PCTerrific

I've been browsing the boards this evening, and have been really heartened to see so many NP students/NPs frustrated by the same thing-- the low, low standards in NP education. Honestly, it's sort of horrifying. I'm still pro-NP in theory, but after my own recent NP education, I'm not sure that I feel as comfortable going to one myself! I hate saying that. Every NP and NP student I know in real life and respect feels the same way-- we need to raise standards for schooling, the board exam, and move more and more towards NP fellowship/residency training. I also feel REALLLLY strongly that every NP should be a nurse for a few years before beginning an MSN-- you can tell when someone has been a nurse and someone has not. The direct-entry, in my opinion, is both a cash-grad and often attracts people who think they are "above" RNs/basic bedside nursing. Our nursing organizations are always promoting advocacy, but this is the advocacy I am personally most interested in. The best way to get independent practice authority is to have really quality education and practitioners to point to. I should probably apologize for being rant-y/offending people/etc, but I'm not going to. I'm frustrated that the field I love is not keeping rigorous standards. the best thing I ever did was become a nurse, and I love being one; I want the profession to thrive going forward. Is anyone else in agreement? Is there more we can be doing to voice our concerns to the powers that be?

Hi all! Posted this in the student board but also trying my luck here Has anyone used exam edge for PMHNP prep? For test banks, I am currently using board vitals (got it at a big discount earlier in the year, good for the sheer # of questions and some review, but doesn't seem much like the actual exam). I am also planning on getting the ANCC qbank, but there are only 200 questions for those. What I would like is lots of questions that actually look like the real exam, and exam edge says it offers 30 unique exams of 100 questions each, with a setup and questions that mirrors the actual exam. I have a job offer pending graduation and boards, so I really need to pass it on the first try, but I also don't want to waste money/time if it isn't a good exam bank. Thanks very much!

Thanks! i did the 15 but don't feel that is enough to get a good sense. I agree it seemed very basic, and they still used DSM-4 criteria, which was a red flag for me, since we have been on 5 for a while now! Appreciate your take on it.

Hi all! Has anyone used exam edge for PMHNP prep? For test banks, I am currently using board vitals (got it at a big discount earlier in the year, good for the sheer # of questions and some review, but doesn't seem much like the actual exam). I am also planning on getting the ANCC qbank, but there are only 200 questions for those. What I would like is lots of questions that actually look like the real exam, and exam edge says it offers 30 unique exams of 100 questions each, with a setup and questions that mirrors the actual exam. I have a job offer pending graduation and boards, so I really need to pass it on the first try, but I also don't want to waste money if it isn't a good exam bank. Thanks very much!

Hi All! This board was such a helpful resource in nursing school and while preparing for the NCLEX. I really appreciated when people reported on their experiences and how they got ready for the exam, so I wanted to do the same. I passed the NCLEX in 75 questions on 2-4-14, after graduating in Mid-December. I was pretty happy leaving the test, got the good pop-up, and my license was posted yesterday to the BON. The test itself: -In a post here, someone described the NCLEX as both harder and easier than they expected. While that drove me crazy, I now understand! The test asks you to think in challenging ways, but the information you need is not obscure or specialized. This is a general test for a generalist. So, while it is good to review everything, spend your focus on concepts. For example, when you are reviewing vitamin deficiencies, I would not worry about knowing the difference between dry, wet, and infantile beriberi. I would instead focus on what thiamin does in the body and what a deficiency would generally do. -There was a TON of SATA. I was praying I would be one of the lucky people who had only 5 or 10, because I couldn't imagine doing any more than that and passing. SATA was far and away my weak spot. (For those of you who used the Kaplan Qbank, my SATA test score (test #3, maybe?) was a 38%! Yikes!) However, I found that the SATA on the NCLEX was much easier. Again, it was based on concepts and critical thinking as opposed to rote facts. So glad I knew about those going in, though-- I feel like SATA is such a small proportion of the questions both in school and in test prep, I never would have expected so many and would have been very flustered. Bottom line, if that is what is making you nervous, relax. If I can get through them, you certainly can! -Know how to prioritize and to delegate. Again, something that wasn't proportionally stressed in my program or review materials. However, it makes a lot of sense-- a brand-new nurse really needs to at least know the principles of how to do this! - - How I prepared: -In school, we used ATI for every class, and extensively in our final semester. We also had to take 2 predictor tests (99% and 97% for me). I don't think ATI is really comparable to NCLEX, but it was good for general material review and for training in NCLEX-style thinking. -Our final semester, we were required to do 1,000 questions on the Saunders CD. I did about 700 on my own after graduation (including all the alternate questions). This was good when I was too tired to focus on anything else, but much easier than the actual NCLEX. Rationales were helpful for content review and showing me weak spots. -I bought and used 100% of the Kaplan Qbank. It was very expensive, but re-taking the exam is expensive, too, and more importantly, my nurse residency start date was riding on passing the exam by a certain time. So, for me, the expense was 400% worth it. I did things only in timed mode, and did 50 questions at a time, all mixed together. My qbank average was 64%, and basically stayed around there the whole time (some 58s, some 72s, but mostly 64%. Again, for practice test 3, the all SATA one, I got a lousy 38%!). -I used the Kaplan review guide that is free for Kindle on Amazon, because it was concise and the right level of detail for me-- enough to remind myself of the concepts and information, not so much that I was overwhelmed. I don't think it was that strong in reviewing the disease processes/mechanisms of action (which are so helpful in critical thinking) but does do a good job with procedures, protocol, and interventions. It's also easy reading, so I didn't feel like I needed to be locked in the library to really soak it in. -I also used youtube and some other internet resources to review. Youtube was awesome for ways to remember things and for helping me to visualize procedures. -I read every rationale. I also kept a running list of questions to look up. I made sure that I not only understood the right answer, but also why the wrong answers were wrong. So, if the answer was right-sided heart failure, I made sure I also knew why it WASN'T left sided heart failure, and what left-sided heart failure would look like (in my head, I always ask: How would the question need to be written so that the wrong answers are right. Not sure if that makes sense to anyone else!). My Random, Lengthy Tips: I did a lot of things "wrong" in my NCLEX prep, but they worked for me. My biggest advice is to know how you learn and don't fight against yourself! I think it is easy to feel overwhelmed reading these boards and seeing the many different strategies people have used. I also think the sheer number of different commercial study programs and resources available makes it hard to know where to start. For example, studying for 10 hours for 6 days before an exam works better for me than doing it for an hour a day for 6 weeks. In school, it was a better way for me to learn, and it helps me to retain the information when I completely submerge myself in the material for a period of time, living and breathing it and blocking out the outside world for a period of time. Again, against all advice I've ever had! -Don't let the perfect be the enemy of the good. One of the reasons it took me so long to begin studying is I felt overwhelmed. I had this idea that I was going to re-read and take notes from the ENTIRE yellow Saunders book, and read a separate review for pharm, and do all of Kaplan (getting in the 80s on all tests), and all of this other stuff. Worrying about being the model NCLEX student made me too scared to start. So, guess what? I ended up reading the much shorter, simpler Kaplan review, studying pharm by making flashcards in front of Keeping Up With The Kardashians, and starting most of my studying mid-afternoon. I told myself I was in it to feel like I was 80% prepared, not 100% prepared. When I tried to really know everything, I felt so stressed and terrified, and it felt like the work would never be done. -If something has worked for you, trust it. I know things like decisions trees really can help some people, but I was worried it would confuse me. I'd done well in school, so I decided that even if there was a theoretically better approach to NCLEX questions, learning it would probably only confuse me. -Listen to yourself, within reason. I was advised to take the exam ASAP, that scores drop significantly the further you get from graduation. I was one of the last in my class to take the NCLEX, around 7 weeks after finishing classes. I took a full MONTH off from even looking at nursing stuff, I was so burned out by the end of my accelerated program. I would try to open the book and end up feeling so unable to focus or retain anything that I just put it back down. I caught up on sleep, saw friends, celebrated the holidays, and finally read a book for fun! Once I really felt healthy and well and like "myself" again, I found it much easier to come back to the information, and was shocked and pleased to realize just how much I had retained and really DID know! If my brain hadn't been rested, I don't think I would have done as well. -Know what to expect. I went to the testing center before the exam to know where it was. I had read on here to remember to ask for earplugs (something they did not offer to me, and had to go into a drawer to get), that I could have breaks, that you get a white board instead of paper, etc. That was a BIG reason I bought Kaplan-- I wanted to be used to what the exam looked like. I think it really helped to feel the screen was familiar- it helped me to feel like it was just another practice exam, not a big scary test. I can't stress enough how much those things helped. -Study where you feel comfortable. Some people say to make sure to go to the library, etc to get a sense of the real conditions, but I ended up studying for the whole thing on my bed, usually with my boyfriend on his computer next to me and the cat at my feet. When I began to feel anxious during the exam, I closed my eyes and imagined being right back there, where I felt safe and calm. -TAKE IT SLOW! I knew my weakness was rushing through the questions when I got fatigued + started to feel stressed (one or the other i'm still ok). I'd think I knew what the question was asking, but be wrong (so, idiotically missing "requires more teaching" and happily picking the statement that shows the patient understand, not the right answer that shows the patient does not understand). So, I was VERY deliberate to slow myself down. I read every question veeeeeeery slowly to myself and sat and thought about it. It ended up taking me an hour and a half to finish 75 questions, which is about double the time I'd have expected based on other exams. -Check in with yourself during the exam. Are you feeling tired? Rushed? Jaw clenched? When I caught myself speeding through a few questions, I stopped, closed my eyes, and took a full 60 seconds to regroup and relax. -Know the patho. Patho saves my butt time and time again. A good understanding of how the disease as a whole affects the body really helps in figure out your sickest patient and makes a big difference in critical thinking questions. Know what the worst-case scenario is. Know what the treatment is and what is does that makes it effective. For every disease, you need to think, "ok, what would a turn for the worse look like, and where would that lead? Now, what would I do to fix it?" -Stick to the basics. Life over limb, etc. When I get a priority question, I usually think, "Ok, if sh*t hits the fan, who would die/who would die FASTEST?" So, both people might be dying, but the person who could die in 15 minutes wins over the person who could die in an hour. -Don't miss the low-hanging fruit. Know how to calculate dosages cold (it may take trying some different ways...I was never taught formula method, for example, but it's the easiest for me and gets me the right answer every time). Memorize your lab values (don't worry if one says 11.8, and another says 12. That used to drive me crazy, that the lab values are different depending on the material, but nothing I saw was every so slight that the variations mattered). Know how to identify a rhythm and read an ABG. Basically, if you can get the answer by simply knowing an often-used fact/formula/pattern, learn that! -Take the SATA's as true/false. This was really helpful for me during the test, even more than it was when I practiced. -Really do take the day before off. And have something fun planned after to look forward to! -Lastly, NCLEX studying should be a REVIEW, not a RELEARN. I needed to trust that I actually did know these concepts, and knew them well; studying was to brush up, keep some details fresh, and go back to thinking in "nclex format". That being said, I know it is easy for things to get missed in school, so for people who really do feel weak on content and concepts, give yourself a break from worrying about the NCLEX and take a review class, use a tutor, work with a study group. Studying for NCLEX isn't fun, but it shouldn't feel overwhelming and confusing-- give yourself the time and knowledge you need to feel ok. For those who are still in school, thinking ahead to the NCLEX, the more you throw yourself in now, the less painful and stressful it will be later. Most of my preparation was simply doing well in nursing school-- I really didn't prepare all that much for the exam itself. In nursing school I studied for every exam by doing practice NCLEX questions, did tons of ATI practice tests and tests for classes, and was required to do 1,000 questions from Saunders in my last semester, as well as 8 different ATI tests and 2 predictors. (99% and 97%). Good luck! it is not something you can blow off, but the exam is doable and anyone who cares enough to be on this board looking to improve and succeed is off to a great start

Yep, NCLEX questions until your eyesballs fall out. The "Success" Series (Pharm Success, Med-Surg Success), was a big help. You can't start stuff early enough. And don't ask for extensions...the load really never lightens up, so don't put things off. Learn and practice teamwork! Nursing is a team effort, as is nursing school. My cohort, for example, used a google folder to pool notes and recordings, and we used our facebook group to post helpful links, reminders about upcoming assignments, etc. Working together to get through all the material helps everyone- but, of course, it means being a good team member yourself! :) Mostly, though, just know how your own brain works. I don't learn from lecture, for example. Just can't seem to do it-- hearing long explainations of things doesn't give me time to process the material and think it through, and it doesn't stick or make a lot of sense. If I read it, however, I will remember it. So, I was one of the rare people who did all the readings (usually at least twice). Once I stopped trying to fit a square peg in a round hole and become a person who could take awesome class notes and really absorb lecture, I did really well. It worked for me. On the other hand, I had friends who SWORE by recording and re-listening to the lectures. Don't let other people tell you how best to learn! As for organization, I just did everything in google. I liked using my google calendar because it could fit everything and be easily edited (I don't know how people used paper planners...how do you fit all the stuff that needs to be done in those small boxes??), and because reminders popped up on my phone every morning. All my notes went straight to google docs-- and thank goodness, because I had a computer die on me. It was also nice because I always had my notes with me-- I just needed to open the app and pull them up, and I could study whenever I had a minute.

I really liked "Med-Surg Success." I swore by that book, and did the whole thing cover to cover. It was a huge part of why I did well in that class. As I remember, there were 100+ questions for each system, with very good rationales. Worth every penny. It begins to teach you how to think, and I found it to be a great way to learn the material.

I don't know how much easier one nursing school really is from another. We all need to pass the same exam...and many programs use HESI or ATI to make sure we are all on target with every class. Grad schools use GPA (in part) to get a sense of whether the student can handle the academic rigors. If you go to an "easy" program, they have no way of knowing whether you would be successful somewhere tougher.

For what it is worth, I disagree with some of the others on the thread that each semester is harder than the last. Going to nursing school was a VERY big adjustment; you need to learn to think like a nursing student. Those first few NCLEX style exams are totally disorienting, and it really didn't click for me until second semester. On top of that, you are adjusting to a very physically and emotionally draining course of study, a demanding schedule, and changes to your personal relationships (even if things remain great, trying to balance family/friends and nursing school takes some time to figure out). Yes, the MATERIAL is at a higher level, and the schedule gets busier, but hopefully you now know what to expect, how to study, and how to balance your time and take care of yourself. Many of my friends has their worst semester first semester. It sucks to miss it by so much, it really does, but that's the reality of nursing school (and nursing!). I know someone who lost a 60k scholarship over literally 1 test question. She bubbled something wrong, as the the paper version of the test showed. But, as the professor said-- as a nurse, you don't have those excuses or that leeway. Nursing school is supposed to be brutal to start to toughen you up and get you ready. So, it's ok to be upset, it's ok to cry, and it's ok to take a bit of time to lick some wounds. Don't let it make you bitter. You came very close, and you can use this as an opportunity to really nail the material and get a good solid foundation. I know many good nurses who have not had a perfect academic path, and they are great! Best of luck!

Thanks all! I probably saw 2-3 threads throwing around some high numbers and that was all I needed to indulge in some serious confirmation bias. I really appreciate the responses and the time!

Hi all, I'm starting to get my ducks in a row to apply in the next year or two, assuming I go the NP route (I am really interested in clinical bioethics, but not sure that is a realistic career). I'm wondering about my BSN GPA. I have a 3.6, which is ok, but not a top GPA by any means. I graduated from Georgetown's accelerated program, where the program average is around a 3.2. I'm in at least the top 35% (thanks, Sigma Theta Tau), but not exactly where I fall-- certainly I know at least a couple people were much higher. As I understand it, Georgetown isn't actually a top nursing program, but they are pretty rigorous and we carried a lot of credits at a time. Is that a factor when looking at my academic record? I see a lot of people around here who say 3.8 is minimum for some of the more competitive schools. I think I will have a strong app in other ways, but I'm sure that is true of everyone applying!! I guess it is silly to worry about, because at this point GPA is what it is, but I don't want to waste too much time and money applying to schools that aren't going to seriously consider me!

I love my littman cardiology 3. love it. i have never had anyone borrow it for longer than 2 mins in my sight or take it or lose it-- i feel like that is kind of a strange thing to have happen. my thought was this: i want to buy 1 stethoscope, not a cheap one and then a nice one later. Also, as a student i want to make sure i can hear things. Sure, a pro knows how to listen to a cheap scope, but a student with untrained ears needs all the help they can get. Never regretted it, and expect at least 5 years of use, 5 years for $150 on sale and actually hearing things? worth it. There are better places to cut corners.

that's really interesting to hear...would you mind expanding on that? I am just finishing my BSN from an accelerated program, and am looking at a DNP in the next 3-5 years. One of the reasons I chose nursing over medicine last minute (as in, was enrolled in a med school program!) was that I decided I really liked the NP role because it was rooted in the nursing model. I realize it is a big shift in thinking to do differentials, etc., but I have been under the impression that it is still nursing-based, not "med-lite." For example, this recent NYtimes blog post talks about how NPs are more likely to offer non-pharm treatments to patients, leading to better, more comprehensive care. I would think this is a direct result of RN training and experience, and I love that NPs bring that viewpoint to the table. I am debating about where I want my career to take me, and do have some concerns that getting a DNP will effectively take me out of nursing as I know it. I would love to hear your experience and take on it. For the record, I do think that we need residencies-- the DNP is really not a "clinical doctorate" without a residency! http://newoldage.blogs.nytimes.com/2013/07/19/in-the-doctors-office-a-neglected-resource/?_r=0

Thank you all so much for such kind words and the time everyone took to give me such thoughtful responses! How can I give up on nursing, when there are so many nurses are people who genuinely care about making other people's day's brighter, in and out of the hospital? The responses helped me so much during a low week, and made me smile. I don't want to lose my love for nursing, so it's a matter of learning how to balance high standards with realistic expectations, and not taking myself so seriously sometimes. I don't want to be so stuck being perfecting that I can't allow myself to make the mistakes it takes to get good!

Oh, yes, very true-- hope my over-the-top rant about it didn't offend! I think the frustration comes from busting my butt in the classroom, and getting accolades for it in a very academic-focused program, but then going out into the hospital realizing ain't no one looking at my GPA or awards or alma mater when I can't seem to do tasks from first semester (nor should they!). We spend so many hours in didactic courses, and relatively few in skills, and it certainly shows sometimes...but, at the end of the day, I can at least be proud and encouraged by my performance in classroom stuff! Thanks for the reminder that I should remember that.