What would the NCLEX be like if our employers designed it.
1. The test should start with all participants clocking in before the time, not one second later and no more than five minutes late.
2. While the participants are getting instructions, they are interrupted repeatedly to find charts, scattered throughout the site, whereupon they return to find their computer taken, and they have to log in repeatedly (the password must be at least 12 digits long, contain a consonant, a vowel, an uppercase and a lowercase letter, a number, a punctuation symbol, contain no recognizable word or name, and Egyptian hieroglyph, and a math equation).
2. At three to eight minute intervals, there must be at least one call bell/phone call from another department/code bell/physician yelling furiously, a JCAHO inspector or a pumps and pearls administrator grilling them on the latest Press Gainey results, the 5 for 5 initiative and how fabulous the hospital's program of patient centered care or planetree rollout is. The participant will have to return to a different computer, and login again.
3. At the one hour mark, the administrator will walk in, tell 1/4th of the participants that they are low censused but oncall for the next four hours to finish the test, if the questions pick up or new questions are brought in. 1/4th of the participants will be sent to a different room to pick up another participant's test, which requires all new passwords, and new and different distractions. The remaining participants in the original room, have to do their test as well as the test of one of the participants that were pulled.
4. At that point, two of the test computers code, requiring all of the students stop, get it back running and transfer them to a different room, while simultaneously receiving two repaired computers that were "repaired but still do not function and start the test over.
5. There will be no eating, drinking or using the bathroom during the test. Foleys with leg bags are encouraged.
6. At various intervals, various artificial odors will be piped in to simulate the nursing environment. regular stool, c.diff stool, GI bleed stool, peanut butter or Dorito emesis, liver failure or drug abuse BO. Add in some stale coffee or diet coke breath. And not to be missed, the odors of delivery pizza, takeout Chinese or Indian food, or the microwave smells of popcorn or heated fish/seafood.
7. Participants will be required to identify the contents of the a unit refrigerator and the approximate age of the contents. They will be tested of on the expiration dates of opened salsa, queso, butter, cream cheese, various salad dressings, coffee cream and hot sauce.
8. During the testing at least ten irate family members will call, five for the same patient, none of whom will speak to one another and no one has the "password".
9. At least once during the test, the wife and the CNA girlfriend of one of the participants will get in a hairpulling fight, knocking five of the test computers out, requiring another log in with the password on a different computer again.
10. Some participants get busted not using appropriate hand hygiene technique when they log back in and automatically fail. Others will lose points for not remembering to use the scripted responses to "five for five" questions after they login.
11. And those that were low censused are brought back one hour before the end of the test and required to start and finish the test in the time left or fail.
12. Everyone will get a required lecture on their poor time management.
Please make your additions as you see fit.
