PCnurse88

I used: 1) Ace the PCCN You Can Do It, review questions by Nicole Kupchick 2) AACN's Essentials of Progressive Care Nursing 3) PCCN Exam Practice Questions by Mometrix 4) The AACN's progressive care nurse review course, with accompanying printable handouts I to transitioned from medsurg to progressive care, but had been in progressive care about a year and a half when I took the exam (my unit is also heavy on the cardiac patients). I would do the random question here or there, but really started studying about a month beforehand- however, I was also on sick leave for a week during that time and was housebound, so I had a lot of free time on my hands and no heavy lifting allowed. Practice questions helped me remember how nursing exams form questions. It was formatted somewhat similarly to NCLEX, but not as long (at least not for me), and I didn't think it was as hard. Heavily cardiac and pulmonary. The AACN provides a blueprint which breaks down the % of each system asked about. Best of luck!

Hi! I have an auditory processing disorder. I'm not hearing impaired by any means, I have EXCELLENT hearing, but my brain does not filter out background noise like most peoples. This makes talking on the phone nearly impossible for me. I have to be in a quiet room with no other sounds, phone on speaker, with it pressed right up against my ear (or wearing earphones). The few times I do have to use a phone at work, whether to talk to a doc or family member or another nurse, is torture. It's 10 minutes of me struggling to hold the phone to one ear, use my hand to block the noise in my free ear, and somehow find another hand to write down what I'm being told. I have had to tell doctors that I can't take a verbal order over the phone simply because I can never be 100% sure what they've said. Back when we had to call doctors for everything, I literally used to carry around earplugs and scope out the quietest corners of the unit. When getting report I am all up in the previous nurse's personal space because all the talking, movement, and beeping on the floor aren't being filtered out. I'm That Nurse that mutes the patient's TV when I walk in the room to talk to them. Now I don't have that problem because 90% of my communication at work is texting! It's via a secure app and all disciplines have it- PT, OT, speech, nursing, doctors, CNAs, RT, you name it and they're on it! I've taught myself many tricks to help with situations where there's a lot of other noises- RRTs and codes, for instance- and can function safely. I know how to judge acoustics in a room and place myself in the best possible place. But texting has been such a lifesaver.

I actually recommend not doing any certifications other than maybe BLS. This is for a few reasons: 1) Many hospitals will pay for you to do certifications, especially if it's required. If they don't pay for it, they may offer bonuses or partial reimbursements. I have multiple certifications, some required and others just to better myself and prepared for the future, and my hospital either a) paid for it AND paid me to do it (required ACLS- extra 8hr day at time and a half? Yes please!) b) paid for it and I got to do it at home (which is honestly what I prefer) or c) reimbursed me (medsurg certification). These things can get super pricey on your own. 2) Most hospitals have some sort of annual review, clinical ladder, etc. where you have to make yearly goals. It's great to start out in the ICU and after a year say "I want to start studying for the CCRN and obtain in May 2020" or whatever. There are only so many times you can put your goal down as "join a committee" and then... not join a committee. This gives you goals PLUS extra study time. 3) While I did not find any of my certifications horrifically difficult, I don't know that I would have been able to pass the exams or have gotten nearly as much out of them if I did not have bedside experience. I can remember learning about GFR in school, but it didn't really MEAN anything to me- but going over the levels and accompanying stages of GFR / what that meant for my patient while stuying for my medsurg cert was a big eye-opener for me. 4) You really have no idea where you'll end up until you get a job. I swore I would only ever work in pediatrics. Now I'm an adult stepdown nurse. Back when I first graduated I thought to myself "should I do PALS? NRP?". It would have been a huge waste since I don't work with anyone under the age of 18 and to be honest, I don't ever see myself going that route. You think you want to end up in crit care, and maybe you will... but maybe your first job is a geri/medsurg floor and you find you really like it. 5) Adding on to above comments, asking about certification during an interview seems, at least to me, better than already having it. It shows you have further goals and want to continue your education rather than fluffing up your resume to get a job. 6) Focus on your NCLEX because that's obviously a million times more important than any certification. Can't get any of these certs without that RN first.

I used to think like that, too. I drove an hour and a half one way to my first nursing job for 15 months before I finally had to change to a hospital closer to home. I was literally falling asleep driving home on the busiest highway in my state. Now I've been at my current job for 3 years. I come in extra all the time to prevent mandatory overtime. I switch shifts to cover holes. I float out of turn. I come in extra on other units if mine is staffed well to prevent other units from having mandatory overtime. I'm a precepting MACHINE, I pump out nurses like clockwork. I'm charge all the damn time. My hospital could not care less. A resident accused me of patient negligence a few months ago. Long story short she was covering her own butt because she had actually put orders in way wrong. Admin did not hesitate to jump down my throat and point fingers at me. Even the union wasn't helpful. What saved me was my own detailed charting, and a fully oriented patient who about had a stroke when they told her what I was being accused of. I don't owe them anything. I give them my time and in turn they give me a paycheck. Life is short; there's no reason to stay at a job you don't want, even if there isn't anything wrong with that job.

The very first time I did CPR the patient woke up and immediately grabbed me while I was doing compressions. I was so shocked the only reason I didn't fall off the bed was because the chief resident was standing next to me and had a hand on my back to steady me (I was kneeling on the bed). Patient went unresponsive as soon as I stopped compressing and we couldn't get a pulse, so CPR was resumed. Again, patient woke up and stared straight at me as I did CPR. Ended up calling it after 30 minutes. I will definitely never forget that experience.

Our med students graduated this week, so we had a couple luncheons and parties for them. It was in the bulletin, we got emails about "hugging a med student!", whole shebang. The managers did something individually for their own units (candy, box of joe, small stuff from their own pockets). The actual hospital? RNs didn't even get a mention in the daily email blast about nurses week.

I've had enough vaccines to cover like 3 normal people. Chicken pox 3 times, MMR I think 4, hep series a few times... nothing sticks. My nursing school made me do the entire series over. My first and current RN jobs accepted vaccination records. My per diem made me do the whole round of vaccinations again and then made faced at me when my titers were still negative, but sill hired me.

I get gel manicures sometimes and they typically last me almost 3 weeks before the first chip, which is when I take them off. Regular nail polish comes off within a day so I don't even bother, unless it's for a very specific event and I'm off work (ie, wedding) or when going on vacation. I also try not to use hand sanitizer a lot since I seem to be insanely sensitive to it regardless of nails, so this timeframe might vary if you're using more sanitizer instead of soap/water.

It would probably vary hospital to hospital. Our cath lab nurses are definitely considered critical care nurses / it's considered a critical care "unit". There is a hospital nearby that is somewhat of a back up cath lab and their facility does not consider them critical care.

You've been there 1.5 years? I'd consider myself lucky if I was given that long before they made me charge! Our facility makes everyone do charge at least a couple times, usually around the 1 year mark but sometimes earlier (I was a new grad with 8 months experience- eeeeek). We try everyone out as a "trial run", but some people just cannot do it, and I've known a couple coworkers who deliberately were horrible so they wouldn't be made charge again. For the most part it's the same group of 5 that just rotate the job, but it obviously depends on who is working that day. I always get the short end of the stick and end up charge on my weekend. Let me tell you, that extra $1/hr is NOT worth it! Good luck! And who knows- maybe you'll like it.

AACN's Essentials of Progressive Care Nursing is a good book, but it isn't a question book. "Ace the PCCN You Can Do It" by Nicole Kupchik was extremely helpful, as was the AACN's online course review. The review was 13 hours long and came with handouts for each section. It was costly but I convinced my educator to buy it for the floor. Good luck!

My (adult) unit recently implemented this and it's going terribly. People are on oxygen for DAYS longer than they need to be because we can't titrate without a new O2 order, but the residents take a million years to put orders in. Night shift no longer touches the oxygen unless they need to go up for desatting purposes.

I disagree. The blocks can be challenging at first, and there are plenty of things (not necessarily tele) that I go home and look up. We cannot possibly know everything about the medical field, especially when we are new or when it is something we do not do all the time. Depending on your unit/hospital's culture, asking the cardiologist can be a great idea. Our cardiologists LOVE teaching us, and will actually go out of their way to bring interesting EKGs or tele strips to us to show us things. They encourage questions, especially when we're new to nursing and/or the field.Of course, if this isn't the culture of your hospital, you may find that they don't want to or don't have time to teach you- your educator can be helpful at a time like this. In fact, that's pretty much their job.

I had all 265 questions with my NCLEX too- horrible. I cried through probably the last 100 questions, and then sobbed my whole way home - probably shouldn't have been on the highway! All of my friends had passed (my ATT was delayed due to getting my BSN out of state and my school not releasing my records or whatever they needed to do) with 75-80 questions. Fortunately, I ended up passing. To study I used a Lippincott question book and did the Kaplan review course. The review course was extremely helpful, and Kaplan had some agreement with our school that if we didn't pass on the first go around, we got to do the review course again with a different instructor for free. I have no idea how much this cost because it was through school, so it was $500 but we got a bunch of stuff through school / it was "part of our tuition" somehow. Don't let it get you down! I know plenty of great nurses who didn't pass their first or second time, either. And best of luck on your next go!

If you join an organization (like AACN, AMSN, or whatever your specialty is), sometimes they give free CEUs. All of mine are free, and my membership counts towards my clinical ladder. Obviously the membership itself can get a little pricey but it was worth it for me when getting my certifications.