Confessions of a (Happy) NCLEX ‘Junkie’

Nursing school is tough, but the upside of that is in many ways, it’s really exciting. It keeps adding to your knowledge, then challenges you to tie all that knowledge together in dynamic ways that make all the difference in patient care. It keeps pushing your personal horizons further and further- the view, over time, gets truly spectacular. Anatomy, physiology, organic chemistry, microbiology, developmental psychology, treatment difference for the pediatric, adult, and geriatric patient (of each gender!), and more are all included in your training. At the same time, you’re learning structured care and procedures - how to form and write a care plan, deal with emergencies, interventions galore. You are exposed to a rainbow of different types of focused nursing specialized areas you can pursue- Med-Surg, Critical Care, Cardiology, Oncology, Neonatal, Public health, Research, Legal, Orthopedic… this list branches out so far and wide, most of us never fully realize its length and breadth. There weren’t many days in nursing school I wasn’t learning something new, or reinforcing something new I learned, and I’d bet it would be the same for you. After you breathe the big sigh of relief at the successful conclusion of your last class and then the NCLEX exam, at some point in the near future, you get your surprise gift: You realize what you’ve been through has left you with an appetite for this whole learning thing. Out in the nursing workforce, most nurses I met were hooked on learning new things, and improving their knowledge, including me. True, out here 'in real life’, the demands of work (and kids, home, society, relationships), keep us from learning things at the pace we did during school, but that process never ends - and nurses enjoy that. I’m pretty sure it was in nursing school that I finally forgot what it means to be bored. You will always be learning new things whether they are asked of you, required of you, or sought out by you. The good news is that’s a great thing, and in fact, a real gift into a nurse’s life. Fortunately, your experience will keep you curious to learn more about the things you run into, and especially as you get into specialized areas of nursing. It’s a natural part of nursing. In my own practice, I spent a lot of time chasing down nursing knowledge in Orthopedics, Hospice care and MUCH more about lab values, and conditions or syndromes that presented themselves in patients. So, Google, medical journals, and nursing journals are my friend. Handy stuff to have at your beck and call (shout out to our lucky stars, it used to be WAY harder to look things up!). Now, about that whole ‘NCLEX junkie thing, and how I became one, ten years after I passed it.

Be warned that there is no twelve-step program to recover from this (although I admit, I never want to).

Whether the NCLEX is in your future or in your past, let me pass this nugget along (and, a disclaimer- sincerely, this is not a ‘self-promotion’ or some kind of hidden ‘ad’). It’s a good idea to keep your NCLEX preparation app sitting on a handy digital shelf somewhere, even if you haven’t looked at it in quite some time. Back in the day (the ones my children claim were ‘before dirt’) I passed my NCLEX-RN in 75 questions, the machine snapped off, and I felt confident. Great feeling. Ten years or so down the road- I had been stuffing myself with State mandated continuing education, hospital mandated training, many hours of ‘Googling’, chasing down detailed knowledge in my specialty, and all that treasures that came from direct nursing experience. I was one happy camper. One ordinary day, a little quieter than most, I reopened my NCLEX preparation app, with a bit of a nostalgic chuckle. I’m not into taking those social media tests to see what kind of Harry Potter character I channel, who my spirit guide is, or what celebrity I most resemble. But this was up my alley, and it felt like a bit of fun in the old neighborhood! Hoo-Rah! I started rifling through the questions- and, uh- the farther I got, the shakier the ground I was standing on seemed to be. And, oh my, the preparation software has been constantly improving itself, really homing in, and identifying things I wasn’t strong on. My world looked a bit different than I imagined with my years of knowledge collection. The big revelation I got out of playing with my NCLEX app, as opposed to leaning hard on it before the test, was that its relevance as a diagnostic tool for areas of weakness hasn’t changed a bit, regardless of whether I had my test ahead, or taken it long ago. Ten years into nursing, I always had presumed without speaking, in that place where you don’t actually think things through, that I could pass that NCLEX again at any point, even if taken by complete surprise during the course of the day. Now, I didn’t feel so sure. The truth is that if a nurse doesn’t pick up a tool to polish up the basics they’ve moved on from since nursing school, they can get half-forgotten and rusty. There may be crumbly areas where you haven’t dealt with for a while, and it could be anything. Acid-base balances, metabolic states (let’s see, was that respiratory alkalosis, or alkatory respritosis?), maternity/parturition topics, basics of delegation, drug classes and effects (what was a muscarinic, again?) Keeping the basics polished up, and not presuming “once you’ve learned it, it’s at hand forever” is a concept I am grateful to have been humbled into. You don’t have to have all your nursing tools and weapons in hand at every moment. But there are some you will want to keep nearby to pick up now and then. A diagnostic tool for your nursing basics that finds your weaknesses isn’t a bad thing, if you’re the one using it. Using patients to identify areas you are weak in is definitely NOT a good practice. I’m keeping my NCLEX prep app at hand for use, PRN. You’ll have to pry it out of my cold, dead fingers, after, as you know from your prep, an MD certifies that. I might have flunked my first imaginary “surprise” repeat NCLEX- but now, I think I have a shot at it after all. I’m sticking with what I know works to keep me sharp, and finds my weakness- before my patients ever have to. I’m a happy NCLEX Mastery junkie. Steven BobulskySteven Bobulsky
My history is a bit unusual, but it provided a broad life experience (shorthand for “OMG how did I make it through all that?”) Teen summers walking behind a garbage truck; worked forging aluminum and titanium in to things from small widgets to Boeing 727 wings; Completed B.A., then went to M.Div. school, ordained an Orthodox priest. Pastored parishes; went on to work for EDS, and GM recruited me out of there; managed district dealers as their “factory contact” for Cadillac Motor Division; started a Computer/web service for dealers. Personal tragedies struck. A decision to pursue Nursing and passing my NCLEX (R.N.) opened up the doors in a career that I didn’t know I was looking for. All the experience a person brings with them is unique, and ALL of it can (and will be) put to use in the course of your patient care. Every good thing you go through, every difficulty you bear, knowledge from any field you’ve studied, any hobbies, talents, quirks, whatever makes one unique- will supplement and support the mind of a nurse, and the heart of your practice.

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