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Saturday, July 29th, 2006There are three types of people that read this blog: nurses, soldiers, and bloggers. Then there is my one lone family member that is internet savvy. This might not interest the latter categories of people, but every nurse has his or her NCLEX story. Here’s mine.
On July 21, I had orientation at my place of employment during the regular business day. My NCLEX was scheduled for the next day in Santa Maria, a town two hours southwest of Bakersfield. After work, I rushed home in the 105 degree heat, threw off my scrubs, put on a comfortable t-shirt and shorts, packed up a days worth of stuff, and jumped in my car to head out of town.
Highway 166 is the road that takes you into Santa Maria. It has two passing lanes right at the beginning, then it is a two-lane road for about 80-100 miles with only one place to stop to take a leak along the way. Cars moved at a reasonable speed throughout 166 to my great luck. It was pretty darn hot on this strip through mountains and sun bleached grass.
I hadn’t been to Santa Maria in years, and was not familiar with the place. I had made reservations at a hotel that was on the same street as the testing center to avoid confusion or consternation on my part. Upon arriving in the city, I drove past my hotel and then over to the testing center to make sure I knew where each was in relation to each other.
I picked a hotel off of Google Maps that sounded respectable and was near the testing center: The Historic Santa Maria Inn. It was opulent and a little pricey at $122/night. I didn’t want any hassle so I forked over the money. My room was nice. I had plenty of hot water, coffee and pot provided, a comfortable bed, alarm clock, and cable TV. I was able to watch a couple episodes of the best show on television to calm my nerves.
That’s something that is unavoidable. You will be anxious before this test and that can be anything from puking and crying to just a general feeling of unease. The latter feeling marked the night before and the hours leading up to my test at 0800. I started thinking of the test as an appointment to be met. I went over some concepts from the different areas of nursing in my mind. That was the extent of my studying; I did not use a book. Basically, I let myself become numb to keep my sanity.
I walked across the street and had a tri-tip sandwich at a steak joint. Since I was dining alone, they had to sit me in the lounge where people were having fun and drinking. As the night progressed, I looked out my second-floor window and could see people walking around, getting ready to enjoy the Friday night festivities. I wished I could join them instead of getting up at the crack of dawn to take the most important test of my life. I took a shower, watched some TV, and hit the sack.
I woke up at 0500. I wanted to make sure I took care of some things before the test: take a shower, drink some coffee to cover my caffeine fix so I wouldn’t think about coffee during the test and also to give myself some time to piss a few times from the coffee’s diuretic effects. All the advice I had heard recommended eating breakfast before the test, so I walked across the street to a Perko’s Café and had a bowl of oatmeal. I didn’t want anything greasy because with the general feeling of anxiety, I didn’t want the grease and spice to give me stomach and digestion problems (if you catch my drift).
Eventually, I drove down to the testing center. The small parking lot was empty. I walked up the stairs to the Pearson office on the second floor. Pearson is the company that has the contract for the NCLEX-RN. There are testing sites all over California, but none in Bakersfield. That’s why I had to drive to Santa Maria, it is the closest one.
The second floor of this office building was non-descript, a long hallway with plain wooden doors and placards listing business names along either side. I walked through the Pearson door and entered the small waiting room with a handful of chairs. There was a receptionist waiting, as well as a redheaded lady. I knew she was taking the same test as me, because I could sense her angst.
The receptionist was friendly, but Pearson has a security procedure that rivals NORAD. With a friendly smile, she asked to see my driver’s license, then had me sign my same on a bank sensor with a stylus “as close to the DL signature as possible.” She took my fingerprint on an electronic sensor, and then had me sit on a chair to take my picture. She gave me a printed disclaimer and a locker key. Everything had to go into the locker, minus my ID. The test administrator was waiting nearby.
The TA was an older guy with a mustache. He pointed at the directions: raise your hand to leave the room or if there was a problem. He told me that I had to have a fingerprint taken, and show my ID every time I entered the room. Then, he took my fingerprint, looked at my ID, and escorted me into the testing room.
Again, the room was non-descript, about the size of a living room with nice, blue, office carpet and about ten cubicles with glossy black Dell computers in each one. The TA sat me next to the redheaded lady that was already taking the test. He gave me my black and white scratchboard and a Sharpie pen and told me to start the test whenever I was ready.
So I did, earlier than 0800. I stared at the black Dell computer and keyboard, and maneuvered through the plain text tutorial for the NCLEX-RN with the nice black computer mouse. A box told me that the tutorial was over and asked if I would like to start the actual test. YES OR NO? I clicked yes, and started my strictly kidney punch asskicking.
I had heard that the first question was easy, maybe to get you comfortable with the test, or maybe to start the computerized adaptation. That’s what the NCLEX is, a computerized adaptative test (CAT). You answer a question. If you get it right, you get a harder question that take you to a higher plain. If you get it wrong, you descend by getting an easier question. Depending on how many questions you are getting right, or wrong, the computer decides how much you “meet the standard.” You get at least 75 questions. You must at least see that many questions, even if you answer every single one correctly (or incorrectly). Between 75-265 questions, the computer continuously judges whether or not you meet this enigmatic standard. When that standard is met, the computer shuts off and the test is over. You also have a six-hour test limit. If you don’t see 75 questions in six hours, you fail.
Whatever the case, I don‘t remember what the first question was, but I do know that it was not that easy. I started answering questions, plain black text on a white background screen with radio buttons next to each of the four answers. There are other types of question formats: fill in blanks, click multiple answers. I did not see any of these. All of my questions had standard radio button answers.
The questions were beyond “meat and potatoes” nursing. Scenarios, scenarios, scenarios involving prioritization and delegation.
“You are a charge nurse. You have these four patients. Who do you give to the LVN over the RN?” This could be in a psych, maternity, or ICU ward.
“You are a home health nurse. These four women delivered yesterday. Who do you call first?” Then four scenarios. This could also be a question about sick kids – a peds question. A home health nurse that gets a call about four sick kids.
Over and over. Over and over. Infection control. Casts. Priority and delegation questions until my eyes bled.
There really aren’t any cut and dry questions where the answer is obvious. At around question 60, I had to use the bathroom. I decided to wait until question 75 to see if my computer shut off, ending the test. At question 75, the computer kept running. At question 85, I finally raised my hand and had the TA let me out of the room so I could take a leak.
I came back and kept answering questions. I went past 100…150. The computer offers you a break every 1.5-2 hours. I declined them. The redheaded lady left. People who had arrived to test after me left. The questions kept coming and I started at the computer screen, trying to get myself as comfortable as is possible when you are sitting in front of a computer for hours relentlessly.
I started to become slightly delirious. “HA, it doesn’t matter what I answer! The questions will just keep coming! HA HA!!!”
And they did. The questions passed 200. I knew then that I was in for the long haul, the whole enchilada. My computer went through all possible 265 questions. Minus my 5-10 minute pee break, I sat and stared at that computer screen for four solid hours answering nursing questions.
After the test, I walked downstairs to my car, still numb and a little shaky. I wished that I had eaten that big greasy breakfast of biscuits and gravy. I felt like I burned up that oatmeal glucose about two hours before.
I wanted to get back to Bakersfield. I got stuck behind a slow-moving big rig throughout the entire run of 166. I stopped at Wendy’s on Panama, bought a combo meal, and woofed it down on the way home. I took a three-hour nap on my couch, and then the waiting began. The nerve-wracking wait.
I had heard that the CA BRN has your results on the computer within two days. Some nurse told me that he had taken his test on a Saturday a couple of years before and that his result was available by early Sunday morning. He is obviously full of shit. I worked Sunday and checked the BRN website for results. None. Monday at work, the same thing. Nothing. I was off Tuesday and Wednesday. I checked upon waking up, throughout the day, and before I went to bed at night. I was convinced that I had failed the damn thing. 265 questions, obviously I didn’t kick its ass.
I told my friend Yomama about this Wednesday night.
“You got your results in two days, didn’t you?”
“No, you dummy. It was two weeks.” I felt better.
Thursday, I had to work again. On a whim, I decided to check the BRN website even though it was 6:30 in the morning and the BRN wasn’t open yet to update results.
After repeated viewing throughout the week, I had memorized that there were sixteen Rusks that had RN licenses in California. I noticed on this morning that there were now seventeen. I scanned quickly, and saw my name on the bottom of the list. I practically got down on my knees in effusive praise and joy. My opportunity to celebrate was short-lived, however. I had to be at work in twenty minutes.
I wrote down my license number on an index card. I guess that was my de facto license, a solitary six-digit number written with a black Sharpie on the blank side of an index card.
At work, people started asking me how the exam went. I told them that apparently I passed and showed them my index card. I got hugs and a lot of congratulations. My preceptor sent me down to the nursing office to notify them on my success. They had me call Human Relations. Both offices congratulated me. My preceptor started referring to me as a “new RN.” I started signing my name with just those two letters: RN. It was and is kind of dreamy. You show up to work one day as an RN with a license that is twelve hours old, yet still valid.
Some of my old classmates asked me about the test. I told them to just take the damn thing as there is no way to avoid an asskicking. No matter how much you study, how well you feel prepared, you will get your ass kicked by the NCLEX-RN. I’m convinced that it is nursing’s version of hazing. Old nurses writing tough questions to kick the asses of us plebes, us knobs, newbies. That’s why every nurse has his or her NCLEX story.
Now all I have to do is learn how to work the damn PCA machine.
