I graduated a BSN program in May and am taking my first NCLEX attempt in a few days. I'm almost positive I am going to fail it, and I don't feel ready at all. Basically, I've already accepted defeat and am trying to plan for my next attempt. I had originally planned to take it at the end of the month/beginning of August, but my spouse is putting a lot of pressure on me to "just take the thing." Primarily, I feel, because she's annoyed by the amount of time I spend studying (6-8 hours most days, sometimes 10-12). I feel simultaneously frustrated, burnt out, and too anxious to function. The hours I'm putting in are no longer productive. I feel frenzied, unfocused, and get lost in the details of material I'm unlikely to even see on the exam. I'm not sleeping well, eating well, and know I'm not taking great care of myself. On top of that, my current job, which was planning on me being at my new job by now, has moved me to third shift (they already hired my replacement, and only had shifts open overnight when I told them I was pushing back the new job offer until I passed NCLEX) and I am not functioning well at all with the change. The only time I've smiled or laughed in weeks was thinking this morning about how absurd it is that I'm basically wasting $200 and throwing away my new dream-job offer (they just want me to pass it by the end of August) to knowingly walk into an exam I don't stand a chance at like a lamb to slaughter all to satisfy my spouse's hunch that I'm ready.
I don't feel like she understands at all. While I get that she's trying to boost my confidence, she doesn't get (and there is no polite way to tell her) that her opinion on my readiness is completely unqualified -- she isn't a nurse, has never taken the NCLEX, and has no idea how much I don't know or feel confident in. I also get the sense that her insistence on me getting it over with has less to do with her confidence in my competence and more to do with her annoyance that I'd rather study for the exam than weed the garden or go out to eat.
Her perspective is that I'm doing well overall on practice material and was a mostly-A student in nursing school, so I'm ready. Not only am I ready, but she figures that/behaves like I also don't need to do any more studying before the 8th. In fairness to her, I am doing well on them overall: I scored an 84% raw score on my school's ATI Comprehensive Predictor (~99% odds according to them). I've taken three CAT exams on ATI's Board Vitals; Attempt 1 shut off in 75Qs (84th percentile of Hard Band), Attempt 2 shut off in 76Qs (99th percentile of moderate band), Attempt 3 shut off in 75Qs (88th percentile of Hard Band). I've taken multiple (10+) readiness exams on Archer with a "Very High" likelihood of passing and 7-ish CAT exams on Archer that all shut off at 75 and said I passed. I tried the last few days of a friends' UWorld and was scoring in the 70s on the longer quizzes. On Hurst Review, I've taken 3/4 of their Q-simulators. They recommend a 77/125. My scores have been 93, 98, and 101. Finally, I took Kaplan's free test and got a 74% raw score.
My perspective, that she is unwilling or incapable of understanding, is that being an A-student means nothing if you crammed/didn't retain the material and that a raw score or overall performance on practice tests does not save you if you're riding near or performing under the passing standard in any of the client need categories. Getting 85-100% right in Physiological Adaption and Pharmacological/Parenteral Therapies does not help me if I'm bombing it in Basic Care and Comfort or getting a 57% in Safety and Infection Control. Being able to explain mechanisms of action for drugs and pathophysiology of diseases isn't going to save me if I'm missing questions or dead guessing on fundamentals/skills content. Nor is it helpful that I'm very weak in Maternal-Newborn and Peds (especially Growth and Development questions). While I generally score fine (65-75%) in the area, I also do a lot of guessing on prioritization, delegation, and assignment questions and find myself either confused by the rationales or feeling like they're inconsistent with other similar questions I got right either on the same platform or on different q-banks.
The general pattern I see is that I do very well on "easy" questions, overperform relative to peers on "hard" questions, but only hit 50% or so on "moderate" questions in my weak areas. I might miss multiple questions 55-60% of peers get right in a single assessment. My inadequacy really shines through on ordered response questions. I miss nearly every single one of these style questions when I encounter them.
I've got a content problem. Specifically, I have a content problem with a lot of first semester stuff, Maternal-Newborn, and Peds. I was an LPN for quite some time before my BSN program and tested out of Foundations in my BSN program. I'm regretting it sorely now. A lot of this stuff are things I was taught as an LPN and knew at one time. Unfortunately, in my practice as an LPN, I've been largely working as a med pass nurse in assisted living. In my job, I basically just pass pills and respond to emergencies if they arise. We don't touch catheters, start IVs, do NG tubes, trachs, tube feedings, or even do much of any wound care beyond band-aids or placing steri-strips.
That is where my problem is. Here is what I've been tried to do to correct it:
- Youtube videos (which I find are often inconsistent between content creators)
- Hurst Review (I regret this purchase. I'm sure this is a wonderful content refresher for people who are weak in med-surg. Their specialty content - including OB and Peds - did not impress me much. I think that their q-simulators are too easy/not realistic and on the questions I do miss, I often don't find their rationales helpful in understanding why I got it wrong.)
- ATI review module books.
None of these materials have been helpful in significantly improving my scores in my weak areas, and I need advice on where to begin with for my next NCLEX attempt. If it is helpful, reading textbooks does not get me very far. I can read them over and over again, highlight, and take notes for hours and feel like I've retained nothing.
If it is helpful, I'm primarily an auditory/visual learner. I learn from listening to somebody explain a concept or watching someone perform a skill and then attempting to re-explain or perform the skill myself in a fraction of the time it takes me to grasp content by reading from a textbook.
What I'm looking for is reliable visual content/lectures that cover Foundations material basically from the brand-spanking-new student point.
