Precepting/Orienting Nurses

A couple of years ago, I was asked to orient a new hire on my floor and was excited as she was a grad from my alma mater, so we had the same frame of reference. She was excited because she had always wanted to work in psych. I felt great knowing she was going to be on a somewhat quiet unit, instead of an acute one, like I did.

So, I began to orient her to the unit, citing procedures, treatments, and daily practices at nauseam. She caught on very quickly, and was doing so well. On our last day together, I turned her loose to do it on her own, and she was excellent!

However.....(you knew there would be something) two days off of orientation, she gets pulled to another unit. Not only does she get pulled, they require her to be a nurse's aid. Not only does she have to be a nurse's aid, they place her with a very psychotic patient. Not good. She begins to cry. They place her with another patient, it does not make her happy.

I guess my spidey-sense went off, even though I had not seen her since orientation. My co-workers began to tell me some troubling things: she is not on the floor very much,  and is seen constantly on her phone. She won't take off orders, help with treatments, or basic patient care. "Hmmmmm," I thought, "maybe she's quitting?" In my typical fashion, I just asked her, "Are you going to keep working here?"  She mumbled an answer about not being a psych nurse the rest of her life, and averted my eyes. Yep, she's a goner. The next day I had asked someone who knows everything at the facility and they confirmed my suspicion that she had turned in her notice.  I took it kind of personally. "Maybe I didn't give her enough training or support?". I found out later that she went to another job and stayed there only 3 weeks before she turned in her notice, too. I felt a lot better after knowing that.

After that experience, I took a precepting course offered by my facility so I would get a little more per hour for training new hires. Over the course of two years, I've probably oriented 10 different people. Some were straight out of school, others just picking up for extra money. I've had a few that were lazy, and some that were very ambitious, wanting to try their hand at every skill, gross or not. My alma mater also has brought me some about to be grads who need to precept their 120 hours with a nurse before taking NCLEX. Those are my favorites! I just love seeing a new nurse with all that positivity in their eyes. And they think you know EVERYTHING! Ha!

If you ever get the chance to precept/orient, take it! I used to think that having a student would be an awful burden and experience, but you learn things from them, too! (I had an orientee that showed me a trick changing ostomies that has keep me from making a horrible mess that I'm forever grateful for.)

What I learned the first semester of RN school

Some things I learned fresh. Others I re-learned.

I've always been a fan of Top Ten lists so here's my list for this past semester:

10.  It wasn't as hard as I thought it would be. I guess going in with 18 months of prior school knowledge as well as almost 3 years as an LPN helped, but common sense kicked in, (which I hoped it would) so those NCLEX type questions were a lot easier to handle.

9.  I still hate ATI as much as I did back in LPN school.  I hate paying for something that I can't fully use. I have subjects I'd like to start working on and they "aren't open" . Well, why the heck not? I have to pay $400 a semester and not be able to use it all? They are trippin'......

8.  I don't stay up all night and study anymore.  Maybe that sounds selfish, but it's true: I'm old....I need my sleep. The one time I did stay up all night, it did me no good, anyway.

7.  Clinical days still aren't fun because no nurse in their right mind wants to have a student for the day. They were nice to me. But I could tell this wasn't on their to do list. To be fair, it won't be on mine, either.

6.  Technology has certainly advanced things. I still paper chart at work, but I got to electronically chart during clinicals. It does seem monotonous though....it's also nice to be able to record my lectures on my cell phone and listen to them back and forth from school to home.

5.  I have forgotten so much about IV's since I don't use them at work. If someone needs an IV at my job, we send them out. Still haven't stuck my first victim...I mean, patient....

4. Working every week-end full time blows.... but when your work is PAYING  6 hours a semester, and you need the insurance, you go.  You hate it, but you go.  I worked every Friday, Saturday, and Sunday. On Mondays and Wednesdays I was in lecture, Tuesdays was lab, and Thursdays were clinicals. I am glad I saved my vacation days to use on the Sundays before an exam.  I'm going to need to bank some this summer for my second semester as well. My schedule will go back to normal starting Monday.

3.  It's still important to make friends in nursing school. After my friend left, I started studying with a guy who had an even weirder schedule than the first one. I found myself meeting him at McDonald's at 5:30 AM to study. Must of been nuts, but we both passed.

2.  It's awful when your BS meter goes off and you notice the teacher not trying. Yes, I am saying she was blowing smoke in a place you don't want to talk about. I'm not that far from her age, so I know she knew, that I knew she was just getting tenure. She read from the book because she didn't know the material. Our last 3 lectures on diabetes, which is fairly involved, she got guest speakers to talk to us. Wow... how lame can you get? It made me want to stay in school to have the credentials to take her job....almost. I'm so done with school.

1. My family is still there helping me through. ( Mostly Hunnybunny) However, they still don't get me on the whole studying thing. I thought maybe my kids would be proud of me. But they think I'm wasting my time. It's okay. While I'd like to have their support and approval, its just not necessary.

First casualty of war

I've been notably silent...which is not like me. That's because all I do is go to work, study, eat, and do it all over again. It's been fine until now. The person who was accepted along with me didn't get to advance to the next 11 weeks. I felt alot like Katniss this past semester.Just jumping through hoops. But the best part is I had a friend jumping with me. We knew no one but each other walking in that first day. And thankfully, the group accepted us pretty easily as they had already made friends in the first semester we were exempt from. He was liked by all, even to the point when we found out he didn't make it, one of the others cried. He never expected to be thought of that highly, but why, I don't know. He has 20 year of LPN experience, and knows his stuff. He just didn't test well. I don't either, by the way. He only missed it by 2 points.
I took it pretty hard the first few days because I couldn't imagine how bad he felt. For our clinical group, it's been like someone has died. But we're coming around.
Hunnybunny didn't really understand. He tried to, but he couldn't really get the whole "nurses in the trenches" vibe. The more he tried to encourage me, the worst I felt. I wasn't trying to make it about me, but I kept thinking, "If HE didn't make it, what makes me think I will?"
So, I'm trying to remember what I did the first time. Pouring over my notes, and finding my notes from LPN school invaluable! Apparently, this particular program doesn't go into too much depth on stuff, so in a sense, we are educating ourselves. And I will revert back to what I said in a previous post: my learning style is my problem. If I can't figure it out by now, what am I doing here?
Y'all are going to have to overlook me....I am just trying to stay realistic.
The ATI demon is back with this program. How I HATE ATI! And if you're reading this and have no idea what I'm talking about, consider yourself lucky. ATI prides itself on preparing you for NCLEX. But all I can see is that its taking us all away from what we should be doing....studying!
I will get off my soapbox now, and take off my black mourners veil and get back to work. Thanks for listening.

A week from today....

.....I will be sitting in a classroom for the upmteenth time. It's hilarious and incredulous to me that I am doing this again. I mean, 240 college hours, PLUS the new ones I'm about to acquire?  Shoot, I could be Dr. Beth by now. But alas, I'm just getting yet another Associates degree. (I have two of them. This will be number 3)

 The part that bothers me is the whole unknown thing again....what's the class going to be like? Am I going to be the oldest in the class? Is my brain going to run on all cylinders?

I'm thankful that one of my coworkers has been accepted with me. It's kind of a drive, so we are going to carpool. He's an older student, like me, so he's pretty serious about doing this.

I'm going today to get the UGLY white scrubs I will need for clinicals and a new pair of sneakers. Books are bought, but I probably need to see about some school supplies.

Truthfully, I get nauseated every time I think about this. Is that normal, or just me overreacting? I made it through medical microbiology with a B, which shocked me to death, but I'm just sort of second-guessing myself. Maybe it's the work schedule that has me very anxious. I will be working every Friday, Saturday, and Sunday this semester. If the last few days are any indication, it will be challenging. My comrades and I ran all weekend long trying to keep up with everything. And they are awesome because they have both gone further in school and are a great support!

Anyway......wish me luck! I will need it.

Time to get on with it

 I work for a hospital that is affiliated with a university. They are offering to pay for 18 hours a year to finish my RN. I think I have finally reached that point where I'd like to do more with nursing. It's not that I'm bored. In psych nursing, there is no such thing as being bored...everyday is a new adventure. It's just that  I had always planned on bridging over. Truth be told, I was pretty burned out on school. The idea of doing it again kind of nauseated me.

So, I'm taking medical microbiology this fall. If one of the community colleges accept me, that's the only prerequisite I will need. If I go to the state university (I'm applying to both) then I will need chemistry. Have they met me? I'm not much of scienc-y kind of girl. But, if I have to, I have to. Also, the community college requires the NLN, which I have taken before and gotten a composite score of 115. I have to get a verbal Score in the 65 percentile. Comprehensive Score has to be 111. If I go to the university, since I have been out of school longer than three years, I must take the Nursing Acceleration Challenge Exam (ACE) I and receive Decision Score of 70 or better. Nothing but hoops to jump through....
I have begun the tedious process of getting all my transcripts together. A college I attended in the 80's is closing their doors, so I had to hustle to get my transcripts before they merged with another college.
That's probably more than you wanted to know, but I'm trying to keep it all straight in my head. If I don't get in either place, it'll be okay. I'm happy to be an LPN. And they can't take that away from me

8's VS 12's

It really annoys me.... I've been at this job 1 year, and I haven't figured out what to do with myself on my days off. Yeah, there's always cleaning, laundry, dishes, dusting, grocery shopping...etc. But, what's the fun in that? ;)

Up until 3 weeks ago, I was "working 8's" which is almost unheard of in the nursing world anymore. The only time I had two days off in a row was when it was my off weekend from work. That really reeked, by the way. So, I had the opportunity to change floors and change hours and absolutely took it! I work more with Geriatrics, which I have had my training in, and now work 12 hour shifts. The pro's definitely outweigh the con's but I'll give you the short list:

Pro's

1.     You get three days off a week. Sometimes even a 3 day weekend.
2.     Therefore, you can plan to travel more because you'll actually not have to take time off to do it.
3.     You don't get asked to stay over.
4.     To me, it's easier to go through a 12 hour shift with a patient to see how they progress.

Con's

1.     Physically, it can be exhausting when your body is used to getting a break after 8 hours and now must carry on an additional 4 more.
2.     It's been hard to figure out when to take a lunch break. Used to be at 11:00 am, but now it's closer to 1:30-2:00 pm. I'm actually having to eat breakfast now to make it until then.
3.     While you work only 3 days a week, every other week, those 12's are 3 in a row.
4.     You lose 4 hours a week because it's technically only 36 hours. You can pick up on your off days, but right now, I'm thinking....uh, no.

My first couple of weeks I spent getting used to the physical change of 12's. This past week, it's my family who has had to manage without Mom being around. Hunnybunny does a great job of being the cook and chief bottle washer while I'm gone. Now that I'm getting  more used to it, I'd like to get back to quilting on  a regular basis. I have so much fabric, patterns, and just can't get organized.

Oh, and by the way, I'm signed up for medical microbiology which is the last prerequisite for nursing school. Yeah, I'm a glutton for punishment. Getting the RN will open a whole world of opportunity for me. This class is online, which blows me away. I have to get a microscope for the lab part. One of my nursing pals did A & P this way and totally endorses it. We will see.

Stay tuned.

The best motivation to help you study for NCLEX

 is to set the date. How true it is! Nothing puts the fear of GOD into you like knowing you could possibly waste $200 if you are not prepared enough.

Our school required we buy this online tutoring program. It is supposed to run you through the 7 areas: fundamentals, pharmacology, pediatrics, mental health, medical-surgical, maternity, and nursing management. This company places you with a tutor, and you do an initial assessment. You go through the books and after each one, you take a test. If you don't score 60% or better, you must do homework to help you improve your score. Then you take it again. It gives you a read out of areas you missed and what you need to work on. I got through fundamentals just fine but pharmacology....I fell short. Again and again, so close but not 60%. The tutor wouldn't let me advance. Really? I paid you $400 to teach me, but you can't advance me until I reach the exact benchmark? I just gave up trying to use them. Besides the aforementioned scenario, their questions were not formatted to helping me with NCLEX. When I started nursing school in the fall of '11, we were required to buy Saunders Comprehensive Review for NCLEX-PN. I had listened to my dean at my school when she said, "if you really want to pass NCLEX-PN, then after lecture every day, use the Saunders book and reinforce it." So, I went through the entire book, and accompanying disc with chapter questions on it. However, I still did not feel adequately prepared. I began to search online for alternatives. Kaplan was good, I had heard, but very expensive. I had less than 4 weeks before I tested and their program was more involved than I had time or money for. NCSBN.org  is the organization which I took my jurisprudence test for state licensure and I was told they were the people who came up with the NCLEX questions. So I signed up for the 3 week PN review.
It did the same as the other companies, but was affordable ($50) and I went through the test questions as many times as I needed to, which really helped. I would highly recommend them if you need lots of repetition to grasp a concept.
I planned on taking NCLEX-PN Saturday, March 23, 2013. Every spare minute I had, I was going through questions. I added up over 4,000 questions and rationales that I had done. Finally, the day came. I showed up early and they decided to go ahead and take me early! Holy cow! My nerves took over and I headed for the bathroom!  So, I still started at the time I was supposed to. ;)
There were many checks of identity, and finally I was sitting down. "Don't stress: you studied, God is with you...." I kept saying in my head over and over again. Then came the first question. I looked at the screen and thought, " I am so in trouble! I wonder how long it will take me to save up to take this again?" I literally prayed through each question. When I got to question 84, I got nervous again. You see, you can fabulously fail with 85 questions or spectacularly pass with the same amount of questions. The minimum questions for NCLEX-PN is 85. The computer will keep asking questions until you get at least 50% correct. 15 of the questions are "experimental" and if you miss those, it's no big deal. But you don't get credit if they are right, either. You have up to 205 questions unless the computer deems that you are not going to pass based on the amount of high level questions you got right.
After question 85, the screen went blue."Oh, no..." My breathing went shallow. I raised my hand and the attendant escorted me to the office. I called Hunnybunny who was very surprised to hear from me. "It's over?" Yes, it's over, I told him. I felt the way I was supposed to after NCLEX: exactly like I failed. No tears or boo-hooing for me, though. It was what it was. I had spent over 300 hours studying. If I wasn't ready by then, I didn't think anything would help.
I had heard about the Pearson Vue trick a year or so ago. After the results are transmitted, you can try to register again for the exam. If it takes your credit card, it means you failed. If you get this pop-up, ( see below) it means you have passed.
            

  

That is exactly what happened to me! I found out that I passed NCLEX-PN by using this PVT (Pearson Vue trick). On Monday, March 25, it posted to my Board of Nursing website, with my name plus LPN! Thank you, God!

On to the NCLEX

So, it's down to this. This one little test. Well, not really "little". It can be as "few" as 85 questions, or as many as 205 on the NCLEX-PN. Am I terrified? Is the pope stepping down? Terrified doesn't quite cover it.
I've been working at a private duty nursing place since May of last year, and now that I'm not in school, I've been working full-time.  When my patient is taking a nap, I catch a few pages.   Also studying at night when I get home. Our school had us purchase a review package from a "nameless" company. It was very expensive, and not very worth it as far as I can tell. I'm getting more out of my Saunders Comprehensive Review for the NCLEX PN Examination-4th-edition, Mosby's NCLEX- RN Review Cards,  and some old ATI books a friend who passed NCLEX gave me. It's weird, now that I'm out of school, I don't feel so stupid when I do these assessments and practice tests.
I've read every "plan" out there, but I'm hoping I picked the right combination of resources. You might be wondering when I'm taking it. Well, keep wondering. That's setting myself up for pressure I don't need. How about I just let you know WHEN I PASS?