For nursing students there is one final hurdle after graduation to becoming a nurse – passing the NCLEX. The National Council Licensure Examination is the standard state exam that all graduating nurses must pass in order to start their career as an entry-level nurse.
It can be a stress-inducing time for a young nurse. But there are some things you can do while you’re still in nursing school to lessen the stress on exam day.
Follow these tips to prepare for test day.
1. Study All Through School
First and foremost, don’t wait to begin studying. Use your time throughout nursing school to prepare. “NCLEX tests safety competency and is not a test you can cram knowledge in a short period of time,” says Dr. Joanna Rowe, interim dean of nursing at Linfield College in McMinnville, OR.
Dr. Rowe says there are several study programs available including Kaplan, HESI, and ATI.
Another resource Dr. Rowe recommends is a PassPoint, which can be purchased for $100 for use on your phone or computer. “Students can design their own tests and they can select areas for the program to generate a test. Also, the National State Board of Nursing has an NCLEX study plan they can download that is very inexpensive.”
Dr. Rowe advises students to take practice tests in an environment similar to the one you’ll take the real NCLEX. That means no music, headphones, noise, or anything to drink or eat. Take your practice tests in a quiet, uncluttered space and take the whole practice test in one sitting.
3. Take Time to Review
“Review each question on the practice test even if you got it correct. Look at why you got it correct,” says Dr. Rowe. “Did you know the answer or guess at the answer and does your rationale match the rationale offered? If you got it wrong, why did you get it wrong? Did you not know the answer, read too fast, misread the question, knew parts of the answer but not in depth?”
Taking the time to review after your practice tests will offer key insights that will help you ultimately pass the NCLEX.
4. Take the NCLEX Right After Graduation
Finally, Dr. Rowe advises students to take the NCLEX within six weeks of graduating from nursing school. “The statistics are clear that students who take NCLEX within the first six weeks of graduation have a significantly higher pass rate,” says Dr. Rowe.
This week marks the 40th anniversary of Nursing Assistants Week and brings with it a great time for healthcare teams to reflect on how all the members of a team help it run smoothly.
This year’s theme for National Nursing Assistants Week is “Specialists in the Art of Caring,” and the theme is one that resonates with nursing assistants. Nursing assistants are essential members of the team and often work especially closely with patients who are disabled or elderly and live in long-term care facilities or are in rehabilitation facilities. They often spend their days caring for patients who may have very limited mobility or have severe dementia or other conditions that may prevent them from performing tasks for themselves. The hands-on care they provide helps people feel better and also provides the comfort of companionship.
Many nursing assistants are so devoted to the caregiving role that they will become certified in their field. The National Association for Health Care Assistants is also joining in the celebration by honoring certified nursing assistants who have taken the extra step toward professional development and education to become certified.
With nearly 1.5 million nursing assistants in the national workforce, the field is one that is growing and in need of additional professionals. With a high school diploma, prospective nursing assistants can gain additional training and certification through many local sources including community colleges and often the Red Cross. Nursing assistants have a physically demanding workload. They frequently move people all day long and so have to be especially careful about proper movement, getting help instead of hoping they can lift or move someone, and using available equipment to assist them in the physical tasks of the job.
Despite the rigor of the typical day, nursing assistants are especially devoted to the people in their care and strive to give them understanding and dignity at a time when they are especially vulnerable. The conversations they provide, even if they are one-sided at times, are an important and uplifting part of a patient’s day. Conversations about everything from the day’s weather to the political state of countries half a world away to comparing family traditions, all help take care of the whole patient, not just their physical needs.
This week is a time to call out the nursing assistants in your organization or on your team to thank them for the caring job they are doing. They are an essential part of making a team run, and because of what they do, the licensed nurses and physicians are able to take care of the pressing medical needs of the patient better, knowing the patient is comfortable and their needs have been met.
Honor this important direct care role by saying thank you to the nursing assistants in your organization and by holding events throughout the week to let them feel appreciated. Flowers, gift cards, a surprise coffee and cake or unexpected refreshments for them, and signs marking the week help make the week special, but can also start some important conversations about the essential teamwork and high-quality caregiving that goes on thanks to this important role.
Dealing with negative patients is never easy. They can monopolize your time, make you angry, and frustrate everyone they come into contact with. What can you do?
According to a number of experts, quite a lot.
“I approach patient interactions using the nursing process of assessment, planning, intervention, and evaluation. These steps are taken with patience and understanding,” says Cynthia Rochon, MBA, BSN, RN, Director of Nursing, Behavioral Health Services, Largo Medical Center. “In order to assist with a problem, you first have to understand the root cause. Never make assumptions because that can lead to more negativity. After gaining a clear understanding of the problem or patient care need, you provide an explanation of how the nurse can assist to remedy the problem or facilitate access to the resource who can provide further assistance. The last step is evaluation—validate that the patient has a clear understanding of how to follow up on directions that have been provided. Patient education is an important component of nursing care. When communicating with empathy, the patient experience will usually change from a negative experience into a positive interaction.”
Oftentimes, patients become negative because they are scared, says Jodi De Luca, a licensed clinical psychologist working in the Emergency Department at Boulder Community Hospital in Colorado. “Firm empathy and compassion are an example of setting structure and limitations. Be kind, respectful, and validate the patient’s feelings, but remain professional and clarify unacceptable behavior and/or unrealistic patient expectations.”
“Although it’s true we deal with these patients in the same manner we would other patients, it does take a lot of listening on our end to determine where the negativity is coming from,” says Debra Moore, RN, Director of Nursing of the BrightStar Care Edmond/Oklahoma City as well as the Midwest Region Nurse of the Year for 2017. “They could feel mad because they’re sick, missing a spouse from a recent death, or they may have just heard some bad news or had a frustrating experience in some other area of their lives. After we determine the cause, we talk with the patients and reassure them that we are going to care for them as much as they will let us. These patients may also need a lot of education on their diagnosis and what we can do to help. While it may take time for them to trust us, they will see that we are there for them and that they still have free rein over their lives. We honor them. It will take them sitting back and observing exactly what great care we can provide them. This will, in turn, help them relax and trust us in the end.”
Kristin Baird, RN, BSN, MHA, president and CEO of the Baird Group, is a consultant who coaches and trains nurses and nurse leaders. She shares two of her training points:
1. Suspend judgement and assume a neutral position.
By doing this, you position yourself for great empathy. Empathy is portrayed more through non-verbal behaviors than verbal, but both matter. When a patient feels you are showing empathy, they will have greater trust.
2. Use empathy statements and body language that will diffuse anger.
Try sitting by the patient, touching his/her arm or hand, and saying something like, “You sound upset.” By validating them with your words and showing compassion with touch, you are demonstrating that you care.
With a constantly evolving healthcare environment in the US, patients and their advocates have become concerned about their ability to access the drugs and medications they need. Pfizer has been offering assistance programs to help eligible patients gain access to the company’s medications for over 30 years. Their current Pfizer RxPathways program connects patients to more than 90 Pfizer medications for free or reduced prices.
To remind patients of the benefits available to them, Pfizer has posted company announcements on their social networks. The Pfizer RxPathways program has been put in place to connect eligible patients with a full range of assistance programs including insurance support, co-payment assistance, and free or discounted medications. Pfizer spokeswoman Sharon Castillo says,
“We’ve launched a national digital ads campaign to raise awareness of the support options we offer. We want to reassure Hispanic patients that, despite any changes in public health care policy, Pfizer is here to help them access their medications.”
From 2012 to 2016, Pfizer assisted over 1.6 million patients in receiving Pfizer prescription drugs for free or reduced costs. Patients can contact the call center to speak with Spanish-trained counselors who will address their individual needs and guide them to the appropriate programs and resources. Castillo is standing by her belief that, “Everyone deserves access to quality health care, and medicines are among the most powerful tools for curing, treating and preventing illness and disability in patients.”
To learn more about Pfizer’s RxPathways program, visit here.
One of the most exciting aspects of your nursing job search is receiving an invitation to interview. You impressed the hiring manager with your resume and cover letter. Now it’s time to impress them during your job interview.
Job interviews are nerve-racking for sure. But you can calm some of your anxiety by doing these four things before your interview.
1. Company Research
Reading through the job posting isn’t enough to prepare for an interview. Dig deeper and read through the organization’s website and any social media pages they have. Spend some time perusing their press releases to learn about new initiatives the company is working on.
Some companies also have an HR section on their website where they publish their employee benefits information and employee handbook. These documents will give you insight to help you determine if the company is a good fit for you.
Finally, be sure to read their annual reports from the past several years if they are posted online. These reports will give you a glimpse into the company’s financial health as well as key milestones achieved throughout the year.
2. Review Potential Questions
Don’t “wing it” when it comes to preparing for any job interview. It will pay off to spend some time thinking through the possible questions you will be asked as well as how you will answer them.
Be sure you can answer questions about:
- Your education and work experience
- Your strengths and weaknesses
- Your patient care philosophy
- Work/school challenges you have faced and how you worked through them
- Your short and long-term career goals
- Why you want to work for this company/organization
3. Prepare Your Questions
There will usually come a time during your interview when you will have the chance to ask some questions of your own. Be smart and have a few questions prepared. It shows that you’re invested in learning more about the job and company.
These questions will get you started:
- What is the training/orientation process?
- What is the nurse-to-patient ratio?
- What shift(s) will I likely work?
- How long do most nurses work on this unit?
- What career growth opportunities do nurses have?
- Describe your management style and/or management philosophy.
One warning: Don’t ask questions about salary or benefits during your interview. Save those questions for after you receive a job offer. At that point you know they want you for the position and you’ll be in a much stronger position to negotiate your starting salary and benefits.
4. Do a Test Run
One of the worst first impressions you can make is to be late for your interview. Mitigate the risk of being late by asking for directions to the interview site, including parking instructions. It’s wise to also do a test run a day or two before the interview so that you can gauge the time it takes to get there and park.
These tips will save you some stress and help you shine during your next job interview.
There are lots of health tips that men and women can both benefit from. Getting enough sleep and exercise and eating a well-balanced diet are some good all-around health tips everyone can use. But the genders have some pretty diverse health challenges. For example, did you know men die, on average, five years sooner than women?
Whether you are a man looking into your own health concerns or a woman with men in her life, Men’s Health Week (June 12 to 18) is celebrating its 23rd anniversary this year and comes right in the middle of Men’s Health Month. If you’re a nurse and a man, use this opportunity to talk to your male patients about the specific health problems men face and what to do to help prevent them or cope with them.
How can men make sure they are doing the best they can for their own health? Here are some pointers from the Centers for Disease Control and Prevention and MensHealthMonth.org.
One of the best ways to stay healthy is to get regular screenings for diseases and conditions that can be detected and therefore treated, early. Get an annual checkup so you can stay on top of your blood sugar levels, your weight, your cholesterol, and your blood pressure. Get a colonoscopy if you’re past age 50— earlier if you have a family history of colon cancer or if you have certain conditions that could increase your risk. Be sure a prostate screening is part of your annual exam and examine your testicles at least every month to notice any changes or lumps and bumps. Check your skin regularly for new moles or those that seem to have changed size, shape, or color. If you notice any unusual changes on your body, bring it to the attention of your physician.
Play Hard, But Play Safe
Whatever your interest—biking, running, flying, rock climbing—make sure you practice basic safety rules. Use proper protective gear and equipment. If you’re swimming, go with someone. If you’re hiking or camping, let people know where you’ll be. Bring along extra provisions and proper weather gear. Basic safety considerations can go a long way toward keeping you healthy.
Men tend to let their social relationships slide when life gets busy. With work and family obligations, it’s tough to carve out time with friends. But social connections and solid friendships can help ward off many health problems including depression, heart disease, and even dementia.
Make Healthy Choices
All the basic health tips hold true because they work. Eat a diet rich in fruits, vegetables, and plant proteins. Ease up on meats, cheeses, butter, fried foods, and treats like full-fat ice cream. Get daily or near-daily exercise. Get enough sleep. Keep your vaccines up to date. Use protection during sex. Don’t smoke anything, ever. Drink alcohol in moderation. Wear sunscreen. Protect your heart health (and keep inflammation down) by keeping your stress under control. Find help for your stress if you can’t manage it on your own.
Wear Blue to Start the Conversation
The Friday before Father’s Day is traditionally a Wear Blue Day, when anyone concerned about men’s health can wear blue clothing or blue ribbon pins to show support of Men’s Health Month. You can also give a shout out on social media with #MensHealthMonth or #ShowUsYourBlue.
Spread the word about men’s health during the month of June. You never know what kind of lasting impact a few words of wisdom might have,
Repaying nursing school loans can be a daunting task, especially if you have several loans carrying large balances. If you add in additional debt such as credit card debt and car loans, it gets even more complicated. Which loans should you pay off first? What’s the fastest way to become debt-free?
There are two popular methods for debt repayment – the debt snowball and the debt avalanche, and they both come with pros and cons.
Let’s say you have three outstanding debts – two student loans, plus a credit card. We’ll call them A, B, and C. With both the debt snowball and debt avalanche, you would:
- make the minimum payments on all three loans each month
- cut back and/or eliminate discretionary expenses (e.g. cable TV, eating out) so that you have extra money to pay towards your debt
- use any extra money in your budget to pay down your loans
For example, when you pay off loan A you would roll that payment into your payment for loan B until it’s paid off. Once loan B is paid off you would roll your payments for both A and B to pay off C. Eventually you will build a huge snowball or create an avalanche in loan repayments.
But the two methods differ in their approach in one key way: the order you repay your debts. Let’s take a look at examples of how each strategy works.
The debt snowball strategy was made popular by personal finance radio personality Dave Ramsey. With the snowball, you would list your debts from the smallest to largest balance and then pay them off in that order, one-by-one until all debts are paid.
For example, if loan A is $3,000, loan B is $5,000, and loan C is $12,000, you would pay them in that order, regardless of the interest rates. So even if loan C has a higher interest rate than loan A, you would still aggressively pay loan A until it’s paid off before focusing on loan C.
The theory of the snowball method is that by paying off the smallest loan first, you will gain momentum and experience success along the way. How awesome would it feel to pay off a student loan? With the snowball method you get to experience paying off the $3,000 loan much quicker than you would pay off the $12,000.
Many people have successfully paid off their loans using the debt snowball. But many others think the debt avalanche is the smarter way. Here’s how it works.
Let’s say you have those same three loans, but the one for $5,000 happens to have the highest interest rate. You would start your avalanche by paying the minimum payments on all three and then throwing any extra money at the $5,000 loan since it carries the highest interest rate.
The debt avalanche is all about the math. You could save thousands of dollars in interest payments using the debt avalanche. But again, you may have to wait quite a while before you experience any repayment victories.
Since personal finance is indeed personal, you should choose the method that you will stick with. If you choose to do a debt snowball you may end up paying higher interest, but if that’s the strategy that will keep you focused, it’s the best one for you.
Conversely, if you’re the type of person who is good at delayed gratification or you’re more motivated by saving money on interest, the debt avalanche would work best for you.
The key is to remember the importance of repaying your student loans and other consumer debts so that you’re free to make career and life decisions without being tied down by debt.
Summertime brings thoughts of slower days, languid days at the beach, and vacations filled with sunshine. Nurses don’t always get to match the ideal vision of a lazy summer, but that doesn’t mean that they can’t take advantage of this fleeting time of year.
Here are a few simple things to add to your summer 2017 bucket list..
Treat Your Feet
Your feet take a pounding – literally. Pamper them with a reflexology appointment, a pedicure, or just a good soak in bubbly warm water. Slather on peppermint foot lotion you stash in the fridge for extra relief. Spritz a cooling spray on your legs (make your own with water and essential oils). A barefoot walk on a sandy beach can also make your feet feel terrific.
Relax Your Neck
Your neck and shoulders probably feel like steel and nearly frozen in place with all the movement your day requires. Buy a heat pack you can warm up in the microwave or make your own with a long sock and some unhulled barley that you can pick up at the supermarket. At the end of a long day, it’s instant relaxation.
Be a Goof
Summer is made for letting loose a little. Skip with your kids, build a sandcastle at the beach, or rent kayaks and splash in the water for the day. Draw with sidewalk chalk. Have a picnic and bring hula hoops and a football to toss around.
Get Extra Sleep
A siesta is always refreshing and the restful effects can last for days. If you can spend extra time in bed in the morning or can hit the sheets a little earlier, you’ll boost your attention span, your mood, and your overall health.
Learn to Unwind
Nurses are never really off the job, so it’s sometimes tough to really relax. On those hot and humid days, grab a book or pop in some music and head to a cool spot. Be still and quiet and appreciate how different it feels from your typical work day.
Summertime food is special. Juicy fruits and plentiful veggies in all hues are at every corner farmer’s market. Pasta salads, potato salads, fresh salsa, and cold soups taste even better eaten outside. A flaming-hot grill waiting for all kinds of seafood, meats, and veggies (even watermelon can be grilled) can keep your kitchen cool and inspire you to try lighter foods. Take advantage of the bounty of summertime. And whenever you can, eat alfresco.
Don’t let the season go by without enjoying some quality time outdoors. Take a beach yoga class, walk with your friends or by yourself, take in an outdoor concert, watch fireworks, learn a new bike path, try a new swimming hole, or climb a mountain. Whatever you do, just being free of four walls is refreshing and inspiring.
What’s on your summer bucket list?
Many rural and urban communities face a shortage of qualified health professionals to meet the population’s needs. These underserved communities face unique challenges and nurses working in these areas need unique skills to meet those challenges.
What’s it like working as a nurse in an underserved community? What skills and qualities should nurses have in order to succeed in this area?
Amanda Buccina, BSN, is an RN for the Street Outreach Nurse Program for WellSpace Health in partnership with Sutter Health. She says that nurses should have a passion for working with underserved communities, possess strong coping skills, and understand the importance of self-care. She also notes that nurses working with underserved populations should be interested in and willing to make deep connections with people from all walks of life.
If you are thinking about pursuing a career as a nurse in an underserved area, these tips will help you succeed.
Understand the Culture
Erin G. Cruise, PhD, RN, NCSN, associate professor, Radford University School of Nursing, who has worked in public health and school nursing in rural areas and small hospitals for more than 10 years, says that nurses wishing to work in rural, underserved areas, and/or with vulnerable populations need to have a good foundation in clinical skills, organization, and communication. Cruise also emphasizes the importance of understanding the cultural dynamics of the community.
“Small hospitals and community agencies generally found in rural areas are often part of a close-knit community,” says Cruise. “People know each other and they want to know the nurse caring for them on a more personal level.”
Cruise says that new rural nurses can be taken aback by the expectation of openness. “Some nurses are not comfortable with having their personal lives become an open book,” she says. “It can be a thin line between patients just being friendly and curious and the nurse feeling that he/she lacks the privacy and anonymity found when working in larger agencies and big cities.”
People in rural or small town communities are also more likely to ask questions about private health information regarding their neighbors. “While neighborly concern and curiosity are usually quite innocent, nurses in these settings must be very careful and familiar with HIPAA and their own hospital or agency policies on confidentiality to avoid sharing that information inappropriately,” warns Cruise.
Build Strong Patient Relationships
A typical day for Buccina includes walking and driving around Sacramento, CA, meeting with patients on the streets, without the convenience of a full clinical facility. She works hard at building trust with her patients.
“A lot of my job is relationship building,” says Bucinna. “I work to build trust and rapport with my clients so even if they don’t need me in that exact moment, we have a relationship and familiarity with one another. I’m there when clients do want and need support, like medical advice, an advocate at a doctor’s appointment, help getting into an alcohol or drug rehab program, or just general wound care.”
Provide Judgment-Free Care
Cruise notes that many vulnerable people lack the resources that allow them to manage their health effectively, and nurses should be prepared to meet these patients right where they are, without judgment.
“They may have low literacy, live in poverty, live in environments that are polluted, run down, or crime-ridden; and work in jobs with low pay and dangerous conditions,” says Cruise. “People in these situations will pick up on a disapproving attitude by the nurse and shut down, shut the nurse out, and be less likely to follow his or her health care directions. Nurses should adopt a caring approach. While not condoning negative or criminal behaviors, accepting clients as they are and demonstrating concern for their health and well-being are more likely to motivate them to listen to the nurse’s advice and make positive changes.”
Jan Jones-Schenk, national director of Western Governors University’s (WGU) College of Health Professions and chief nursing officer for WGU, encourages nurses working with underserved populations to avoid making assumptions about their patients.
“Don’t label or assume individuals who don’t follow prescribed advice are non-compliant,” says Jones-Schenk. “There may be financial, social, physical, or cultural reasons why individuals do not follow the advice given. In such cases, the problem can easily be that it’s the wrong advice for that patient. Taking a patient-centered approach means the advice given has to be something the patient thinks makes sense too.”
Jones-Schenk advises nurses to remain open to listening carefully to understand the barriers and limitations individuals may be facing.
Gain Mental Health Experience
Buccina says that her best advice for nurses considering working in underserved communities is to gain some experience in mental health in order to understand human growth and development from a psychological perspective, and to become well-versed in social issues in order to avoid judgment and approach the population from a place of knowledge and compassion.
Finally, Cruise advises nurses working with vulnerable populations and/or in rural areas to find the time and space to take care of themselves.
“Because these communities are close-knit and vulnerable populations, they may mistake the nurse’s caring approach for a desire to have a more personal relationship. The nurse will have to set boundaries in a way that is kind and not perceived as rejecting of the client, yet allows the nurse to be seen as a professional and not just a friend,” says Cruise.
The American Association of Critical-Care Nurses held its annual National Teaching Institute and Critical Care Exposition this week in Houston, TX. During the four-day event, 25 acute and critical care nurses were presented with the Circle of Excellence Award, recognizing their efforts to achieve optimal patient outcomes.
Jose Sala, night nurse manager, surgical and liver ICU at Houston Methodist Hospital, was among this year’s honorees.
“I feel so honored and privileged to be a recipient of this prestigious award,” says Sala. “I consider it one of my most rewarding accomplishments. I dedicate it to my family, my former professors, and preceptors, and most importantly, the patients whom I’ve cared for at the bedside during the past nine years. They have been my best teachers.”
Sala earned his BSN in 2012 from the University of Texas Health Science Center at the Houston School of Nursing and feel in love with critical care nursing during his capstone preceptorship in a general medical/surgical trauma ICU in South Texas.
“I was awed and impressed by how knowledgeable my preceptor was about pharmacology, pathophysiology, and patient management,” says Sala. “I saw how she was such an integral part of the critical care team, and how she had finesse, confidence, and a strong rapport with the surgeons and intensivists and all the other professionals in the unit. That two-month period played a seminal role in my journey in critical care.”
In his current role as the night nurse manager in the surgical and liver ICU, Sala has had the opportunity to work on initiatives that have improved not only patient care, but the overall work environment for his team. These initiatives led to his Circle of Excellence award.
He is most proud of his work to develop “flash rounds” in his unit – an initiative that directly impacts patient outcomes.
“Together with Dr. Atiya Dhala, one of our intensivists, and with the support of my director, Michele Ramirez, I implemented what we called “flash rounds” in our unit that focused on the ABCDEF bundle,” explains Sala. “This bundle aims to prevent the unintended consequences of critical illness, including delirium, prolonged ventilation, and excessive muscular deterioration. Every morning, at 8 a.m., each and every bedside staff nurse presented their patient to the team – the intensivists, nurse practitioners, residents, physical therapists, and respiratory therapists – as they rounded on the whole unit. Strictly focusing on these components and separate from teaching rounds, the flash rounds set the tone for the day for the team. This was not only met with much enthusiasm and support by most of our staff, but it also helped increase the mobilization rate, decreased our self-extubations, and reduced our ventilator days.”
Sala has also worked hard to improve his unit’s work environment.
“One of our key challenges in our unit was the rocky transition of our new graduate nurses (GNs) into clinical practice,” he says. “I mentored a group of GNs whose project for their nurse residency program was to create a buddy program that paired upcoming GNs with a buddy (who is a different person from their preceptor). This allowed them to integrate more easily into the culture and fellowship in the unit.”
Sala offers this advice to aspiring critical care nurses: “Work hard and study hard, and don’t lose sight of your goals. When you do rotations in nursing school, or work in any unit, find key mentors who can either directly guide you in the process of becoming a critical care nurse, or introduce you to people who can. Be inquisitive, read widely, and always ask questions.”