Feeling Productive!

Thanks to seven straight days off earlier this month, I was able to spend time working on some projects I've wanted/needed to do since my move in early October. I painted some furniture, restored a piece of furniture that I inherited and made a Roman shade for my kitchen window.

I inherited an antique "bookshelf" from my grandparents over five years ago. It was falling apart because it's actually a modular shelf made of six different pieces (base, case #1, door #1, case #2, door #2 and top) and therefore had gotten a lot of abuse over the years. My dad and I spent a while working to restore the integrity of it (gluing, nailing, adding supports) and then I cleaned it up with some wood cleaner, added a touch of stain to scarred areas and then added a little polish to it. Part of the design is that doors slide up and into the case. The doors originally had glass in them, but as you can see, I put in plaid covered inserts (thin paneling). Now I have a nice little storage case. It's been done for about two weeks and I've yet to decide what to put inside. The doors are still a bit fragile because the grooved tracks have worn out. So whatever I put inside will be stuff I don't need on a regular basis. But I LOVE the plaid fabric- it really "crisped" up the design of this piece. I wasn't exactly sure where it was going to end up, but it fits PERFECTLY on this wall!

And here's the picture of the Roman Shade. Yes, it's plaid too! (I'm a bit of a plaid freak!) I was originally planning to use "ring tape" but the ring tape my mom had was irregular, so I ended up having to hand sew the rings on the shade. It was a LOT of work, but I'm so thrilled with how it turned out! I still need to hang a lift-cord anchor on the wall. Right now I'm simply using a clip attached to an adjacent flower pot. I keep forgetting to go by Lowe's.




...and tonight, in less than two hours, I turned a beloved sweater into a Christmas stocking! This is a thick, wool petite (hits just below the waist) sweater that simply was too hot to wear with a shirt under it and too itchy to wear alone. I've owned it for a number of years and dutifully pull it out with my winter clothes every year, but I'm hard pressed to remember the last time I wore it. So today, it's now part of my knit Christmas stocking collection. I think this makes either #4 or #5!!

The point is to use the hem of the sweater as the top finished edge of the stocking, so while I'm a tiny bit disappointed at the position of the colored areas (wish it was higher), it was VERY easy to do and I'm pleased with my first attempt to re-purpose a favorite sweater! Thanks Pinterest!

It's been years since I've done any pleasure sewing. It feels really good to use my creative side, and even better to produce something I end up loving!! I have some left over plaid fabric from the above projects, so I'm contemplating how I might use the leftovers along with a bunch of other plaid fabric I have collected over the years. Maybe my first quilt? or a quilted wall hanging? or a braided rug like this, or a fabric seat belt cover (I'm short, these are a life saver!) or perhaps one of these? Hmm?

Time and Patience

Today I stopped by my nursing school to drop off a couple things and as luck would have it there was a faculty meeting and so I waited a bit and got to see a handful of my instructors and the program director. It was really good to see them!  They asked about where I was and how I was adjusting. It made miss having people in my life that care about my success. The faculty do care, despite what students think.

There are days when I wish I was back in school and enjoying the slower pace and low pressure environment. I am far happier on night shift because things are a bit less hectic and whirlwind. I've had a couple doozy nights. On night shift, we are pretty much non-stop between 7 and 11p but after that the work ebbs and flows depending on our patient load, acuity and any admissions, but usually there's another nurse that can come help when needed. There are still plenty of things I have not seen before or dealt with. In those instances, I HAVE to find help. Last night I administered blood and it was my first time. I printed out the hospital policy and procedure and with help and coaching from my Charge Nurse, things went well. Last week I had my first NG tube-fed patient that required me to do flushes and meds according to hospital policy. Every week there's something new to learn. Obviously learning is good, but I really hate asking for help (but of course I do). It's inexperience, and I hate it. One of the instructors that I saw today said that it's usually at 9 months where you start feeling a bit more confident and less insecure.  Guess I need to start another countdown timer.

Those who know me know that I don't lack self-confidence or strength. I am strong. I am confident. I just HATE feeling out of control. And honestly, that's probably the hardest thing for me as a new nurse. I have NO actual control over my patients and what happens next. I can certainly plan how I will go about my shift, but hypoglycemia, fever, arrhythmias, delirium, vomiting, chest pain, stroke, bleeding, and pain can totally disrupt those plans and I must respond accordingly while also still managing to get everything done that I must get done. I will become more proficient - more efficient. But it will take time and practice. So daily I am practicing patience with myself and others. 

The BEST part of my job is the opportunity to make a difference for a patient. Just this week I had a patient who was having trouble sleeping because of his shortness of breath combined with claustrophobia. He was a handful at night as he was uncomfortable and needed to move around but was not physically strong enough to move himself safely. He rotated from in the bed, to side of the bed, to the chair and back around and around.  At one point he said, "I'm sorry that I keep calling and needing your help... can you tell me why is it harder to breath when I'm laying in bed and a bit easier when I'm sitting on the side of the bed?" So while he was sitting on the side of the bed, I just sat down on the stool and sat with him and took the opportunity to spend time with him and explain how positioning makes a difference for people with heart failure and/or COPD. He was so grateful for my explanation. No one had ever validated his feelings or explained this in a way that helped him understand. Fortunately, I was finally able to get him some medication ordered that took the edge off his anxiety and shortness of breath so that he could sleep. In the morning I came by to check on him before I left for the day and he said "I want you to know that I really appreciate you taking the time to  explain things and your help last night. Thank you." Yes, he was a lot of work for three nights, but it's so satisfying to come alongside a patient who is really struggling and to not only help them with their physical needs, but to also see the light bulb go off after providing just a little bit of education about their situation. 

When I look to the future, I don't see myself doing bedside care for the long-term, but rather I see myself in a patient education role or working in a clinic where I can spend more time with patients. Perhaps a cardiac device clinic? I think I'd be happier in a position that is a bit more predictable, consistent and is less "in the moment" acute care.  But who knows - maybe with time and increased experience, I will grow to love bedside care such that I can't imagine being anywhere else. Time. And. Patience. Oh joy!

Missed Me?

Yeh, well, returning to work full-time has certainly reduced my leisure time. And working twelve hour shifts has certainly taking some getting used to. Last week I switched over to nights and tonight is my last shift on official orientation. I still have so much to learn and there are plenty of things that I haven't seen before that I will need assistance with.

Last weekend I officially moved in to my new apartment. Well, I'm not exactly moved INTO my apartment as there are boxes and piles of stuff that I need to find homes for. I still have flower pots outdoors and a few things in the garage at my previous location, but the homeowners are not chasing me out - yet. It's nice to be in my own place and allowed to decorate and organize as like. But I have too much stuff and yet it's hard to let go of perfectly good stuff knowing that ONE DAY I might want it!

Two weekends ago I flew to Michigan for the 20th highschool reunion for the school I attended through 9th grade. Since I was in touch with most of former classmates they invited me to attend even though I didn't graduate from there. It was really great to go back and catch up with those friends!  A week from tomorrow I will drive down to South Carolina to attend my actual 20th highschool reunion. I've been to SC within the past five years and have seen a few classmates during those visits, but I haven't seen the majority of my graduating class since our 15th-- which was before my trip to Liberia (I think). My night shift brain is kinda unreliable with that sort of information. While I'm looking forward to my SC trip, I will be glad to have my big travel plans and events (moving!) out of the way for a while. I'm ready for normal for a while.

I will eventually get around to writing about my orientation in a very general way. Eventually. Won't promise when! :)

Until next time.

Back to School for Some

It's hard to believe that the buses are running again and that it's back to school season. Makes me very happy that I am not heading back into the classroom this semester.  One of the gals that I went to school with, who works in another department at my same hospital, has gone back to school this fall. I cannot imagine!  I am taking the advice that I got when I was applying for my job and I am going to hold off on going back to get my BSN until I've got my second year of nursing under my belt. My brain is on overload as it is after three twelve-hour shifts and it takes my four days off a week to recover and recharge for the next week. I cannot imagine trying to attend classes or studying on my days off! I need to build my confidence and knowledge for my day-to-day nursing practice before trying to squeeze more into my brain.  

But best wishes to my friends who are starting back to school- in whatever field they are in... but definitely to my friends who are starting their last year of nursing school! You are almost there!

RN Orientation: Week Five

Well, I failed to update as promised, but that's because as soon as my work week was over, I headed out of town! So I'm going to skip my Week Five update, because there's really nothing new to mention. Just continued to care for patients with my preceptor.

Thursday I drove up to Northern Virginia to joined my sister, my niece and some of her friends for a Kelly Clarkson concert that night. On Friday, I caught up with an old friend from C'ville and her VERY cute six month old baby boy! After that, I headed over to the highschool where my sister teaches and helped her get her classroom and other misc. things ready for the start of school (today). From there I went and had dinner with a blind date which we both discovered right away was not a good match. I ended up staying another night with my sister and helped her out again in her classroom on Saturday morning and then joined my sister to go watch my niece play in a travel soccer tourney (first of the season) in Germantown, MD. After dinner I made the trek back to C'ville. Whew! Full but great few days with my sister.

Next weekend my mom's family is having a reunion of sorts to commemorate what would have been my Grammy's 100th birthday. I'm looking forward to seeing everyone, especially my sisters and my cousins who I don't get to see that often.

For the past four years I've been fortunate enough to be house-sitting and not paying rent or a mortgage --just utilities. This was so perfect for when I was fresh home from Liberia with no idea as to what to do next (work-wise). And then for the past two years I've been able to go to nursing school without having to worry much about my finances. If it wasn't for this house-sitting gig, I never would have considered going back to school. The original thought was that the homeowners would be gone five years, then possibly a sixth year, but last week they called and said that he is switching positions and they'll be returning to to C'ville next month. So now I am busy making lists and exploring housing options. Thankfully they are not pushing me out and I can take my time to find my next place-- even if it takes a couple months to find.

I'd love to find a place close to work, but it also needs to be inexpensive and somewhere quiet where I can easily sleep during the day (when I move to night shift). I totally expected that I'd be making transition to night shift while living where I am currently where I don't have to deal with roommates or loud neighbors. I really need to stay away from student housing/apartments as they come and go all day long. I also need to avoid basement apartments--unless the person(s) upstairs work day shift AWAY from home. The Lord has provided abundantly for me with my current housing and I can only believe and trust He has a good plan for me. The timing is amazing (done with school and I have a job!).  I'm excited and hopeful that my next home will be beyond what I could ask for or imagine!  I have my wish list that I'm praying about.

RN Orientation: Week Four

Well, I'm already half over with week five and I realized I have not posted on week four!

I'm doing a bit better with packing sufficient food and taking breaks to eat. I've tried a few protein shakes (soy, whey, other) with mixed results. I've started packing two hard-cooked eggs which are quick and easy to eat (if I peel the night before). And I'll eat one mid-morning and another mid-afternoon. I also made a batch of peanut butter balls (PB, honey, powdered milk) and they've been tasty treat that I look forward to. I think part of my issue of feeling tired and hypoglycemic is partly being dehydrated, so I'm trying to make more of an effort to drink more water throughout the day with a goal of drinking 16 oz in the morning before work and 16 oz at lunch and 16 oz on my way home. It hasn't worked out completely that way, but I when I have consumed more water, I have felt better. Of course more water means more trips to the bathroom - which often feel like a luxury to a day-shift nurse!

There are certainly moments where I feel completely overwhelmed and clueless as to what to do or what's expected. I was an excellent student but it doesn't mean that I retained it all (disease processes, meds, heart rhythms, etc...) And here I am learning so much at one time, that I feel like I'm not retaining it very well. But with practice comes familiarity.

In school I never got to insert an IV in a live person (only fake arms) and within the last week I've had two opportunities to insert them but b/c of various circumstances I didn't get to... But chances are I would not have been successful anyways as BOTH patients were elderly and ended up being VERY difficult sticks...even for the experienced nurses (requiring several attempts). My time will come!

In a few weeks I will be caring for three patients "independently" with my preceptor as backup. I'm a bit nervous about this as every day I'm experiencing all sorts of new scenarios with each patient I'm assigned. And while I feel comfortable with certain aspects of patient care and assessments, the other aspects such as calling docs, IV therapy, patient teaching, answering patient questions, knowing protocols for post-procedures and other scenarios (stroke, chest pain etc...), well, they are a bit more intimidating. Everyone says I'm doing well, but yet I have a lurking fear that I just have everyone fooled. But I KNOW that I will rise to every opportunity. Every new RN has strengths and weaknesses and deals with feelings of insecurity and feeling stupid. But we all have to start somewhere. Everyone has been so nice and supportive and encouraging -- it's my own insecurity that makes my sleep a bit restless and not restful.

I'll write again in a few days with update on this week (week five) and some things I'm looking forward to that are not work-related.

RN Orientation: Week Three

I have survived five shifts and have completed my third week of orientation (first 1.5 weeks were classroom orientation). My unit is absolutely hopping! In one day my preceptor and I discharged all five of our patients and then admitted another four (in those same rooms!) before our shift was up. My head was spinning!

One thing I'm really struggling with is feeling hypoglycemic (hungry, tired, weak, irritable, unable to concentrate) during late morning and mid-afternoon and late afternoon. My preceptor and I will be in an alcove charting and discussing stuff and my eyes will glazed over and I know I'm not really absorbing all that she's saying. It's really frustrating. I am really trying to get to bed early so that I'm getting at least 7 hours of sleep. My unit really does encourage nurses to take their lunch break (30 min), but my body needs food much more frequently than every 5-6 hours, but it's tough when I'm not in control of what happens next (my preceptor does) and I'm afraid I'll miss something if I take a quick break. 

 I'm researching and thinking through what I can take to work food-wise that will help keep my blood sugar up that won't require any food prep (like heating up) and that I can possibly have in my pocket for those moments when I start to feel that edgy feeling. I've never learned to like coffee, so any caffeine would be a diet soda...which I really don't want to consume on a regular basis or in large quantities. I know caffeine is not the answer and neither is sugary food (although it does help short-term). I can feel crappy with a blood glucose of 80, which is not considered hypoglycemia. However, someone suggested that it can be the rate at which the blood glucose falls that can make a person feel crappy. My blood glucose tests have always been fine and my doctor has never been concerned, and the advice is always to eat several smaller meals throughout the day to keep glucose levels relatively consistent. That's easy when you can stop what you are doing to grab something to eat, but now I'm working 12 hour shifts and don't always have the convenience of stopping what I'm doing to go grab a snack!

So I probably need to go see my doctor and find out if there are further tests or recommendations. But first I think I'm going to start doing a better job of writing down when I eat, what I eat and when I start to feel crappy...and what helps or doesn't help... and maybe I'll even get a glucometer to keep track of my levels throughout the day.

I'd like to drop some pounds and I'm hoping that with the increase of activity (36 hours a week on my feet), that I will be able to. Unfortuately, there's no time to hit the gym on the days that I work - there's only time for sleeping, eating (barely) and working. But that means that I will HAVE to get to the gym on my days off and pay attention to what I'm eating...and not eating crap (sugar) when I feel like crap. Easier said than done.

Hopefully in time I will adjust to twelve hour shifts and figuring out what works for me. Right now it's just tough because I'm paired up with another nurse who has grown accustomed to shifts and knows what SHE needs to do to keep her energy up. We were a bit disorganized this past week for a variety of reasons and I'm hoping we can be a bit more organized this week. Here's hoping.

Aside from the above, I'm getting to see and DO a lot and learn a lot of new stuff! There is no way for nursing schools to teach us everything. Every hospital and every unit, has their own way of doing things (admissions, discharges, charting, etc...). I am fortunate that my hospital moved in to a nice new facility and really thought through the design and made really smart decisions about patient rooms, and access to meds/supplies, which can significantly cut down the amount of trips (and wasted time) to/from the supply room!

Aside from my patient care, I also have a number of classes that I have to take during my orientation period that are related to my unit. Since I'm working on a Telemetry unit, I am scheduled to take classes on topics such as EKGs and dysrhythmias and a handful of other classes that are cardiac and neuro (stroke) related. This coming week I'll be taking a class to prepare for a change in how physician orders are entered and retrieved (we currently work with electronic and paper charts and will soon go to just electronic).  It'll be a very good change and hopefully will save time for everyone...not to mention saving money and trees and counter space at the nurse's station!!

I've been adding some more links to articles on the side bar. I decided to break down the topics into: New Nurse General Tips, 12 Hr Shift Tips, and Night Shift Tips. When I find articles that I want to come back and read, I will link them there...but reality is that I haven't necessarily read them in their entirety (or even followed the tips). As I get time to read them, I may end up removing some if they end up repeating each other or end up useless.

RN Orientation: Week Two

My First Twelve

It's going to take a while getting used to twelves! By the end of my first twelve hour shift all I could think about was my feet. Now that I'm home and my feet are up, I'm now thinking about my knees. Maybe when I go to bed it will be my ankles. Ha!  I've not done anything about shoes. I wore my Danskos today, but since there always two of us together (my preceptor and me), she's often the one sitting and I'm left standing... so maybe I'll wear tennis shoes on Friday and see what the difference is.

This morning I was set to wake up at 0430/0445  (to leave the house at 0600), however at around 0300 I woke up and sneezed. It wasn't until I got up at 0430 that I realized my nose was running and I was probably dealing with a head cold!  It's been two years since I've gotten sick...and my first day on the unit and I start coming down with a cold! Sigh. So I'm going to treat tomorrow as if it was a sick day (even though I'm not scheduled). I'm going to get up at 0430, get a shower and then I think I'll go back to bed as if I'd called in sick. So much for getting to the gym tomorrow.

My main preceptor typically works Monday through Wednesday, so in order for me to get my hours this week, they put me with another nurse for my first day (and again this Friday). I was basically thrown into the mix of everything. Doing vitals, meds, discharges, admits, charting, calling dietary, etc... The best part was being told I can sign or co-sign something because I'm RN!! Such a strange, but fun, new experience.

The most awesome part of it all... I leave my work at work. No homework, no studying, etc... Sure I will have things I will want to review and look up at home, but I'm thinking that for now the majority of my learning is going to take place on the job. Which is how I best learn anyhow.

Overall a great first day on the unit.

RN Orientation: Week One

First day of work, er, orientation. I'm so thrilled to be at this hospital. Having been through orientation in other jobs...this has been well-organized, well-staffed, and everything has tied together well and feels pertinent to my role. Class act!

I think the most thrilling part of the day was the end when they took my picture and handed me my ID. To see the RN tag attached was a really cool moment. I've been envying everyone else's RN tag for years. Now I have my very own!

Tomorrow will be another day of basic hospital orientation. Then Wednesday through Friday and Monday and Tuesday of next week I will be in the simulation lab getting trained and tested on a variety of nursing skills and related information. Then next Wednesday and Thursday I will hit the unit for 12 hour shifts! Wow, it's been a LONG time since I've worked a 36+ hour week!

I stopped by the unit this afternoon and learned that my preceptor primarily works Monday through Wednesday. So it seems that I will be working few, if any, weekends during orientation. I'll take it! Working 12 hour shifts is definitely going to take some getting use to! I'll wake around 5am, leave house at 6am, work 7am-7pm, then have two hours to drive home, eat dinner, & chill out  before heading for bed at 9pm so that I can get eight hours of sleep. Whew. I'm not sure it's even realistic to think that I could squeeze in a quick trip to the gym after work...I'm thinking that it might wire me up if I work out and then shower right before going to bed. Oh well...something to try a few times to see.

Last week I ordered up a bunch of scrubs on-line and they are scheduled to be delivered tomorrow! Can't wait! I bought a variety of top/bottom styles and I'm hoping that I'll like the majority. I decided to go with solids and skip printed tops all together and the local shops did not offer options that I liked. I'm not all that inspired by the scrub top prints that are out there these days,and it's also recommended that I wear monochromatic tops/bottoms to make me appear taller and leaner [prints/color blocks make your look short and wide(r)]. We'll see.

Well, I am exhausted and about to fall asleep. Guess I need to take a short nap to revive for another couple hours.

Reflections on My NCLEX Experience

As promised, here are my thoughts, tips and suggestions related to NCLEX.

Testing Location | The Lynchburg, VA PearsonVue testing center was AWESOME! Relatively easy to get to and the two women staffing it were very kind and friendly. I am so glad that I switched from the Richmond location to the Lynchburg location. Rumor has it the Richmond location has room for over 50 people to test at their center (maybe even 75?), whereas the PearsonVue testing center in Lynchburg has room for only NINE people. While smaller does mean there are fewer available spots/times available on the schedule, the reason that smaller is better is that there are far less people making noises and creating distractions during the exam. PearsonVue administers over 100 different types of tests/exams and so there's no telling who you will be seated next to. Some of these other tests/exams require essays, so there could be extensive typing noises -- imagine that in a room with over 50 people. While waiting to be registered/admitted to the exam room, I learned that the nine of us were all scheduled to take the NCLEX-RN exam...so minimal noises coming from each mouse. PearsonVue sites offer earplugs...so take advantage of them if you are stuck testing at a location with lots and lots of people.

Scheduling/ Time of Day | When I signed up for the Richmond testing site, the only available time was 8am around the dates that I was looking for. Since it was going to take me about 1.5 hours to get there...plus I needed to be there at least 30 minutes early... I was looking at trying to leave my house at 6am (at minimum)...and so that meant waking up at 4:30am. Uh, no thanks! I could've gotten a hotel room... but who wants that extra expense and the possibility of a poor night's sleep in an unfamiliar, possibly noisy environment? So I was really happy that the Lynchburg site had an afternoon slot available when I checked their availability.

Scheduling/ Day of Week |  I did enough research in advance, that I learned that it's best to schedule early in the week and not right before a holiday. The reasoning is that you don't want to have to wait any longer than necessary to get your results. After taking the NCLEX, all you can think about for the rest of day is whether you passed or not. Do you really want to wait all weekend? Probably not. In Virginia, you are supposed to be able to call a phone number and get results the next business morning if you used your social security number at the time you applied with the Virginia Board of Nursing. Being the ever-conscientious me, I didn't want to use my SSN and therefore used my driver's license ID number to apply for licensure. I discovered several weeks before my exam that I'd have to wait until the second business day after my exam to find out my results over the phone.  WHAT I DID:  I scheduled on a Friday. Yes, exactly what I don't recommend. But my options were limited and my priority was to get an afternoon slot - even if I was going to have to wait all weekend (and possibly longer) to get my results. WHAT HAPPENED:  Well, I got my results on Monday via the Virginia Board of Nursing's website (so much for having to wait a second business day!) I also was not freaked out all weekend primarily because I was distracted with the big storm that blew through our area. The derecho hit Friday night and out went my lights, water, air conditioning, internet, etc... So I ended up packing up and heading over to my parent's house (45 minutes away) on Saturday to avoid the unrelenting 100+ degree heat. So I was at my parents house all weekend and the disruption to my normal routine was all the distraction I needed. And it was fun to be able to get my NCLEX results and be able to tell my parents right away and in person. So it worked out for me, but I'd definitely recommend scheduling for early in the week (also avoiding holidays like Memorial Day or July Fourth).

Mock Run |  I totally recommend doing a dry-run to the testing site. Ideally done at the same time of day and same day of the week that you are scheduled to test. I planned to go the Friday before my Friday exam, but something came up and I couldn't. So while I still made the drive (using Googlemaps and my GPS for directions) and got a rough idea of the time it would take and knew I could find the location, I still didn't absolutely know the timing on a Friday afternoon. However because my test was at 2 pm and I knew it would take roughtly 1.5 hours, I decided I would eat lunch in Lynchburg in advance of my test, and allowed myself an hour to do that-- which provided plenty of buffer time in case traffic was bad (accident) or if there was unexpected/new road construction. Another girl from my same school did not do a test run and she arrived several hours ahead of time to make sure she could find it... and then proceeded to camp out at the testing site. Boring, stressful, etc... I arrived 30 minutes before my assigned testing time - as instructed - and I was glad that I was not any earlier. A lot of the girls taking the test with me were really anxious and stressed out. You generally want to avoid that - it's not going to help you stay calm. If you arrive early...just wait in your car (unless a 100 degree day like it was for me!).

Here are some other thoughts:

• Take the Kaplan course, or at least buy access to Kaplan's Q-Bank. Doing 50+ questions in one sitting builds endurance. And you will need endurance for the NCLEX!  I feel that Kaplan's Decision Tree was very helpful--especially when I wasn't sure of the answer. And I'm not sure I would've really understood or used the Decision Tree if I had had to learn it myself. I'm SO GLAD I took the Classroom Anywhere (online) class!  I did not complete every QBank question, only about 750-800 qeustions. I simply ran out of time, but I did do all the QTrainers. While taking the Kaplan course, I posted about my experiences each day: Day One, Day Two, Day Three, Day Four, and then posted my scores here.   Also, Kaplan's QBank and Qtrainer formatting and questions look EXACTLY like the NCLEX. So while taking NCLEX...you can calm down and pretend you are just doing Kaplan questions. :)
• Take NCLEX before starting your RN job. Starting may not even be a possibility for you as some hospitals require that you get your license before you start orientation (too expensive to begin orientation of a new grad only for the new grad to fail NCLEX). My hospital is not that way, they are willing to allow new grads to start without their license (which is permitted by the state of Virginia, of course!) Yet I knew myself enough to know that I would feel better having it out of the way. Orienting to a new job is stressful enough, not to mention 12 hour shifts! I'm relieved to have it behind me and to be able to start orientation without having NCLEX hanging over my head. However, I understand that some folks need to start work right away because of finances and in that case... just make a plan for studying for NCLEX. Pick a test date and work towards it...don't put it off. Get it over with as soon as possible.
• Before exam day, READ all materials on the PearsonVue and NCSBN sites related to NCLEX and testing center...especially the rules. No sense in being caught off guard that you can't chew gum during exam or that you cannot take lip balm in with you! No surprises...take responsibility and know the do's and don'ts and what to expect! 
• Don't study/cram the day of your exam or even the day before your exam. I found this particularly helpful in de-stressing. Reality is that you only know what you know. No amount of cramming is going to help! Also, looking back, there is NOTHING that I would have chosen to study that would have helped me on any of the questions! The material is to vast to even have a clue what you should cram for!
• Take deep breaths from time to time. There were times when my eyes glazed over while taking the exam and I ended up re-reading several questions multiple times - simple because I was having a hard time focusing mentally! I was aware of every little thing: the clock, the video monitors, the audio recording (yes, they do audio recording of you taking your test!) and the sounds of other test takers... and of course the voices of your head saying "what happens if I don't pass?" (despite trying to avoid that type of self-talk). So when I would catch myself being distracted, I consciously took a few deep breaths and tried refocus.
• Select your answer, then REREAD the question. No sense in getting a question wrong because you failed to read the question correctly. One of the things that doing endless Kaplan questions does -- is that it reinforces the need to really understand what the question is asking. It is looking for a positive or a negative answer? Is it looking for a psychosocial answer rather than a physical answer? While doing Kaplan I regularly went back and reviewed the questions that I got wrong and there were always a few questions that I failed to read the question correctly.
• The PearsonVue Trick (PVT) DOES work. Essentially by trying to sign up to take the NCLEX again, you can find out if you passed or not. I did the PVT trick within an hour of taking my exam. Here was my "good pop-up."  You can read more about the PVT here. 
• Other thoughts about NCLEX that I posted are here and here.

I hope there's something here that you might find helpful. I can only talk about it from my point of view and to   point out what I've read online (mostly at allnurses.com) that influenced me and my experience.

Whatever you do... keep a positive attitude. It will take you far and reduce your anxiety about NCLEX! Best wishes for those who still have NCLEX on the horizon. You can do it!

Bad Dream

Last night I had my first dream related to starting my new job. You know...those dreams where everything is crazy and goes unbelievably wrong and when you wake up you are sooo relieved that it was just a dream. For me, throughout my dream I was in a state of frustration, stress, embarrassment and completely overwhelmed. When I woke up, I was so relieved that it was not real and started processing through all the problems encountered in my dream and how I should've handled them or how I could've prevented the problem in the first place. For example....in my dream, I had multiple patients (five?) in one room and I had an elderly patient who was peeing endlessly and consuming all my time as I repeatedly tried to clean her up! Hello??? Why the heck did no one think to put a brief on her? And because of this I had not gotten any vitals on any of my patients and not a single assessment either! In my dream I was glued to this patient and stressed out about not getting to my other patients. Ack!

This afternoon I was telling a friend from nursing school about the dream, and she laughed when I told her that I reviewed everything that went wrong in my dream. She said... "It's like you were evaluating your nursing interventions!"  Yeah, what interventions?!?! hahah!  But it's true- I was using the nursing process in my dreams (albeit mostly unsuccessful), but especially after I woke up when I starting thinking through all the things I could've/should've done instead. I guess I learned something in school!

So there you have it... I guess I'm experiencing some anxiety about starting my first RN job. I guess I should be prepared for some more crazy dreams in the coming days, weeks and months. So not fun.

Scrubs for Your Body Type

Stumbled upon an online tool by Scrubs Magazine to help you figure out the best scrubs for your body type. Find it here.   Guess I'll be sticking to plaid shoes or hair ties and not plaid scrub tops.

Scrubs Magazine also has interesting articles too. You can follow this link to their current edition. And be sure to scroll through archived articles for other interesting reads.

Off to go scrub shopping (again). 

Shift Work

Since it looks like I will be working the night shift once I get off orientation, I have been doing a little research trying to collect info, strategies and tips for working nights. I've been adding some links regarding working night shift to the "NEW NURSE LINKS" on the side bar - mostly for me to go back and read.

My hospital organizes a couple mini-retreats for new grads throughout our first year of nursing. My understanding is that one the topics at the retreats is sleep and/or night shift issues! Obviously the nursing admin is interested in patient safety issues and want to address issues that affect job satisfaction, but they also want to keep us medically and mentally healthy too. I'm nervous about the health aspects, but also about effect it will have on my social life. Is this going to be one more obstacle to dating? 

An "Ah-ha" Moment

 During my recent interview process and through reading of various hospital documents, I have become more aware of the importance of developing a professional nursing portfolio. A nursing portfolio is basically a snap shot of one's career. It is now expected and/or required when applying for jobs or when challenging the clinical ladder within institutions. I've been told and have read in multiple places that it's never too early to start working on your portfolio.

The past couple days I've been doing some internet research and information gathering (so grateful my school doesn't cancel my access to online journal articles through the library) on nursing portfolios. I am a very visual person and so I want to SEE an example, what's included, and to understand how it's presented or submitted.

While searching for articles and examples on-line, it occurred to me that I had already started a nursing portfolio, except mine was created and then subsequently forgotten after NUR 100 (my very first nursing course two years ago). At the time, my instructor, who was requiring it, did not call it a portfolio. I have no recollection of what she called it or how she framed the assignment, but I do not remember the word portfolio being used. But at the time, we were all pretty clueless about why we were being asked to develop a website. It made absolutely no sense to us at the time and even a year or more later we were still joking about the assignment - still clueless! If you are curious, here is mine.

Obviously it was created without regards to professionalism. I'm not kidding, on the "About Me" page under Factoids, I actually include "I can touch my tongue to my nose. My tongue regularly palpates my tonsils."  Oh boy! At the time I was just looking for filler and looking to amuse my instructor. I remember that I proudly went above and beyond the requirements for our assignment.  Definitely a little too far.  Anyways, my website is desperately out of date and not even close to the professional portfolio that I would actually create and submit. But it's good for a laugh now.

One year from now I will be gearing up for my first performance evaluation and at that point I will  automatically be bumped up from RN-Clin I status to Clin II status. But to advance further on the Clinical Ladder, I will need to submit a portfolio for consideration. It could be a couple years before I would pursue Clin III status and that's time enough to misplace important documents or to forget stories that might be appropriate as an exemplar of my clinical and/or leadership skills. My thinking is that by simply collecting and writing supporting documents over the next couple years, I will have much less work to do when the time comes to prepare and finalize it for submission. It seems overwhelming now because I'm at ground zero, but over the next year or two I can certainly spend time working on it (once I know what MY hospital is looking for). And then the point it is to never really let it get out of date.

Looking back, I really wish I had understood the reasoning and rationale behind that website assignment. It makes sense now. Perhaps it wasn't sufficiently explained or maybe it was explained but it just went over my head? Either way, I'm sure there will be a lot of "ah-ha" moments in the coming months and years as I connect the dots between my education (and what we thought were bordering on ridiculous, time-wasting assignments) and my actual practice. Life is funny that way.

One of the most significant things I learned in nursing school is that the majority of people/patients need a rationale in order to fully embrace the need for change (or to do homework). It's one thing to inform a man with high cholesterol that he needs to change his diet and lifestyle and something else all together to explain WHY he must work to lower his cholesterol levels. Preaching rarely gets you the same results as teaching.  Well, at least that's true for me. I need to understand the rationale and the bigger picture before I'm able to embrace new information or change.

Footwear

So... I have been looking for some nursing shoes. Something that will be both functional and also reflect my personality. The other day I was inspired to look for plaid clogs. Why? Because plaid is my favorite color!!!  (Yes, you could argue that plaid is not a color, but for me it is. I don't have a favorite color...and who says they have a favorite print?)  My favorite plaids are tartans, specifically:'

Royal Stewart Tartan Plaid

Dress Stewart Tartan Plaid

Black Watch Tartan Plaid

So I start looking around for plaid clogs. This is what I found:

Perfect, except that I really want my heel covered.

Too cute, but since they are fabric they would absorb bodily fluids. Also I think my feet would kill me before my 12 hour shift is up. Oh so cute. Maybe I should get them for every day use?



At some point I bumped into the idea of handpainted clogs. And these "argyle" ones are the closest I've come to plaid. But at $219 they are way out of my price range.

I even posted on Facebook my disappointment in lack of plaid footwear for nurses and the mom of a childhood friend mentioned that her son (my childhood friend) airbrushes all sorts of things and is quite talented. But plaid is plaid and I'm not sure you can airbrush plaid effectively. Sigh. And I'm not sure I'd have the courage to buy expensive red patent leather Dansko clogs and paint my own. I know I'd end up hating them.

So I think my dream of plaid nursing footwear is kaput unless I find someone in Scotland who could locate a pair -- but the whole "buy without trying on" freaks me out--especially if I'm also looking for comfort. I don't need a $150 pair of uncomfortable shoes.

Today I strolled into the local high-end shoe store that sells Danskos. And I fell in love with their 20th anniversary clog.

Dankso 20th Anniversary clog

20th Anniversary shoe artwork

I LOVE the script, the words (very appropriate for nursing), the color -- EVERYTHING. But alas, a limited edition means just that. I'm late discovering these awesome shoes. The only size I can find online (including e-bay) and local stores is a size 37. I need a 39. Ack!

So back to the drawing board!

May be I should write to Dansko and suggest they add a tartan plaid to their shoe designs. It would be a BIG seller!   If anyone has any ideas for where to find plaid clogs, please drop me a comment!

Another thought crossed my mind... what if I ONLY owned and wore plaid scrub tops? I'd FOR SURE become known as the plaid nurse!!  There's no flying under the radar for this girl! haha!

Why I Want to Be a Nurse

Once upon a time I promised to post my "Why I Want to Be a Nurse" paragraph. This was required when I applied to my nursing program. It's kinda fun to go back and read my thoughts from over two years ago.

Why I Want to Be a Nurse!

I recently spent a year living in West Africa where I worked with a health-oriented NGO. My days were a mishmash of emotions as I poured myself into my work as a nutrition volunteer. I experienced great heartache as I uncovered the willful neglect of a malnourished four-year-old child. And then experienced profound joy and pride five months later when that same child was growing and laughing and learning how to walk again. Those experiences, and many more, revealed to me that I have the heart of a nurse, but I am frustrated with my lack of knowledge to really be effectual in that role. I carry in me a desire to educate and to bring hope and encouragement to my patients. To advocate and fight for those who have no voice and to empower those who have lost their voice. To help families find solutions for themselves and to laugh and cry with them as they walk uncertain paths. To promote dignity and life in the midst of the most challenging of circumstances. I want to be a nurse so that I can make a positive difference in people’s lives—whether they are taking their first breath or last breath. I also want to be a nurse because the nursing field is diverse and affords limitless opportunities for learning and professional development. The demand for nurses has also made it a field where there is excellent income potential and opportunities for advanced education. And finally, I want to be a nurse so that when earthquakes and tsunamis, wars and famines happen across the world, I will have critical skills that can be put to use immediately!

Copyright © 2010 Joy Hancock.
This is my intellectual property. Please do not steal and/or use any portion of it for your own use. It would be unwise and unethical to take my words to use as your own. Think.

Thinking Ahead

Found this article "Tips for Your First Year as a Nurse" and it definitely has some helpful tips...even includes her 12 hour day shift routine.  Think I'll post this on my side bar links.

I'm looking for other articles. I'll keep posting as I find them.

Registered!

It's official. I am a Registered Nurse!

I logged on to the Virginia Board of Nursing website to check my status. I went from "pending license" to having a license number issued! Woohoo!  Feels great!

In other great news, I got the job! My nurse manager just called with the official offer (I was told on Friday to expect it early this week). I'll be working on a 30 bed telemetry unit that is primarily cardiac and neuro patients. I'll be starting orientation on July 23!  Now, I have about two dozen thank you notes to write to faculty and friends who provided references and/or put in a good word for me with those looking at my application. Plus, then there are all those great nursing instructors who helped me from start to finish!

How cool to get license confirmation and job offer all in the same day! God is good! I must tell you that I am SO GLAD that I went ahead and took NCLEX before starting work. Starting a new job is always a bit stressful for me. There's always so much to learn and remember, that my brain is usually shot at the end of the day. I knew it would be too hard for me to manage starting a new job and studying all at the same time, so I really forced myself to study and get the NCLEX over with.

Virginia permits new grads to work without a license within 90 days of obtaining their ATT (authorization to test for NCLEX), but it's up to the hospital to decide how they want to handle it. The larger teaching hospital in town does not permit new grads to start working as RN's until they have their actual license. They hire tons of new grads and it costs mega bucks to train and orient a new grad, that they don't want to take the risk of having a partially trained new hire fail NCLEX and not be able to work. The hospital where I'll work does permit new grads without a license to begin orientation with the expectation that they will pass NCLEX within orientation. But thankfully I don't have to worry about it anymore. I'm registered. :)

So two great pieces of news today is quite a feat! Even better would be to get news that power has been restored at home. Been without power since Friday night. I'm presently crashing at my parent's home where they've got the benefits of electricity... WATER, AC, and internet.

Good Pop-Up

If a person were to trust the PVT (PearsonVue Trick), the following pop-up is a very good sign that I successfully passed the NCLEX.

I felt very good about my performance when I walked out. Many do not have that "feel good" experience when they walk out - regardless of whether they passed or failed.

The exam shut off after 75 questions and it took me a little under two hours (including tutorial and end-survey). Out of curiosity, I did the PVT within an hour or so of finishing and got the good pop-up. I've heard that for some people it has taken several hours for the "good pop-up" to show up (they get a "results on hold" pop-up instead).

I will be able to get results from the Virginia Board of Nursing early next week. I'm planning to write a full update with thoughts, tips, and reflections from my NCLEX experience. But not tonight.  I have some other good news, but I'll make you wait on that.

Signed,
Joy Hancock, RN (unofficially)

The Sky's the Limit

Finally feeling a bit of nervousness. I am heading to bed shortly and I hope I'll be able to sleep restfully tonight. Probably will need an Ambien to help get me into la-la land.

It's kinda surreal that what I've worked long and hard for is now at my door. Finishing school and graduating was such a big deal, but reality is that I'm not a nurse until I'm licensed.  I can't do anything with my nursing education until I apply it to this exam. It's the same for medical students, law students, architects, engineers, etc... Lord willing, tomorrow I will become a legitimate professional nurse.

I've never been a career girl. Never aspired to climb that ladder. That has never been my dream. Still isn't. But reality is that I'm in my late 30's and no job I've ever held has had any potential for advancement (or advancement that I was interested in). There's a chance that I may never marry. There's a chance that it will be just me making plans for retirement, something I really have no interest in. I always figured that I'd marry a guy who'd have a clue about such things and I'd be off the hook for making those financial decisions. I'd contribute, if needed, but I totally didn't expect to be the one figuring out my financial future. Alas, reality has smacked me in the face and I've woken up to the fact that it is up to me. No one else (except maybe my dad) cares about my financial future. Despite my fervent denial of my situation, the years have passed quickly since my first college degree. I wish it hadn't taken me so long. I honestly thought I'd be married by 28, then it was 32, then 36. I'm grateful that I finally woke up and realized that I needed to make a change and grow-up and take control of my financial future. So I went to nursing school, graduated and I'm now preparing to start my career. But YET, I still do not think of myself as a career woman! It's not in my soul to climb the ladder for the means of achievement and status. For me, climbing the ladder is now a sort of financial necessity. And wonderfully, in nursing, the sky's the limit! And speaking of skies... I could even become a flight nurse and combine my love for flying and medicine!! 

Well, it's time to say goodnight. Big day tomorrow. And hopefully the next time I post...I'll have a few extra letters after my name!

You Know You Are Ready When...

You know you are ready to take the NCLEX when you go ahead and offer to sell your prep materials BEFORE attempting NCLEX!!

Almost There

With only one more day to study for NCLEX, I finally finished the Kaplan QTrainers. I didn't get as many QBank questions done as I had hoped. They recommend doing all the QTrainers (1-7, which I did) and about 90% of the QBank questions. I think there's around 1300 QBank questions and I've only done 750 of them. I will do more tomorrow.

Below are my scores for Kaplan:

Diagnostic 69% (mixture of questions- taken before Kaplan course)

Readiness 69% (only passing level questions- taken at the end of the Kaplan course)

The rest of these were completed AFTER the Kaplan Course (on my own)

Q Trainer 1 63%

Q Trainer 2 76%

Q Trainer 3 62%

Q Trainer 4 69%

Q Trainer 5 74%

Q Trainer 6 67% (only passing level questions)

Q Trainer 7 72% (only passing level questions)

QBank Cumulative Performance  Score: 70%  (750 questions so far)

I'm happy with my scores. My Kaplan instructors told us the following: 

"Goal for Question Trainers 1-5 is 65%. Goal for for QTrainers 6 & 7 and all QBank tests is 60%...aim for 65!"...

"Remember that every candidate taking the NCLEX®RN examination gets 50% of their questions correct and 50% of the questions wrong. The difference between passing and failing is level of difficulty of question. If you are getting 50% of your questions correct answering passing level questions, you will pass. Passing questions are written at the application/analysis level of Blooms Taxonomy."

 All throughout my studying, I've kept a positive "I can do this" attitude. And while I've certainly gotten tired of studying, I've never felt defeated. I feel that I've prepared well and will do well and will pass. This is not a test that I have to ace. It's pass/fail  and it's adaptive in that it's designed to keep pushing you to a higher and higher level of questions. It'll be a good thing if I get a lot of the SATA questions (Select All That Apply) because those are generally considered higher-level questions and means I'm doing well enough that I'm staying in the higher level question zone. It'll also be a good thing if I get questions on topics I've never heard of - because again, these questions are likely higher level. My Kaplan scores show that I'm doing better than 50% and that's good! Lots of people post their scores at AllNurses.com and from what I've seen, my scores are comparatively high. So I am very hopeful.

On Thursday I am not planning to do any studying (the day before the test), so that means that tomorrow is my last day of studying! Woohoo!  I've completed nearly 4,000 NCLEX questions since graduation and I fully expect to top 4,000 by tomorrow (only 80 to go!).

Tomorrow morning I have my second interview. I shadowed on Monday and LOVED the unit. The staff was great and I can totally see myself working there. It will be challenging, but in a fantastic way! I'm hoping to have good news to share...possibly next week. We'll see.

And to celebrate the end of my studying, I am planning to celebrate a friend's birthday tomorrow night. I MIGHT go to the movies on Thursday evening (to do something fun and chill out) before my big test. I really don't have money to spend on this...but hey-- I've studied my butt off and need a brain-break! And then hopefully NCLEX will go well on Friday and I'll be able to get back to town to go to another birthday party that night.

Then comes the long weekend of possibly not knowing if I've passed or failed. I'm REALLY hoping that I can try the PearsonVue trick on Friday evening or Saturday morning and get the "good pop up".  Otherwise it will be Monday or Tuesday before the Virginia Board of Nursing will acknowledge my results. I cannot imagine what it was like in the "old days" when you took the written board exam over the course of several days and official results took much longer than a few weeks to arrive. The was the case for my mom in the 1960's. Yeesh.

Better get to bed -- interview in the morning!

The Heat Is On

Four days, eighteen hours, twenty-four minutes... the heat is definitely on!

Today after church I drove down to Lynchburg to find the PearsonVue site and to scout a good spot to stop for lunch before NCLEX. It was a lovely drive and it was good to have some quiet time to think. My initial schedule will work great and I think I've built in enough time that even if I got a speeding ticket, I'd still be able to manage to get to the exam location on time (although I'll have to skip Panera and have to eat my pre-packed snack for my lunch). However, if my car breaks down, that will be a bit more challenging.


Note to self: locate numbers for Lynchburg taxi services!  (No surprise there... I'm a bit of a planner/control-freak).

Weather forecast is calling for 100 to 103 degrees on Friday- my NCLEX date!!!! Aaack! I HATE hot weather. I'm just not sure what to expect inside the testing site. Some places (buildings in general) are notoriously cold, some have HVAC systems that lag and have a hard time catching up to really hot or really cold days. I've read that it's suggested that you wear layers to NCLEX, that way you can be prepared for whatever the situation. However, my understanding is that if you remove a layer of clothing, you will be escorted out of the testing room by a proctor to your locker where you then have to be rescanned and so forth before going back into the testing room (same goes for bathroom breaks outside of unscheduled break times).  They won't let you hang your layers on the back of your chair. Also the clock on the exam does not stop if you take unscheduled breaks.

I'm very optimistic that I will do well on NCLEX. Hoping that I get the "good pop-up" at 75 questions...but I'm also trying to prepare myself for the worst--being that I have more than 75 questions, more than 100 questions, more than 200 questions. That's the joys of computer adaptive testing...the computer won't let you  stop until it's sure you meet the basic competency level... and hopefully you'll meet that competency level before question # 265 or six hours - whichever comes first.  If you don't know anything about NCLEX's computer adaptive testing... Kaplan has a FREE Strategy Seminar that they offer every couple weeks or so to explain how computer adaptive testing and NCLEX work together. Here's a link to where you can find these free events through Kaplan. I found this information very helpful AND very encouraging.

In addition to my continued NCLEX preparations, I am also shadowing (Monday) on the hospital unit where I want to work AND will be interviewing (Wednesday) there too. Gonna be a full, GREAT week! Here Goes!

You've got to be flexible!

Well so much for a trial run tomorrow to Lynchburg's PearsonVue site. Discovered Wednesday that my AC is not working. I haven't used it but maybe once for a few hours (a month or more ago), and now the outdoor unit fan is not coming on. Hopefully it's something small. Anywhoo, the repair tech is only available tomorrow afternoon...so if I want AC before Monday (and I do -- it's 80 degrees downstairs and 85 degrees upstairs!), I figure I'd better postpone my trial run. Thinking maybe I'll drive down on Sunday afternoon or early next week.  I have job interview on Wednesday, then I work all day on Thursday and then take NCLEX on Friday. Whew!!! I will be so relieved to have NCLEX behind me. Not sure what I will do with myself to not HAVE to be studying. And any "studying" I do will be related to my job and will be completely relevant to my patient population and related skills-- which is very motivational!


It's crazy to think that I've been out of school for almost six weeks!!!! Yay!

Another Countdown!

8 days, 13 hours, 33 minutes, 52 seconds until I sit for NCLEX!

Yesterday I reached my goal of 3,000 NCLEX-style questions. I still have a little over 1300 Kaplan questions left to do. And I'd still really like to do more prioritization/delegation/assignment questions via LaCharity's PDA workbook.

Since my test is a week from the day after tomorrow (Friday), I guess I should be heading to the Lynchburg site on Friday morning to do a dry-run. You know, drive there on same day of the week, same time of day to estimate drive time (r/t traffic) and of course actually FIND the location. Googlemaps says it'll take about an hour and forty minutes. Since my test is at 2 pm, and they suggest arriving by 1:30, I'm thinking I'll be eating lunch in Lynchburg, so I have to factor that in as well. I plan to sit down tomorrow and plan it out, so that I can do the dry-run on Friday.

The good news is that others from my nursing program have taken the NCLEX and passed. I'm expecting the same. I'm so ready to get this over with!

Nothing Much...

Been working (temp odd jobs: babysitting, companion care) the last couple weeks, trying keep my head above water- financially. It will be so nice to have a regular income again. I think I've decided that I will not turn the on air conditioning until I get a job. It's not been that bad yet, but still a long summer ahead, so hopefully I'll get the job/income thing figured out soon. Hey, I can always drag a mattress downstairs to sleep where it's cooler. On that front, I have a interview scheduled for a new grad position in great unit. This is a follow-up to the interview I had about a week and a half ago. Fingers-crossed.

Still on target for taking NCLEX end of June. And then, Lord willing, I will have my license...which makes me more legit when interviewing for jobs. I'm not worried about finding a job - but I am getting a bit nervous about my bank accounts. However, God has abundantly provided for my needs every step of the way these last two years of school, so I am confident He'll continue to provide what I need. And hopefully that's in the form of a job!

NCLEX Indecision

Yesterday evening I drove to Richmond to have dinner with my nursing school study partners who are taking the Kaplan Course live this week. On the way, I stopped by the NCLEX testing location (PearsonVue). It's nice to visit the location, make sure you can find it and estimate time (usually test runs are done at the same time of day and same day of the week as scheduled test).

My friend's experience with the live Kaplan course has been disappointing. Apparently the instructor just rushes through each question and starts eliminating answers using Decision Tree BEFORE the students have even gotten the chance to read the answers for themselves. Uh, hello? Obviously the teacher is very familiar with the questions (same for every course) and has forgotten that these students haven't seen these Q&A's before. Too bad. My friends said that they've gotten out of class early EVERY DAY (and were ahead of schedule) - which obviously points to the fact that the instructor is rushing through the questions. I feel so bad for them- sounds like a less than ideal experience and possibly a waste of money. My online instructor was really great about pacing our class and we never got out of class early.

Anywhoo, the title of this post alludes to my indecision over NCLEX. What is there to be indecisive about? Basically the when & where. Why? Well, last night one of my friends said she remembered hearing rumors that it was better to test in a location other than Richmond and that she's planning to test in Lynchburg. The reasoning? Something about someone (or multiple people) who failed more than once at Richmond, and ended up passing in another Virginia testing location. Well, I could see several scenarios where this could happen. 1) This person simply wasn't ready and therefore third time was a charm (regardless of location) and 2) this person simply needed a change of location to reduce anxiety and remain calm--thus improving her performance. So I'm not really sure what to think of this rumor.  Is this just one person's experience? Is it even feasible that there might be a glitch in the system that would make once testing center's experience more difficult than another? I have a hard time imagining that. Yet...I have rescheduled my exam...to the Lynchburg location. And because of the location switch, I had to move up my exam date. BUT that gave me a better testing time of 2pm rather than 8am. Which means I won't have to get up crazy early or get a hotel room. So now I can drive down late morning, grab lunch and then catch a snooze in my car before going into exam.

I didn't really want to test on a Friday (because it takes longer to get results from Board of Nursing website/phone), but I think because I used my driver's license (rather than SSN) when I registered with the BON, I probably won't get results the next morning anyways. I'm hoping that the PearsonVue trick will work for me (way to get unofficial results by trying to sign up to take the exam again; see allnurses.com), otherwise I'll just  have to wait until Monday or Tuesday of the following week to get my results. But whatever. Reality is that once the exam shuts down, there's nothing more you can do. Worrying about passing/not passing is not going to change anything.

But thankfully, I can still change my test date. However, the closer we get to the date, the fewer the options are for rescheduling. The good thing about moving up my exam is that it's done that much sooner! I've re-worked my calendar (and will have some Saturday studying to do), but it's still very doable!

It's a Process

Part one of the interview process went well this morning. I was impressed with how organized and informational it was and I'm still very hopeful to be invited to join their nursing team. I'm also impressed with their orientation process for new grads and what they offer. Next up includes shadowing and an interview with the nurse manager for the unit I'm interested in. We did discuss start date options and I chose second week in July. At this point I have gone ahead and scheduled my NCLEX exam for first week of July. Now to decide if I'm going to get up at 6am and drive to Richmond or if I'll just get a hotel (or maybe I know someone who will let me crash at their place overnight?). I can still reschedule my test up to 24 hours before hand...which is REALLY nice circumstances change.

So I guess this means NCLEX studying/review begins in earnest tonight!?!

My closest friends from nursing school are taking Kaplan (live) this week in Richmond. I'm thinking about driving down tomorrow night to join them for dinner. Will be good to catch up in person.

Interview!!

First RN interview tomorrow. I've been pretty chill up until now. I get a few butterflies when I think about it. Heading to bed shortly (with a sleep aid, of course), but first I'll lay out my clothes and spend a little time reviewing my interview notes which I wrote up a few weeks ago. And hopefully I'll sleep well and be rested so that I'm coherent and able to speak with clarity and purpose (no rambling!)

Of all the places and all the new grad RN positions available right now, this is where I want to work. And it's my first RN interview! No warm-up interviews for this girl. Hahaha! Actually, I'm hoping this will be the first of several interviews (for the same position).  I've got a number of questions, and I'm hoping that I'll have most or all of the answers after this (roughly) two hour interview.

Kaplan: Day Four

And it's over. I'm kinda relieved. I'm ready to get going on my studying for NCLEX. Haha! Not really, but I'm glad to have Kaplan behind me.

For the last session today (the first session was for independent taking of the Kaplan's Readiness Test) included a review of questions from the Readiness Test. Not all 180 questions but just the ones that students generally miss (not just our section, but Kaplan-wide). Helpful, but many of the questions I had gotten right. But there were a handful that I had gotten wrong and were surprised by the correct answer.

For the last half hour of class, our instructor talked to us about what we need to do going forward before taking our NCLEX exam. Completing all the Question Trainers (1-7), completing at least 90% of the QBank questions (total 1300), and aiming for a cumulative performance of 60% or higher on the QBank questions. Expectation is for us to review every question and rationale in every Trainer and after every QBank test. They suggest doing no more than 150 questions a day so that we really spend time reviewing every question and rationale and spend time looking up content that we don't know or understand.

My head is spinning. But I've broken it down and here is my initial plan with the materials provided by Kaplan:

At this point, I do not expect to study seventeen days straight. No way. My goal would be maybe five days a week. Kaplan suggests answering questions every day. Eh. There certainly will be days when I simply can't. Plus, who knows what's going to happen regarding work. If I get the job, then this schedule will have to be modified in a big way. I'll know more after Monday's interview as to their goal for hiring and orientation. But reality is that if I'm offered a job it will be at least two weeks before I'd start work because there are drug tests and background checks that have to get done. So if I can get at least ten full days of studying done before starting work, that would be awesome. Maybe I really should push myself to study every day and then if I do get the job, I'll still be able to take the NCLEX in early July.

And of course this schedule is just reflecting Kaplan resources and does not take into account my earlier expectation to use Saunders and LaCharity resources. Maybe I won't need to? I will continue taking flash cards to the gym (this has worked REALLY well with the cards put on rings) and of course I can apply Decision Tree to the flash card questions.

So the question is... when to start?

At this point I am glad that I did Kaplan's prep course. I'm glad I did the "Classroom Anywhere" format. A few bumps (see Kaplan: Day One post) but these were largely due to the fact that I was going through my school for Kaplan and my school did not adequately communicate with us. Can't blame Kaplan for that. The Kaplan instructors and staff were all very good and very helpful and managed the online aspect very well. The only downside was the chat window and dealing with people who don't follow instructions. But that's life, right? I guess the true test will be whether I pass NCLEX the first time or not. But then again maybe I would have done fine without Kaplan. I DID get a good score on the Diagnostic before I'd even taken Kaplan course. Well, we won't know now will we? 

Provision.

God is good people.

This morning I had plans to head over to campus to pick up a reference letter that I need for my job interview on Monday. At 11:45, I'm in the car and leaving my neighborhood and realize that due to it being close to the lunch hour, I should call the division office and ask if someone will be there to give me the letter that is waiting for me. But when I call, the automated message for the school says that they close at 11:30am on Fridays. aaaaah!  oh no! I try calling both admin assistants directly and just got their voice mails. So I know they are probably gone. I almost turned the car around and drove home. But I hoped that somehow, someway, someone would still be at the school to let me into the office to pick up my letter. I did NOT want to walk into the interview on Monday only having two out of the three letters.

I've had weeks to get these letters pulled together. But reality was that faculty was on vacation and busy starting the summer semester and I was not a priority. However, when I went to campus earlier this week (to pick up my Kaplan book), I ran into the faculty member who had not replied to my requests for a reference letter. She promised she'd do it on Thursday. So I made plans to pick it up on Friday (Kaplan prevented me from picking it up on Thursday). So here I am, in my car, realizing that I'd blown it and would have to pick up my reference letter on Monday after my interview. Sigh.  I hate excuses. I hate getting them and I hate giving them. And in my mind I was determined not to go into my interview passing blame onto my faculty member or stupid campus hours. I was willing to suck it up and look bad.

So I kept driving to campus. I get there and find there are still about three dozen cars sprinkled in the vast parking lots. I park my car and start walking toward the building when a girl calls out to me and says, "Do you know why the Main Building is locked?"  aaaah!!!  I tell her that I myself just learned that they close at 11:30 on Friday mornings. She's dejected and I'm less hopeful, realizing the science/nursing building is probably locked too. But with great hope (and desperation) I walk towards the nursing building. I put my hand on the door and am shocked when it gives. It's NOT locked! Hallelujah! One boundary crossed. A few more steps and I find the main office reception area locked. Shucks. I look through the glass wall and yes, I can see an envelope with my name sitting there. So close.

I head downstairs and find the door to the nursing faculty offices ajar- hoping that someone with a key or password can let me into the office upstairs where my envelope is (I even brought my ID with me to prove it belongs to me). I notice a guy sitting in the student lounge area downstairs, but head toward the faculty offices. No one. I head out the other end of the hallway and track back deciding I should see if that guy has seen any faculty or staff. He says he's not sure, but that there were two ladies that he saw upstairs walking towards the back of the building. I say thanks and rush upstairs. Sure enough the back door to the upstairs faculty office wing/area is open...and that's when I realize that there are TWO entrances to the main office. The main office is just in the middle of the upstairs faculty office area/wing. I can hear that someone is in one of the faculty offices (which is why the entry door is open), so I head into the office wing and head towards the reception desks. The lights are off (but light comes in through the glass wall) and I immediately have this moment of thinking "Wait, could I get in trouble for this?" Would someone think that I had broken in? Surely not- the door was open. So I quickly skirted the desks, grabbed my envelope with my name on it and booked it out of there. Whew!  With my letter in hand I head out the building saying "Thank you, Jesus, thank you, Jesus, thank you, Jesus!"

When I called the office this morning I was disappointed and discouraged. But my God is good and nudged me to keep driving to campus. It could have ended up all for naught, but it ended up okay! God provided. I have my letter. And I don't have to hang my head and apologize on Monday for only having two of the three letters.

Now I'm just hoping that what's written in this reference letter was worth all that stress. I have no idea what she wrote in the letter. My instructor sealed it and signed over the envelope closure. Her opinion is that the reference carries more weight that way. I'm hoping! =)

Okay, my last Kaplan session starts in 30 minutes... Here goes!

Kaplan: Day Three

Pretty much the same routine today. Just answering a bunch of NCLEX questions with the instructor walking us through each question using the Kaplan Decision Tree. Each day we cover a different area (see schedule on yesterday's "Day Two" post), so the content changes and there's still stuff to learn and to consider.

During our one hour break, I didn't really break, I just played on my computer and then got REALLY sleepy right before we were supposed to start back. So when class began, I laid back on the sofa, my head on a pillow...and oops! I dozed off for about 5-10 minutes. hahaha! Not good. So I forced myself to sit back up and drank some cold water...

Tomorrow's schedule has us independently taking our "Readiness Test" during the time period when we'd normally meet for our first session and then we meet back online for the second session late afternoon. My understanding is that we'll go through a select number of the questions from the Readiness Test - perhaps the most commonly missed questions--I'm not sure. But then they'll also generically discuss our results and what they mean for us and what we need to do to get ourselves ready to take the NCLEX using Kaplan's resources--based on the results of the tests within Kaplan's site.

I went ahead and took my Readiness Test this evening, so that I don't have to do it tomorrow. 180 questions in three hours! ugh. I'm glad it's over with! But I couldn't believe my eyes when I got my result!  My score was EXACTLY the same as what I got on my Diagnostic Test (which was the test required to be taken before starting this class). So, I'm not sure what this means. Possibly, that I didn't learn anything or possibly that it didn't really help me. But I'm just very happy that I didn't score worse, as I'd interpret that as I just got lucky on the first test or else Kaplan just screwed me up.

Kaplan explains that for NCLEX the goal is 50%. That's just the way the Computer Adaptive Testing works to determine competency above or below the line.  Below is the explanation we were given in class regarding goal scores:


"The goal score for Question Trainers 1-5 is 65%. For the Readiness, Question Trainers 6 and 7 and all QBank tests, the goal is 60%. Remember that every candidate taking the NCLEX®RN examination gets 50% of their questions correct and 50% of the questions wrong.  The difference between passing and failing is level of difficulty of question.  If you are getting 50% of your questions correct answering passing level questions, you will pass. Passing questions are written at the application/analysis level of Blooms Taxonomy."


So for those of you who have been online and have seen people posting their scores on the Readiness and Question Trainers, understanding the above, will hopefully help. Kaplan does a great job of explaining how NCLEX determines passing/not passing.

So I'm sure you are wondering what my scores were? Okay, okay. On both my Diagnostic and my Readiness Tests, I scored a 69%.  So I'm well above the 50% and well above the 60% -- so that is encouraging. But I really don't understand why I didn't score higher on my Readiness Test after spending three days learning Decision Tree strategy. My theory is that I really just need to jump back into the content and review what I've forgotten or never learned. I've been surprised at what I have retained and how things will just jump back into my head when I'm working on NCLEX questions (even for the past two weeks). My biggest fear has been that it's been slowly draining out of my head. Review, review, review! Practice, practice, practice!

Well, it is late and I'm beat. Until tomorrow...

UPDATE:
My Kaplan instructor explained that the Diagnostic Test had questions from every level, but that the Readiness Test included only "passing level" questions. So the Readiness Test was actually harder, so the fact that I kept a high score was a good thing.

Kaplan: Day Two

So.... Class started at noon. Power went out at 12:30. hahahaha! Um, so what do you do? Well, after waiting a few minutes to see if the power might come back on, I called and reported the outage. Then I changed my clothes into something more presentable, all the while hoping that the power would come back on. I called a friend 2 miles away to see if his power was out (if not, I'd have run over there to use his internet), but his power was out too. So I shut down my computer, threw it in the car with a pair of headphones and headed to Panera (nearest free wifi). I texted that same friend and asked if he'd text me when the power came back on. I rushed into Panera (it's 1pm at this point) and find an empty table with a accessible outlet. I boot up my computer and then head over to the counter to order a drink. I head back to my table, pull out my headphones and log-in to the site. The audio is horribly choppy- I call it bit-mapped audio (again, Kaplan warned us about wireless being less than ideal). *SIGH* Then I get a text from my friend saying power is back on...it's 1:10 or so. The Panera connection is lousy and my power is back on...so I pack up my stuff and headed back home.  I had to laugh. That's all I could do. The *only* thing I could've done differently was to wait at the house and *hope* the power would come on soon. But, this is me we are talking about...I made a plan and stuck with it...but then reversed course when the plan failed. Thankfully Panera is less than 15 minutes from the house, so I was home and logged back in by 1:30... exactly an hour after losing connectivity.

Sure, I missed an hour. But what did I miss? Oh, about 12 NCLEX questions. And rumor has it that I can go back onto Kaplan's course site and find those questions and walk through them myself! Kaplan recognizes that life happens sometimes, so they have really done a good job duplicating resources so that we can get them one way or another.  I forgot to mention that yesterday, my online instructor lost video feed several times and had to reboot and reconnect. Apparently there were having pretty bad storms and tornadoes in her area. Thankfully the TA's are in a different location and were able to jump in and take care of the class details. I think we lost our main instructor for the last 30-45 minutes of the class - she just wasn't able to reconnect. But the TA's who are also Kaplan instructors were able to keep us going and getting us done on time.

Today I didn't do anything productive while watching/ listening to the class. I let the clothes sit in the washer (why???) and never pulled out any hand weights. I did get sleepy, but instead just got up and just got some cold water and sat back down. The class was was pretty much the same as yesterday. Six hours of answering question after question using the Decision Tree. There are definitely tips I'm learning - like questions to ask myself while going through the possible answers, but when I get a question wrong...it's because I don't know or can't remember the related content to justify that answer. I'm a pretty good tester in general and I surprise myself at times at how well I can guess, but sometimes I'm at a complete loss. I do think that having these isolated questions on a given topic, can somewhat help me with recall later for specific content areas--seeing as I've had to apply information or learn information after getting a question wrong.

I'll definitely need to do a fair amount of content review before taking the NCLEX. Kaplan's course site is going to help...but I'm a bit overwhelmed at all that I need to do before testing. Kaplan does provide several study plan schedules which can help. I think I'm still in a bit of denial that I really need to sit down and be ultra disciplined about studying for NCLEX. I suppose it doesn't help that I haven't selected a date to test yet, but I'm waiting until after my interview and until after I know what is going to happen with that job. I definitely plan to start studying for NCLEX in earnest next week, regardless of job, but having a test date will definitely drive the studying and give me a goal.

I should've posted the course schedule yesterday, but here it is:

Tuesday, Session 1: Orientation/Class Start/Decision Tree

Tuesday, Session 2: Pharmacology/Reduction of Risk

Wednesday, Session 3: Reduction of Risk/Physiological Adaptation

Wednesday, Session 4: Physiological Adaptation/Basic Care & Comfort/Mgmt of Care

Thursday, Session 5: Management of Care/Safety and Infection Control

Thursday, Session 6: Safety and Infection Control/HMP/Psychosocial

Friday, Session 7: Readiness Test (taken online at home during class time)

Friday, Session 8: Review of the Readiness Test/Roadmap for Future Study

Tomorrow I have Sessions 5 & 6.

Until then...