My NCLEX story as a first-time taker.

[ICU#RN, BSN, RN]

A story about just another guy's preparation, personal hardships, struggles, work scuffle and life realizations after taking the infamously sanity-taking NCLEX. This is a testament of this person's fidelity in keeping his promise- a promise fiercefully made on the middle of the time when this nobody was reviewing for the test, consuming his youthfulness on things that go unseen and unappreciative for the hot girls and passersby- that is feeding your brain instead of building up your abs; learning some things you would not use in boosting up your MMR for gaming geeks, and some other places you could be able to travel for that 2 months study time.

---

First of all I would like to share my background. I'm 26, male and a 5 years licensed nurse registered and still living in the land of the Orient Pearl- a land wherein its well-educated, well-mannered middle class individuals are unfairingly deprived of a US visa.., the breeding ground of apathetic social elite politicians, drug protectors, arrogant rich spoiled aristocrats yet an astonishing, beautiful, patriotic, lovable, irresistible country- the Philippines!

In another country, to pass the NCLEX is an outstanding feat for most people. Yet though, in this country it is not considered that much of that regard. I'm not saying we don't value NCLEX a lot.

You see, here in our country we have our Nurse Licensure Examination or NLE. Like NCLEX in the USA, it is an examination for college-graduate nurses to become a registered nurse here in our motherland. However unlike NCLEX we do it with 5 tests, 100 questions each test, 2 hours per test. That's a total of 500 questions on 10 hours duration with around some 50 questions solely based from Philippine setting like topics from community health nursing (CHN) and Philippine nursing jurisprudence. First test was all about fundamentals of nursing. Second was for CHN and Maternal Child Nursing (MCN). Third to Fifth was about the care of clients with physiologic and psychosocial alterations(medical-surgical and psychiatric nursing). While the questions are similar on what you can see on NCLEX reviewer books, there are only few books locally published to cater the Philippine Nurse Licensure Exam(NLE), and most of them don't even have detailed rationale of the answers.

Having read about the weight of our NLE, it is not surprising therefore for an individual who averagely passed it to find NCLEX easier, more so for those Philippine RNs who were already typically working for more than a year in our hospitals when taking NCLEX.

But even so, other Filipino nurses still failed the exam in their first try(and that's a good topic for another post). On my part though, the long break I have since the last time I exuberantly exhausted myself for a review decades ago was the area of concern. The vastness of my detailed nursing knowledge was deflated, shrinked and constricted as years passed into a limited penumbra of familiarity as an ICU nurse. In short, my knowledge was enclosed only to cases often encountered in my work specialization. My MCN and Pyschiatric books and notes look like strangers to my memory. Even some important Medical-Surgical diseases and its characteristic manifestations (like koplik spots, reed steen berg, etc.) were forgotten simply because I was not exposed to these cases ever. I was then anxious, I was worried.

I secured a 1 month study leave from my work at my hospital. Nevertheless, before that I started already reading some nclex materials at home after work.

But it took me 14 hrs of consolidated time and consumed my energy everyday for a week before my leave was granted since there were 3 to 4 admin personnel I must personally meet for my request letter for study-leave to be signed. It was a draining experience since I was on a 11pm-7am night shift the whole month and I had to wait for our chief nurse and admin to come around 8-9am. Sometimes these old bosses fed you up with unrelated and useless talks just for them to be entertained and to let you join some nurses groups not worth of your priority time. I came home around 10am, sleep at 11 and only had 5pm to 8pm to study before sleeping again in preparation for upcoming night duty.

All of these was not without distractions in family, invitations from friends birthdays, other occasions and boyfriend duties. Additionally with some old habits like the urged to open that facebook or youtube notifications, or spending some day-offs addictively playing DOTA 2 boosting my rank number, or bringing attention to some important highlight news on tv... it was beginning to look like a road to failure.

When I came to our province to study at my parents house, I painstakingly brought home all my 10 hardbound books since college, tall stacks of paper notes and few notebooks. If my parents had not just recently brought a second-hand car, it would be hell bringing those to our house and if I can't, my anxious mind will always be restless of the thought that some questions in the NCLEX might come from that few books I had not brought home.

The first day when I was at my study room at my parents' house I dig immediately on answering HOGAN's NCLEX Question and Answer program on my laptop. I remembered dozing off after 140 questions. What made me exhausted was not the number of questions but the fact that I have to search in my nursing book the related concepts found in every question's rationale. What I did was answer a question in tutor mode, read the rationale on that question and search for the main topic on my nursing book. Like a question about Parkinson's Disease, after reading the rationale, I then open my Brunner's Medical-Surgical book and read the whole section about Parkinson and afterwards also open my Tortora's Ana/Physio book to read the section of Nervous system. It was draining but was definitely worth it in the long-run as you can connect the normal system to its disease therefore longer retention. However, I read the Anatomy book in skimming fashion since it was just a review.

After a week I reorganized my drafts and wrote the normal values and other important notes on bondpapers and post it on the wall of my room. Everywhere you look there is some paper. Even the thyroid hormones, CSF, serum and electrolytes values were at the back of bathroom door.

Unfortunately I was struck with a flu and a low-grade fever that gave me unrelenting headaches and migraine. I was not able to study for 4 days. It made me limp inside. My schedule was broken. I was feeling powerless. Anxious I began searching of a good online reviewer to assist me with studying. (Yeah, I was not given the financial luxury of enrolling in a review center for NCLEX since it costs around $380 for only a month review). That's where I found UWORLD! I googled for comments regarding about the product and I was swayed when I tried using their free trial 25 questions exam. Keep in mind that I was considering too other web review application such us Hurst and Kaplan. But the thing that got me in choosing uworld was is was only for $75 for 1 month and there is a rationale in every incorrect options. Basically, it fantastically explains in detail why the other options are wrong-something other reviewer don't completely have. I considered this feature outstandingly great! In other programs you are just given with a broad generalized explanation of why the other answers are wrong or no explanation at all... only for the correct answer.

What's more they have an app for mobile users to download at Google Play Store or iOS to sync all your account therefore you can answer questions and sync all the test you took in all devices.

Then halfway during my review I felt a deep feeling of regret not having uworld sooner before. I felt sadness flowing through my veins because of being uninformed of this wonderful program weeks ago.

However, I did manage to pull it off because of my girlfriend's encouragement. My other half was also studying for NCLEX, and I postponed my study to took a flight and accompanied her to the national capital city for her scheduled exam. I introduced her to uworld 1 week before her exam and she really liked it. She did passed NCLEX on 82nd question. I was thrilled and motivated again to study. However I had worried thoughts still since my GF had her review started a year ago and has also passed other international nursing exam like HAAD and DHA for Abu-Dhabi and Dubai, respectively, given both by Pearson Vue testing centers. She kinda had the edge.

My 1 month study leave was consumed and I began again to have my work as an icu nurse but this time I was on 7-3pm, 8 hours shift working 11 days per 15 days. This time though I was about 3/4 of my review, having read thoroughly through MS, and fundamentals first and barely touching MCN and Psych. However MCN and psych were my least mastered topics, so it felt like I still have a long hurdle to overcome especially when you think about the developmental stages of the newborn, infant, toddler, preschool, so forth.

Reading through Maternal and Child Nursing was a roller coaster ride. It was tough yet fullfiling one. I used Saunder's Nclex review book but It was still difficult to integrate and absorb all the knowledge because these topics were not so much seen in icu settings. What's more, i felt cringy about assessments of children since they had varied manifestations to various diseases.

It was just 2 weeks and 2 days before my exam and I started to focus more on taking Uworld tests. It really paid well, however, the sheer amount of information in MCN and the need to memorize most of those information (Unlike MS which you just grasp the concept) is such a difficult task. Things like when will the child be able to climb stairs, say his name, able to ride different toy, build some blocks, or say 150 words is such a pain in the temporal lobe to remember.

In addition, whenever I finished a long set of questions, I felt to reward myself with entertainment on the internet. The mindset that "I deserve some rest" hits me always.. I found myself watchig my favorite youtube channels, binge reading interesting comic mangas, or having a telemarathon of some addicting korean drama series. Afterwards saying this will be the last episode or game.. but found repeating what I had promised in a few hours soon. It was a vicious cycle. And when I started to review again and learned many important points I felt remorse and sad that I wasted my precious time.

I also was not able to join with my family in their 1 week vacation trip outside the country since I felt that I would deeply regret the decision if ever I'll fail the exam.

It was depressing. However, miserable as it was the thought that I could somehow make a big step towards improving my career as a international nurse focused my vision towards my goal.

I could barely see the light inside the tunnel but that flicker of light alone is enough to remotivate me.

I scheduled a double off and a without-pay 1 day leave for my exam date. But like a storm before sunrise I raged through toxic duty days before my offs. It was like a test of will. I had the most toxic patient that week and would often to go overtime for an hour(and yes! Here in the Philippines, nurses don't get paid for OT).

I flew into our nation's capital 2 days before the exam date and stayed in a hotel near the testing venue. The infamous Manila's horrifying trafic will drain the life out of you. I arrived at 2pm tired and slept without changing clothes. I managed to set an alarm before dozing off, so before 6 pm I found myself opening my Saunder's book and Uworld web app on my laptop. It was a long night as I was still memorizing the different communicable diseases, its different incubation periods, unique assessment and its management barely 2am. I took some light meal and slept few minutes after.

Just 6 hours after I rise on my penultimate day. It was like the previous day except more cramming as I was getting nervous for tomorrow. I requested my cousin who lived miles away to sleep in my room later that night so that there will be someone to wake me up in case I get general anesthesia from too much sleep and will miss my exam 8 am on the following morning.

It was 2am and still I was not sleeping. I couldn't sleep for another 1.5 hrs. And when I woke up at 5:15 am I felt so tired. It was a nightmare, a disaster! But the adrenaline drove me. I took an early breakfast at a fast food restaurant just a block away. And shower myself without getting my head wet. I then rested for 1 hour before the time ticks at 6:55 am, together with my cousin I walked down the road towards anxiety to the Pearson testing building. We walked almost 20 minutes and found myself wondering why the heck the building was still no where in sight. I check on google map and was shocked! We transversed the wrong path during the last road intersection! Call me whatever but the night before yesterday I had personally went through the streets to orient myself of the way. However, I was not able to include on foresight the tunnels downwards at road intersection because I could easily cross streets at night time and had not accessed it.

I turned backwards and hurriedly ran towards the testing site. It took me 15 mins to run 5 blocks and that is with heavy people traffic. When I get inside the testing center I panted heavily, knees weak and palm sweaty(no pun intended). I arrived 7:35 am and tried to relax hurriedly. When the pre-procedures was done, moments of my sleepless nights flashed right in front of my eyes. I was getting hyped-up. When I sat on that high back chair, I draw all of my energy on focusing on what was written in front of me. When the first question began it slowly dissipates the tension inside of me. I then slowly analyzed each questions. I was happy somehow since the exact NCLEX program was like the uworld app- the colors, headings and borders was exactly the same. Uworld really copied the exact program "design" from the actual nclex application itself.

Most of them, around 70% was the SATA type. I found myself composed and relaxed as I breeze through each items. Then there were some items I was not so sure of. I wrote ticks on my paperboard to count every questions I had doubts. It was around a total of 22 questions in the end. When I reached the 45th question I felt the urge to urinate and opted to use my comfort break at the 50th question. I only took around 3 minutes for bladder break since I do not want to slowdown my momentum in answering the questions. There were simple questions like prioritization of ABC'S and complex one like culture spectrum care and even drugs I never heard of. When I clicked the next button on the 75th question, the monitor turned all blue and after a couple of seconds a message was displayed telling the exam has ended. I then answered the optional survey questionnaires. I finished at 10:30 am. Surprisingly I was contented of my performance. I went out of the building completely relieved of the stress! It was a once in a lifetime experience.

I flew back to our province and worked back again the day after the exam. I immersed myself being too busy with other things so as to not feed my anxiousness in waiting for the result. At around 6pm, on the 2nd post exam day I tried to checked my result. But there was no result yet. Waiting for another few hours was a mind-cracking experience. Together with my girlfriend we played some video games and read some comic mangas... and at 9pm we then checked again this time it was available. I payed $7.5 thru my credit card to view the quick result. Alas! I passed! I hug my girlfriend tightly and was feeling elated. I paused for a brief moment, signed a cross across my chest and said my thanks to Him. I could not believe I made it into just the 75th question. It was such a great moment in my life. All the energy, precious time and great amount of money was not wasted. I went home, reflecting on my journey and slept the whole night. I never had such a sound sleep after many years in my life.

After a couple of days still I still had not told my co-nurses in our unit about my feat. I prefer to keep low and for them to just find it for themeselves. I liked it more that way. It gives me peace and I will always have the impression that I'm still studying for the exam when I read a little bit of something.

Right now I came to the realization that I could be able to pass the exam earlier if I was not that reluctant back then. Now, my mother was more supportive more than ever in my goal to work abroad. My personal confidence as a Philippine nurse licensure examination topnotcher came back. The drama was over.

Now, I'm refocusing myself to get a us visa.

Hopefully in time I'll get there.

But for now I must keep a promise to myself that once I pass NCLEX I would help my fellow ex-coworker who will still apply for NCLEX. I planned to consolidate all my notes digitally into a ONENOTE account and let my chosen friends had a read-only access to all of it. This way I can have an easy access of information of my review notes whenever I have question about specific diseases or procedures. I can conveniently add up more notes whenever I came across something beneficial and important in my line of work. On the other hand, I can share this vast resource material I have to my friends for study when preparing for their NCLEX. It would be a win-win situation for me and humanity, leaving a legacy to them in some point of their life.

All of these post-NCLEX "notes consolidation" to help avoid a great fear of mine- to someday wake up forgetting all what I learned and going dumb as a nurse as I grow old developing my chosen vocation.

A piece of advice for those who want to take the NCLEX, invest in a online review application like Uworld and a reliable NCLEX review book like Saunder's, get yourself focus and concentrate! Remember you're so lucky enough because other non-US citizens nurses still have many hurdles to overcome to work there. Don't waste that privilege. Avoid distractions. You'll be saving yourself a whole big of stress! Do it now, and do it with a plan. Goodluck!