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NCLEX did not fail the students, the Canadian Nursing Association and the regulating provincial bodies did.

I’ve been a nurse for under 5 years and I still remember all too well studying for the CRNE (Canadian Registered Nursing Exam) and the stress and anxiety I felt from it.  I  also knew that CRNE for the most part attempted to  reflect on what I learned in nursing school as well as how our Canadian Health Care system operated.

Then all of a sudden arrived the NCLEX.

A number of years ago, the CNA (Canadian Nursing Association) and the rest of the provincial nursing regulating bodies in Canada were being proposed of a new exam called the NCLEX (National Council Licensure Examination) that would serve as a uniform way of testing all nurses both in Canada and the US (the  US has had this testing since 1994.)  This year was the first year that graduating Canadian Nurses wrote the exam.

Nursing_Textbooks_1

And unfortunately many of them failed.

Questions and possible answers immediately started to arise as to why this was the case.  Blames to the type of school and programs immediately surfaced as many tried to find an answer.  Many schools however have proved that statistically prior to the NCLEX they were had successful rates with the CRNE.  So the real reason is not because these students were not smart enough.

The real reason is that simply these unfortunate students were used as guinea pigs in a failed experiment that did not prepare them.

It seems the one thing that was often overlooked and what some organizations such as the RNAO (Registered Nursing Association of Ontario) had chanted for years is that simply nursing in Canada is different from the nursing in the United States.   Nursing up here tends to be more psycho-social where in the United States it is more bio-medical and pathophysiological.  There is no argument as to which one is better or worse but it is also unfair to subject a test to nursing students who essentially spent four years if not more studying and learning nursing in a Canadian health care system to only be subjected to a licensing exam that does not reflect this at all.

Furthermore, a lot of nursing schools did not have enough time or prep for these graduating students to take the NCLEX exam.  Most of the prep exams for students are based on the CRNE format.  A brand new curriculum would have to be implemented to prepare these students and usually preparing such curriculum can take months if not years.

What I always found quite odd (and also a waste of money) is that though the NCLEX is an American standardize test, as Canadians if we want to practice in the United States, we have to take yet another NCLEX just to practice in the few states that we are allowed to if we chose to practice south of the border.

In my department where I currently worked, we hired 8 new graduate nurses who all took the new NCLEX.  Out of the 8, only one passed.  This is a staggering number considering in the past, most if not all of our new grad nurses d passed the CRNE.  As a new graduate nurse, I can only imagine  how detrimental this must feel, especially if this was your first nursing job to only have taken away from you because of this botched exam.

I wish I could give advice to these new students but because I have not written the “Canadian NCLEX” it would be like the blind leading the blind.  But more importantly I wish the CNA and the other regulating bodies across the country can see that this was not implemented or planned properly and perhaps was a big mistake.

And most importantly…….If ain’t broke…..don’t fix.

Medsoulbrother

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Posted by on August 26, 2015 in Uncategorized

 

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Life of a Murse Episode 3: The Lady in White.

IV

The last two years of nursing school were not so bad but the workload was still heavy. Perhaps the most anxious thing was writing the CRNE (Canadian Registered Nurse Exam.) I literally had nightmares of failing the exam (likewise with other fellow students.) While in my last year and juggling two jobs I got a sweet summer job at a hospital close to me working as an extern. For better lack of terms, it was being nursing assistant, and I got to be one in the Emergency Department. At that point this is when I knew I would love nursing. As a nursing assistant I was doing so much and helping the staff. In fact, I was doing stuff that I never got to do in my other clinical settings in school but was only taught in lab. I was putting in Foley catheters, doing ECGs, doing vitals signs, and even helping with doing bloodwork (which was so nerve wrecking at first.) As I was in my final year and continued working as a nursing assistant.(I was working three jobs just so I would not have no school debt) I was encouraged by the educator and the charge nurse to apply for a new grad position in the emergency department. Without hesitation I applied, and I was hired.

One of my first ER shifts was when I was with another nurse in the acute area on a nightshift.
Oh boy.
One of my fondest memories was learning how to start IVs. Doing straight blood draws was not an issue as I learned them quite well when I was an extern. The tricky part came when i had to put in an actual IV. The IVs were quite tricky as you had to make sure you applied pressure so the blood would not spewing all over the place like a bloody crime scene. I said to myself.. nope I am gonna do an IV I don’t care.
Again…..Oh boy.
One night I was working along with my preceptor. It was a Friday night so of course we were getting all the drunks coming in. We had one lady who was dressed in complete white who was here for a problem that to be honest with you I could not remember. All I remember was that she was wearing all white. White blouse, white jacket, white pants and white shoes to match.
Maybe there was a white sale at Sears? Maybe I should have told my mom at the time?
Who the heck knows. Anyhow, the distinct thing I remember about this patient was that she had some form of social issues at home that required to be seen by our crisis worker. The doctor had ordered some blood for work and I told my preceptor that I was going to the blood work.
“And you are putting an IV in her.” she chimed as a reminder.
I closed my eyes for a quick second and kept repeating myself. “Don’t fuck up, don’t fuck up, don’t fuck up. You can do this.. you got this man. You’ve done straight pokes before, you can put an IV, it will be ok.”
Clearly my conscious lied to me.
The patient rolled up her sleeve as I tightened the tourniquet on her arm trying to feel for a vein. I felt a nice fat juicy one right in the centre of her arm. I had all my equipment and blood vials set.
I took a deep breath.
You can do this. You can do this it’s okay you can do this.
Grabbing my 20 gauge IV, I aligned it with her vein and slowly entered. Learning from all the nurses, I would count one to three so the patient would know (for those who had quite apprehensive to needles.)
Immediately I saw blood return to the tip meaning that I had entered the vein.
Great!!! Okay so part 1 was done.. .now I had to remember the rest of the parts. I indistinctly remember to make sure I had placed good pressure over the IV so the blood would not spew out before I attached it to an IV lock.
Ok you are doing good. You got this bro.
The patient then gazed at me with this weird look. “You’re quite good looking you know that?”
I lifted my head surprised by her comment. “Huh??” My fingers immediately released from the IV as I was trying to make sure who she was referring to. I guess you can call me modest but I never considered myself the model GQ type or that attractive so when usually when a woman makes a comment like that either she is intoxicated, high on some kinda of drugs or had a dementia. I forced a smile trying not to be rude but then my eye caught something red on her sleeve.
SHIT!!! I let go of the IV!
I did not even have time to respond as blood started pouring out of her IV like a leaky faucet. The blood started soaking on her white blouse, jacket and her pants.
Fuck my life!
My voice all of a sudden sounded like Grover from Sesame Street. “Uhm, help me here please.” As I turned to my preceptor.
She saw smiled a bit and quickly grabbed a couple of two by twos gauzes. She immediately helped me IV lock the patient but at this point this woman looked like a bloody mess. She look like she was part of a crime scene from criminal minds.
Immediately I began apologizing while we were cleaning up. “I am so sorry about that. ”
Surprisingly the woman did not react or act mad. “It’s ok.”
My preceptor immediately grabbed a patient’s gown and gave it to her to change while we grabbed her white clothes and placed them in a container with hydrogen peroxide.
She turned to me. “And this is why we always tell patients to dress in a gown before they are seen by a doctor.”
I nodded still feeling like shit. “Yeah I got it. ”
“Don’t worry you were okay, you will be a pro at it.”
“But I screwed up. ”
“Trust me, this is so minor compare to other things.”
“Really?”
“Trust me as you work in the ER you will know and you will look back to this and laugh.”
I was not laughing. I just kept thinking how I screwed up.

Later on that week was my actual graduation ceremony. The day I was graduating was such a rewarding time for me. But it was also a time of mixed emotions.
“So, dad are you and mom going to be at my graduation?” I had asked a month ago.
My dad shook his head. “I can’t I am busy.”
“Busy with what?”
“I am going to the racetrack that day for a big race. Sorry.”
“So a bunch of horses galloping around a track is more important than seeing your son cross the graduation stage?”
“I’ve been to your graduation before for your first degree.”
“You really don’t like what I am doing do you?|
My father ignored me and shrugged his shoulders. “All I want to know is what you are going to do after. Do you plan to stay as a nurse are you actually gonna do something better?”
I glared at my father. “I can’t believe this. My father does not want to go my graduation for a degree program that I worked my ass for because it makes him look like a fool in front of his friends.'”
“I am not gonna this discuss with you. ”
“WELL I AM!”
“Don’t you dare raise your voice at me! Have respect for your father!!!”
“Well have respect for me dad!! This is my graduation. Not every parent gets to see their child graduate. Not everyone graduates period. This should be a happy time for me and yet you are making it miserable.”
My dad grabbed his jacket as he headed out the door. “I have other plans. You’re mother is going. She will be there to support you.”
I stared at the half opened door as he started the car and drove off.

 
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Posted by on February 27, 2015 in Uncategorized

 

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