How to become a nurse....

You know you're a nursing student when: You find yourself studying while on summer break! We can now add this to my list.

I found myself surfing through my NCLEX books lastnight answering questions. What is wrong with me? I also read a few pages of OB material...I guess it takes a while for the anxiety to fade. I feel as though I should be doing something, reading something, learning something. I'm definately not use to enjoying myself. A part of me wants so bad to open up a book and get a head start on OB and Peds. Another part of me says that I really need to stop thinking like that, because I deserve this time off. THEN I start to think that if I did infact get a head start it will be much easier on me next semester. Sigh. I MUST STOP THIS MADNESS!

3rd semester really did a number on my psyche. I was taught that there is no such thing as a 'break' and that if I slacked for one moment it could all go downhill, so I never let that happen. I am afraid of failure. One failure can mean hanging on by your nails and I never wanted to feel like at any moment I could take the dreaded plunge. That fear is what kept me climbing and reaching for, what sometimes seemed like, impossible feats. Of course, looking back now I realized I was entirely too hard on myself. I guess I could have given myself some kind of breaks, but I didn't.

Many of you who aren't in nursing school or aren't even affiliated with nursing in any capacity may fail to understand. I do not exaggerate and make up stories to make myself appear smarter than the average bear. Nursing school is an entirely other entity than any other curriculum. I have spoken to a lot of people who don't even understand (mom) how to get the degree so I will break it down for you. And no, this isn't because I am assuming you are stupid, it's because I have had MANY ask so I will clear it all up now.... There is a heiarchy in healthcare.

In the 'nursing' spectrum it usually begins with the CNA (certified nursing assistant), their typical duties include basic healthcare needs such as: feeding, changing, bathing, comforting the pt, helping them dress, meeting their needs etc... They are some of the hardest working people in the universe. I know this because I was once a CNA for a very short period of time and it is ruthless and most of the time, unfortunately, thankless. In order to become a nurse (RN,LPN,CRNP etc...) you must first get a CNA liscense(at least in my state anyway)and we have to maintain it throughout nursing school. It takes a few months to obtain if you are going the school route. So as you are working toward your goal as a nurse you are certified in basic care and are also CPR certified. The average pay in my area is around $6-10 an hour. (They should be paid much more IMO).

The next step is an LPN (Licensed Practical Nurse). AN LPN has a much broader scope of practice than a CNA. I'm not exactly certain of all the new changes to their scope of practice, but I know they are allowed to give most meds and do most procedures, but there are certain medications they are not allowed to IVP (IV push). Please correct me if I am wrong, but this is my understanding. Just like the CNA, LPN's work under the supervision of a registered nurse. An LPN nor CNA can't do any job that is out of their scope of practice and if they do this blame usually falls on the RN. (Scary) I believe the education time for an LPN (also called an LVN) is a year and a half (plus pre-req's- so about 2-3yrs). The difference between and LPN and an RN education wise is that the RN's education is more extensive. Once someone is an LPN and they pass their state boards (which is different from the RN boards) and LPN can then, if they choose to, bridge over to become an RN. Basically meaning that they can take a couple of extra semesters starting in the middle of the RN program and become an RN (after they pass the NCLEX-RN that is). The avereage pay for an LPN in my area is anywhere from $12-$14 and hour.

The RN...here is where it gets tricky. There are two different types of RN programs: 1) ADN (associate's degree nurse) and 2)BSN (bachelor's degree nurse). Here is where many get confused. Both programs have the exact same state board exam, there is NO DIFFERENCE! Once you take the NCLEX-RN, whether you have a bachelor's or an associates and you pass you are a registered nurse. As my instructor had told me, the ADN is a crammed up version of the BSN. The only difference is that if you eventually want to teach (need your MSN-master's) or go into other avenues of nursing (there are tons) then a BSN is the road to lead you there. There is no difference in pay between a nurse who has a ADN and a BSN. Not even a dollar (in most cases. MSN is a different story). The exceptions are that some people have senoirity etc at their workplace. The avereage pay for an new graduate RN in my area is anywhere from $18-$25/hr (not including nurses who have been at their jobs for a long time). There are also differentials such as night shift and weekend pay and a new nurse can make upwards of 28 dollars an hour. It is much higher in the bigger and more populated areas.

Here is another thing I want to clear up....many have asked me what specialty I am doing 'schooling for'. I'm not in any specialty right now. In nursing school you learn (almost) EVERY specialty area so that you have a broad spectrum of knowledge. We are taught, legal issues, eithics, Cardio, Respiratory, GI, Renal, OB, Peds, Psych, Immune, Endocrine, Integument, Neuro, Cancer, Ortho and on and on. Within those catagories we learn meds asscoc with the diseases and their side effects and how they work in the body, physiology, pathology, signs, symptoms, treatments, judgement, nursing care, nursing diagnosis etc... We area also taugh skills to coincide with our profession such as feeding tubes, catheterization, injections, IV's, calculations, sterile dressings, nasogastric tubes, intubation etc... Once you graduate you can (most of the time) get a job in a specialty of your choice and are trained in that area on the floor.

With every program you have to complete clinicals. On top of the studying, the skills, your family and friends you also have to got to the hospital once or twice a week and complete about 10 hours a day clinical time. Usually clinical coincides with what you're learning at the time so you can put what you've learned into action. You are graded on your performance, usually by pass or fail, and are under the supervision of one of yor clinical instructors. There is a strict dresscode (ugh) and behavior that you're upheld to during this professional training.

If you decide to go the ADN route please don't assume it's just a 2 year program. Before you can even be considered for admittance you must complete pre-requisites like any other degree. Science, math, english etc. I went full time (including summers) and haven't stopped and by the time I graduate it will have take me 3.5 years to obtain an associates degree in nursing. So they may as well give me my bachelor's and let me be on my way-HA! Joke. The admittance process for nursing school is gruelling. Competition is fierce and I've seen grown women cry their eyes out because they were rejected. It isn't pretty. First of all you have to have a pretty good GPA for them to even look at you (especially in the sciences). You have to meet certain ACT and SAT requirements and the score varies for most schools. In mine I believe it had to be a 20 for the ACT. In many schools they require an interview process where they make selections. Many schools have a lottery system where names eligable are drawn at random (that stinks). A lot of schools have a 1-3 year waiting list. Many schools, like mine, base admittance on a points system. You're given so many points for you ACT score over 20, x amt of points for your GPA, x amt of points for science classes completed and so forth. The higher the points the better your chances. All schools are different and it's best you check with them on their policies. So, in other words...you have to work you tail off to compete with people and getting accepted is a big deal and a big accomplishment.

Once you're actually in nursing school you have to continue to meet a certain standard to stay in the program. I will use my school's policies for examples: Each semester you must have a 78% (C) or better to stay in. If you make a 77.9% they do not care and will not round up. In nursing school, maintaining a C avereage is really good because the exams are so hard and really push your knowledge to the limit. At my school all you classes are in one big class. Ex: we are taught and tested over everything at once. Whereas, many schools have different classes (patho, pharm etc...) for each subject and are tested individually. Each skill that you are performing is in front if an instructor and one slip or one cross of your sterile field and you fail. You can only skill twice. If you fail the second time you're out of the program and must reapply for the semester all over again. Same goes for the calculations/math exams. We also have 4-5 ATI exams per semester we're required to pass according to the state board of nursing. It judges whether we are meeting the standard curriculum guidelines and it fares how well we're being prepared for NCLEX. We have regular exams every other week and on top of that you have clinicals, care plans, drug cards, bibliography cards, group projects, school/community projects, sometimes other classes, extra credit assignments, reading assignments, nasty (and nice) instructors and skills to worry about. If you miss an exam you must wait unti the end of the semester to re-test.

I have had so many people say to me..."it can't be that bad". That is when I look at them and bite my tongue, because my mom always taught me that if you don't have anything nice to say then don't say anything at all. LOL SO, I hope this sums up some of what it takes to be a nurse. I wanted to put this down so that other people can see that it isn't just a black and white career. It is challenging, worthwhile, technical, fun, heartbreaking, backbreaking, and most of all rewarding career. I am sick and tired of nurses, of every kind, not getting the respect they deserve. In order to stop this, the public needs to be more educated. There's my opinion. :-)

p.s. Looking forward to The Bachelor tonight. (He he he)