We hire a lot of new graduate nurses where I currently work. I actually help with the orientation and transition process of new grads transforming from Student Nurse (SN)to Graduate Nurse (GN), to the auspicious Registered Nurse (RN).

The biggest question on all GN’s minds is taking the NCLEX-RN.

“What’s the best way to study?”

“How did you study?”

“I don’t want to fail! I only want to take it once.”

Of course we all want the above. The NCLEX-RN exam is simply a pressure cooker. It doesn’t really measure your knowledge, or your total knowledge of nursing basics. What it measures is how you react under pressure. Do you crack, or do you rise to the occasion? Because the reality is, that’s exactly what an RN does everyday.

“It doesn’t measure our knowledge?”~ It does, but not like you think. It wants to know how sound your nursing judgement is, and how developed are your critical thinkin skills. Nothing more.

You’ll find that some of the most intelligent nurses you attended classes with will have difficulty passing their boards, due to this very simple fact. It doesn’t matter how much knowledge you have consumed, if you can’t apply the  given lessons to everyday nursing responsibilities, it will only do one thing. Get a patient hurt. A good nurse has sound judgement and good critical thinking skills, not a know it all.

So here is the key to passing the NCLEX-RN: Mental Aerobics.

We have all heard and done our homework when it comes to the specifics of the exam. We all know that you will be asked a minimum of 75 questions and a maximum of 260-ish. It all depends on how well you answer your questions. Answer them correctly and you’ll have less questions.

So. 75 questions MINIMUM.

There is the key. You need to guarantee your mind will be sharp all the way up to that 75th question (or more). Because if not, you will be sitting in front of that computer to answer the 260!

Practice questions. Practice questions. Practice questions. Do them. And when your done doing them. Do some more.

You have to start small and work your way up. You’d be surprised at how fast your mind will wander and lose focus after just 20 questions. And remember… you have no idea if you’ve answered them correctly. So your anxiety is building with each additional question.

Practice daily. Start with 20. Once you can efficiently answer 20, move to 30. Then 40, 50, 60, etc. You get the idea. My suggestion is to be able to sit in front of that computer screen for 100 questions before you become mentally fatigued. That way you’ve factored in fatigue and anxiety. (Trust me, pressure cooker is a quaint description of the exam environment)

Oh and one last thing. Do nothing 2 days before the exam. You’ll do nothing but drive yourself crazy if you study up to the night before. Give yourself the mental break to refresh and revitalize.

Best of luck!

Carpe Diem

A special thank you to Beth over at PixelRN. She rounded up all the meditweeters on twitter this past week. She’s the reason I got motivated to create and/or give my blog a facelift. I missed blogging about nursing, and all it’s trials and tribulations. I think my new blog will be a goo mesh. Just gonna take some time I think. I of course migrated all my other posts from To Be A Strong One, just for posterity.

I’d like some input from my fellow nurse tweeps on my new blog. Any and all suggestions are invited. I plan on making my new home nursing focused with a dash of sports medicine and fitness all rolled into one. Ergo the reason for the name of my site.

I’m lovin the nurse twitter chatter. I find myself tweeting way more often now due to the conglomeration.

Uhm, I still hate the night shift. My body is achy and tired. Over the past 2 days I think I amassed about 4hrs of sleep total. So my body is punishing me for not providing adequate rest.

I think someone should start a poll on what we could/should refer to ourselves on twitter? As in the medical personnel, or the nurses on twitter. I can’t come up with a catchy short name. I need some help. ( I still like tweeturses.. or twiturses..LOL)

If you’re reading this, I sent you the link here for some input and suggestions. How do you think I should roll out the conversion from To Be A Strong One? I want to try and keep all the great readers I have, but they are definitely not nurses. Mostly fitness enthusiasts and wellness advocates mixed in with some metaphysical deep thinkers. I truly think my blog posts won’t change too much, although I will be blogging more about my nursing adventures of course.

I look forward to your thoughts.

Carpe Diem

This is for all you student nurses out there. This is a lesson we all learn the hard way, and it’s a lesson you will learn one way or another.

If you can accept and embrace these to constants in the nursing world, you’ll have much less stress in your day and will not burn out of this career as fast as most do.

1. You start your day behind schedule.

: The moment you clock in, even before you get your assignment. Even before you grab your gear. Even if you’re one of the many nurses that comes in early to get your lab work before report. You are already behind schedule. You will always be behind the 8 ball, and the minute you think you’re ahead of the game… something happens. Either a pt has an emesis, you have a difficult family member, or a difficult dealing with a physician…or a pt codes. The list goes on. Accept this and move on. Nursing is a 24hr job, you do the best you can, with what you have, in the allotted time you are given and hand-off to the next shift.

2. Charting is never done.

: There will come a time when you will be finishing your 12hr shift. You’ve given report. And you are just now going to sit down to to your AM assessment note. For instance, in the ICU world we do 3 full assessments every 4 yrs. Sometime more depending on the acuity of the pt. I work a 7a-7p shift. I have had a handful of times where I sit down at 8pm to chart my 8am note. Yes, that means I have to chart 3 assessments, and all the happenings throughout my crazy day. And apparently it was crazy for me to charting 12hrs later!! Accept this and move on. Charting comes last in the tangled web of nursing.  Yes, you are correct. If it’s not charted it did not happen, but your patients are your priority.

If you can accept and embrace these two maxims, your gonna be a much happier and much more pleasant individual. New nurses always get caught up in swimming upstream and not having any charting done.

Accept them and embrace them. You will have good days and bad days, but theses two concepts will be with you every day of your nursing career.

Welcome to nursing. Enjoy the ride!!!

Carpe Diem

Why are  patients who are intubated or have a tracheostomy tube adamant about TALKING to you? No matter how many different ways you try to explain to them that you cannot understand them, they repeatedly ‘mouth’ words to you.

The intubated ones usually are one step away from being extubated by this time because the sedation is obviously off and they are alert and moving. So to some extent I can understand.

The trached patients I still wonder about. I think, that they think I can hear them in some way?? In fact whenever they are being down-sized they start to talk more forcefully to let air escape around the balloon so that they get some remnants of a voice with they’re squeaking. LOL

It’s all very frustrating since you want to communicate effectively with your patient, and you both ultimately have your ‘hands tied’. I usually try to remind them to keep things simple. Stick to YES and NO answers. And the communication billboard that most hospitals have, is usually about 60% effective. Once again due to their illness and the resulting foggy mental acuity.

THEN.. to boot. You break out the clipboard and have them attempt to write what they are trying to say. BIG MISTAKE THERE.

*Shaking Head*

Due to there obvious condition they do not realize they are scribbling hieroglyphics. I’ve seen pre-schoolers write better than some of my patients. But who can blame them. It’s difficult to write on a clipboard that they more than likely cannot even see, nor can they decipher what they themselves are trying to convey.

Yet another obstacle we nurses have to endure.

How do you communicate with the intubated & trached patient?

Carpe Diem

Being a nurse has been a great joy of my life. The only regret and/or complaint I have about nursing and me becoming a nurse is I wish I would have done it earlier in my life! It’s a double edged sword. If I had entered nursing sooner, I would have never met my wife. And as you learned before, I kinda like being married to my wife. So that’s bad. 

I have worked in many different arenas in my short time as a Registered Nurse. Each one has taught me more about myself and about me as a nurse.

I entered the nursing world as a new grad in the ICU. And as anyone who knows nursing or the ICU, it is not an easy environment to work in. Let alone start your career as a nurse in the critical care field. Nursing is a tough job, and the ICU is very, very demanding.

I survived my orientation and was a staff nurse for just under a year. Due to scheduling conflicts and personal issues, I left the ICU. I found a job working for an Orthopedic Surgeon. It was a great gig. It combined my previous career as a Certified Athletic Trainer (ATC) and nursing all into one. I worked in the office, rounded on patient’s in the hospital as well as assisted in surgery. I got to see and do things that were pretty darn cool when it comes to Orthopedics.

That job go boring fast for me. I never could shake the Critical Care bug. And the surgeries, at least to me, became very repetitious. So I ventured out again. This time I landed myself in a Level 1 Surgical/Trauma ICU.

I’ve been there ever since. I did go casual for 6 months while I experimented with travel nursing last summer, but I never left the place permanently. My travel nursing experience was an eye opener for me. I learned a lot about what nursing I do and do not like, as well as what kind of nurse I can and should be.

Over the past year I have become CCRN certified and advanced my position on my ICU unit as a senior staff nurse.

Being a nurse is hard. We are required to do so much with such little.

It’s not for the faint of heart, or the weak of stomach. You have to have razor sharp nerves and pinpoint time management accuracy. I liken our job to being a professional juggler.

I’ve tried to chronicle a day in the life of a nurse, but it’s just too damn time consuming and difficult to log everything we do, see, learn and know. May, over at About A Nurse has a great storyline that can give you a great idea of how the flow goes as a nurse!

Carpe Diem