urty

I remember being grateful there was a window with a pretty tree in front of my computer to stare at when I had no idea what an answer was. That was the only window in the little room. They gave us ear plugs to block noise, so I actually listened to my tachycardia during the test. With lots of anxiety, and 45 minutes later, I left after 75 questions. I was so nervous I had failed I couldn't do anything that day because I was so out of focus. Fortunately though, I passed!

I have total test anxiety. I remember taking NCLEX a couple years ago and this was my study method. Understand that this test really has nothing to do with what you know, it's about how to take a test. The study guides I used totally focused on that point, and instead of explaining why an answer was right based on anatomy/physiology/chemistry stuff, it explained why the other answers were wrong because of the way they were phrased. Good stuff. Good luck on your next go round.

Lucky patient who actually had an MD willing to prescribe a nicotine patch. Where I'm at the MDs rarely do that, it seems only if the nurse makes a fuss about it will it get ordered. Definitely not a life or death priority in their mind.

Critical thinking definitely comes with experience. Know your basics as Faith07 suggested, and know your pathophysiology. Part of critical thinking is knowing if something is out of whack in the patient, how will it manifest to you. For example, if a patient is having a lot of ectopy on their tele perhaps electrolytes are off, so check them. If the patient is tachycardic with a temperature, is it an infection or are they dehydrated. Are they peeing? Give a fluid bolus, is there a response? I work in ICU and I know our nurses grill the capstone students on this stuff. They become pretty good at identifying a patient about to circle the toilet. As for communication. Ask questions! If you can, look up the patients meds before your day starts so you know the adverse reactions and patient education regarding those meds. Your nurse may ask you what will happen to the patient if you push morphine or toradol too fast, what to expect with their vital signs, etc. All in all, if you don't know then ask. Who cares if you think it's a stupid question, at least you'll know the answer and be a smarter nurse.

If it isn't written it isn't valid. It's the same with our charting as nurses! I had a very similar experience with AM. When I declined an offer after a verbal contract I was contacted by many different people within the company who tryed to, in my opinion, bully me back into it. My recruitor became very passionate and argumentative. I definitely did not want to work for them after that fiasco.