Sunday, April 5, 2009

Taking the good with the bad

I have good days and bad days. Sometimes I am irritable and moody. There is no predictability about it. I am not a machine and have been unable to sit and do question after question after question after question. Today I am feeling particularly discouraged. Then I feel guilty because I am just not always this constant stream of optimism especially when faced with the number of study days I have left.

There is so much pressure on me right now. I just don’t know when nor how it is going to lift off of me. Studying for this test with the heightened pressure of passing, places me in this weird space and time. I feel guilty if I am out enjoying myself. I feel awful if I am not constantly thinking about lab values, interventions, or medications. I still wish that I could just stow myself away in some far away cabin and live and breathe NCLEX up until the test date. But, this is simply not my reality. I have a very, very high maintenance family. In addition to have an adolescent, my husband is a foreigner plagued with his own issues of adapting to American culture, learning English, and trying to find a place for himself here. He relies so much on me to help interpret, assist with employment searches, directions (he is always getting lost), and anything else that you can imagine. To his credit, he played a similar role when I lived in his country the first few years of our marriage. So, this is me returning the favor. Unfortunately, I need a vacation from this role while I am trying to study for this exam. I cannot be superwoman these days.

But he more than anyone knows that there is so much riding on me passing this exam. He knows that amid many things our future economic security is tied into me passing this exam.

My foul mood got set off when I accessed my friend’s online test preparation this morning and did a 150 exam. I got 58%. It was the first time since I have started studying again that I have sat down to answer so many questions without accessing the immediately rationales. In tradition of the NCLEX, I had no idea how I was doing until I finished the exam and saw my score. I have no idea what the correct answers and rationales for them where because it never offered them. So, that sucked! Seeing that 58% made me feel really crappy.

I have to find a way to lower my anxiety levels. I am learning a lot. I do know more than I knew the first time around. The first time around I had no idea what to expect. None whatsoever. I went into the exam with serious knowledge gaps. I am much better on content than I was the first time around, however I do recognize that I still have a long way to go. My friend—the only other person in the world who I know is taking the NCLEX—is already registered with Pearson Vue took a look at the local testing schedule. I have to test by May 26th. I wanted to know what the calendar looks like because I am not going to be able to pay for the darn test until the first of May. I am concerned that the dates might get booked up. There is only one testing center for miles and miles around. I’d have to travel to another state to take it if I cannot get the date I need. Of course this can change at any moment, but as of today there is testing appointments available on the 20th and the 26th of May. Now, I do not think that it would be wise to take it on the 26th—my last day of eligibility simply because anything could go wrong. If there was a fire or the computer stopped working, it’s not like they could say come back tomorrow. Or could I still test, since it was not my fault? I don’t know.

So, it looks like the 20th is the last possible available date before the last day of my eligibility (as of today).

After taking the practice exam, I came across the first hand account of a woman who took the NCLEX six times and passed on the sixth try. Oh my gosh, I am so happy for her! But I do not want to go through this six damn times. I cannot imagine the resolve that she must’ve had in order to keep picking herself back and keep pressing forward. At some point she did have the luxury of quitting her job and solely concentrating on passing. Although she did not specifically pinpoint what it was that helped her pass the sixth time, I am certain that it was just willpower and drive. I suppose that if push came to shove, I would be just like her and keep at it until I passed.

However, let me state here and now that I am not trying to go for six times. I believe that I am going to pass this time. I say that half heartedly really, because I was all on the positive thinking kick the last time and it did not get me a passing score. I remember that one of my better nursing professors told me that “chance favors a prepared mind.” So, I am going to run with that mixed in with being positive.

I know that I sound like a commercial or something, but I believe that Kaplan is the best test prep for me. So, although I cannot truly afford this $418 that I am about to spend . . . I am going to pay for it. I make decisions not always on what is the most logical (you can’t afford it so don’t buy it), but based on my gut-feeling. My feeling is telling me that I can pay for this again and go through the entire package in order to make it worth my money.

I need to calm down on this high-strung do or die energy. I’m too old for this crap. So, while I am putting my best foot forward I am doing research to learn if I can indeed apply for licensure by examination through another state if I was unsuccessful at licensure by examination through another one. I would also like to know which states have unlimited testing, quick results, and are apart of the compact states. Although I am from the state that I applied through and my parents still live there, I have no plans of returning there to work despite my wayward fantasies of working in a gritty urban emergency room.

I feel like I am giving myself permission to fail on some level. It is really not that. When I say that I believe that I am going to pass . . . the truth is that I do not know. I have absolutely no idea and I refused to set myself up for that fall. My mother still does not know—or has not said anything to me—that I do not have my nursing license. See, I told everyone that I had passed (kind of like naming and claiming it shortly after testing). Truth was, I had no idea if I had passed or not. But I could not stomach the thought that I had traveled so far to take an exam only to fail it. It was a nauseating though. In the end, I just could not bring myself to tell my mother that I did not pass. I just told two of my closest friends the truth instead.

So, I am not giving myself permission to fail as much as I am trying deflating the power that this test has over my spirit right now. The NCLEX is the end all, be all in that I have to take it to become an RN (real nurse) in the States—not in its territories though. But it is not the end all in that I am going to die if I don’t take it and will be left without any recourse or remediation.

So, how much time do I have left to study? I can say that I have a good six weeks left. Provided that May 20th test date is still available.

Sunday Monday Tuesday Wednesday Thursday Friday Saturday
5 6 7 8 9 10 11
12 13 14 15 16 17 18

19 20 21 22 23 24 25
26 27 28 29 30 1 (May) 2
3 4 5 6 7 8 9
10 11 12 13 14 15 16
17 18 19 20 21 22 23
24 25 26

I already did 150 questions today. For the rest of the day, I will reread the NCLEX examination guide and maybe do some psych questions. I have an exam tomorrow for my graduate class, so at some point I should stop fussing over the NCLEX and get myself prepared for that.

Found, another NCLEX taker

Wednesday, April 01, 2009

Today was April Fool’s Day, but there were no practical pranks or jokes for me. It was a really good day for me! I met another woman studying for this exam—a second time around test taker. We decided to form a study group, just her and I. We met through a mutual friend. I was hoping to share some of my materials with her, but she really did not need any of the material I had because she has a phenomenal library and access to good reference and study materials.

We were not quite sure how to study together, but set some goals for our first upcoming meeting that include lab value review and disease review. I suspect that I may have more riding on this test than she does, because she does not necessarily have any immediate plans to work in the field of nursing. But if she is willing to meet and discuss content material, then I believe that it will be an enriching experience for us both. She also has access to an online test prep service and offered to let me use it. I had never heard of it before, but while doing an internet search I found many online comments from former users. Many posed the question if it is an actual indicator for NCLEX success rates. She also gave me an audio NCLEX review. I have one to some extent, but this one is different. They read the question and the answers, offer the answer, and the rationales. That might not be very effective for me because while I do like audio content review listening to questions and picking out possible answers might feel like too much work. After all, I am going to be reading the question on this exam.

Today, before I met her. I called the State Nursing Board in a desperate attempt to find out if this was truly my very last attempt to take the test with the State. I explained that although there is a 3-year open application limit that my application was not actually complete until 2007, as opposed to 2006when I initially applied because I was still paying off my nursing education debt and the university refused to send my transcript to the nursing board. So, therefore the 3-year rule should not apply to me.

An impatient customer service representative flatly told me that the state starting counting from the date the application was received as opposed to the date it was complete. She said to take the exam and pass it by my last eligibility date or go back to school or apply through another state. That really ticked me off: “go back to school” but I ignored it. Instead, I asked her if there was an appellate process for special cases. She put me on hold to confer with someone and returned with the same prognosis. I then asked to speak with someone who was in a position to make decisions and she transferred me but cautioned that the woman she was transferring me to rarely takes calls. So, why are you transferring me then!? The woman did in fact pick up and she basically explained to me the exact same thing, but with a bit more patience. She explained that the legislature changed the law effective 2009. “At first there were no limits, but then we had people who were ten years out of school still registering and re-registering to take licensure exams. So, now you have to take the exam, according to your profession, within two years of graduation. You happen to be over that with nearly three years out of school, but if you pass your exam you can still get licensed through us,” she said.

I thanked her for her time and willingness to listen and she quickly got off the phone. They must have to attend to loads of hopeful applications filled with test anxiety. So, as if it was not settled before. This test is do or die! Damn, I hate to have my back up against the wall, but this is just they way it has to be.

I am not going to beat myself up about it. Things just unfolded the way they did. There is no use in crying over spilled milk. No one is crying anyway. I am feeling hopeful.

I read a few journal articles, went through nursing fundamental questions, some pediatrics and maternal/newborn. I logged onto her online site to check it out. I just had time enough to go through one subject area. I was trying to see if my pending Kaplan subscription is necessary after all. I am desperately trying to see if I can save myself $418 or not. I came away feeling like Kaplan still would be another good investment.

I definitely did my 100 questions today. I am going to do some more before crashing. I worked really hard today.

Feeling anxious

I am feeling anxious about my upcoming test. I do not feel as though I have been studying as hard and as focused as I could be. I continue to study at home. Believe it or not, it is my husband that distracts me the most not our son. Nevertheless, I still have some serious knowledge gaps that need to be addressed. On a positive note, I definitely understand much more than I did when I first took the exam. If my memory serves me correctly, I think that I was simply answering questions. Serious content comprehension eluded me. I mean, I understood many things but not as much as I could.

My anxiety comes when I think about what will happen to me if I do not pass the exam. How will I be able to pick myself up off the floor? Where would I get the nerve to start studying again? It took me a year and half to registered for this damn test again after the first failed attempt. If it had not taken so long to get re-registered, perhaps I might have at least another attempt under my belt but as of this coming May I will have maxed out my three years from the date of my original application, so this is my last testing opportunity with this particular State.

I know that I should not think about it that way, but I cannot emotionally afford to fall with a great impact. I simply cannot afford to fail this exam. I should have the most positive mindset possible. But I had one the last time and look at where that got me. It is completely normal that I would feel nervous and extremely intimidated (and angry too because we were not taught all this stuff in nursing school!). Anxiety related to NCLEX! This is a kick-ass exam.

Well, let me stop my bitching and moaning. I can pull myself together. I have a month and a half to get myself as prepared as possible. One thing I have noticed with the practice questions I have been doing is that when you know the answer because you have a good grip on the content, the other answers appear to be absolutely ridiculous. Caution though, this can be a two-edge sword. Sometimes you know the answer so much and that you can misread the question. For example, it might say “except” or “needs further instruction” which entirely changes the type of answer you are looking for.

What am I doing to study?

• Reading nursing journals, particularly issues of “Nursing Made Incredibly Easy”
• Reading Frye’s 3,300 Bullets (excellent book!)
• Answering questions on flashcards

I prefer the flashcards because I do not sitting at the computer answering hundreds at a time. The flashcards I can answer while I am sitting in the car waiting or laying down. The books are often times structured in such a way that to get the correct answer you have to constantly flip pages, except Saunders. With Saunders the answer is right there, but I found that I had to use stick notes to cover up the answers ahead of time because my eye had a tendency to wander and glance at the answer while I was still reading the question. But, I do not have that problem with the flashcards. They are just more convenient for me. Problem is, there are not many updated flashcards out. I have using Springhouse and Saunder’s Q and A in the blue box. The newest Q and A edition, colored-orange does not have flashcards available yet.

Throughout the month of April or perhaps early May, I am going to start to build up my resistance. When I took the NCLEX the first time, I felt like I was just melting inside the testing center. I think that it had to do with three factors: (1) I did not know the answers to many of the questions; (2) I had always studied in “study mode”. Meaning that I answer the question, but the answer appears on the screen shortly thereafter. Like the flashcards (I just flip over the card). Instant gratification; and (3) I was just too anxious! So, when the test shut down at 75 it was more than a gift to me because I would’ve lost it if I had to go all the way to 265. It would’ve been more than I could handle.

So, when I say building up my resistance I am thinking about daily runs to 75-265 questions in “test mode” without answers and rationales until the end. This is to say that my honeymoon with my flashcards may be over soon.

Finally, I need to make a decision as to how to best spend my last available resources on test preparation material. A former classmate of mind said that she passed the exam with Saunder’s alone. Another one reported using Kaplan, NCBSN, among other materials. I am thinking about paying for Kaplan online $418. Now, this would be the second time that I will have paid for Kaplan. I did not use it for the first test but paid for it shortly after I failed and was supposed to be preparing for the second test. It was a waste of my money, because I halfheartedly studying with it. They were even nice enough to extend it for me a second time free of charge and I did the same thing, just blew off the opportunity.

Okay, so why invest in Kaplan a second time? There are some other books/resources that I could buy that would be less expensive than that. For example, I could definitely use a book on delegation, some pharmacology flashcards, and a book on ECG. I also saw a visual pathophysiology book that looks interesting as well.

From what I saw, it just seems like a good test preparation tool. Now, because things are tight for me economically I will ask myself some serious questions as to if I feel this is the absolutely best route (you know play devil’s advocate). But I really feel like Kaplan is the route and so far I have been on target as far as identifying the correct tools I need to prepare. The visual aides have been of an enormous help by making the test jump off the page for me. It makes things click for me.

Out of a job

Life is always full of surprises and today failed to be no different. I lost my job today. I was informed that they are not sure how a provisional license in nursing, which is what I have, will work with their accrediting body. I worked in telephone nursing. They did not exactly come out and say that I was being let go, rather they needed to get clarification on the law and would get back with me. I took it to mean that I was being let go.

I live in an US territory. Here, just like every other state, they have there own nursing board. This board allows for an immediate provisional nursing license and three exam attempts. So, you can work in a hospital or any other facility for close to a year without having taken this exam. The nursing licensure exam is not the NCLEX, but one they have developed. It is only offered three times a year and costs about $34 to take. It is purported to be way easier than the NCLEX. Since October, I had been working here on a provisional license as a nurse in and out of hospitals.

I did not like hospital nursing here because nurses are assigned as many as 20-40 patients. The people you work with eat you alive. I could give you a million reasons why you would never want to be hospitalized here. So, I was eager as hell to get out of the hospital.

I decided to take the loss of my job as a sign, a good one, that what I really need is to invest my time and mental energies in studying for the NCLEX and finishing my graduate degree here. It also more than ever stresses the fact that I need permanent licensure more than anything. I am not feeling as sad as I thought I would about the loss of my job. It was a relatively easy one, it paid well as far as nursing jobs go, and it got me out of the hospital. However, I had been racking my brain like crazy as to how I was going to juggle so many competing roles.

My ex co-workers asked me if I would return after nursing exam. I take the NCLEX in May, but their nursing exam is in June. I said “No”. There is absolutely no reason to return there. Don’t get me wrong. I don’t feel like I was shafted or anything. I am simply going to put all my effort into finishing my degrees as soon as possible so that I can leave here. I moved here to specifically attend this university and once I finish I would like to leave as soon as possible.

Sunday, March 1, 2009

Sunday, March 1, 2009
Day 1, not really . . . but let’s just call it that

My NCLEX exam is going to be scheduled for sometime in May. My last date of eligibility is May 26, 2009. I have decided to take the exam sometime a week before this date to be on the safe side. Just in case I arrive at the testing site and find that they are closed for some emergency and my test has to be rescheduled. I just want to make certain that there is sufficient time between my actual testing date and eligibility date. I am probably just being paranoid, but I feel like I need to think about things like this.

My study plan is not a particularly formal one. It consists of knowledge deficits and reinforcements that I know I need. In between all of this, I have to find time to be a mother, wife, work, and take my graduate classes. “Overwhelmed” is an understatement, but I truly believe that I am going to pass this time. Why? Because I am going to do everything possible to prepare myself for a passing score. Not just that but things are different from the first time I took the test.

For example:

1. I have three months of medical-surgical hospital staff nurse experience under my belt. It’s not a lot, but it is extremely significant in that the medication names are not all like Chinese to me as they were before. Also, there are procedures like blood transfusion, central lines, narcotics, etc. that I now have a visual reference of what they look like and the procedures involved. These are experiences that I never had in nursing school.
2. I have six months of nurse midwifery graduate school completed. This means that even if I got every other question wrong, there is no way that at the very least that I would get the maternity health questions wrong. I pray that the exam gives me lots of those questions.
3. This is my last chance to take this exam! Fear is a BIG motivator. My thesis advisor explained to me that it took her 10 years to complete her PhD. She said that she was sputtering along, but it was not until she received a letter from the University indicated that she only had X amount of time to complete it (or of course all her time and effort would be lost) did she finally pull things together and get it completed.

Last time when I studied, my goal was doing 100 questions a day. This was the advice given to me by my former classmates who had taken and passed the exam. I achieved that for the most part. Some days, I only answered 75 or 90 questions. There were many days where I answered well-above 100. It all depended on what I had going on that particular day. Nevertheless, I did answer a lot of questions.

I can admit now that my problem was that I did not always understand the answers. So, I need to invest some serious time in content review. I also fell terribly short on pharmacology, respiratory and metabolic imbalances, cardiology, and developmental theories like those of Piaget.

My study plan is to come at this like a gorilla-war. That’s a funny expression, I know. But it is the only way I can think to describe my study plan. I am not simply answering 100 questions a day. I also have:
• Audio content review on my MP3 player
• Illustrated books and flip cards that help me to visualize content
• Nursing journals, particularly “Nursing Made Incredibly Easy” whose articles I review frequently. These journals are available online as well. I just ordered Nursing2009 and am awaiting the first issue.
• Reread Nursing Medical-Surgical textbook cover-to-cover
• Questions and studying their rationales

I will continue to answer 100 questions a day. I find the question flashcards particularly helpful. We have a desktop and it is not always practical for me to sit before the computer screen with the CD-ROM clicking and answering questions. The flashcards are portable. I can answer questions while lying in bed, while waiting in the card, on my lunch break at work, or any other time where I have some minutes to spare.

I also feel as though I need to actively look for more question sources. Meaning, I am finding eerie similarities between the Saunders, Mosby, and Lippincott, Williams, and Wilkins. I suspect that they are all owned by the same parent company. So, my advice to anyone reading this and currently studying for this exam would be to use these publications, but to also actively search questions outside of them as well. You may want to try NCBSN’s Online NCLEX-RN review or Kaplan Q-Bank. Once I exhaust all the questions I currently have at hand, I may explore those other question sources.

These study techniques take into the account that I utilize all my senses to learn. It depends but at times I can grasp certain content quicker if I am listening to it, looking at pictures that explain it, or reading it. Of times, there is no particular logic to it. It just depends. So, I am working on covering all of those bases during my studies to make certain that at the very least the information enters.

I think that diet, exercise, and stress levels have everything to do with how we live our lives. Up until this point, I have failing grades in all three areas. My life has been so hectic that I am always a sneeze away from a nervous breakdown with going to graduate school full-time, working full-time, and my household responsibilities. We often times eat on the go and do not include exercise as apart of our normal, everyday schedule.

I do not know what type of changes I am going to make, but I am going to try to improve my diet, exercise, and decrease my stress levels over the next three months. I will definitely start taking my daily vitamin and mineral supplement, whose bottle is just sitting in a cabinet.

I tried taking Ginseng and Ginkoboloba thinking that it would improve my memory and stamina (energy levels). About a week or so into this therapy, I began to experience vertigo. I felt as though if I stood up, I would just fall down and die. I stopped taking them and the vertigo subsided. So, no herbal aides for me. I am just going to have to go after this the old fashion way.

Writing this blog helps to relieve stress. There isn’t anyone that I know who is currently actively studying who I can identify with except for the people who post on www.allnursing.com. It is a lone process. My husband listens, but he does not really understand. He does figure that it must be a difficult test if I did not pass after all the study I did the last time. I told him that this time I would be doubling that study time.

There is a park nearby my house where my husband goes to play basketball. They have a walking track. I think that I will go with him, walk, and listen to my MP3 play simultaneously.

Thursday, March 19, 2009

Refocusing

More than a year has passed since I took and failed the NCLEX, November 2007 to be exact. I recently found out from the State Nursing Board that I HAVE to take it by May or I lose my application, fee, and the chance of becoming a registered nurse by testing in the State. So, faced with this, I have no choice but to pull myself together and get moving. Right?

I felt motivated at first and still do to a certain extent, but the pressure upon me now feels unsurmontable. I have just let two weeks slip by without any real effort to study. To be honest, life is really kicking my butt now and I have to admit that I feel somewhat depressed.

My family is being seriously affected by the country's economic crisis. The bills just keep piling up. On top of that I just feel completely overwhelmed with all the responsibilities before me. I wish I could just row my boat and books out to some far away island, fish for food, swim, and study day and night until my test date. Unfortunately, the life of a wife, mother, and graduate student (with graduate courses and clinical practice hours) simply does not permit one to stow herself away. Somehow, some kind of way I have to pull myself together. I have to pull myself together.

I do know that I cannot study very well in the house unless no one is there or everyone is sleep. So, for these past two weeks I allowed myself to be sabotaged by not leaving the house for the library to study. I simply lay in bed half-answering questions and being interrupted every five minutes with this and that.

Today I have found my way to the library--which is very good--however, I am sitting here blogging before making my way over to the nursing collection to read the medical surgical textbooks and see if anything new as far as NCLEX review/questions has arrived. I know that I need a plan, even if I do not follow it minute-by-minute I know that I need something in writing and something structured.

I will try not to be too hard on myself for blogging because I know that I need an outlet. I only know one other person that is studying for the NCLEX and he is doing it half-heartily. It's like a hobby that he picks up every now and then. For me, it feels like do or DIE. So, blogging helps to reduce my stress and keep my thoughts organized. Okay, so what is my plan? I'll get to that in a minute.

I recently purchased "Mosby's Pharmacology Memory NoteCards: Visual, Mnemonic, and Memory Aids for Nurses". This is a flip notebook of sorts that reviews pharmacology for nurses. There is also one for Assessment, Fluids & Electrolytes, and Pathophysiology. This was incredibly helpful for me. I always knew that I was a visual learner. There does not appear to be a concrete pattern to it, somethings just enter my brain easier through different channels. I am also listening to an audio NCLEX content review on my Blackberry. So impressed was I by these visual aids that I ordered some more references and am awaiting their arrival by post.

They are:
-Visual Nursing: A Guide to Diseases, Skills, and Treatments
-Illustrated Study Guide for the NCLEX-RN Exam
-Memory Notebook of Nursing: A Collection of Visual Images and Mnemonics to Increase Memory and Learning
-Memory Notebook of Nursing, Vol. 2
-Mosby's Fluids & Electrolytes with Clinical Applications: A Programmed Approach

I do not have any money to pay for a good Medical/Surgical textbook yet. This area I feel is my weakness, along with pharmacology.

I do have Saunder's the third edition. I am thinking of buying the Saunders Q & A Review for the NCLEX-RN® Examination, 4th edition as well as investing in either Kaplan and/or NCBSN NCLEX review to expand my question database.

Okay considering that I have about 9 weeks to take this exam, this is how I am going to tackle my preparation for it:

Each day I am going to review content. I feel like I need to dedicate myself to 3-5 hours of content review and 3-5 hours of answering questions. Sounds crazy doesn't it? In other words, I am going to spend 8 hours daily studying for this exam. It is a job for me. There are no days off.

Now, part of these hours could be that I am walking in the local park while listening to the content or transporting husband and child back and forth to work and school.

As far as the number of questions, some former classmates of mine, who have passed the NCLEX, reported that 100 questions a day was more than enough. I will set that as my very minimum, meaning that I have to reach that at the very least. If I can push on and do more than I will.

I think that this is the plan that I will stick with. I won't consider my blogging as apart of my study regime of course :-).

Last time I used a lot of visualization/metaphysical attraction and stuff like that. I failed. It could not have been for lack of faith. I don't know if I am going to go down that road again. I will be sending off lots of positive energy and remain prayerful.