nascentRN

Sounds fishy, no? I don't know where else to put this, so I'll put it here since I'm in New Jersey. I just got off the phone with some recruiter for a social services staffing agency that places nurses in contract mental health positions. Mind you, I have been applying everywhere throughout Nj for two months with hardly a response. One of the staff members at a free clinic where I have been volunteering recommended that I contact this agency. She works in mental health at her real job, but does not know anyone personally at this staffing agency. But, she spoke to someone from this agency and they offered her a job. She said she wasn't looking because she already has the mental health gig, but thinking of me and trying to help, she asked them if they were looking for only experienced nurses. They said, not necessarily. So, she gave me their contact number. So, today, I called the agency and was thrilled that I got an interview. But, upon immediate reflection when I hung up the phone, this recruiter seemed a little too eager to get me in there. Within a minute of talking to her on the phone, she asked me to come in for an interview. She told me everything I'd need to bring, including resume, diploma, cpr card, drivers license and (and this is what really raised a red flag): a $27 dollar fee for a background check. First of all, isn't that a little inexpensive for a background check? Second of all, shouldn't they run the background check AFTER they decide to hire me? Is it normal practice for these contract staffing agencies to run a check at the first interview? Mind you, I have nothing in my background to hide from anyone. It's just that this seems to me like a great way to make a lot of money: interview a couple hundred people a week and collect 30 bucks a pop-- sounds like a great business. A search for this company on the New Jersey better business bureau website turns up nothing. Am I just being paranoid or am I just not that stupid? The thing is this: I'm in such a vulnerable position being unable to find gainful employment that I am ripe for being scammed. I am almost willing to entirely ignore this. Should I go to this interview? I can afford to lose 27 bucks, but not my identity (SSN), you know? I'd appreciate any advice. Thank you for reading.

Howdy, Back at ya! he..he. Oh, geesh, I'm in for a culture shock. lol. I'm from New Jersey. I've only stopped in Texas (Houston I believe) during a fly-over to California. Not to invoke that dreaded buzz word, "flyover country." I don't really like referring to my fellow citizens so dismissively. I know Austin is the live musical capital of the United States or one of them. In addition to having my RN license, I also have a degree in visual arts and play guitar to boot. So, ideally, I would like to land in Austin too. But, unfortunately, I'm not feeling that I can be too discriminatory as to where I wind up. The most important thing is that I find gainful employment and soon. I'm sure that Texas, while maybe not my cup of tea entirely, has many new and interesting experiences to offer me wherever they may be.

Thank you for your response. It's good to hear they were receptive. I was just thinking of perhaps contacting the Board of Nursing in various states I am applying to and then mentioning this somehow in the cover letter. I'm going to try to apply in Tulsa myself and pretty much everywhere else. I hear that nurses are really in demand in Tusla, although interestingly a quick job search on monster does not turn up much. Were did you look? And just out of curiosity, were the call backs you got from postings that mentioned welcoming new grads or did they require more experience but call you anyway? Thank you, again.

I heard in another thread somewhere that San Antonio is the big one, but since I came into this forum for basically the same information you are requesting, I'll see what others have to say. In the meantime, I going to search for jobs in San Antonio and see what comes up.

Did you know that all new grad applications sent out in New Jersey get sucked into a black hole? Really, it's true. There's a big black hole somewhere in New Jersey sucking up all the new grad resumes. This is job market scene here is a trainwreck. Been applying for the two months since the state licensed. I can't continue this much longer. I'm about to take the search nationwide. Nationwide, baby, here I come! Now, er, how do I go about doing this?

I'm not reading anymore of this. I'm a new grad with a fresh RN license. I need a damn job. I need to pay bills. Period. I'll take what I can get. I don't expect it to be a party nor a disco nor a CBGB's. I expect lifetime during wartime. (to reference the talking heads). But better than homelessness. Throw me into the inferno, now please, I am begging! I will stick it out for at least one year to get some experience, do the best I can and then move on!

Congratulations on getting the job. I wish you the best of luck in your career. I live in New Jersey. I got my license here about two months ago after passing the Nclex on the first shot but have not found anything yet after applying liberally throughout my state. I am currently volunteering at a free clinic just to keep at least some of what I have learned as fresh as I can and have now started to apply out of state. I am willing to relocate anywhere for a full-time RN position in any kind of healthcare facility. I noticed that Georgia is not party to the compact agreement among certain states (neither is New Jersey) and I was wondering if you (or anyone else) had any tips on how to approach potential, out of state employers in online applications and cover letters. Obviously, I would like to have a current license in every state I am applying to, but this obviously is not realistic.

i hear that! i waited a month or two longer to take the nclex than some family members officiously advised for my own good and was no less annoyed by this either. of course, no one is second guessing anything i did now that i passed the exam the first time i sat. my feeling was that anyone who thinks that it's the end of the world that, in the grand scheme of things, i'll be an rn merely four weeks later than expected probably needs to get a grip. of course, it sounds like at least your aunt is afraid that you'll wind up never doing it and i think some of the same fears motivated my family's pressure. i figure that if they aren't convinced by now, after several years and successful completion of nursing school, that i am for real about this, then that's their problem, not mine.

Way to Go!

I think this idea about nclex vs real world is interesting. I can see how it seems unfair to people who have years of clinical experience that the Nclex is its own little universe with its own laws. Nurses with years of experience, as PNs for example, are essentially working backwards from practice to theory. Admittedly, this must be frustrating. It's kind of like some music theory professor telling a master of jazz improvisation how to play guitar, or telling jimi hendrix that purple haze was written in dorian mode and that some of the notes he's playing are out of key. However, It can't be any less difficult and frustrating an experience for nurses with less real world chops who must adapt from the nclex, nursing school world to the real world. Approaching the profession from both places has advantages and disadvantages. At the end of the day, however, I'm not sure the real world can be replicated on a test, anyway, or that it would be the most beneficial for the purposes of screening potential new nurses if it could. Understanding the core, textbook knowledge base, and applying this theory with critical thinking to a "perfect nclex hospital", is, it would seem to me, the logical first step that years of clinical experience in the real world is supposed to build on. But, obviously, nurses do not have to grow in this direction either, as people with years of practical experience prove every time they pass the Nclex-rn.

I think the best benefit of trying to apply all these test taking strategies during the test is that this forces you to slow down, think things through and you'll wind up using your time more productively than you would have just operating on autopilot. Anything that can help you do that, can't be bad. At the end of the day, though, I believe that a lot of the strategies are very imperfect or only apply to the perfect questions, which somehow the example questions used to demonstrate the strategies always are. :chuckle So, I say, learn all the strategies you can and use them to the extent that you can on the test, but don't be shocked into a state of paralysis or anxiety when during the test your strategies don't apply perfectly. You are right. One can't just blindly apply these strategies. Ultimately, you have to judge if the answer the strategy leads you to makes any sense. And I agree that visualizing yourself in the clinical experience is helpful.

I'm not sure what you mean by incomplete questions and answers. Most of the practice questions I studied were pretty long. Most of the questions I got on the exam surprisingly were VERY short. Not all, but most. As far as there always being two incorrect answers, I don't know about that. There were at least a few questions that I couldn't eliminate any of them very easily. Yikes! But, that may have been reflective of my lack of a grasp on some of the content. One thing that the ATI has got going for it is lots of these "Nurse knows client needs further teaching (or client understands teaching) when client says A, B, C, or D or nurse would question which order, a, b, c, d. Those kinds of questions were all but ubiquitous on on the Nclex and I recognized the format from the ATI. I'll give the ATI that. I've heard others disagree, but the ATI predictor, IMO, captures the basic gist of the exam pretty well in terms of question format, the length of questions, a focus on safety, and the randomness of the questions if not the specific content. Aside from the fact that it isn't a CAT, the ATI does have the "feeling" of the Nclex. Which probably explains why I HATED the ATI. lol.

Someone can correct me if I'm wrong, but I doubt they'll have you counting those damn little boxes to determine intervals or whatever. I seriously doubt they are going to ask you to identify heart block either. If they ever do, I would bet 10 to 1 that it is only complete heart block, so know that. First degree, second, etc, you'll be tested on that if you ever get certified for EKG. If you know the rest of the basic rhythms I think you'll do fine. If you need to know anything about a wide bizarre QRS, it is probably just that these are found in PVCs or Vtach and that they represent an ectopic beat. i.e. a beat that starts in the wrong place in the heart - that is, not the SA node. That's why it gets so wide, because the electrical impulse is traveling through a wacky winding abnormal path. As far as P waves, I think you'll be fine knowing that they are absent in Afib and such. St elevations. Peaked Ts or inversions. Other than refreshing up on basics like this, I wouldn't spend too much time on EKG, if any time at all.

Thanks!

Hang in there. I walked out of Pearson on Monday and the first thing I said to the first person I talked to was, "If they give me a license, they are CRAZY!" :chuckle I really couldn't have felt any worse about it. Same thing as you guys. Tons of meds I didn't recognize. I had no idea that chicken pox was airborne. I had no idea what Orthodox Jewish familys' rituals are. I'm supposed to figure out which pts I should room together, but wait, how can I do that when I don't even know what half the listed diseases are? Holy moley. I spent the last two days waiting for the results scouring the web for information in preparation for my retake. False Alarm. Shut off at 75 and passed.

One of my classmates recalled a few questions on scheduled immunizations, so I would try to memorize them all. Super tedious and I did it but didn't see any of it on the exam. Neither did I see EKG or fetal monitoring. What, specifically, do you feel you are unprepared for relative to this stuff?

As far as which predictor is best, I have no idea. The only thing I know is that I scored 76% on the ATI predictor which gave me a 96% chance of passing. Only predictor I took. I passed first time, at 75 questions.

Yes, Trust. I think that is key. Once you stop trusting yourself and your body of knowledge, you are at the mercy of the test and each and every question just gets more nerve wracking, and your answers less thought through. You'll just start taking emotional hunches. Don't. Slow down. Relax. Read each question thoroughly. Subject each answer to the context of the question. Don't assume any are wrong until you've at least thought about each for a few moments. I didn't do this for every question, but I tried to. It's easy to get swept away in the anxiety of it all and I did a few times. But, each time I saw this happening, I slowed down, and tried to trust myself. My objective when I went in was framed by the fact that I knew I had SIX HOURS to complete this thing. With that in mind, I took my jolly time and was determined to give everything I had to the first 75 questions. It took me an hour and half to finish 75 questions, maybe almost two hours, I'm not sure. I realized within the test that when I tried to hurry, I would only wind up reading each question five times. I caught myself doing this a few times. That's when I knew I needed to take a breath, and slow down. This way you'll understand the question the first time and, ironically, you'll actually spend less time on it by slowing down then if you tried to rush. I have also tried to remind myself, in school and on this test, that some of the best test takers in my school wound the clock down every time. The kids who scored in the 90s were mostly (not all) the last to leave the room. Thanks for your comments. May you pass your exam with flying colors!

Thank you. I wish you the best.

Definitely do. Forget about Reductionism! If you try to know everything you only will wind up knowing nothing. There is a reason why great notes are put into outlines! Once you can structure information into general categories, the rest of the information, if you even need to know it, will fall easier into place on its own. If you keep this in mind, I think you will do well. Aside from this there is test taking strategies. I am hesitant to advise people to forgo courses that teach you these, even though I didn't take advantage. If you need the reinforcement and confidence boost, then by all means go for it. A great instructor can be really inspiring and rally you to the task. But, at the end of the day, I'm not convinced that these are a magic bullet. You already know that "client needs further teaching", means eliminating the true answers. They only tell you (ah-ha!) what you already know. You already know that you need to eliminate wrong answers. You already know that the nursing process (AAPIE), Maslow, ABCs, and, intuitively should know, that acute vs chronic, expected complications vs unexpected complications (etc) should inform how you answer questions. You should already know that you should slow down, calm down, and put yourself in the driver's seat instead of letting the test writer dictate how you react. You should already know that you should read each answer as if it could be the answer before you just eliminate it - consider each in the context of the question. I'm not sure that anyone needs to drop several hundred dollars to have these things explained to them. I just don't believe these strategies are the magic bullet that can seal the deal, much less esoteric information that you should shell out lots of money for. If you need to brush up on the basic test strategies, you can learn most of them through books, that are, as I learned after I thought I failed, available for free on Google books. Some pages omitted from each. But, if you read enough of these free pages from books, you should get the idea. What's omitted from one, is covered in another. I even found a Kaplan book that had hardly any pages omitted from it for free on google books. I can give people the link, at request. Others are free to disagree with my POV; I'm hesitant to be controversial. What works for one person may not work for another and you should do what you think is best for you. But, at the end of the day, I believe that your core basic knowledge is what will see you through. Learn it, trust it, don't look back. Remember, you graduated nursing school. You belong among Registered nurses. You wouldn't be sitting for the exam if this wasn't true.

Thanks!

First things, first: You graduated nursing school. I don't know what your school was like, but if it was anything like mine, it was not easy. Only half the people I started with graduated with me. IOW, you have the base of knowledge required to pass the test. If you didn't, you wouldn't be eligible to sit for it. Remember that! Second, there is no point in trying to study every single little thing, it's tempting but don't. The best advice I can give is to know the base knowlege and HOW to study. I said this above. If you know, for example, that Graves disease, revs the metabolism up, hypothyroidism downshifts the body, the BASICS, then you will have a much better chance at guessing the correct symptoms for each even when the symptoms presented are not the most obvious ones. This way, you don't need to remember FORTY-FIVE different symptoms. Glance at them but don't spend too much time doign that. It's the same thing, for example, with spinal injuries. You don't need to know every single little last thing. For example, you could spend forever studying the nuances in outcomes among injuries at various points in the Cervical spine, but don't! Don't get hung up on the fact that C3 is where the phrenic nerve branches off (lower injuries put people on vents anyway) or where other certain nerves branch off the column. Chunk large portions of the spine together: C1-4 will affect breathing, probably even 5 and six to a lesser extent, heck just throw the whole cervical spine in there with breathing. Most C injuries are Quads. End of Cervical. Below that you start getting into Para. Know this stuff! Know the basics of C, T, S injuries. Know where bladder and bowel control starts to become affected. Know upper motor and lower motor disease. Know central cord syndrome, posterior cord, anterior cord, brown sequard. etc. Decerebrate, Decorticate. Know spinal autonomic hyperreflexia, the basics of spinal shock (hypotension, and unlike other shock, BRADYcardia), then promptly move on to the next topic! The notes for my spinal injuries slides from school are probably >30 pages long single spaced. The information I just outlined for you is the core base knowledge that will give you the ability to correctly answer almost any spinal question, and, while it sounds like a lot, it can actually be condensed to a single PAGE and memorized in an hour or two, even much less if you are somewhat familiar with it. Most of the spinal stuff above, is basically just a handful of definitions.If you are worried about being prepared for content, you've got to start thinking about topics this way. And remember, spinal and endocrine are two of the more complicated topics. If you can do this with these, you should be able to tackle the rest even easier. Definitely know your infection control. Cannot be stressed enough. Practice priority questions. Practice teaching questions, as I said above. Know cultural stuff just to make sure you don't answer one or two correctly to be bombarded with several in a row.

Well, I sat the first time for this river bottom nightmare of an exam (anybody remember emit otter's jug band christmas?) on Monday and walked out of the place feeling utterly bludgeoned. I truly felt clueless on the majority of the questions both in terms of content and format. It was one of the hardest nursing tests I've ever taken. But, apparently, there was no reason for my premature swan song, as I passed at 75 questions. I never visited this board until I was sure I failed the test and then began searching desperately for a clue. Having now read many of the threads, I realize I should have found this site along time ago. Today, I signed up (hi, nice to be here!) Having passed the exam, I can only advise incipient test-takers what others on this board have advised ad nauseum. I know the test is different for everyone, but I'd nevertheless make sure you are over-prepared for the following kinds of questions: 1) Infection control. Yes! To say there is a lot of infection control probably is an understatement. I was BOMBARDED with these. I am lucky I passed because I was not prepared to answer these questions! I never had ANY questions like this in school, which is ridiculous, and they were not in any of my study materials either! Yet, it is no wonder they have these questions on the exam because this is such BASIC nursing! How can you be safe if you don't know this stuff? In addition, if you've ever been in a hospital, you've probably been on floors in which almost every person has Special Organism Precautions - presumably because caregivers breech the precautions all too frequently. This is causing lots of people to get sick and is costing hospitals patients and the healthcare system a LOT of money. If you've followed the political healthcare debate at all, you know how topical expenditure is. Again, it shouldn't be a surprise that the Boards are chock full of these questions. Anyway, I don't want to preach, the point is this: Know all stuff IC. Knowing now what the exam is like, I would advise everyone about to take the test to read the Standard Precaution (and Contact, Airborne, Droplet) section in the Appendix of your Medical Dictionary. I know Tabers has one. From there, start figuring out which diseases fall into which categories.Which of the following patients with diseases x, y, and z can be roomed together? Do doors need to be closed? Do they need monitored negative air pressure? Do they have to use disposable dishes? Can they share dishes with family members? Bathrooms? How long can vistors stay in rooms? What PPE do both you and they need to wear for disease x, y or z? Surgical mask? Particulate filter? What happens if they need to be transported? etc. etc. 2) Priority questions. It has been said there are lots of these on the test. Guess what? It cannot be said enough: There is! Which patient will you see first? Which intervention do you need to do first? etc. 3) Teaching questions. Holy Smokes! LOTS of these. e.g. Nurse understands teaching has been effective, if patient makes which of these statements? Nurse understands further teaching is needed, if patient says, which of the following? Which of the following should nurse teach patient being discharged to report to the provider? Nurse understands assistant needs further teaching or performed actions correctly when assistant says a, b, c, or d. Familiarize yourself with these formats. Take out your med surg book and look every single care plan given, at the very least. I've found that care plans make a lot of the teaching stuff easily accessible. 4) Client Confidentiality Questions. I had several of these. Nurse knows that which of the following constitutes a breech in confidentiality? You may think a question like this should be easy, that is, until you see the answers listed. 5) Patients condition is X, y or z. Nurse should question which of the following orders? Nurse should clarify which of the following med? I had a handful of these. 6) Cultural Questions! Not prepared for these at all and that's probably why they smacked me with several. One after another in a row. What religious practices need to be incorporated into care for Islamic people? What about for Orthodox Jewish people? Hindu? What are their rituals across the life span? What about their special diets? What about use alcohol? Were I to have to retake, I would learn as much as I possibly can about the beliefs and behaviors of major Orthodox religions AND "ethnic" groups such Hispanic, Chinese. etc. Do you know what "evil eye" is? It wasn't on my test, but it could be on yours. Anyway, priority, teaching, infection control - you can't waste enough bandwidth reiterating this stuff! It was, for me, as for many others who posted here, the majority of the content. Don't make the same mistake I did, and enter unprepared for these questions. Sure, maybe I am a just a good test taker, maybe I won a dice roll. One thing is certain: I would not chance it and be so unprepared again. The only book I used was a Mosby's. I can tell you this: It was GARBARGE! I seriously think this book left me little more better off than I would have been had I sat for the exam without studying a lick. The content and format of the questions in this book, as I read someone accurately state in another thread, could not have been anymore different than the content and format of the Nclex. I was prepared to throw it away and sign up for Kaplan or NCBSN. Fortunately, I can start looking for a job instead. Anyway, do what you will and best of luck to everyone! Dude, I am an RN! I hope as we continue into the future, I can be of help to those of you who are looking.