YKYW - Nursing Student Blog

My NCLEX experience was pretty rough. I wasn’t the best of students in school and didn’t make the best grades. I struggled with tests because I had a bad habit of over-thinking the wording of the questions. I’ve had a lot going on in my life and have been very stressed out. My stress level has been so high that it made it very difficult for me to focus and study the material. Add my general performance/test anxiety to the mix and well, it hasn’t been pretty.

The night before my test date, we had tornado warnings, and so I was in the bathroom (for safety) with 3 other people and 6 animals when I wanted to be resting. I woke up early and made it to the testing site with plenty of time. When I feel anxious, I tend to experience GI issues. During school, I took a bottle of Maalox with me into the tests (yes, I’m odd). Since I knew I wouldn’t be able to do that for the NCLEX, I took some Zantac, and Immodium before I left my house and put two chewable Pepto Bismol tablets into my mouth as I went through the check-in process. It’s better safe than sorry, right? I had a few more chewable Pepto tablets in my pocket, and I asked if I could open them into a tissue and take it in with me. They said that wasn’t a problem.

As I sat down to take the test, my hands were trembling. I went through the tutorial and started the test. Egads! I had a ton of mother/baby questions and drugs — my two worst subjects! I kept watching the clock and was racing through questions. I kept telling myself to slow down. At one point, a question comes up that is based on a medical term that I don’t know. Frustrated, I put my head in my hands, closed my eyes, took a few deep breaths and tried to relax. Wait! I do know that word because I studied it during 3rd semester; and look, there’s an answer that’s appropriate!

In the end, I had 75 questions and it took me right at an hour to finish. I only had two alternate response questions, and both were SATAs. No med calcs, no ordering of answers, nothing like that. When the test stopped at 75 questions, I was shocked. Surely I failed! With all those mother/baby and drug questions, there’s no way I had passed this thing. I wanted to shake the computer and beg for more questions. Don’t stop now; let me show you that I do know something!

When I got to my car, I couldn’t help it. I cried. I felt terrible and knew I’d let everyone down who believed in me and supported me. How would I tell them?

I spent the next 48 hrs as a basket case, obsessively checking the website to see if my results were available. On Friday morning, they still weren’t available when I got to work. After we finished the first surgery, I used my phone to check the Internet for my results again. They were available! I went over to the BON website and my name wasn’t listed. Oh no! Shaking like a leaf, I found a secluded computer to enter in my credit card information and looked at the screen:

Pass

That is such a beautiful word! Relief rushed through my body and I couldn’t believe it. I passed; I passed!

I was all giggly the first time I signed my name as “Jaxia, RN.”

I’m sharing this because I thought there may be other graduate nurses out there who were in similar situations. Trust me, if I can do it, YOU CAN DO IT!

Well, I made it. I did well enough on my exit HESI to score my highest lecture average of my entire nursing career. This has been a crazy semester, and I worked my tail off to get to the end.

I’m not sure what to do with myself now. It’s strange to have so much “free” time. I still need to prepare for the NCLEX, but I’m having a hard time getting motivated to do much … other than nap and catch up with friends.

It still hasn’t sunk in; I’m a graduate nurse!

I sit down in a few hours to take my final final of nursing school. I’m anxious, nervous, excited and … a bunch of other emotions that I can’t quite pin down at the moment.

We use the exit HESI as our nursing school final. We are allowed up to 4 hours to complete the test.

If you can spare a moment around noon central time, any and all good juju sent my way would be most welcome!

This semester, I’m in the ER for my clinical rotations. Right now, I’m about halfway through my clinical hours, and I’ve seen a ton of stuff!

- One patient had a GI bleed, and I was able to insert a nasogastric tube and do lavage. He lost so much blood that he needed blood transfusions, so I was able to monitor blood products, too.

- I’ve been involved in 3 patient codes and did chest compressions. One of them was an infant. Nursing school did not prepare me for dealing with patients dying.

- I got to set up continuous bladder irrigation and care for a tracheostomy.

- I watched a doctor intubate a patient. Another patient had a spontaneous pneumothorax, and I got to watch the doctor insert a chest tube.

- Not to mention the broken arms, motorcycle accident, broken legs, mangled fingers, chest pains, threatened abortions and various other things.

Every shift, I get to practice a ton of skills. If I only get the opportunity to start 5 IVs, it’s a slow night. Toss in a few tetanus and rocephin shots, IV piggybacks, and foley catheters and I’m a happy student nurse!

If you have the opportunity to spend some time in the ER during your clinical shifts, I highly recommend it.

My psych clinicals were pretty interesting. We spent some time observing at a state mental hospital, and I was assigned to the forensic unit. Patients on the forensic unit are there because they committed some type of crime, and the courts are trying to settle issues of competency to stand trial. I enjoyed getting to see how they try to help patients with mental illness understand the judicial process.

It was a little disturbing to find out about how the hospital handles deciding when to confine a patient to the unit, and when they are allowed to go out on the hospital grounds without a chaperone. I must admit I was a surprised to find out that someone could commit a violent crime, yet work their way up through the reward system and earn full grounds privileges. It isn’t all that hard to get out of the hospital, and I’m not sure I’d want to live near the place.

The hotel experience was like a comedy of errors. Since it takes about 2 hours to get there, my school friend and I decided to get a room near the hospital for each of the two weeks that we had to be there. For the first week, my friend made the arrangements. We arrive at the hotel, and I go into the bathroom — there are roaches everywhere! Luckily, we were able to find another room at a different place. On the second week, we check in and our toilet overflows, so we wind up switching rooms around 1130p. It made for a very long night.

Oh! And, I almost forgot to write about the best part of the clinical experience! I was able to observe 2 sessions of ECT. Now, I don’t know about you, but I had a lot of misconceptions about “shock therapy.” As they were setting up one patient, the doctor asked me if I wanted to touch the patient’s foot so that I could feel the seizure.

“Do I touch it after you remove the electrodes?”
“No, touch it now and keep it there throughout the procedure.”

I had no idea I could touch someone while they were getting shocked! It was really a very cool experience. And, you could see a positive change in both patients within minutes of having ECT.

Going into my psych clinicals, I really wasn’t looking forward to it. All that “touchy-feely” theraputic communication just isn’t my thing. But, I was pleasantly surprised by the whole clinical rotation. As a TK learner, I appreciated getting to actually hear clanging and echolalia, see akathisia and talk to a patient with delusions and hallucinations … it was invaluable. I don’t think I could work as a psych nurse, but my clinical rotations did change my attitude about it.

While trying to keep abreast of stuff this summer, I found a great website that is really helping me study. Flashcarddb is a website that allows you to create flashcards online, and you can even share with other people (or choose to make your cards private, too). One cool thing about the site is that it uses the Leitner System to help you study.

I haven’t been using the online flashcards for long, so I’m not sure how much spaced repetition will actually help me, but it seems like it should.

If you are interested, here is a link to the cards I have already created. I’m trying to remember to tag all the cards I create with ‘nursing’ to make them easier for other people to find. Let me know what you think!

Clinicals have been interesting lately. I spent a few days in the ER. Things get really busy in the evenings! I was able to do an in and out urinary catheter on a woman, and I started 7 IVs. Well, I attempted 9, but only successfully started 7 of them. Considering these were my first attempts on a real person, I’ll take it!

I also got to see an active MI (myocardial infarction)! Seeing someone come while in the middle of a heart attack was very exciting. To see how it was handled, how people responded … I even got to follow it up to the cardiac cath lab and see them place several stents (not shunts) and a pacemaker. I’m still amazed at how fast everything was done.

Our major care plans were due last week. Mine came in at almost 40 pages long. I wrote mine on a patient who had a recent kidney transplant, and developed an infection.

For the most part, my teacher has turned me loose. I’m giving oral medications, injections and hanging IV piggybacks totally on my own. It’s almost like I’m a real nurse!

As for lecture, I’m doing okay. Not great, but not too horrible, either. Things are still a bit touch-and-go, but I’m trying to turn it around.

Several people have written to ask me how things are going. This has been a heck of a year, lemme tell you!

One of the reasons I’ve been stressed out is because I’ve been experiencing significant abdominal pain pretty much every time I try to eat anything. Over the Christmas holiday, I went to the doctor to have some testing done and when I got the results, it threw me for a bit of a loop. I’m allergic to a ton of stuff, including gluten, egg yolks and whites, dairy, soy, corn, tomatoes, and safflower. And those are just a few of my food allergies! The entire list is rather long.

Needless to say, since I was trying to live on bananas and orange juice, I tortured my immune system. I’ve been sick since early January and finally went to the doctor earlier this week (being a student with no health insurance really bites!). It’s just bronchitis, so they gave me some steroids, antibiotics and stuff like that. I’m trying to bulk up on my vitamin C and take better care of myself.

As for school … I really didn’t do well on the first test, but I did fairly well on the second one. I didn’t quite pull myself out of the hole I dug, but hope is not lost. I’ll have my third lecture test next week (out of five total), so I’ll have a good idea then of where I’m sitting overall.

Clinicals are going fairly well. I’ve had some really interesting patients, and I’m getting to do a ton of nursing skills. I’ve been giving oral meds on my own for a while now (no more waiting on the instructor!), and I just got the OK to start hanging IVs on my own, too! The first time I went around handing out oral medications to my patients on my own, I really started to feel like a nurse. I can only imagine the feeling when I get to hang that first IV without my instructor!

I haven’t been able to start on IV yet on a real person, but our instructor is really trying to find us good situations. Since I’m still trying to develop my sea legs, so to speak, and not get queasy, I’m not in any hurry.

So, yes, I’m still here, plugging away. Thanks to everyone who’s written to ask about me and wish me well!

In this nursing program, passing requires a 78 minimum average. If you fail one class, you have to repeat every class in the entire semester. Going into my final this morning, I knew I was barely passing my lecture class.

As I sat down in front of the computer, I tried to give myself a pep talk: You just need to pass this test. You can do it. I closed my eyes, took a deep breath, and started the test.

And had no clue what the first 10 questions were even talking about.

After going through all the questions at least twice, I was ready to finish the test. Hovering over the ’submit’ button, afraid to know my results, I tried to prepare myself for whatever might happen. Steeling my resolve, I hit the button.

70

I don’t think I can even tell you a portion of the things that went through my mind as I saw that failing grade come up on the screen. I disappointed everyone who believed in me and I was ashamed to have let them down. What’s wrong with me and why am I such a failure? Could I really do this entire semester all over again?

Still in shock, I spoke to my teacher about the readmission process. My friend was waiting for me in the hall. ‘How’d you do?’

‘Not good,’ as I slowly shook my head and headed down the hallway.
‘Are you still in the program?’ she asked, worry clouding her voice.
‘Nope. I failed. Bad.’

She was silent, then, not knowing what to say to comfort me.

After a moment, ‘Are you sure?’
‘Pretty sure,’ but I dug out my phone to use the calculator. ‘I can’t even remember my grades; I just remember my average!’ as the frustration starts to creep over me.
‘Just multiply it by 4.’
‘Oh, right.’ *4)+70))/5

I lean heavily against the wall, trying to find the courage to look at the answer.

77.8

Turning to my friend, I whisper, ‘77.8?’ Then there’s a slight pause because I can’t find my voice and I literally collapse onto the floor. ‘That’s passing, right?’
‘Yes! Are you sure?’ She pulls out an adding machine (yes, she carries and adding machine with her; I have no idea why) and we’re both doing the math.

It’s right! I made it!

In the end, it wasn’t that close after all. There were a few test questions tossed out of this test and the last test, so I wound up with plenty of cushion. Even knowing that, while trying to write this, attempting to recapture the horrible feelings from this morning, I feel nauseous. That walk down the hallway, with dismay weighing so heavy on my soul, was the longest 10 steps of my life.

I almost didn’t write about my morning; I could just say I passed, and nobody would know that I came so close to failing. But, I’m not perfect, and this is a difficult journey.

I’m just glad I’m still on it.

My time in labor and delivery and in the newborn nursery went well. Actually, it went a lot better than I thought it could. The brief version? Not only did I see babies born — I actually CAUGHT one as he came out. It was gross, and pretty awesome. While in the nursery, I was appointed the offical ‘Fussy Baby Holder.’ People with several kids couldn’t get some of the babies to settle down, but they’d snuggle up, content, within moments of being passed to me. I really have no idea why, but they stopped crying, so I’m trying not to question it. But, the biggest news?

I DIDN’T FAINT.

Woo! Thank you all for the support and encouragement!