Tag Archive for NCLEX

Confessions of a Nursing Student

Aaron Montgomery, BSN Junior, BUNDLE Scholar

It was cold. It was 5 a.m. so the sky was still pitch black.  There was not a single car riding through the streets.  I had never seen that stretch of road so empty.  I sped up my walking pace to make sure I didn’t arrive late.  The first day was here and I was determined to make a good impression.  I had a feeling that I was forgetting something so I did ongoing checks to make sure I had my supplies: white shoes, watch, stethoscope, blood pressure cuff, and pen.  I started going through all the skills I had been taught in school.  There was no way I was going in unprepared.  As I approached the building, a feeling of nervousness took over.  I took a few seconds to calm down.  Then it was time to go in.  This was my first day of clinical and it was time to get started.

Looking back at that first day in October, it’s hard to believe that I was ever that nervous for clinic.  My first clinical experience has hands down been the best part of my first year of nursing school.  Early in the semester I had a hard time adjusting to the struggles that came with the program.  I had to get used to life in a new city, a new college, and professional school.  I wasn’t used to a full class schedule in addition to clinical experiences.  I didn’t know how to condense the seemingly infinite amount of information down to pass a 50-question exam.  And most of all, I thought I would never get an NCLEX style select-all-that-apply question correct. Ever.  But never once did I second guess my decision to go into nursing.  However, it was hard to envision all that hard work paying off. But that changed when clinical began.

During my first day, I was assigned to a patient in his mid-fifties who was recovering from a stroke.  I started the shift by giving him a bed bath.  Up until that point I had always taken for granted my own ability to bathe myself.  It was truly an honor to help someone perform such a simple but personal task.  After he was ready for the day, I accompanied him to radiology for a swallow evaluation.  I had only read about this procedure in textbooks so I was excited to get to see it in practice.  At the end of the shift, I went with my patient to therapy.  I got to see how the therapists transferred patients from their chairs, helped them walk, and assisted them with their daily activities.  This became valuable during later clinicals when I had to help move larger patients.  I stayed busy the full day.

Then it was time to meet with our clinical group to discuss our day.  My instructor was very direct and open about the expectations she had for us.  She didn’t hesitate to tell me the areas in which I needed improvement.  I worked on those areas, which improved both my confidence and competence.  It was time to leave for the day.  I walked out and instantly started thinking about the following day and how much I dreaded the idea of returning to class.  It hit me that not once during my shift did I think about school, or any of my other struggles.  For those eight hours I put my needs aside and focused on my patient.  There was no doubt that this is what I wanted to spend my life doing.  So far nursing school has had its share of struggles and triumphs, but I wouldn’t trade the experience for anything.

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Aaron Montgomery is a junior in the traditional BSN program.  Originally from Torrington, Connecticut, he moved to Atlanta to attend Emory following four years in the military.  He is part of the BUNDLES program and is hoping to serve as a Student Ambassador for the 2017-2018 school year.

Preparing for the National Council Licensure Examination (NCLEX)

Simulation Poster 015After completing nursing school, every practical nurse (PN) and registered nurse (RN) in the United States must first pass the National Council Licensure Examination (NCLEX) to obtain a license. A final step in the journey toward practicing as a nurse, the exam is designed to test essential knowledge and skills necessary for safe and effective care. While preparing for a comprehensive exam, like the NCLEX, can be challenging, Dr. Angela Amar, PhD, RN, FAAN, Assistant Dean of Bachelor of Science in Nursing (BSN) Education at the Emory University Nell Hodgson Woodruff School of Nursing, said that nurses build the foundation for success throughout their nursing education.

“Preparation for the NCLEX begins on Day 1 of nursing school,” said Dr. Amar, “All of our coursework, assignments, and testing follows the NCLEX blueprint designed by the National Council of State Boards of Nursing (NCSBN).”

Preparation and perseverance are the keys to success with NCLEX. Dr. Amar offers some tips and strategies to help ease nurses’ anxiety and better prepare them for a successful NCLEX experience the first time around.

Start the Registration Process Early 

State Licensure: Know the licensure requirements for the state where you intend to practice. The licensure requirements and deadlines are different for each state. Visit the board of nursing’s website for the specific state where you intend to practice (for the State of Georgia, visit: www.ncsbn.org/Georgia.htm). Find out if there are any special requirements and address these as quickly as possible. Georgia, like many states requires a criminal background check, which can take several weeks. The State of Tennessee has a special form for first-time, out-of-state applicants that must be requested from the state’s board of nursing and is not available online. To avoid unnecessary delays and additional fees, do your due diligence well in advance of taking the NCLEX to ensure that you have met all of the state’s necessary licensure requirements.

Register with Pearson Vue: In addition, to registering with state licensing boards, you also need to apply to take NCLEX with the test vendor Pearson Vue. Registration can be completed online, by mail, or by telephone. I encourage nurses to call the testing center where they intend to take the exam ahead of time. Some test centers are really busy and have a backlog of students needing to schedule a test date. You may be able to schedule and earlier test date if you are willing to travel outside of your immediate area.

ATT Authorization: After the board of nursing authorizes your eligibility to test, you will receive an Authorization to Test (ATT). Keep this in a safe place. You will need to present this at your testing site to be admitted to the exam.

Prepare Yourself Mentally
Have confidence in yourself. As with many things in life, attitude is everything. If you are eligible to take your state boards, you have already triumphed through the rigors of nursing school and have the knowledge you need to succeed with the NCLEX exam. The NCLEX exam is not filled with trick questions or new information. The exam is designed to evaluate your critical thinking and ability to apply your knowledge and nursing skills in real-world scenarios. Nurses hone these critical analytical skills in the classroom and through experiential learning opportunities throughout their nursing education. The NCLEX style of questioning will be familiar to you from your testing in nursing school.

Analyze – not Memorize  
Memorization can be helpful for some information that may be needed for the NCLEX such as, units of measurement, and laboratory values. But attempting to memorize every detail that you have learned during nursing school will only serve to overwhelm and distract your focus from the mission at hand. Focus on truly understanding the broader concepts of nursing practice knowledge and patient needs in such areas as safe and effective care management, health promotion and maintenance, psychosocial integrity and physiological integrity. Practice the areas that gave you difficulty during nursing school.

Understand the Question  
Read the question carefully, so that you are clear on what is really being asked. Don’t over-analyze the question and deliberate over potential ‘what-if’s.’ The NCLEX questions are focused much more broadly. Understand the rationales of the questions. Think about the concept to which the question is relating and organize your thoughts around that topic.

Don’t Get Bogged Down Trying to Figure Out the Testing Methodology  
The NCLEX exam is administered in a computerized adaptive testing format, which means that each test is tailored to the examinee. Each time the examinee answers a question, the computer will re-estimate his or her probability for success and present the next question based on how they performed with preceding questions. The computer stops the test once performance at a certain level is demonstrated to be the test-taker’s highest ability level. I tell nursing students not to panic if the computer doesn’t shut off after 75 questions. It just means the computer is still trying to figure them out. Most students receive an average of 100 to 110 questions. Likewise, if you are given some easy questions following a few difficult ones, it doesn’t necessarily mean that you didn’t answer the previous questions correctly. The NCLEX also includes at random several test questions (that don’t count) for future exams. Don’t waste time trying to figure out the testing mechanism. Keep calm and keep your head in the game. As long as the computer keeps asking you questions, you are still in the running.

Take Advantage of the Resources Available to You     Deliberate Prac 015
Before you study for the exam, take a practice test, so that you know where you need to concentrate your focus. There are many study guides and resources available, but make sure that the materials that you are using are based on the most recent test. Emory University’s School of Nursing has a list of recommended resources available on its website. Don’t be shy about utilizing your mentors if you need extra help.

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aamar-HiRes (1)Angela Amar PhD, RN, FAAN
Associate Professor,
Assistant Dean for BSN Education

Angela Amar joined the School of Nursing in September 2012. She earned a doctoral degree in nursing at the University of Pennsylvania, a master’s degree in nursing and a bachelor’s degree in nursing, both from Louisiana State University Medical Center.