Studying for the NCLEX

This book has some good figures useful for visual learners. (Source)

I have spent most of my time the last month preparing for the National Council Licensure Examination (NCLEX). It is the epitome of all exams we have taken in our lives thus far. The NCLEX is the exam nursing students take to become registered nurses. As one might imagine, it’s a big deal and it takes some preparation to ensure passing.

At the beginning of fourth semester I purchased an illustrated review book that I had repeatedly checked out from the school library. I am a very visual learner so it helped me to lay out the body processes and complications that could occur.

Occasionally throughout the semester I would crack it open and study for an hour or two. It wasn’t until the middle of May that I really started to focus on my studies. By that time my clinical hours were complete, assignments submitted, and stress (almost) non-existent.

My friends and I all signed up for a review course which was scheduled for the first few days after commencement. The review was very good and really helped me focus on particular concepts instead of trying to learn and understand every illness and disease known to humankind. Take, for example, fluid volume excess (FVE). The treatments for FVE and causes of FVE are applicable to the understanding and treatment of various conditions such as heart failure and kidney failure.

I utilized this to practice answering questions. Not only does it have thousands of questions, it also has their rationales. (Source)

After the review course, it was all up to me. With the support of my family and friends, I spent at least 4-5 hours a day studying. At first it was easy, because I methodically pursued the concepts I did not yet fully understand. Once my knowledge expanded, I had a hard time figuring out what to study. It was as if I was perusing the material and not necessarily studying anymore. I turned my attention to medications and their classifications.

I knew I would never fully understand all there is to know about pharmacology, but I thought if I could distract myself (in a sense) with medications I would focus less on my mounting anxiety. It helped, but so did talking to friends that were also studying for the NCLEX and taking better study breaks.

My idea of a study break up until that point was to snack, have a mini-dance party, or browse social media. As my exam date approached, I took the opportunity to go running daily, hiking, and paddle boarding. I also spent some time in mental relaxation mode and turned reflexively to Netflix and sleep.

Overall, I felt mentally prepared for the NCLEX and that is what mattered most to me the day of the exam.

To be continued…

NICU Nursing: Taking It Slowly

The topic of neonatal intensive care nursing has been a difficult one to write about – it has literally taken me months to start this post. The reason for that is it is so near and dear to my heart and I want to do it justice in my portrayal of it. Though my experience is limited, I do want to share what I have seen so far in clinical.

An example of the isolettes our patients reside in. (Source)

As part of my senior practicum I am paired with a nurse who is responsible for teaching me and guiding me through 168 hours (or fourteen 12-hour shifts) of direct care in the neonatal intensive care unit (NICU). I am so grateful for the preceptor I was assigned! She is equal parts challenging and encouraging. My preceptor cares about the quality of care for her patients and their families and is an extremely patient teacher.

Initially I feared I would be completely unprepared for my first day of clinical, not having had a pediatric rotation. My fears were assuaged by my preceptor the first day when she looked me in the eye and told me she had not expected me to know anything and that we would take it slowly. I soon learned that “taking it slowly” was the NICU way.

I first learned the basics, such as calculating feeding rates and administering feedings and changing diapers. Simple stuff, yet I had taken for granted how incredibly important nutrition and gastrointestinal health are to the little ones. Next, I learned how to do room safety checks and deliver medications. Then I learned how to complete a head-to-toe assessment on a neonate.

(Source)

It was a frustrating process at points, but after having observed my preceptor’s nursing style I came to trust her judgment above my own. That is not to say I did not offer myself up for new experiences and opportunities to learn, but I followed her lead. I knew she only wanted the best for our patients, especially because they are a vulnerable population. My preceptor does not want me or any other new nurses to make any crucial mistakes that could harm our patients. That is why “taking it slowly” is the NICU way.

Breastfeeding and the Pope

(Source)

I recently read an article about the Pope inviting mothers to breastfeed in the Sistine Chapel while celebrating the Feast of the Baptism of the Lord. The article reminded me of an important part of my Labor and Delivery rotation – feeding. I had the opportunity to shadow a lactation consultant for almost an entire day and it was an enlightening experience to say the least.

First of all, I have not borne a child nor had I had the opportunity to feed an infant at that point. Sure, I have held my little cousins when they were babies, but that is about all the experience I had had even including my shadowing in the NICU. Thus, I was learning about the special cases as well as the basics of breastfeeding.

For instance, I had no idea of the mechanics of sucking. Infants push the breast against the hard palate to expel milk. If an infant is unable to push the breast effectively, the results are sore breasts and an inadequately fed child. There are several reasons why an infant may have difficulty sucking and it is up to the lactation consultant to assess the issue and direct the parents on how to help the infant.

Of course, mothers’ breasts also play a role in the effectiveness of infant feeding. If the milk duct is inflamed or obstructed, the infant will try harder and harder to get the milk flowing to no avail. The lactation consultant can also help determine the problem feeding and help alleviate any pain or condition mothers may have with feeding.

The size of a newborn babe’s stomach at days 1, 3, and 10, as represented by comparable objects and milliliters, respectively. (Source)

Lactation consultants also have a hand in educating parents on alternative ways to feed their newborn. Some women prefer simply to feed from the breast. Others prefer pumping then feeding. Still others prefer feeding their infant with a mixture of donor milk and formula (if there is a medical condition preventing mothers from proffering their own milk).

I was amazed at how much lactation consultants know about the breast and about infants. Without establishing a good feeding regimen immediately postpartum, newborns may struggle to thrive. The fact that Pope Francis encourages mothers to disregard societal pressure to feel embarrassed about breastfeeding is important because without breastfeeding (or however a mother or father may choose to feed her or his infant), the baby is denied a consequential piece of its childhood.

I also appreciate the fact that Pope Francis encouragement stems from an understanding of global issues. Although I tend to remain ethnocentric (that is, focused solely on the culture and society of the United States), it is true that there are parts of the world where women are so malnourished that they cannot offer their infants breastmilk even if they want to. There are also areas of the world where formula may be contaminated because of the water used to make it. Pope Francis has realized this and responded in a commendable way by encouraging breastfeeding whenever possible.

Impending Travel Plans

The simple thought of traveling excites me. Add in friends, new places, and a cause for celebration and one can imagine the anticipatory excitement I feel for the upcoming month. A friend of mine currently goes to college in New Orleans and I have been wanting to visit ever since he moved. By the time my friend experienced his first Mardi Gras, he was thoroughly engrossed in the culture of the “Big Easy.” His excitement about the Mardi Gras festivities was infectious and I have deemed it an item worthy of The List (#35 under Not-So-Impromptu) to celebrate Mardi Gras in New Orleans.

This year, I have the good fortune to fulfill that item and I am so grateful! Mardi Gras falls on the 17th of February, the Tuesday of the second week of my spring semester. My friend is lucky enough to have the entire week of Mardi Gras off, but because I do not, I will be visiting the weekend before. It just so happens that I do not have classes Thursday or Friday, so I have the opportunity to spend an entire 4 days and 3 nights in New Orleans! My hope is that it is enough time to sight-see, visit with my friend, meet his friends, and enjoy a few Mardi Gras parades.

Are there any tips for traveling to Louisiana? Any must-see places in New Orleans or must-attend events?

2015 Resolutions

As promised, here are my actual new year resolutions:

• Volunteer my time at least once a week. Whether it be a local organization or just time helping friends or family, I want to spend my time wisely.
• Explore someplace new. Both Portland and the greater Tacoma area are perfect places to find little nooks and crannies full of gems. Not to mention all of the other places in the world I have not been yet.
• Continue learning. I will graduate sometime in May with a BSN and will take the NCLEX in June/July, but I will not stop learning there. At this point, I do not know what I want to learn, but whatever it is I will share it. Of course, this includes in part my goal of reading 52 books in a year.
• Write more consistently. Blogging weekly is a goal, as is finally accomplishing NaNoWriMo. I am hoping to send more letters this year – everyone loves a handwritten letter!
• Last but not least, I want to relax. My anxiety level has continued to rise the last few years despite my attempts to assuage it. I hope that this year, I can finally learn to control my anxiety better and be a generally more easy-going person.

Whether or not I accomplish my resolutions, they are now set in place. Hopefully in December I can reflect on the year and see how I have changed.

What kind of resolutions are you thinking of or would you ever consider committing to?

2015 New Years Resolutions

I do love good lighting. Wintertime is the best time for mood lighting – and what better way to light the mood than by stringing white Christmas lights up everywhere?

My new years resolutions are based on six characteristics I would like to foster in the new year. The chosen characteristics are ones that I may have but are underdeveloped or ones that I feel I lack entirely. I have written resolutions based on the characteristics I want to exemplify – and some things I just want to accomplish.

The six characteristics are as follows:

1) Patience

One can never have enough patience. This year especially I have noticed how my patience has grown and how much I still need to improve.

2) Trust

I have been challenged more than ever to be trusting of others in my professional and personal life. I hope that in the next year I can develop a sense of trust that will enable me to care for my loved ones.

3) Wisdom

Of course, this does not simply mean “learning.” It goes without saying that my education will not end when I graduate next May. I want to develop the wisdom that comes from experiencing joy, tragedy, love, and laughter. I hope that this next year I can truly devote myself to the relationships I have previously nurtured.

4) Faith

My faith journey is a very long and twisty one. I hope that in the coming year I can foster good habits in my prayer life and pass along only the best for my friends.

5) Courage

This one is a difficult one to explain. While I may be able to advocate for my patients, I want to develop my own sense of courage. I want to be able to withdraw from relationships and revoke bad habits that hold me back from becoming the best person I can be and providing the best care I can as a nurse. This will be especially beneficial as I progress in my nursing career.

6) Compassion

The above being said, I hope to have the compassion to understand others and develop relationships that will benefit others. I want the compassion I develop to transfer to the patients I care for.

Now I know this post does not necessarily cover my new years resolutions themselves but there will be another post coming that will cover them. Although, I’m curious as to what others’ new years resolutions are… Two of my more practical ones are to exercise more regularly and finally learn how to snowboard.

The Nightmare After Christmas

This post is nothing like the movie. I just thought it was a clever title.

The night before last I had a horrific dream in which I was caring for a young patient. While I cannot remember what the patient looked like or whether the patient was male or female, I can remember the patient was kind, patient, and humorous. Suddenly, in the dream, I realized the patient was bleeding from the nose. Then I looked at the patient’s ears and they too were bleeding. Everywhere I looked, the patient was starting to bleed.

For some reason the patient did not have IV access so I tried to start an IV. I repeatedly failed and the more I tried the more the patient bled. Some how my scrubs began saturated with blood and I woke up with the same damp feeling on my skin. The smell of fear mixed with the scent of blood lingered in my nose as I rose from bed, disoriented, gasping for breath.

I do not know if others have had dreams like this (or if nightmares like mine are even remembered), but this dream hit me hard. I awoke frightened and with the heavy feeling of guilt and inadequacy which was hard to shake. Now all I want to do is study and practice my nursing skills.

As the new year draws closer I think about the changes that will occur in 2015, including receiving my BSN and RN license. I wonder if the dream was my way of preparing for the future… I obviously need to find another method of doing so.

That being said, I have been working on my New Years Resolutions and will post them within the next day or two. In the meantime, enjoy this:

Belated Merry Christmas from a student nurse!

FIRST DAY OF CLINICALS EVER!

Basically all of my morning led up to clinical. Or at least that’s how I felt. I was not nervous or anxious until I went searching for my ID badge. For some reason I had slipped it into the front pocket of my backpack and skipped over that pocket until about a minute before I was supposed to leave. My frantic search built up my anxiety for the evening ahead and arriving early definitely made it worse. Fortunately there was a chapel nearby so I took a moment to duck in and say a quick prayer.

 

Anyway, there was no need to worry. The nurses, CNAs, and staff were more than accommodating and many of the residents we encountered were encouraging and glad to have us there. Clinical proved itself to be an integral part in our education – for instance, I knew the steps to transfer a patient, but in actually doing it I realized sensitivity and forethought must accompany the steps. Thoughts such as adjusting pillows before seating a resident or scooting the resident back in the seat to make the resident more comfortable are simple things that one may not think about when learning from a textbook or practicing on a fully functional partner.

 

For fear of HIPAA and falling asleep at the keyboard (it has been a very long evening), I will cut myself off here. I hope to share more of my thoughts about and adventures in clinical in the future!

How Not To Make A YouTube Video

In filming a video, it occurred to me that YouTubers have to have a certain knowledge or awareness about how they want everything to look. As a novice, I had no idea about lighting, background, or sound or how I wanted my video to look. So of course, I winged it! This was my setup yesterday. I used the tips on vlogging given on Jacksgap.com to help set up my video. 

The purpose of my video was to share my summer favorites. I thought it would be a simple video to start off with. Unfortunately, I was wrong. It was more difficult than I anticipated to remember all the things I wanted to say about a certain product – and since I don’t like reading off a script, I used a lot more space-filling words than I wanted (things like “umm,” “yeah,” “so,” and “okay”). Fortunately I enjoy editing, but it was still a struggle to get comfortable in front of the camera. I pretended that I was talking to a friend and it helped a bit. 

 

 

Anyway, I’m glad I tried making a YouTube video. I know I’m not the best at it, but I had a lot of fun making and editing the video. I’d love to make more – I just don’t know when that will happen. Maybe I should simply vlog – my life is normally like the bloopers at the end of the video, so at least that will keep viewers entertained.