The Comprehensive Predictor seemed a lot scarier than it actually was. I was more than prepared, and I must say that I did, in fact, rock it! In fact, our entire cohort passed on the first go. ‘First time in the history of our program. Go us!

If we hadn’t worked our arses off the last 18 months, it probably would have been a much a different story. So in that way, believe the hype. Nursing requires critical thinking and intelligence.

But on the other hand, trust that you’re going to learn what you need to learn. I can’t believe how much information they have crammed into my brain. But it’s sticking and I’m kinda amazed at the crazy nonsense I can rattle off.

So the hard part is over…

There is one clinical shift standing between me and turkey.

There are three post-turkey clinical shifts, an annotated bibliography, and a paper (most of which is already written) standing between me and the completion of my pre-licensure coursework.

There are one fingerprinting fiasco, a $200 test registration fee, and goo-gobs of flash cards standing between me and the NCLEX-RN.

There are mountains of job applications, resumes and cover letters standing between me and gainful employment.

This is an odd version of the 12 Days of Christmas. But I’ll take it!

Need I say more???

Headed to campus and the basement computer lab that will signal my doom…er, joy…er, fate…

Oh hell, I know this stuff. We’ve certainly been well prepared. I just need to not let my anxiety get the best of me. And read the questions carefully. And take my time.

Hope to have good news in a few hours… Wish me luck!

P.S. Stay tuned for a post on the hullabaloo over mammogram guidelines. It’s been a big topic this week in the news and I have a few thoughts. They’ve just been overshadowed by other priorities.

P.P.S. Stay tuned also for some exciting news regarding my interest in peds palliative care. I had a very productive meeting with a very helpful contact on Tuesday and came home jumping out of my skin!

One of my friends has dubbed the ATI Comprehensive Predictor our program’s “exit exam”. That’s a really good way to look at it, especially considering we’re not eligible to take the NCLEX until pass this 185-question monster.

Which begins tomorrow at 0800. I’m amazed I have fingernails left.

I was going to take one more practice test tonight, but I decided that it would make me completely freak out if I scored lower than last time. And I do NOT need to have a nervous breakdown less than 12 hours before the real thing. So I will take a Melatonin (my Godsend for early bedtimes and earlier mornings) and tuck myself in with my drug and lab values flashcards until I pass out.

I’ll be waking with the roosters and fitting in a little Tae Bo action to get the heart pumping and the blood circulating. It seems fitting to visualize giving this test a knockout punch.

May visions of CVP values and theophylline levels be dancing in my head…

Phew, glad that’s over with!

The oral comps were a lot less painful than I feared. Of course, I was lucky enough to have two of my favorite professors as my “panel”, so that helped.

I was especially excited to learn that not only did I pass those puppies, but I passed with distinction! I had been hoping that might happen, but by the time Friday rolled around, I was just focusing on getting through it without requiring a benzo.

Quantitatively the difference is five extra points in my comprehensive review class.

Qualitatively, it’s a much bigger deal to me. It means that I was able to think “big picture” and demonstrate growth as a nurse when I described the nursing school outcomes and what they meant to me. It also gave me a huge confidence boost going into job interview season.

This week is featuring furious studying for the Comprehensive ATI (Friday at 0800…pray for me!) and furious writing of my ethics paper (also due Friday). Nursing school is nothing if not a lesson in time management.

But the light at the end of the tunnel is in sight…

The next 7 days are going to be critical to beginning the end (does that make any sense? My brain is mush).

Tomorrow are my oral comprehensives. I sit in front of two faculty members and tell them what our nursing school’s program objectives mean to me, plus provide examples from my class and clinical experiences. Not daunting at all.

Ha.

A week from tomorrow is my ATI comprehensive exam, which apparently predicts our likelihood of passing the NCLEX. We have to pass at a certain level for the school to release our names to the state board of nursing. If we don’t, we have another chance to retake in December. If we don’t pass that, we have to take a review class at our own expense and pass an assessment before they release our names.

The good news is, I took a practice test before I started my study plan in September and another practice test today. My score increased by 9 percentage points! And I’m in the range of passing if I were to take the test today. But I still have to buckle down and take my studies seriously for the next seven days.

The home stretch is here, folks.

Now I just have to become gainfully employed. Which will be a challenge considering they cancelled the internship I was invited to interview for.

Welcome to the real world, Nurse Teeny!

I had a dream last week about one of my first capstone patients. The one who asked me if I knew what I was doing.

Come to find out today that she passed away…last week.

It hit me. Hard.

Maybe I was so affected by it precisely because I thought I could “handle it”. Maybe part of “handling it” is actually letting myself grieve. I’ve been looking ahead to a career in pediatric end-of-life care for so long that when people asked, “Won’t that break your heart?” and I answered “Probably,” I never stopped to think about how that would actually feel.

She was at home when it happened. I hadn’t seen her in over a month. But she was apparently still in my heart and on my mind until the day she died, and beyond.

It sucks. But if I didn’t feel it profoundly, perhaps I shouldn’t be doing this work.

Nurse Teeny is thus far 1/1 in job application success! I had a voice mail awaiting me after class on Friday afternoon, inviting me to interview for the Med-Surg internship! I am beyond thrilled!

The process was not without its share of snafus, however. I got an automated e-mail from the hospital on Monday saying I did not meet their minimum qualifications. As if!

I triple-checked that job description and I was not going to take “No” without a fight.

I think the snag was that the job posting said “BSN required.” I do have a baccalaureate education from my previous degree, but because we already have that undergrad degree, our program skips the BSN. We take the pre-licensure curriculum and become licensed as RNs through a special agreement with the state board nursing, provided we continue our education and get our MSN.

The problem is, one of the questions on the application was “Will you have a BSN by Winter 2009-10?” I had to answer “No” because I won’t, even though I DO have a Bachelor’s degree (cum laude, even!). Since it was an online application, my response was automatically flagged for a rejection.

So when I got my “Thanks but no thanks” message, I immediately e-mailed the nurse recruiter and explained the situation. She made sure I’d be taking the NCLEX in time for the internship and agreed to pull out my application for review. Four days later I got the call for an interview!

The moral of the story is: Persistence pays off! Especially in the era of online applications, it’s important to make a personal connection and be assertive when applying to jobs for which you think you’re qualified. Technicalities can get you flagged for elimination during the first cut, but make sure you do your homework and confirm with a human being.

Next on the agenda…Meet with my capstone unit nurse manager. The stated purpose is to pick her brain about the role of management, but you can bet I’ll be bringing my resume, cover letter and references with me too!

I am officially halfway done with my capstone rotation and decided to commemorate the occasion by working three shifts in a row this week. Man, that is brutal.

It’s interesting how different each shift can be. Day 1 was a little overwhelming (as the first day after a long stretch off can be). Day 2 I felt like I was on the game and could take on the world. I was delegating to my preceptor and assumed almost total care for 2 of our 3 patients. I even had time to take a break!

And I bonded with an adolescent girl with osteosarcoma whose cancer had spread to her lungs. Her family had just decided to change her code status to DNR (Do Not Resuscitate). We were trying to keep her as comfortable as possible. When she found out I was taking my boards in December, she said she’d come back to the hospital and congratulate me. It broke my heart.

Day 3 was hell on earth. For some reason the stars aligned to produce a complete cluster! Our three patients all ended up being more complicated than we had anticipated. A different nurse’s patient had a crazy scary Ativan reaction right before being discharged. Because his nurse was super busy, my preceptor and I ended up helping.

Then we had a chemo spill 30 minutes before change of shift. Luckily it was more of a splatter, but the protocol for cleaning up is quite intense. 15 minutes later, another patient pulled apart his IV line, right as the lab called with critical values that needed to be reported to the resident on duty. His response when I brought the values to him pretty much summed it up: “Sh*t.”

I didn’t get out of there til past 2000 (that’s 8 p.m.). It was the first day I felt like crying because I was so overwhelmed.

But tomorrow is another shift. And I’m ready to go back for more. Just gotta keep pluggin’ along.

Today Nurse Teeny turned 29. One more year as a twentysomething!

To be honest, I won’t miss the twenties. A lot of stuff went down and I’m happy to report that the next decade looks much more promising and full of moments to look forward to. As does the next year!

In honor of my birthday, I applied to my first RN job!!! It is a new grad med-surg internship at a hospital about 45 minutes away, starting in January. There is not really a nursing shortage in my city thanks to an economy in the toilet and the 10+ nursing schools that feed into (read: saturate) the local job market. So they encouraged us to think outside the box and look for positions not in the immediate area or that may not be our first choice but would allow us to build up our skills.

So I did.

There are four specialty areas we can request in the internship: oncology, general medical, general surgical, and surgical telemetry. My first choice was obviously oncology. That was a no brainer! If I can get hired into hem/onc whatever the patients’ ages may be, I’ve got one foot in the door.

I decided to go with surgical telemetry for my second choice. Basically pre-op and post-op patients who are on cardiac monitoring for one reason or another. The heart has always fascinated me! And I’m intrigued by the challenge of learning to read EKG strips really well.

My references are awesome – my advisor/professor who also happens to be our dean (score!), my current preceptor, and the medical director of the free clinic where I used to work. The job posting also did say they’ll give preference to a high GPA, and my grades have been good. So I’m feeling confident that I’m at least as qualified as the next person.

The one thing that makes me nervous is that the position description said “BSN required.” I will be taking the NCLEX in December but I won’t have my BSN because my program skips that step and just gives us an MSN when we finish everything in 2012. I obviously have a baccalaureate education, so hopefully they will take that into consideration. But it made me nervous to answer “No” to the question, “Will I have a BSN by Winter 2009.” Keep your fingers crossed on that little detail!

So there you have it. My first job application as a nurse is in! This is starting to feel very real all the sudden…