Tag Archives: nursing student

Nursing Students – Alternate Item Format Got You Down? I Recommend. . .

Strategies for Alternate Item Formats on the NCLEX-RN Exam, by Silvestri and Mojica (ISBN-13: 9781416038412) is the best resource I have found for tackling the dreaded SATA (select all that apply).  You know’em, and you hate’em.  I have never encountered one nursing student (or a nurse, for that matter) who LIKES these types of questions.

And, guess what?  They don’t end with nursing school and the NCLEX.  No siree. . .turns out RN-BSN programs love’em too.  Yay.

So, I present to you a link for purchasing this resource, dirt-cheap at Bookbyte.  Unfortunately pour moi, I am paid nothing for selling their stuff, but frankly, the warm, fuzzy feeling in my heart that will come from knowing that someone listened to me, took my advice, and had a less hellish time in school/NCLEX/RN-BSN program will be enough.  (Yes, I am being unduly dramatic.  And, guess what?  I don’t care.)  Because I bought this book as an impulse buy (much healthier than my usual gazillion-calorie latte as an I-love-me indulgence).  I loved it.

My hilarious classmate (loved the way he would say, during study sessions in the library – “Damn you, (insert nursing instructor’s name here) I hate your questions!  This is shit!” (imagine Russian accent) at the top of his lungs – well, he loved this book too.  Another classmate who failed NCLEX the first time around and then slayed it – partially, she said, due to this book – loved it.  Now the book lives on, humbly serving this year’s second-year nursing students who suffer after us.  I’m sure it will continue to be passed on.  You need this book, nursling.

If you don’t heed my advice?  I’d better not catch you complaining about SATA questions (except to say that, darnit, there were not NEARLY enough SATA questions for me when I took the NCLEX).  Said no nursing student, ever.




Dutch Apple Cake


Maybe it’s that I’m no longer being actively tortured by nursing school (online BSN program is keeping me busy, but I no longer lose 5-10 hours/week driving to/from campus and/or clinical) – I’m rediscovering my love for baking, particularly recipes I haven’t made since, oh, MTV was cool.  Here’s one of my favorites:

Dutch Apple Cake – recipe cheerfully liberated when I was a teenager from my mother’s ancient Better Homes and Gardens cookbook. (Reading under the covers with a flashlight so I wouldn’t get caught with it. You’re welcome.)

Preheat oven to 400 (375 convection)

1 cup flour
1.5 tsp baking powder (I use Calumet)
0.25 tsp salt
*sugar (as sweet as 0730, or 1930, depending on what shift you work)
*butter (you can use margarine, but I detest that stuff)
0.25 cup raisins (grapes that spent a wee bit too much time on the tanning bed)
1 egg, well beaten (like my spirit after nursing school)
0.25 milk (just regular milk, not the milk of human kindness-save that for work)
0.5 tsp cinnamon (do not inhale. this is bad. you might die.)
0.25 tsp nutmeg (couldn’t find mine today, not exactly a crisis)
3 cups peeled apple slices (although I think one could leave them peeled and be just as happy. In fact, research indicates one’s gut flora would prefer it, so they can party with it)

Mix flour, baking powder, salt and 2 tbsp sugar. Cut in 1/3 cup butter (Whoops, looks like I “accidentally” doubled that today. Was delicious, not sorry.) Add raisins and combined egg and milk, blend well. Spread in buttered (because you can never have too much butter) 10 x 6 x 2 (or 9″ round, or 9×9 or 8×8) pan. Arrange apple wedges fancily on batter (sneakily gobbling down any extraneous wedges while the dog watches, drooling). Brush with 2 tbsp melted butter, then sprinkle with spices mixed w/2 tbsp sugar. Bake at for 30-40 minutes. Cut in squares and serve warm. Yum!

Prospective Nursing Students – Some Articles of Interest

Nursing shortage?
Nursing shortage?

My baseline personality type is Golden Retriever/Optimist, so please keep that in mind when referencing the articles linked below.  But gosh-darn-it, I’m pretty grateful to have my acute care new grad position; not all graduates, particularly on the West Coast, are so fortunate (I hesitate to use the word lucky as I worked full-time as a hospital CNA and bypassed things like sleep, family, exercise and gardening to survive nursing school and get my proverbial foot in the proverbial door).

New graduates need to be aware that the nursing shortage doesn’t necessarily equate to a shortage of new graduate nurses, but rather experienced nurses, particularly those with a sexy specialty, such as OR, ICU, ED, L&D, etc.  New graduates are expensive to train. . .I estimate about $20,000-$50,000 per nurse (considering the new nurses compensation/benefits during the orientation period, compensation/benefits cost for preceptors, whether the hospital offers an RN residency program, hospital-based training classes, educator cost, etc. etc.).  *Note:  I have done zero research about this cost. . .just a good educated guess on my part.  Maybe it costs less, maybe more. . .your comments/references are welcome.

So, with that in mind, please read each and every one of the attached articles, prospective nursing students.  These are not meant to discourage you, just to allow you to enter into this adventure with your eyes open and living/lifestyle costs calculated, particularly if you are contemplating leaving an established, successful, remunerative career for nursing.  Obtaining a position is not automatic, no matter what your school’s recruiters tell you! It’s not that the schools are being dishonest, it’s just that they themselves are not actively looking for new grad RN positions, and they may not be surveying their graduates 4-6 months after graduation to find out what sort of nursing employment has been obtained.

Recalculating: The “Nursing Shortage” Needs New Direction

In Debt and Misled: New Graduate Voices on the “Nursing Shortage” (I wonder to what extent for-profit nursing schools and the push for the BSN play into this?)

Realities of the Current Job Market (What you, the nursing student and soon-to-be new grad can do to enhance your employment prospects. Like, be a CNA!)

Lastly, I recommend looking at the National Student Nurses Association website, which has information for current and prospective nursing students.

Sorry to be such a Debbie Downer, but I encountered these article links at the end of the new grad RN survey sent to me by NSNA, and I thought they were relevant.

Pinned. . .so now what?

I’ve earned the RN pin. . .the culmination of five years of hard work, lost sleep and intense caffeine consumption.  Our critical care director, probably one of the kindest docs around, and much beloved by our hospital’s nurses for the respect and admiration he has for the nursing profession, spoke eloquently, with just the right touch of humor.  A Nightingale ceremony, with an appearance from Flo herself (reincarnated), really capped things off.

So, one set of busted pumps, several beers, and a couple of deadly Fireball/beer cider dunkers consumed (imaging a cinnamon apple that makes one extremely tipsy), plus one barbeque (huh, who knew my classmates’ talents included keg stands? Impressive!), I’m contemplating the future to come.  There’s an NCLEX review class at my community college (a good deal at $200), plus some interviews (critical care and surgical units at my hospital). . .but what I really wonder is, what’s next?  Will I gain employment at a hospital without a BSN in my grasp? Can I hope for a critical care job?  Can I hope for any acute care job?  Does it really matter?

After a gut check (after the weight gain of nursing school/working full-time night shift, there’s plenty to check), I find that, no, it really doesn’t, as long as I have the privilege of caring for patients, in any care setting.  Long-term care, long-term acute care, acute care, community-based care, home care – I think any of them would work out, as long as I have the right attitude and the willingness to continue blooming where I’ve been planted. Til’ then, I’ll be happy to continue walking in circles for 12 hours a night, caring for patients within my scope.  The path will be there, I just have to take it when it appears.


HESI RN Exit Exam Musings

Hello, faithful readers!

I’m pretty relieved. . .passed the HESI Exit RN Exam with a score of 1091.  Since I only needed 900 to get the 10% of my grade for this term that was my goal, I’m quite happy.

You know what makes me even more happy?  Validation that my affordable 2-year ADN community college nursing program, and 2-year ADN programs nationwide, must do a pretty good job of teaching us not only the content we need to know, but also critical thinking skills needed to answer these damned questions.  According to my test feedback from the nice folks in HESI-Land, the average HESI exit score for students in the last 364 days for BSN students was 846, LOWER than the average for ADN students (847).  Okay, just one point difference, but that is my point. . .ADN nurses are as well-prepared to become brand-new, wet-behind-the-earns new grad nurses as those with the vaunted BSN.  (Interestingly, the average for diploma RN students was 852.  I wonder where one would find a diploma program these days – perhaps not on the West Coast?)

Well, whatever, I’m pretty happy, and glad that I’ve paid attention in class and read my books these last two years.  I also must give props to the supplemental preparation method I used (cheap at $25), the

Evolve Resources for HESI Comprehensive Review for the NCLEX-RN Examination, 3rd Edition.

While the questions on this internet-browser based resource tended to severely damage my self-esteem, they were useful for diagnosing my weak points (like knowing about glaucoma and a bunch of medications that I never saw in clinical or coursework, and, of course, as always maternity nursing.  I suck at that.) and made me a stronger test-taker.

So, if you are facing the HESI-RN or HESI-PN exit exams, I recommend Elsevier’s resources.  No, they don’t pay me a damned thing, but I still think these resources are bomb.

R.E.M. Daysleeper

Quit waking us up during the day!

Lyrics, so you can sing along in a grumpy, resentful, sleep-deprived fashion with the rest of us vampires who work nights:

Receiving dept. 3 a.m.
Staff cuts have socked up the overage
Directives are posted.
No callbacks complaints.
Everywhere is calm.
Hong Kong is present
Taipei awakes

All talk of circadian rhythm
I see today with a newsprint fray
My night is colored headache gray

The bull and the bear are marking
Their territories
They’re leading the blind with
Their international glories
I’m the screen the blinding light
I’m the screen, I work at night.
I see today with a newsprint fray
My night is colored headache gray
Don’t wake me with so much.

I cried the other night
I can’t even say why
Fluorescent flat caffeine lights
Its furious balancing
I’m the screen, the blinding light
I’m the screen, I work at night
I see today

Don’t wake me with so much. the
Ocean machine is set to nine
I’ll squeeze into heaven and valentine
My bed is pulling me.

Daysleeper, daysleeper.
Daysleeper, daysleeper, daysleeper


What to do? What to do?

Geehosiphat!  My final term – and nursing preceptorship – are flying by.  I realized it was time to update the ol’ resume, start putting in some job applications for when I’m all grown up and a real nurse, and to finish up some scholarship applications that I’ve been cheerfully ignoring.

I realize, the job market being what it is, that choosing a nursing specialty might not be my option, but that it will instead choose me.  I personally think I’d make a hell of a med-surg nurse – I actually enjoy meeting new friends all the time (but not at the turbo pace of the ER).  I realized that getting people excited about eating hospital food, getting them their meds on time, and making sure they are safe actually makes me happy.  Let me tell you about our pudding and jello options, folks!

Don’t get me wrong. . .I have loved my time in the ICU, and if I landed a critical-care job or new graduate internship I’d be wildly happy. . .but at the same time, the ICU doesn’t always afford a lot of chances to be joyful.  Every day, bottom line, you are guaranteed to be surrounded by people who are having a crappy time (at a minimum) and are possibly dying.  Yeah, yeah, I know death is part of life, blah blah blah.  Try telling that to little kids who just lost their mom or dad because they couldn’t sustain life and the grownups had to let go and turn off the pressors and the machines.  Tweakers who OD’ed trying to get out of bed and painting themselves with their own offal.  People who may never get out of bed again, period.  The sad, sad, futile sadness of some of it.  There’s just a lot, and it’s hard to describe it until one’s wallowed in a large ICU for some time.  Yeah, the machines that go ping! are pretty neat, and I know they save lives, but sometimes it’s a bit much.  (The ice cream parties for the staff, courtesy of the organ transplant coordination agency aint bad, either.)

My coworkers tease me sometimes. . .”Oh disorderlyCNA, sounds like a long-term care nurse in the making!”  So it’s not like there’s a betting pool, but some of my coworkers are starting to put down bets one where I’ll end up.  I will end up somewhere!  I’ve told them that if I’m still there as a CNA six months from now to kick me squarely in the ass!

Some think I’d be great in peds (they are insane!) or in the NICU (yeah, right. . .tiny sized critically ill patients sound so much better than adult critically ill patients!).  One of my managers thought I’d be a great psych nurse.  Really?  (Are you mad at me?  Writing me up?  Glaaahhhh. . .)

So, I guess it remains to be seen where I’ll end up.  So for the time being, I’m enjoying the learning opportunities afforded to me by my preceptorship, and acquiring the rest of the RN role.  Long way to go, though.


Cardiac dysrhythmia EKG Venn Diagram Fun

Well, it’s official, I have no life.  I even have the T-shirt for it (actually, I was so darn strung out from lack of sleep I accidentally ordered two.  Yay!  Clean clothes!)


I have a hard time wrapping my pea brain around cardiac dysrhythmias.  I can spot the pretty pictures easily, thanks to some time served as a tele tech and Skill-Stat, but the RN-type stuff – knowing causes, interventions just doesn’t go in sometimes unless I make a picture.  

So, here are my study aids for anyone on the interwebs to enjoy!

A-Fib vs. A-FlutterImage

First Degree Heart Block vs. Third Degree Heart Block



And, just in time for Valentine’s Day – V-Fib vs. V-Tach:


Blazin’ Fast Chicken Pot Pie for Two

So, it’s a little hard to afford Claim Jumper chicken pot pie when you’re making bank as a CNA. Yet, there it is, the craving for comfort food with only an hour to spare….the solution? This recipe!

Blazin’ Fast Chicken Pot Pie

Faster than a drug seeker in the ED with a call light, this yummy recipe is just the thing for a long night of studying or work!

1 – 10 oz can condensed cream of chicken soup
1/2 cup milk
1 to 1-1/2 cups frozen carrots/peas/corn vegetable mix or similar
1 can chicken breast (drained) or 1-1/2 cups cut-up cooked chicken
1 egg
1/2 cup buttermilk baking mix
1/2 cup milk

Note: to make this recipe more heart-healthy, use skim milk, low-fat baking mix and just the egg-white or Egg-beaters

Preheat oven to 400 degrees Farenheit

In a 1 quart oven-safe casserole dish, stir together soup and milk until thoroughly blended. Stir in vegetable mix, then microwave on high for 3 minutes.

In a small bowl, stir together egg, baking mix and remaining milk.

Remove casserole from microwave, top heated mixture with batter (will be a little runny, that’s OK). Place casserole in preheated oven, bake uncovered for 20 minutes (crust should be nicely browned).

Serves two quite nicely (or one hospital security guard, or one member of the Lift Team)

No More Cable Bill. . .Also Known As Saving Over $100 a Month

Guess what?  When you work as a CNA and are a full-time nursing student, you don’t have very much time to watch TV. 


So unless you absolutely must have ESPN, switching to free, over-the-air broadcast television, supplemented by a couple of other goodies, will help you save a bundle while still getting your Grimm on.  (Yay for a nationally broadcast series that not only gets the whole “Keep Portland Weird” vibe but also features a leading lady who is the niece of my CNA course teacher.)


How do you still watch football, OPB (yay for muppets and McNeil-Lehrer) and other stuff without cable?  Here is my personal collection (thank you husband for the research and installation) of components you can easily install to get back some of the features you’re giving up:

1.  The Mohu Leaf antenna:  this flat little insanely amazing piece of engineering goodness installs in seconds and has amazing range.  I use the amplified version of this indoor antenna (can be powered by USB or electrical outlet), but if you live in a major metropolitan area, you can probably get away with the original or the non-amplified HD antenna.  Price tag?  $38-74 plus shipping (about $10).  Look, just buy it, OK?  This company also sells a digital-to-analog converter box if your TV is not able to receive a digital signal. 

2.  Orca Antenna:  $70 plus shipping as charged (varies).  Advantages?  Looks like it came out of Star Trek, signal strength reception independent of whether it is mounted on/adjacent to exterior wall.  Disadvantages? Some assembly required, requires electrical outlet, makes husband feel silly for buying it.  You could mount it outdoors (have fun finding the needed pole/adaptor) or in your attic.  Or, you can be like lazee me and stick it on top of a bookcase and have done with it. 

3.  Channel Master CM-7000PAL Tuner/Dual DVR:  The other half bought this one through eBay. Someday, there will be no more from this source, as this particular model is no longer manufactured.  Features an easy-to-use channel guide and DVR recording setup.  This product was manufactured for DISH network; DISH has since switched to another product, but this one works extremely well!

4.  Subscription TV service of your choice.  Netflix (about $8/month) has been around the longest.  If you’re a procrastinator, don’t bother to add DVD delivery service to your account.  You’d be better off with a quick trip to the store or McDonalds to visit Redbox or Blockbuster’s vending machines.  Hulu Plus (about $10/month) is favored by others (different offerings).  Amazon Prime ($79/year) allows pay-per-view viewing. Beyond that?  Waaaaay more expensive!

Yeah, I’m spending my savings on movies at the theater (with beer, thankyouverymuch), more beer, textbooks, and support socks. 

Happy Idiot Box watching!