Friday, August 21, 2009

Why I Hate NCLEX Questions!

Here's an example of a fairly routine NCLEX question, and rationale of why I hate them.

A nurse is performing CPR on an adult who had a cardiopulmonary arrest. Another nurse enters the room in response to the call for help. After checking the client’s pulse and respirations, what should be the function of the second nurse?

1."Relieve the nurse performing CPR."

2."Go get the code cart."

3."Participate with the compressions or breathing."

4."Validate the client's advanced directive."

This is why I hate NCLEX-style questions. It seems that I could think of situations in which each of these answers would be correct! I pulled this off of a Question of the Week site which didn't provide any rationales for the answers. However, let's re-analyze:

1."Relieve the nurse performing CPR." If the first nurse has been performing CPR for a long period of time and is physically exhausted, I think this may be a great option.

2."Go get the code cart." If you know the patient is a full code, and the first nurse has been doing CPR for only a few moments, perhaps having the second nurse get the crash cart is not such a bad idea if it does not take too much time.

3."Participate with the compressions or breathing." Fortunately, I did choose this. Under normal circumstances, I do believe this to be the correct answer. I chose this, and it is the correct answer, and I believe it applies to the majority of situations that can occur.

4."Validate the client's advanced directive." This I believe would be applicable in a certain setting. If the patient removes, for example, a bracelet that lets staff know his/her DNR status, the nurse performing CPR is still liable and can lose his/her license for performing CPR on that patient. So if the status was unclear, I certainly would direct a second nurse to check the chart if the DNR status was in question. If the patient's advanced directive is unclear at the time they require CPR, it's far worse to waste valuable time checking DNR status only to find out your patient is a full code; a potentially deadly delay.

In this situation, I got the question right. However... depending on how you perceive the situation with the limited information that is provided, it's very easy to get these questions wrong. I hope I can improve my critical thinking before school starts on September 9th!

Hospital Job Going So-So; Nursing School Around the Corner!

Well, I've been just about totally trained at the hospital for my job as a CNA. It's been pretty cool so far, and I can do more things here than I can anywhere else.

At the hospital, I'm authorized and trained to discontinue IVs and foley catheters. I'm also trained on using a glucometer and can get blood sugars on pretty much all of my patients. It's pretty neat and I'm glad I have the experience doing these procedures. I'm even tentatively signed up for a neonate resusitation class in October.

However, like all wonderful things, I have a pretty horrible supervisor. I signed on for a particular schedule and now she wants to change it all around. She's been scheduling me without getting my schedule requests and she jacked up an entire schedule by scheduling me during my nursing classes. I informed her I was in nursing school and her response was, "Are you actually in the nursing program, or just taking some college classes?"

Another quotable quote is, "Well, we have eight CNAs in nursing school so I don't know if I can accomodate these schedule requests." Yeah, so damn, I'm just going to have to miss my clinicals and flunk nursing school because you don't feel like adjusting a schedule. Yeah right. Not mention she even told me that due to my restrictive schedule, "I wouldn't be making any friends in that department."

The schedule was supposed to already be hammered out. I told my supervisor my availability before I was done with my orientation and the schedule still got messed up. If my school schedule can't be accomodated, I don't know if I can fit this job in my schedule. The schedule requirements are not what was discussed during my interview.

Nursing school is around the corner. I just paid for it (well, most of it). I definitely am getting nervous. I'm doing some practice worksheets and stuff since I know mostly what the beginning of class is going to encompass. Again, I stress... nervousness!

This is my last shot at completing nursing school anytime soon. I really need to succeed this time or if I want to continue nursing, I'll have to go to another school and go through the prerequisite requirements... again. Not looking forward to doing that again; that's a fact.

Saturday, August 8, 2009

Calm Before the Storm...

August... Only a month away before I begin that nursing school "journey" yet again.

Not to much new to report. I've been working my job at the Rehabilition Hospital for awhile, but all is pretty slow there. I've pretty much got that job down. Very easy... my job consists of the following on the overnight shift:
  1. Clean up said poop.
  2. Assist people to the bathroom.
  3. Change bed as needed.
  4. Give ice water.
  5. Take vitals.
  6. Scan bladders with a PVR machine after voids.
  7. Collect samples for tests.
  8. Do a metric-ton of paperwork.

I've pretty much got it down. I think the experience will really help me during nursing school. Not to mention I've got a good base of people who I know will help me (including a few of my high school friends I found on Facebook who turned out to be RNs!)

One cool thing that happened was that I got another job! Yes, I know everyone thinks I'm nuts, but I'll probably cut back to strictly PRN at the Rehabilitation Hospital. I got a job at the actual hospital down here, which is really awesome. There's so much even a CNA can accomplish there, even without an LPN or RN license, such as patient care techs or surgery techs (not the degree kind, the kind that assists the OR nurse, not the Doc).

Not to mention the benefits... I can get all my schooling paid without having to use financial aid! It's a really cool opportunity and I'm excited to have been offered it. My job would be to assist CNAs, RNs, and PT moving any exceptionally large patients. I'd be on a "mobile" nursing team and have access to all parts of the hospital. Not mention the flexibility is outstanding, making this job a better fit than the Rehab Hospital during my nursing school career.


So, hopefully with the experience I have now I'll have a better experience in nursing school. The stack of nursing books looms ominously on my dresser as I get more and more nervous about my final shot at nursing school.