…

Just a mom/wife/nursing student extraordinaire trying to make it in the big bad city…

Posts Tagged ‘NCLEX’

D-Day: Operation NCLEX-RN

Posted by isntshelovlei on February 3, 2012

After proceeding through various security measures—fingerprints, photographs, and palm vein scans—I sat in front of that infamous computer terminal. The last two-and-a-half years of my life had been leading up to this moment. I took a deep breath and clicked “Start.”

It wasn’t that bad—I kind of pretended I was sitting at home doing practice questions on my laptop. I had beyond my fair share of the dreaded SATAs (select all that apply) which supposedly is a good sign—I’ve heard that they’re considered upper-level questions and if you’re getting a lot of them then more than likely you’re above the passing line.

For those of you who may not know, the NCLEX-RN can be anywhere from 75 to 265 questions (which is why they give you up to six hours to complete the exam). Obviously, everyone wants to only get 75 questions. And most people whose exam cuts off after 75 questions do seem to pass. But it’s all about demonstrating minimum competency. If you’ve accomplished that by 75 questions then that’s great but if not the computer will usually continue to give you more questions so that you can try to dig yourself “out of the hole” so-to-speak and get above that line. Contrary to popular belief, it is also possible to fail with 75 questions. How you answer those first 20 or so questions sort of determines your general competence level. Get most of them right and you position yourself comfortably above the passing line; however if you start off not doing so hot…

After I clicked the radio button for my answer to #75, I hovered my mouse hesitantly over the “Next” button. With one eye shut, holding my breath (and before I passed out), I clicked…and the screen went blank!

It was over!!

Afterward there’s a survey, another palm vein scan (they wanna make sure you’re still you and all), and they send you packing.

And then you wait…

This is truly the nerve-wracking part. The waiting. Official exam results can take weeks to receive in the mail; quick-results can’t be obtained for 48 hours. What on earth are you supposed to do in the meantime? Most people opt for the “Pearson Vue Trick” aka “PVT.” This is an unofficial way of checking whether you passed or not. Basically you log on and attempt to register for the exam again. If the system doesn’t allow you to register again and you get a popup that says something along the lines of “you’ve already registered for this exam, contact your board” you passed. However, if the credit card page comes up, then…sorry, you did not. A nifty little step-by-step guide can be found here.

So I did the PVT and got the “good” popup (make sure the status says “delivery successful” otherwise it’s too early to do it) so I was feeling pretty good. And the very next day my RN license was already posted on the state website—I don’t think you can get much more official than that! I’m a nurse! 😀

To those who have yet to take the exam be encouraged, be confident, and kick NCLEX butt! Good luck!

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NCLEX-RN Review Course Compare & Contrast

Posted by isntshelovlei on September 6, 2011

Since I’m so close to taking my boards (knock on wood), I figured now would be a good time to look at a couple NCLEX-RN review courses. As studying awaits (and time waits for no nursing student), I am only going to compare two for now—NCSBN’s Learning Extension and Kaplan.

The price: Nursing students (well, any students in this economy) are interested in the numbers. How much am I gonna have to rob Peter (or the parentals) to pay Paul? Well NCSBN’s courses will cost you any where from $50 – $160 depending on how many weeks of access you are interested in; whereas Kaplan is gonna run you about $418 – $499 (this figure is based on my zip code, so double-check your own zip code for the most accurate price in your area). But holy moly cannoli!

The timeframe: NCSBN offers 3, 5, 8, or 15 weeks of access to their course. Kaplan provides 21-hours of class time, plus 3 months of access to their online resources (more on those coming up).

The format: NCSBN is a totally online “campus,” offerring 24-hour access and the ability to work at your own pace. Kaplan has three basic format options—Classroom, Classroom Anywhere, and On Demand. Classroom is basically an in-class, brick and mortar type of deal (like we nursing students want to go to anymore classes—but, to each his own)—set dates, set times, set locations. Classroom Anywhere courses still have set dates and times, but allow you to log in from wherever. And On Demand pretty much speaks for itself—you hold the reins, and can log on and do your thing pretty much whenever (within your 3 months of access of course).

The meat and potatoes: NCSBN boasts access to 1,100+ “NCLEX-style” questions, 2,000+ pages of content review, in addition to other resources such as medical dictionaries and other online references. And if the idea of no professor standing in the front of the room freaks you out have no fear—they do offer the ability to ask questions via their “Ask the Instructor” feature. With Kaplan’s program, after your 21-hours of class instruction (if you selected one of the “Classroom” options), you’ll have 3 months access to 3 online resources—Qbank (question bank), Question trainer (practice tests), and a Diagnostic and Readiness test. Kaplan also offers a pass-or-your-money-back guarantee (certain restrictions do apply).

So that’s an *ahem* brief overview of the NCSBN and Kaplan NCLEX-RN review courses. On the one hand my id is screaming “What are you waiting for? 50 bucks?!? Can’t beat that with a stick!” But on the other hand my ego is saying, “Well wait a minute now, they must be mighty confident to offer a 100% money-back guarantee…”

So what’s a girl to do?

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HESI Smesi

Posted by isntshelovlei on April 22, 2010

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…

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Finally—Patients With A Pulse!

Posted by isntshelovlei on October 16, 2009

thumbnailSo we are finally out of the lab and in the hospital—woohoo for making it through all the exams, math tests, and lab practicum that made it possible. For a minute there I was becoming a little unraveled and thought I wasn’t going to make it. Our first day we had hospital orientation—which of course was boring as all hell. Videos upon videos we watched—fire safety, restraints, Accu-Cheks—ancient VHS tapes (do they still make those?) that they’ve probably been using for decades. And since watching TV has become such a rarity in my life these days, having to sit there and actually watch those videos for hours was just pure torture. Afterward we took a tour of our unit and the staff rolled their eyes at us with this “OH GAWD–we’re being invaded by nursing students” look on their faces. But whatever—never mind them. On my way home I stopped at Barnes and Noble to pick up a care plan book—Ackley’s Nursing Diagnosis Handbook—I LOVE that thing and highly recommend it. That along with my Medical-Surgical Nursing textbook (which at 2016 pages is more like a nursing bible) helps me crank out care plans with no problem.

Day 2 of clinical we were actually assigned a patient. The nurses were still less than enthusiastic at our presence, but none of them were downright nasty—though there were a couple that were a little more snappish than I would usually tolerate. But since this wasn’t my turf I had to fall back. I was assigned a sweet, older woman who basically had surgery but was discharged from the hospital too soon (imagine that—damn insurance pressure). So she had a fall, which landed her right back where she didn’t want to be. Acute pain, impaired mobility, and risk for peripheral neurovascular dysfunction were my nursing diagnoses for her. Probably should throw risk for impaired skin integrity in there as well. But basically all I did all day was vitals, hygiene/toileting, and meals. I didn’t get to give meds even though my patient was on plenty of them. I must admit I was bored out of my mind. The downtime at least gave me a chance to get a head start on my care plan. But even that was difficult given how cumbersome the nursing station had become with all the extra bodies—the only place left to sit was probably the bathroom!

And last but not least, we took our Fundamentals midterm last night (NCLEX-style questions of course)—I didn’t think it was so bad. You can usually narrow each question down to just two possible answers anyway. Both might even be right answers, but you have to determine which one is more right. Ah, the joys of nursing school…

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Ready, Set…

Posted by isntshelovlei on August 21, 2009

NursingSchoolSurvivalIt’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…

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