30
Jul
Hi!! :) I'm a new RN grad and I will take the NCLEX in about 3 weeks. I am a nervous any words of encouragement please? Any advice or suggestions?
— Anonymous

YOU CAN DO IT!!!!

I’m super excited for you! Is it going to be hard? Yes. Will there be multiple multiples? Yes. Will you walk out whether you got 75 questions or 250 and think you failed? Yes. But it will be okay!

My Keys to Success:
Here are some of the things that I did to prepare. Mind you that I only had 4 days to study. I signed up on a Friday and took in on a Tuesday. That’s just how I like to fly.

  • Buy this

    What’s funny is that I Googled this game and found this photo—which is my photo I added YEARS ago. Apparently it’s a Pinterest tag now. Anyway. I didn’t play this game with anyone I just read the questions from the categories. MANY of them are almost verbatim with NCLEX questions. It really helps and it can break up the monotony of studying. I think you can buy it at Barnes & Nobles?
  • Study Kaplan. Prior to the test I read Kaplan’s “The Basics" as well as Kaplan’s "The RN Coursebook". I thought they both helped quite a bit. It’s like a crash course review of all the basics in nursing school and it really prepped me well.
  • Remembering Prioritization. If you are super poor and you say, “Hey ATP I have no dollars for any of that,” then this alone should be helpful. You need to think about prioritization. Of course we start with the ABC’s but that isn’t a rule set in stone. For example, let’s say you have:
    John TestTaker reports to work and has all these patients with terrible stuff going on, who do you see first?
    A. Airway Problem
    B. Breathing Problem
    C. Bleeding Problem
    D. PsychSoc Problem
    If you go with the A first, you could be right, but is it possible this isn’t correct? Yep. Why? Because you have to weigh a couple of different factors: normal vs. abnormal, and expected vs. unexpected. Going through this process is called the Kaplan Decision Tree, and I discuss it here.
  • Make sure you know your Pharmacology. Try to know the basics about what meds in what categories follow certain behavior patterns. Like knowing which drugs to know the therapeutic levels for (Lithium, Dig, etc), and knowing beta-blockers (ends in -LOL) drop the heart rate, etc.
  • Breathe. Take deep breaths. You are going to be okay. Study what you are not feeling super confident about. Make a list and take it day by day. Take lots of breaks. Don’t do anything the day/night before the test. 
  • High Fat Dinner. This is a code I live by to this day. When I was a program advisor I had a guest speaker come in to discuss some aviation stuff. She told the students and myself that pilots were given high protein, or high carb, or high fat dinners the night before a stressful cognitive exam and then their performance was tested. The pilots who ate the high fat diets performed the best in the cognitive exams. SO I always eat McDonalds the night before an important test.

You can do it! Stay positive. I’m rooting for you! Let me know how you do!

30
Jul

Quality Improvement 

This morning I got up with the birds rather than falling asleep to their chirping. I got ready for the day with warm sunlight beaming through the windows, the air still cool outside. “Feels like the first day of work all over again,” I think to myself. I wear my best scrubs, steamed and pressed, with a white coat I’ve had since nursing school but haven’t had an occasion to wear it since. If I’m going to make an impression on new people outside my floor in the daylight, I might as well look the part. Fake it till you make it.

I drove to work thinking about the differences between day and night shift. Working the night I don’t really get to miss the day. I see sunsets and sunrises from the windows as I teach my patients about a new medicine, bathe them, gently tuck in their blankets as they stir in the morning. If I need to, I can skip the sleep altogether and make the use of the day with errands, seeing friends and family, appointments and exercising. I see much more of the sun on the night shift than you would imagine.

I thought about how different the hospital looked in the day time. The halls illuminated, the break room feeling so open and wide. I chuckled to myself a little when I was assigned to a windowless cubicle in a windowless and forgotten annex of the hospital.

How had I gotten here? All I ever wanted to be was a nurse, at the bedside with my patients. Instead I faced an outdated computer and fabric walls lined with the previous passenger’s staples still clinging with little threads of paper captured. I wonder what was hung up in that spot. A calendar? A picture of a family member, a Christmas card? I’ll never know.

Everyone is very kind, telling me all about my new responsibilities. Chart reviews for analysis of compliance with the core competencies, first up: pneumonia.

Why am I here again? Oh yes, the crippling pain in my back. The “new” desk chair is quick to aggravate this injury. Have to keep working, have to support myself and my family.

I look down at the list of patient names on my desk. The list is triggered by an ICD-9 code of Pneumonia at some point during the stay. I see the first name and smile. The name is familiar, I can see her face immediately and am comforted because this name here means this woman is still alive. I haven’t seen her in a long time which is good, she was readmitted almost weekly during the winter. She was the first patient I ever admitted by myself as a new nurse off orientation, with an amazing family who is so kind and helpful.

I am reminded again that everything happens for a reason. My injury, this assignment, even the pain in my back nagging me now. How else could this be? The first patient I ever admit alone is now my first patient for quality improvement analysis.

I think that’s the purpose of all of this. Quality Improvement. Here I was suffering in my job, losing touch with why I became a nurse, only then to be sidelined by an injury. It’s time to improve the quality of who I am as a person and as a nurse. I know that, I’ve known that for a few weeks now but it’s been solidified once again. I have to be better, I can be better.

Hopefully the pain in my back subsides. I like the work and look forward to coming again tomorrow. Grateful to still be able to participate in helping people, and seeing old friends if only on paper.

29
Jul

Cleared for Duty! 

Hooray!

Cleared to begin modified duty tomorrow at 0800!! Probably chart review or case management but who cares! Excited to get a little work done!

My back is still killing me but who cares!! I need to woooorrrrkkk!!!

29
Jul
Gut instinct almost knocks you on your ass in nursing. It’s the feeling that something is about to happen to a patient - your own, or a coworker’s; It’s the inner voice that tells you something is amiss when your patient is talking to you; It’s the sensation you get when you walk into a patient’s room and something just doesn’t feel right. Sometimes it just happens when you wake up, and sometimes it’s an overwhelming sensation when you simply walk onto the unit. Sometimes without knowing, you just know.
— Nurse X (via dancingnurse-ed)

(via nightnursenotes)

28
Jul

Journal & Research Articles 

I have been attempting to write a journal article based on the research I conducted in May. Holy heck. It’s incredibly difficult. When you go on and on about how boring it is to read these articles for school, be mindful of the sheer number of hours and love put into them. Lately I’ve been reading articles with a new found sense of appreciation and respect. These nurses are our heroes, leaders and champions.

If I ever get this thing done, and am lucky enough to have it published, I’m framing it and putting it on my wall.

28
Jul
28
Jul
When I was a patient on a surgical ward, a staff nurse told me it was time to turn my television off and go to sleep. If she had taken the time to sit and talk to me, she would have known that my grandmother had died just two days before. It was no wonder I wasn’t able to sleep. So imagine people being admitted to hospital with two suitcases; their physical luggage containing their possessions and their baggage containing their thoughts, feelings and emotions.
— (via mentalhealth-nursing)

(via dancingnurse-ed)