Post by Admin on Jun 22, 2015 12:31:16 GMT
Here is another test experiences from my past files....
My experience in Utica, NY on June 2nd, 3rd and 4th.
I drove from Massachusetts to Utica in about 4 hours. The ride was uneventful, not too much traffic, I drove on Sunday and the gas prices are scaring people to drive anyway. After I crossed into New York State I entered “cow country”: green fields, farming machinery, herds of cows by the highway…Very peaceful. After checking into the Holiday Inn recommended by Excelsior I found out my rate was $129 a night, not $89 like I was promised when I made reservations. Somebody made a mistake so I had to talk to the manager and everything was corrected. After unpacking I took a ride to the Faxton-St. Luke’s’ Hospital which is exactly 700 yards away from the hotel. Practically walking distance. The Hospital is not too big, about 250 beds, 3 or 4 floors. Right after you enter there is a small chapel on the left, small lobby on the right where we all met Monday evening for labs. Second and third floors were where we had our CPN’s, basement was for labs and cafeteria. Most of the rooms in the hospital are double rooms, with bathroom and sink inside. Hand sanitizers are everywhere on the walls. Used linen is packed in plastic bags and goes to dirty linen utility room, garbage into plastic red bags and bins. There are holders on the walls inside the rooms for gloves; usually they have three different sizes in each room. There is a little kitchen, family room, staff room and few counters alongside the walls where you can sit and review chart and write your care plan. After I went back to hotel I practiced a little with syringes, packed my wound few times and went to bed. That was Sunday night.
DAY ONE
Monday I had nothing to do till evening so I drove around, studied mnemonics and watched TV. Utica appears to be very small and kind of boring but if I had to send my daughters to college Utica College would be up there between choices. Very green, seems very safe and very far away from all the bad influence. Places to eat: Moose River Restaurant in Holiday Inn, opens at 6:30 am, the cafeteria in the hospital opens at 6:30 also and has very, very reasonable prices. When you exit the hotel and go right toward hospital there is Friendly’s on the left on the corner of Burrstone Rd and Chaplin Rd. (closes at midnight), across there is an Burrstone ice cream place and Fast Track gas station with mini market (something like 7-11 or Mobile on The Run). If you turn right onto Chaplin Rd and go down the hill, there is IHOP, pizza place, local pharmacy and large food supermarket Chantery’s.
LABS
Monday evening scheduled meeting with CA was for 4:45, I arrived right on time, everybody was waiting for me. CA – Civita Allard took us to the basement where she read her spiel, and we had labs later on. There were six of us, one girl from Michigan, two girls from NYS, one guy from Brooklyn, NY, me and Paul from CA whom I’ve met three weeks before during Tina’s workshop. Everything went like in the EC video: reading the script, checking ID’s, and then everybody picked the card with assigned CE’s. After that we had 15 minutes to check equipment and the examiners’ came. Introductions, and we started. I flunked my first one, IV push: had a tiny air bubble in the second NS draw. They told me I will have to repeat it the next day but I had to finish stations anyway which I did. Then next was IM. Everything was perfect till the moment I stuck the dummy with a needle.The CE said: “Leave the needle as is, don’t touch anything” and she called CA. Apparently I pushed the needle a little bit too high. Half an inch. Another repeat. Of course I was already down but did not give up and the next two stations I did fine, with time to spare.
Anna, the CE who flunked me for an air bubble took me upstairs on the floor because she was going to be my CE for the next day’s first CPS. Needles to say that didn’t give me too much confidence. The floor appeared very busy, lately they had renovations and everything changed so even nurses were confused and did not know where is clean or dirty utility room etc. Got my Kardex, spent 10 minutes with the chart and went back to the hotel. Wrote my care plan and went to bed around 10 pm. Surprisingly, I slept well.
DAY 2
Tuesday morning six of us, all in whites, sat in one corner of cafeteria, CA and CE s in the other. Exactly at 7:10 CA came to us and started dispatching us to the floors. I went with Ana, who was a very nice, older lady and very absentminded too. My first pt. Was Pedi substitute, single room, 72 y/o male who had right knee arthroplasty the previous day, bed rest, reposition once, A&O + 3, PVA, right lower leg continuing compression device plus some kind of pump connected to right knee. Had to give 6 po meds, check AP for digoxin, and give insulin. VS assigned: manual BP, oral temp. Radial pulse, resp. pain level. Care plan: risk for injury- lack of awareness of hazards and acute pain r/t surgery. Plan was accepted; too bad that pts level of pain was zero. My interventions were to assess pain level and reposition, which I did, pt had overhead trapeze. That took care of mobility also. After I entered the room I did HIPPI COW, there was hep lock but nurse already flushed it. Pt was chatting with CE while eating breakfast so I could catch up on documenting 20 min checks and intake, luckily for me his foley was d/c an hour before and during PCS he did not void, so nothing to document. After breakfast I was already done with my PVA, decided to give meds. Unfortunately, the MD was sitting in the room and writing in the chart and the CE didn’t want to interrupt doctor when I had to give insulin. Then MD took MAR and we couldn’t do anything. Time is running away. CE tells me she can add a few minutes to my PCS, I said sure. Finally we got MAR, I’m trying to get stuff from med cart (remember to wash hands and put gloves on before handling meds!), constant interruptions because students from another nursing program were coming up to the cart. Finally I got my six meds in one cup, CE decided to give two meds and we were ready to go back to the room. Then this doctor starts chatting with CE - another 10 minutes wasted. Then I gave my meds, washed my hands, gloves, ID MAR ID, opened them in Pt presence, my hands are shaking but I did OK. CE wants to give hers, she drops them, we start looking for them, we found them on the floor. Pt doesn’t have spares in med cart. CE is calling pharmacy to get more meds. At ten o’clock we are done, I thank patient and I have 15 min to document. Not enough time, CE added 15 minutes and I barely finished on time. She reviews my charting, rationale and everything else and I passed! Down to cafeteria for mandatory 15 min. break that lasts till 11. Then back on the floor for pt. No. 2, CE is Susan. Also very nice, appears less stressed and more laid back.
Pt. No. 2 in double room had amputated rt. Foot 2, 3, 4 toes this am, he is up in the chair. My dx: risk for injury and impaired mobility. VS, oral, AP, can use automatic BP machine but nowhere in sight. CE and I were hunting it down for a good 10 minutes. AP had to use the stethoscope, can’t use machine’s reading-it would be a failure. Areas of care: mobility, PVA, skin lower extremities. Well, rt. Leg pt has surgical dressing, ace wraps and orthopedic shoes. Left leg below knee amputation. Now, try to do skin and peripheral vascular assessment! Did popliteal pulses, asked pt. to remove prosthesis, skin moist under rubber compression stocking, right one dry but can’t see too much because of dressing. Pt ate 0% of lunch, is on fluid restriction had already two cups of coffee, during PCS wife brings 2 16oz. Dunkin donuts coffees, pt non-compliant with fluid restrictions, CE tells me to estimate intake. That was nice of her. One po med at noon time, Phoslo. We went to get med, after we are back pt in the bathroom and wife is helping him to get washed. Good 20 minutes. Used that time to document few things. Pt exhausted but decided to go with walker to the end of hallway and back. Mobility done! All done! Had 45 min. to document and to write rationale! Everything was OK. I passed.
2 PM labs repeat. I’m repeating labs with Susan, same CE I had for Pt no. 2. No problems. What a relief! One more to go! Went back to the hotel. Rewarded myself with TV, paperback and ice cream from Friendly’s.
DAY 3
Meeting with CA Wednesday at 7: 30, There are only five of us left. One girl didn’t make it. Claudette theCE and I went to the third floor. Pt. Is 72y/o female admitted with back pain and diarrhea: My dx: risk for injury of course and impaired mobility r/t weakness (older adult) – you can find exact wording in Carpenito’s AEB Pt requires assistance with transfer from bed to chair.
We went in, pt was already sitting in bed, finishing breakfast, did quick intake, no output, check hep lock, assist her back to bed, and did abd. Assessment, PVA, also pain management. Now pain level she says 10 but if she could say more she says she would say 20. Primary nurse notified, too soon for pain meds, just got them an hour before. I’m taking vitals, respirations – pt decides to hold her breath, started 3 times and 3 times couldn’t do it properly. CE tells me to do it for 15 sec and to “estimate”, fine with me. We move to AP. Can’t hear a thing because pt talking all the time, laughs and giggles, says that stethoscope is tickling her. She was a comedian, granted I was her 3rd or 4th student in 2 days doing the same stuff over and over again, to the point that when I was doing her abd assessment she tells me:” And don’t forget to write about my hernia.” Finally, when I am ready to leave she tells me her pain level is six and that probably putting her back to bed helped. So, one pain intervention I could check off, then I put a pillow under her legs, offered to turn TV on and I left very happy knowing that I did it all. Had 45 min. to document everything. Then I was sent to family room, 10 minutes later the CE comes, she said I passed, congratulations and I feel like a rock is lifted off of my chest. Then we go to the basement, CA is waiting for me, she congratulates me and here I go, off back to parking lot and on the way back to Massachusetts.
I am very I pleased. I must say Tina’s workshop was the best help. I also had 4 mini lab stations set in my basement and I was practicing every night for an hour or two. Invaluable was my family support and my wife’s patience. Poor thing,I was calling every time I could, especially after I flunked labs on the first evening. CE’s and CA were very nice and helpful. I don’t believe that they are out there to get you. We need nurses and they will let you pass if you prove that you are safe and that you know what you are doing. Everybody who reads this, especially people testing in Utica – good luck.
My experience in Utica, NY on June 2nd, 3rd and 4th.
I drove from Massachusetts to Utica in about 4 hours. The ride was uneventful, not too much traffic, I drove on Sunday and the gas prices are scaring people to drive anyway. After I crossed into New York State I entered “cow country”: green fields, farming machinery, herds of cows by the highway…Very peaceful. After checking into the Holiday Inn recommended by Excelsior I found out my rate was $129 a night, not $89 like I was promised when I made reservations. Somebody made a mistake so I had to talk to the manager and everything was corrected. After unpacking I took a ride to the Faxton-St. Luke’s’ Hospital which is exactly 700 yards away from the hotel. Practically walking distance. The Hospital is not too big, about 250 beds, 3 or 4 floors. Right after you enter there is a small chapel on the left, small lobby on the right where we all met Monday evening for labs. Second and third floors were where we had our CPN’s, basement was for labs and cafeteria. Most of the rooms in the hospital are double rooms, with bathroom and sink inside. Hand sanitizers are everywhere on the walls. Used linen is packed in plastic bags and goes to dirty linen utility room, garbage into plastic red bags and bins. There are holders on the walls inside the rooms for gloves; usually they have three different sizes in each room. There is a little kitchen, family room, staff room and few counters alongside the walls where you can sit and review chart and write your care plan. After I went back to hotel I practiced a little with syringes, packed my wound few times and went to bed. That was Sunday night.
DAY ONE
Monday I had nothing to do till evening so I drove around, studied mnemonics and watched TV. Utica appears to be very small and kind of boring but if I had to send my daughters to college Utica College would be up there between choices. Very green, seems very safe and very far away from all the bad influence. Places to eat: Moose River Restaurant in Holiday Inn, opens at 6:30 am, the cafeteria in the hospital opens at 6:30 also and has very, very reasonable prices. When you exit the hotel and go right toward hospital there is Friendly’s on the left on the corner of Burrstone Rd and Chaplin Rd. (closes at midnight), across there is an Burrstone ice cream place and Fast Track gas station with mini market (something like 7-11 or Mobile on The Run). If you turn right onto Chaplin Rd and go down the hill, there is IHOP, pizza place, local pharmacy and large food supermarket Chantery’s.
LABS
Monday evening scheduled meeting with CA was for 4:45, I arrived right on time, everybody was waiting for me. CA – Civita Allard took us to the basement where she read her spiel, and we had labs later on. There were six of us, one girl from Michigan, two girls from NYS, one guy from Brooklyn, NY, me and Paul from CA whom I’ve met three weeks before during Tina’s workshop. Everything went like in the EC video: reading the script, checking ID’s, and then everybody picked the card with assigned CE’s. After that we had 15 minutes to check equipment and the examiners’ came. Introductions, and we started. I flunked my first one, IV push: had a tiny air bubble in the second NS draw. They told me I will have to repeat it the next day but I had to finish stations anyway which I did. Then next was IM. Everything was perfect till the moment I stuck the dummy with a needle.The CE said: “Leave the needle as is, don’t touch anything” and she called CA. Apparently I pushed the needle a little bit too high. Half an inch. Another repeat. Of course I was already down but did not give up and the next two stations I did fine, with time to spare.
Anna, the CE who flunked me for an air bubble took me upstairs on the floor because she was going to be my CE for the next day’s first CPS. Needles to say that didn’t give me too much confidence. The floor appeared very busy, lately they had renovations and everything changed so even nurses were confused and did not know where is clean or dirty utility room etc. Got my Kardex, spent 10 minutes with the chart and went back to the hotel. Wrote my care plan and went to bed around 10 pm. Surprisingly, I slept well.
DAY 2
Tuesday morning six of us, all in whites, sat in one corner of cafeteria, CA and CE s in the other. Exactly at 7:10 CA came to us and started dispatching us to the floors. I went with Ana, who was a very nice, older lady and very absentminded too. My first pt. Was Pedi substitute, single room, 72 y/o male who had right knee arthroplasty the previous day, bed rest, reposition once, A&O + 3, PVA, right lower leg continuing compression device plus some kind of pump connected to right knee. Had to give 6 po meds, check AP for digoxin, and give insulin. VS assigned: manual BP, oral temp. Radial pulse, resp. pain level. Care plan: risk for injury- lack of awareness of hazards and acute pain r/t surgery. Plan was accepted; too bad that pts level of pain was zero. My interventions were to assess pain level and reposition, which I did, pt had overhead trapeze. That took care of mobility also. After I entered the room I did HIPPI COW, there was hep lock but nurse already flushed it. Pt was chatting with CE while eating breakfast so I could catch up on documenting 20 min checks and intake, luckily for me his foley was d/c an hour before and during PCS he did not void, so nothing to document. After breakfast I was already done with my PVA, decided to give meds. Unfortunately, the MD was sitting in the room and writing in the chart and the CE didn’t want to interrupt doctor when I had to give insulin. Then MD took MAR and we couldn’t do anything. Time is running away. CE tells me she can add a few minutes to my PCS, I said sure. Finally we got MAR, I’m trying to get stuff from med cart (remember to wash hands and put gloves on before handling meds!), constant interruptions because students from another nursing program were coming up to the cart. Finally I got my six meds in one cup, CE decided to give two meds and we were ready to go back to the room. Then this doctor starts chatting with CE - another 10 minutes wasted. Then I gave my meds, washed my hands, gloves, ID MAR ID, opened them in Pt presence, my hands are shaking but I did OK. CE wants to give hers, she drops them, we start looking for them, we found them on the floor. Pt doesn’t have spares in med cart. CE is calling pharmacy to get more meds. At ten o’clock we are done, I thank patient and I have 15 min to document. Not enough time, CE added 15 minutes and I barely finished on time. She reviews my charting, rationale and everything else and I passed! Down to cafeteria for mandatory 15 min. break that lasts till 11. Then back on the floor for pt. No. 2, CE is Susan. Also very nice, appears less stressed and more laid back.
Pt. No. 2 in double room had amputated rt. Foot 2, 3, 4 toes this am, he is up in the chair. My dx: risk for injury and impaired mobility. VS, oral, AP, can use automatic BP machine but nowhere in sight. CE and I were hunting it down for a good 10 minutes. AP had to use the stethoscope, can’t use machine’s reading-it would be a failure. Areas of care: mobility, PVA, skin lower extremities. Well, rt. Leg pt has surgical dressing, ace wraps and orthopedic shoes. Left leg below knee amputation. Now, try to do skin and peripheral vascular assessment! Did popliteal pulses, asked pt. to remove prosthesis, skin moist under rubber compression stocking, right one dry but can’t see too much because of dressing. Pt ate 0% of lunch, is on fluid restriction had already two cups of coffee, during PCS wife brings 2 16oz. Dunkin donuts coffees, pt non-compliant with fluid restrictions, CE tells me to estimate intake. That was nice of her. One po med at noon time, Phoslo. We went to get med, after we are back pt in the bathroom and wife is helping him to get washed. Good 20 minutes. Used that time to document few things. Pt exhausted but decided to go with walker to the end of hallway and back. Mobility done! All done! Had 45 min. to document and to write rationale! Everything was OK. I passed.
2 PM labs repeat. I’m repeating labs with Susan, same CE I had for Pt no. 2. No problems. What a relief! One more to go! Went back to the hotel. Rewarded myself with TV, paperback and ice cream from Friendly’s.
DAY 3
Meeting with CA Wednesday at 7: 30, There are only five of us left. One girl didn’t make it. Claudette theCE and I went to the third floor. Pt. Is 72y/o female admitted with back pain and diarrhea: My dx: risk for injury of course and impaired mobility r/t weakness (older adult) – you can find exact wording in Carpenito’s AEB Pt requires assistance with transfer from bed to chair.
We went in, pt was already sitting in bed, finishing breakfast, did quick intake, no output, check hep lock, assist her back to bed, and did abd. Assessment, PVA, also pain management. Now pain level she says 10 but if she could say more she says she would say 20. Primary nurse notified, too soon for pain meds, just got them an hour before. I’m taking vitals, respirations – pt decides to hold her breath, started 3 times and 3 times couldn’t do it properly. CE tells me to do it for 15 sec and to “estimate”, fine with me. We move to AP. Can’t hear a thing because pt talking all the time, laughs and giggles, says that stethoscope is tickling her. She was a comedian, granted I was her 3rd or 4th student in 2 days doing the same stuff over and over again, to the point that when I was doing her abd assessment she tells me:” And don’t forget to write about my hernia.” Finally, when I am ready to leave she tells me her pain level is six and that probably putting her back to bed helped. So, one pain intervention I could check off, then I put a pillow under her legs, offered to turn TV on and I left very happy knowing that I did it all. Had 45 min. to document everything. Then I was sent to family room, 10 minutes later the CE comes, she said I passed, congratulations and I feel like a rock is lifted off of my chest. Then we go to the basement, CA is waiting for me, she congratulates me and here I go, off back to parking lot and on the way back to Massachusetts.
I am very I pleased. I must say Tina’s workshop was the best help. I also had 4 mini lab stations set in my basement and I was practicing every night for an hour or two. Invaluable was my family support and my wife’s patience. Poor thing,I was calling every time I could, especially after I flunked labs on the first evening. CE’s and CA were very nice and helpful. I don’t believe that they are out there to get you. We need nurses and they will let you pass if you prove that you are safe and that you know what you are doing. Everybody who reads this, especially people testing in Utica – good luck.
