Tuesday, July 19, 2005

Dictation

The Unlikely RN is dictating this post to her handsome boyfriend, who is NOT editorializing as he is dictated to. The post is being dictated because the Unlikely RN is trying to pack up 13.5 months worth accumulated nursing school junk, which includes 22 hardcover nursing text books, totalling about 200lbs and a cool grand.

My last couple of shifts on the floor went very well. My primary preceptor was on vacation, so I worked with a different preceptor each day. This was a little nervous-making as everybody likes things done their own way (so much for standardization of healthcare). But it was obviously a great way to draw from different people's experiences.

As mentioned ad nauseum, my final hurdle is to write the licensing exam (the NCLEX), so Kathy and I have been doing practice questions. The questions run the gamut from depressingly obvious (I spent a year learning this?) to tear-producing difficulty (I only had a year to learn this?) to willfully obtuse. An example of the first would be something like:

1) A patient discloses their intention to commit suicide to the nurse and says that he has a handgun at home. The nurse's most therapeutic response would be:
a) "Please promise me to go home and throw away the gun."
b) "Doesn't your family love you?"
c) "What type of gun?"
d) "I am really concerned about you. We need to admit you to the hospital."

I'm not even going to bother telling you that the right answer is c).

An example of the second type (tear-producing difficulty):

2) Aluminum hydroxide gel (Amphogel) is prescribed for the client with chronic renal failure to take at home. Why will this patient receive this drug?
a) To relieve the pain of gastric hyperacidity.
b) To prevent curling's stress ulcers.
c) To bind phosphate in the intestine.
d) To reverse metabolic acidosis.

Amphogel? I have no idea what it is. Do we bathe in it? Do we stick it up our butts? Do we suck it down like so much Pepto-bismal? And what in god's name does it have to do with curling? These are things I do not know. Things are things I have never known. These are things I will not know when I am in a sweaty cubicle trying to write this damned exam in several weeks. As it happens (and this does make sense) Amphogel is used to help eliminate excess phosphorous. And it turns out that you drink it. I would like to see the compliance rates for this drug (Mmmm...yummy gel).

The worst sort of question is the one that makes no sense at all. For example:

3) A 30 year old patient is experiencing a spontaneous abortion (miscarriage) at 8 weeks. What do you expect the patient's primary emotion to be:
a) Anxiety
b) Guilt
c) Fear
d) Ambivilence

One thing nursing school did not teach me and, in fact, taught me NOT to do was to presume a patient's reactions to a difficult situation. I would be frightened if baby-parts were coming out of me; I would be anxious about my ability to conceive again; I would be guilty because maybe I did something to cause the miscarriage; and, depending on the circumstances, I might feel quite ambivilent, since I might not have wanted the baby in the first place. The answer is guilt.

So this is what I'm struggling with. To prepare me for questions like the last one, the Illinois liscensing board has been kind enough to make the application process an absurdist's wet dream: a charming combination of Ionesco, Beckett and the flippin' urinal on the gallery wall. It keeps me awake at night.

So all this brings me to this Friday when I graduate, which signals the end of both nursing school and the Unlikely RN. I think it's inaupicious to go into nursing with the epithet "Unlikely" and I plan to go about becoming a likely RN offline.

I'll be back on Friday for one last post. See you then. And boy my boyfriend is handsome.

38 Comments:

Anonymous marj said...

NCLEX questions... I feel your pain, my friend! Sorry to hear that you're going to be offline once you are a Likely RN. Be sure to drop a line on my blog every now and then! :) Good luck on the exam!

8:50 PM  
Anonymous Sacha said...

There's something irresistible about us former skinny nerdy types.

2:17 AM  
Anonymous Anonymous said...

Well, if it's any comfort I got all 3 wrong. Since they said "handgun" and my knowledge of guns is such that the type would make no difference to me (I guess "fake" versus "real" would matter)then I couldnt figure out which answer was right. In terms or harm reduction 'd' is the closest, but I wouldnt say that either.

Glad I dont have to write the exam again! Good luck! Dianne

4:42 PM  
Blogger may said...

i am no expert in NNCLEX review, but these friendly reminders helped me pass:
1. ALWAYS remember that if it is a psyche question; you always want the client to talk more. thus the answer.
2. it is impossible to remember all drugs, but if you know a little bit of the pathophysiology of the disease, it will be more likely that you will guess correctly.
3. the test questions are based on theory, so it is really unsafe to base your answer on your own or other's personal experience. erickson's developmental stages always come handy. at 30, she is more likely to blame herself for doing or not doing something that caused the abortion.
God bless on your exam!

7:28 PM  
Blogger Heather said...

The NCLEX will not be as hard as you are expecting it to be. Take this approach: If you don't know it by now, you probably can't learn it by the time you take the test!

Nursing is mostly common sense, time management, and intuition.

Good luck!

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Blogger Ilan Muskat said...

Well dictated, ("you").

Well typed, ("handsome boyfriend").

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Program on the emergence of civilization.

"14 species of large animals capable of domesitcation in the history of mankind.
None from the sub-Saharan African continent.
13 from Europe, Asia and northern Africa."
Favor.
And disfavor.

They point out Africans’ attempts to domesticate the elephant and zebra, the latter being an animal they illustrate that had utmost importance for it's applicability in transformation from a hunting/gathering to agrarian-based civilization.

The roots of racism are not of this earth.

Austrailia, aboriginals:::No domesticable animals.


The North American continent had none. Now 99% of that population is gone.






Organizational Heirarchy
Heirarchical order, from top to bottom:

1. MUCK - perhaps have experienced multiple universal contractions (have seen multiple big bangs), creator of the artificial intelligence humans ignorantly refer to as "god"
2. Perhaps some mid-level alien management –
3. Mafia (evil) aliens - runs day-to-day operations here and perhaps elsewhere ("On planets where they approved evil.")

Then we come to terrestrial management:

4. Chinese/egyptians - this may be separated into the eastern and western worlds
5. Romans - they answer to the egyptians
6. Mafia - the real-world interface that constantly turns over generationally so as to reinforce the widely-held notion of mortality
7. Jews, corporation, women, politician - Evidence exisits to suggest mafia management over all these groups.



Survival of the favored.




Movies foreshadowing catastrophy
1986 James Bond View to a Kill – 1989 San Fransisco Loma Prieta earthquake.




Journal: 10 composition books + 39 megs of text files

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Blogger shrimplate said...

Throw away the nursing textbooks.

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Anonymous Anonymous said...

Bizarre I know, but I am working on NCLEX questions today and I got a similar question concerning Amphogel and was google-ing it--Lucky me! You've been there done that...LOL..so thanks for the answer.

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Kudos! Very informative article, keep up the good works! More power

Hi guys, visit nursereview.org, very useful source for nurses.
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