CoachChris

I have to say that the NCLEX exam was very difficult. My emotions are all over the place. But I felt like today just wasn't my day. On the SATA I felt like there was always one choice I wasn't sure about. On the multiple choice I was able to narrow the choices down to two but felt like I was just making educated guesses after that. My test shut down at 75 questions so either I failed spectacularly like I suspect or I passed flying blind. If I passed its by God's mercy. As I read through the threads here I get even more anxious. How does one know what a higher or lower level question is? If one gets a lower level (easier question) toward the end does that mean one is failing? How much do the kinds of questions I got really matter? I can't even remember most of my test anyway. Paying for quick results on Sunday will only give me time to think about what I am going to say on Monday to my new employer. So I vent with this post and try to manage the anxiousness. I have a whole new level of empathy for those of you who have taken the NCLEX before me. It really does launch an emotional roller coaster ride.

For most of our clinicals we did have patient assignments. For our medical-surgical clinical we would prelab on up to 2 patients. But half the time we'd get there the next day and our patient was either transferred to a different place in the hospital or released from the hospital. We'd come in and listen in on shift reports at 6:45am. Then we'd do assessment on patients. Then, depending on when our CI got to us we passed meds. She had 9 students and I wasn't going to stand around waiting for her to show up so I could do my meds. The Clinical Instructors I've had have all been good. But they have also all been very busy. If the patient I prelabbed for was gone I wasn't going to just stand around. I want to learn how to be a nurse. So I jumped in and helped however I could because I wanted the staff nurses to want to teach me stuff. If I made their jobs a little easier then I knew they would be more likely to invest their time in me. There is always something to do. Patients need turning every 2 hours. There are bed baths and bed changes. There are bags to empty and I&O's to document. There are ADL's. Just jumping in and doing what I could and learning "tricks of the trade" from experienced patient care techs were very helpful. My point was that staff nurses will be more willing to donate time if they see you working hard for them. I tried to do as much of the care for my patients as I could. But I also recognized that I only had 2 of the 6 patients the nurse had. Rather than stand around I did try to help. In my critical care clinical our Clinical Instructor assigned us to work with nurses she knew were good teachers. Their patients became our patients and we were expected to be right there alongside the nurse every minute of the day and to do whatever the nurse asked us to do. We are also expected to respond to codes. Two of my classmates actually got to work codes (doing CPR) during the semester. Our CI expected us to then to go home after the clinical day and write up a nursing plan that tied our interventions that day to nursing diagnoses that accurately reflected what was going on with the patient. In some ways it was harder than doing a prelab because the staff nurses would be asking us questions and we didn't have the benefit of reading charts 2 hours the day before and looking up patho or meds. The more we showed we knew our stuff the more we were allowed to do.

I've had a different experience in my clinicals. In fact, after my clinical in a Neuro ICU some of the nurses were asking me to apply to the hospital and said they would vouch for me. My advice. At least this worked for me. From day 1 in my first clinical I jumped in to help the patient care assistants with all the work that the nurse didn't want to do...cleaning up soiled bed linens, draining full Foley catheter bags, etc and charting I & O. I kept myself busy doing little things that I knew they would appreciate, like answering call lights and taking care of simple requests like getting extra pillows, ice chips (if they weren't NPO), etc. When a nurse was overwhelmed in medical-surgical clinical I would jump in and just ask to help. They are scrambling and it's time for 11am vitals. I asked if I could check vitals and chart for them. Even the patients that weren't assigned to me by my clinical instructor. I'd be listening to the physicians. They are talking to the nurse and telling her to put in a Foley. I've got all the stuff she needs by the time she finishes the conversation with the Doc. By the last 4 weeks of the semester nurses would call me into the room when they were doing something interesting. The same was true in my critical care clinical. I was there helping the patient care tech clean up from a displaced fecal tube with a 400lb paralyzed patient. I help clean up a room where the patient had projectile vomited all over the place. Wherever the nurse went I went and jumped in and did all the stuff I could do that I knew wasn't pleasant for them. By the end of the semester not did only the nurses teach me how to do procedures but more than once the doctors took me aside and explain to me what their residents were doing as they were doing their procedures and what kind of care they would expect the nurses to provide in the aftermath. I think it was because they nurses were talking me up as a team player. In my observation too many nursing students don't jump in and clean poop, pee and vomit. They don't do the little things that take up time and are a little unpleasant. My advice is to jump in and be a part of the healthcare team and work hard every clinical day. It will be noticed after a while.

Are you addressing the original poster or someone else in this thread?

I guess I'm not sure where you are getting the idea I'm competing with anyone from my posts. In fact, in my first post I stated that probably some ADN students will end up being far better nurses than I will ever be. The original post in this thread stated that BSN programs are harder than ADN programs. My goal was to share my observations regarding the differences in the programs. I don't think one program is harder than another. The BSN program is just longer than the ADN program and covers more ground. There may also be clinical opportunities available to BSN students that are not available to ADN students. I was going to do the ADN route because it was a much cheaper option and it was easier to get admitted to a program in my area. I started looking at BSN programs when I learned that the majority of hospitals in my metro region wouldn't be hiring ADN graduates anymore beginning in 2016 or 2017 and were requiring ADN staff nurses to complete a RN-BSN bridge program to remain employed. I am 50 years old and this is my second career. I wanted to make sure I really did my research before jumping into a program. For me that top issue is employment after graduation. I think everyone should care about the direction hospitals are moving. If it is true that hospitals are getting higher reimbursement rates for having higher levels of BSN prepared nurses then it is going to matter to ADN prepared nurses when looking for a job after graduation. The same thing applies if it true that hospitals seeking magnet status are being pressured to have higher levels of BSN prepared nurses. Hospitals are trying to cut costs right now. Why provide tuition reimbursement for a nurse to do a RN-BSN bridge program when they can hire a BSN prepared nurse right from the beginning? It is a safer investment to hire a nurse who already has a BSN from the hospital's perspective. We can disagree all we want but we aren't the ones doing the hiring. I am sure that ADN nursing students will make excellent nurses. There are probably many who would do much better than I in a BSN program but don't have the opportunity. It is sad to me that someone might invest so much in gaining a nursing career only to be caught up in the rapid change in the healthcare industry. It is even sadder if all those changes happen around them but they are so focused on getting through their program that they miss the bigger picture.

So then, it just may be that ADN programs just don't get opportunities for ICU clinicals if they don't do them somewhere else. That is, they get bumped by BSN programs. I could see that happening in our area as most of the hospitals are moving toward the BSN has a hiring prerequisite. The catalogs of the ADN programs in my area that I looked at basically promised clinical experience in medical-surgical areas but said that clinical experience in specialty areas would be subject to availability. I'm wondering if that is the experience of others.

Interesting topic. I read a sampling of comments throughout the thread. When I explored nursing programs in our area I noticed that the four ADN programs required between 36-39 credit hours of nursing courses and about 500 clinical hours. The BSN program I am in has 66 credit hours of nursing classes and almost 1,000 clinical hours. The other 3 BSN programs in our area are about the same in this respect. The entrance requirements were much different. GPA in prerequisites, ACT/SAT scores, and nursing school admission test scores were all much higher for my BSN program than for the ADN programs among students accepted for the respective programs. That doesn't make a BSN program harder than an ADN program. It just means our program admitted students that obtained higher levels of academic success than those in ADN programs in our area. In core areas like medical-surgical, obstetrics, pediatrics, mental health, etc it looks like the same ground is covered except that the BSN goes more in depth. That could just be we get more "extra" stuff and not just the "need to know" to pass NCLEX. In our BSN program we do clinical rotations in medical-surgical, community health, mental health, geriatrics, obstetrics, pediatrics and critical care (ICU). Our last semester includes a 24 hour per week clinical rotation working with a preceptor in the hospital. Many students do their final semester clinical rotation in specialized critical care settings (i.e., Neuro, CV, Surgical, etc.). Most get hired by the hospitals for the unit where they do this clinical rotation after graduation. We saw a number of ADN students doing clinicals during our medical-surgical rotation but now that we are doing clinicals in ICU settings we are not seeing them. The ADN programs, I am told, do not provide the theoretical knowledge necessary for the complexity of the specialized ICU setting. That may just be bias in the teaching/research hospitals where we do our clinical rotations. It is a possibility that the community college ADN programs just do their ICU clinicals in different hospitals than us. I am glad I did the BSN program rather than the ADN program. Most hospitals in our area are getting the word out that in either 2016 or 2017 they will not be hiring ADN program graduates any longer. At least 2 of them have informed current ADN staff nurses that they have to complete RN-BSN bridge programs by 2017 to remain employed. Some are already stating in their hiring criteria that BSN programs are preferred over ADN programs. One of the major research hospitals in our area no longer considers graduates from ADN programs for employment. I have heard this has to do with hospitals getting higher reimbursement rates under the Affordable Care Act if they maintain a certain ratio of BSN prepared nurses on their staff. I really don't think I'm any smarter than someone in an ADN program. They may be a far better nurse than I ever will be. In my mind one has to make the most of the opportunity before them. Nursing is nursing. Best practices are best practices. So someone from a good ADN program may be much better prepared than I am in my program. In my area my BSN will open more doors to employment opportunities for me. In that respect I would say the BSN program is superior to an ADN program. I am 5 months away from graduation an am already being contacted by hospital recruiters.

The best advice I've gotten is to start thinking about a job once you are less than 12 months from graduation. There are areas in the country with overages (more applicants and jobs) and shortages (more jobs than applicants). I've started to look at areas where I'd like to work and am compiling lists of facilities in those areas. Once I've got my list I will do a little research on the hiring process in each potential job site. I'll also talk to people in my personal network to see if there are any mutual friends who could help me get a job in one of those places. Over the summer I'll visit potential job sites and introduce myself to HR people and some nursing managers. Next fall, while I'm in my last semester, I will be relentlessly following through on any lead that comes my way. I guess I'm trying to say this: Getting a job is a job. In this economy jobs just don't happen. Hiring someone is an investment for any organization, including hospitals. You have to sell yourself and convince the people making hiring decisions that you are the best investment they can make when it comes to hiring for whatever position they are looking for. Since the days of internet applications I have always gone in within a day or two of submitting an online application and personally introduced myself to someone in the HR department. "I submitted my application the other day, I am really excited about this hospital and the opportunity to work here, is there anything else I can provide you that will help you take a serious look at me?" If I know someone in the organization I will give them a call and say, "Hey, I just applied for this position in your organization. I'm thinking I'd be a really good fit for the job. What do you think?......Is there any chance you could put a word in for me with the person doing the hiring for that position?" Again, it is work getting a job. Jobs just don't happen!

Any advice for those of us who may have several years experience working with the mentally ill when it comes to a psych rotation? I've done so much crisis intervention while dealing with children and adolescents who have serious issues that I'm afraid I might just jump in and start intervening when I should be backing away and acting like I don't know what to do. I've worked in residential facilities where I gave out meds. I don't want to come across as a know it all. Should I just stay in the background and let those with less experience with that population get more in the mix of things?

Colby-Sawyer College in New London, NH has a B.S.N. program. Colby-Sawyer was founded in the early 1800's. It is historically tied to Dartmouth College back when Dartmouth was an all men's school. Colby-Sawyer used to be the all female counterpart. It has been Co-Ed since the 1970's I believe. What makes that program interesting is the opportunities to do clinicals at Dartmouth Hitchcock Regional Medical Center, one of the top research hospitals in the country. Colby-Sawyer is about 40 minutes from Concord just off I-89.

Started nursing school at age 49 and am looking forward to the future. Entering my second semester this spring.

Interesting and educational app. I wouldn't post anything though. I hope there is a feature that prevents anyone from reposting pictures in other social media not connected with the site.

LSON is a good program with great faculty! The curriculum was changed around. I think you will have pharmacology first semester and the professional nursing course later. You really have to stay on top of things to do well in the program. Pharmacology and pathophysiology are the two most difficult courses for most students. Got my scrubs from Identity Factor. Have been happy with them.

I can empathize. I am in my late 40's, married more than 20 years and have 4 kids. Once I take finals the 10 days after Thanksgiving I will be finished with my first semester. About two weeks ago I started feeling depressed. All the excitement of starting nursing school gave way to the reality that, even as a student nurse, I bear responsibility for the health and well-being of others. I also realized just how much I've short-changed my family in terms of spending time with them. My wife told me that underneath the grumbling and complaining she and the kids do from time to time they are really proud of me. They are just as much invested emotionally in my success as I am. Further, she said, that if I wasn't a little worried about being good enough as a student nurse, she'd worry. Being a nurse is a big thing. My confidence should come from actually mastering nursing skills. That is what nursing school was for - helping me master skills so I can become a competent nurse. Maybe her words might be helpful to you and others as well. Emotions are an inescapable part of being human. Someone once told me that feelings only have the power that you give them. Feelings can be good advisors but they are, for sure, horrible bosses. Listen to them but don't let them tell you what to do.

Just got my participant email on Thursday, August 28. It is a relief!