Category: Transitions

The final ATI assignments for this course were completing the Pharmacology Proctored Exam as well as the comprehensive proctored exam and the 2 practice exams that went along with that. The Pharmacology exam I believe went as well as it could have for that moment. For the 60 questions, there was some distraction in the room for me and I was a little anxious. I know my time per question for this exam was not the best, but I am still content with the results. For this exam, after reading the question if I had not ever heard of the medication and didn’t have any guesses then I made an educated guess and didn’t waste time to dwell on the question and just moved on to the next. There were plenty of medications that I recognized and believe that I could pick out the right answer for. I think that with more focus and remediation I will increase my confidence on this section, but it has greatly improved since the first Practice Pharmacology assessment. For the 2 practice comprehensive exams, I believe overall the practice exams went good, my timing for each question as always is still lower than the average but I don’t think that as a test-taker I will greatly improve on that. If I end up looking at a question longer than I should I end up second guessing myself or talking myself out of the correct response. The day of taking the proctored comprehensive exam was a tough day, I was at Maine Med for preceptor until 3am, got 4 hours of sleep before coming in at 9am for class and then this exam in the afternoon. By question 100 my eyes were shutting every few seconds and I was forcing myself to stay awake. Based on these factors against me, I believe I did okay and with an 88% chance of passing the NCLEX with those things not in my favor I will take that as a positive. I really liked the chance of taking a comprehensive exam, some pharm questions some maternity some fundamentals. I look forward to practicing more of this style of exams in the coming weeks prepping for NCLEX. Overall, I thought these ATI assignments were going to end up being tedious this semester, but looking back now we have completed an incredible amount of practice questions, remediating each and every incorrect answer and practicing under stress of proctoring. I think this will greatly help and I look forward to the ATI review session this weekend.

Throughout the semester, I used my remediation from practice assessment to look over before we had a proctored exam. For my remediation, I would use the ATI rationale as well as sometimes even go in the textbook for the course of the subject matter. Having double the check and different wording helped to solidify why it was wrong. I liked to take my assessment at home and then was comfortable to remediate my wrong questions in any setting. Having as minimal distraction as possible was key since some practice proctored ATI when I did them on campus didn’t go so well and I felt distracted. Some self-care strategies I allowed myself to do throughout the semester was successfully scheduling my time, finding and making time for self-care and trying to go to the gym every morning. I feel like I had the best balance I could have during this tough summer semester and having a schedule to complete these ATI assessments really was the key – take the exam on the Sunday of the week and evenly split up remediation for every day to be done on Saturday and then start back up the next day. I think keeping these same good habits will allow me to have a successful plan in place for NCLEX prep and I’m looking forward to using ATI website to prepare and some other resources as well to get as much practice problems in before the big test day. 

1. Where (what state/territory) do you intend to become licensed by examination, and is this a Nurse Licensure Compact state?
   1. I intend to become licensed by examination in New Jersey, and New Jersey is pending implemention to become a compact state. According to the NCSBN website, until 2021 pending implementation, NJ residents cannot hold a multistate license, someone with a compact license can practice in NJ, but NJ nurses cannot go the opposite way right now. The other state I am considering practicing in is New York, and they are not a compact state and if I get a job there I would need to apply for licensure by endorsement for that state. 
2. How is the application completed and submitted (web-based, manual/paper-based, or either), and does the application you are filing require official transcripts, verification sign off by the director of the program, or both?
   1. Paper applications are not accepted, online application is on the board’s website and I upload all supporting documents required. I need an online application, 2’’ x 2’’ passport style photo, birth certificate or passport, letter of nursing program completion, background check and successful completion of NCLEX. I am unsure at this moment if I need to file official transcript as it sounds like I can just have a letter of nursing program completion. 

3. Does the state where you intend to become licensed require criminal background checks and/or fingerprinting? If so, what is the process?
   1. Yes, obtaining fingerprinting I need to go through Identogo and to receive a service code I need to click don’t know my service code to receive a new one. Criminal background checks will be done and information on this will be mailed out to each applicant. 

4. Reflecting on presentations from the Attorney General’s Office and the Medical Professionals Health Program, consider the following:
   1. Describe any provisions for impaired nurses in the state where you intend to become licensed as described on or linked from the State Board of Nursing website, including any mandatory reporting requirements for suspected impairment, disciplinary measures, and resources for recovery. 
      1. All applicants have to report all arrests and/or convictions, even if they have been dismissed. If you have ever had that done then all supporting documents must be uploaded right away or then licensure will be delayed. 

4. Some of the most commonly occurring legal issues that impact nursing and nursing practice relate to informed consent and refusing treatment, licensure, the safeguarding of clients’ personal possessions and valuables, malpractice, negligence, mandatory reporting, abuse, and unsafe practices.  How will you protect yourself and your license from these legal issues? 
   1. I will protect myself by knowing the rights of delegation, knowing the scope of the profession that I am delegating to. Knowing that when I delegate I am still responsible for that care and I would need to check on the job to protect myself and the public. Another thing would be to obtain professional insurance to protect myself as well as knowing what my facility will protect me on. Knowing policies, rights and procedures of my facility regarding all things and how I can advocate for myself will protect from legal issues. If I ever had a question if something arises before it is done, I will feel comfortable asking charge nurse or nurse manager to clarify and then go up the ladder to find out if necessary. Documenting all of my care to cover myself and place proof on what I have done and not falsely charting. 

Completing Pharm Practice B assessment is definitely increasing my confidence with pharmacology questions. There was only a handful of questions that I hadn’t heard of the medication in question. Scoring a 90% on this makes me feel good, there were still a few questions that I guess I took a lucky guess on but for the most part I knew the right answer right away. This was the last assignment that was pharmacology focused, so I know that I want to still develop and increase my confidence for this subject area so I will set a goal to work on this during my NCLEX prep. I was really excited to notice that I got the select all that apply questions right, as that was a sore spot on my last adaptive quiz for Med Surg. I notice a lot that I’ll initially pick the right answer and then I’ll let my head think through the other options and possibly change the answer from correct to incorrect, so I need to not do that. Looking forward to more practice questions over the next month. 

This week we had the last adaptive quiz assigned to us for this class and the subject was Med Surg. I went in pretty optimistic, however that optimism really dwindled quickly. I kept passing the amount of questions my previous adaptive quizzes had went and I also wasn’t feeling my best after a night of bad sleep. I ended up having to complete all 265 questions and had an average time of 30 seconds per question. I know this isn’t close to the NCLEX average, at a certain point I just needed this adaptive quiz to be done so I was just going at a faster than normal rate. Despite the amount of questions, I ended up with a 69% which I’m happy with. A weak point that I noticed within my remediations were the high amount of select-all-that-apply questions that I got wrong and think this should be a priority for me for NCLEX prep. Some of the content that I got wrong I now realize is wrong because we just learned it this week in Adult Health 3, so I feel better that I will know even more after this class is over. My mindset really needs to improve if I get a high number of questions in any other adaptive quiz or my boards. I did take several breaks when I felt myself losing concentration and don’t think that I would’ve been able to complete this with the number of questions without a few breaks. 

This week’s transition to practice assignment gave a nice break from completing adaptive ATI quizzes and instead moved into the first of two Pharmacology practice exams. Having completed an adaptive pharmacology quiz last week, that gave me more confidence into this week’s quiz and believe I did well. I got 10 incorrect including one math problem and my average time on this quiz was faster than adaptive completing 60 questions in 22 min. I felt like these questions were more straightforward than the adaptive questions. Going into the second Pharmacology practice quiz next week, I will try and slow down and take my time more on the questions and my goal is to not have an incorrect math question on this next quiz. During the quiz as I am reading the questions most of the time I have remembered hearing the medication that they are inquiring about but can’t correctly identify the right answer. This shows that I need to focus more on this area of the NCLEX and dedicate more time to reviewing medications and their uses, contraindications and complications. 

This week’s assignment for Transitions to Practice was to complete the Adaptive Quiz for Pharmacology as the start of review for pharmacology content that is to come over the next couple weeks. Admittedly I was not as confident going into this quiz since it has been some time since our pharmacology course in the fall, but very important to start to review. My timing taking this exam wasn’t the best idea, I took it after getting home at a day at clinical and I was quite tired so I will not make that mistake next time when deciding to start to do an adaptive quiz at 7pm. My average time for each question was 30 seconds, which has gotten faster again since my last adaptive, and I think I can attribute this to when if I wasn’t familiar with a medication, I just took a guess when I really didn’t know the answer. I’m hoping that with more review and practice for pharmacology section I will be able to improve my average time per question for this subject. I believe my thinking has improved regarding the number of questions that the adaptive quiz will take, I just am expecting it now to go past 75 and then this time when it stopped at 82 I was happy. On this adaptive quiz, there started to be more hard rated questions and I would like to improve on my percentile of correct questions. One area of medications that I know I need to re-visit is insulins and the time of onset and patient education surrounding each type. Looking forward to getting more review on pharm questions these next couple weeks. 

Completing this next ATI Adaptive quiz was for Nursing Care of Children this week. My quiz was 100 questions in total and scored 58% with a total average time of 47 seconds and ranked in the 72^nd percentile. I felt good throughout this quiz while completing it and took a very short break around 50 questions for around 3 minutes and then jumped right back in. Once I reached around question 80, I didn’t feel fatigued as compared to previous adaptive quizzes and I think it’s because of the very short break and I am trying to change my mental framework not to get disappointed if it goes past 75 questions since it almost always does. Most of the content on this adaptive quiz could be related to identifying important nursing interventions for surgical procedures that are commonly done to children and developmental stages and fine and gross motor skills to expect at each age. I have noticed by the remediation that this is an area that I need to review more on to feel more confident and improve on those questions. For my next adaptive quiz to complete, I would like to improve on my timing even more again, I keep going up by 10 seconds for my average. Additionally, I would like to have a good mindset going into the next couple adaptive quizzes since I don’t feel as confident with the subject matter as I have with maternity and pediatrics. 

I can’t believe the time has come that I am entering my last semester of nursing school. I am most excited about starting the job search process, having more time in the clinical setting and completing preceptorship later this summer (and finding out where I was placed for that!). All of those things that were just mentioned that I’m the most excited about, I am equally as anxious for those same things too. I love the anticipation of going to clinical each opportunity we get, however a main goal for this semester for me is to work on my confidence in the clinical setting. The past two times that I have gone to clinical in some moments I found myself holding back when given the opportunity to be hands on and practice a skill first, and I want to be able to let myself take the chance and learn. Not having as much clinical time up until this point in our program has been limiting and I believe that with the significantly increased number of hours we are about to have will be a great learning chance to get caught up with everything. I am also anxious about our Nursing 456 class just based on what peers have said about the class, so I need to let what has been said go and breathe and put my all in and focus and learn. After completing an exam or a big assignment, I will celebrate by giving myself some time and check something off my Maine To-Do list that I want to accomplish before I move back to NJ. 

Planning my weekly schedule will be a big challenge at first since it will be different having 3 asynchronous classes along with 1 clinical course in person. I believe that starting the semester off strong with making a plan with when I will dedicate time for each course will be my best bet to follow for a successful completion. An example of a SMART goal would be to: Complete my weekly transitions assignments on the Saturday of the week that they are due by midnight, as they are due by midnight on Sunday. Allowing myself a day will give me space in case of a very busy or hectic week and still have enough time hopefully to complete what I need to submit. In addition to planning out when I will be doing course work, I would want to make a plan for myself in the beginning of each week what assignments are due and when, where I need to be and when, when I have time to fit in going to the gym and possibly planning out meals so that I don’t have to waste spare time on that. 

The Nurse Logic 2.0 Modules had four sections of lessons to review prior to completing the advanced quizzes. The Knowledge and Clinical Judgment section was helpful in going over the styles of learning and the explanation of each of them helped me identify that I am a tactile learner. Being hands on and in simulation is very helpful for me to remember concepts and I take detailed notes in lecture but need to keep re-writing them. Along with learning styles, this section also laid out strategies for success that are realistic and important to hear again as I approach this new summer semester. The next module was focused on Nursing Concepts and in this I focused on the sections as an advanced student nurse as it reviewed the 5 rights to delegation, time management strategies and styles of leadership that can be seen on the unit. The next module was Priority Setting Frameworks which goes over the 7 frameworks that can be used in nursing practice and NCLEX questions. The last module went over testing and remediation strategies which included tips of things to do and not to do on days of exams, how to come up with a code for answering questions and not to change that code and question types that can be seen on the NCLEX. Even though we had been exposed to this material before, it was good to brush up on it again and hear all the modules over as we approach our final semester. I will definitely use the testing and remediation strategies module most with my upcoming ATI assessments. 

The maternal newborn ATI Adaptive quiz was a great way to review the material that I had just completed this past semester. For this adaptive quiz, it took me 132 questions which definitely was hard for me to accept and concentrate with as I felt confident during it that I was answering many of the questions correct, but it just seemingly never ended. My time has improved even more since my last adaptive quiz going from 32 up to 37 seconds average per question, aiming to keep improving until I’m more near the NCLEX average of 1 min 21 seconds. There were a few questions that I thought I was confident with answering such as with reflexes and reviewing the Moro reflex and I was incorrect, so I am glad that this gave me an opportunity to reframe my understanding. I enjoy this content area and would like to improve even more. This was my best scoring for an adaptive quiz out of the 3 that I have taken so far with a 67% correct. This quiz took me a total of 1 hour and 22 minutes and I believe that taking a break would have helped me in the moment of taking it as I was losing concentration towards the end and started making silly mistakes. Reflecting back on this adaptive quiz, some ways to improve when I take my next one would be: to take a break if I feel pressure increasing, slow down and read all of the options even if I think I know the answer right away and to not worry how many questions it takes me and remain headstrong throughout.