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.”
2. Practice
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.
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.
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.
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.
Practice Self-Care
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.”
