Sue's Blog

The Beauty of Scripts

Mon, 30 Jan 2012 15:17:57 +0000

What to say…when to say it

“Compassion automatically invites you to relate with people because you no longer regard people as a drain on your energy.” ~ Chogyam Trungpa

For the last several months I have been dealing with the declining health of my mother and the sudden death of my father. It’s been a very difficult time for me, as I’ve weathered an unexpected surgery for mom, my dad’s funeral, and an endless stream of bills.

Most people have been helpful in settling my dad’s affairs and have offered appropriate condolences. Unfortunately, some health care workers have come across as less than compassionate. Whether they meant to or not, at times their words and actions seemed uncaring, or even worse, inappropriate.

A simple “I’m sorry” and “let’s see what I/we can do to help you” would have been nice to hear.

Unsure of what to say?

This leads me to a recommendation I read in an online blog called “10 Ways to Help Nurses Improve Patient Satisfaction.” What stood out for me was the suggestion at the top of the list, called “scripting.”

In nursing school, we all learned the importance of effective communication. Some of us practiced drawing out both patients and other health care practitioners by role-playing. Then we applied what we learned in the clinical setting.

But didn’t you still find yourself unsure of what to say in many important situations? As a new nurse, I know that I did.

Bring on the scripts!

The point of scripting is to provide nurses the words to use in many different situations. Now, before you protest…Geez, don’t you think I know how to talk to my patients?...hear me out.

In his Nursing Leadership Builders Blog, Dr. Michael B. Grossman says that the point of scripting is “to provide a set of comments that have worked well in similar situations and have had effective outcomes.” He adds, “If you are sincere and truly are there to help the patient, then the script is a gentle reminder of your mission.”

These mission-sensitive scripts could help nurses with a myriad of situations. For instance, scripts can alert nurses how to better…

Set the tone with new patients — Warmly introduce and identify yourself and your professional credentials.
Keep patients and loved ones in the loop — Explain treatment regimens and answer questions.
Prepare patients for operations — Equip a patient (and his/her support group) for what to expect, before, during and after a procedure.
Streamline the discharge process — Make sure a patient (and their loved ones) has everything they need for the transition from hospital to home.
Communicate with team members — Effectively communicate with your manager, or with nurses you manage, with the same tone you want to impart to patients.

Scripting can also provide nurses with the tools for handling potentially volatile patient issues, such as delayed procedures, lost test results…or the death of a loved one.

Personalize the message

Again, I’m not saying that we should be like little robots and simply memorize words. Nurses are so much more intelligent and caring than that! But a script can lay the foundation of what to say in any number of situations, even more so, if you are new to nursing.

With time and practice, each of us will find a way to personalize the information. With more consistency and accuracy of the message, as well as an emphasis on caring, I truly believe that patient satisfaction will indeed increase.

Now it’s your turn

Sometimes knowing just what to say and when to say it will help control a difficult situation. When emotions are raw and the situation is overwhelming for family and loved ones, all you may need to do is stop what you are doing, look the patient and family members in the eye, and say “I’m sorry.”

Have you ever been in a situation where a health care worker could have used some help with scripting?

How can scripts serve as “gentle reminders of mission?”

For some examples of scripts for nurses and nurse managers, see Dr. Grossman’s Rounding for Outcomes Scripts.

Follow Us!

Wed, 04 Jan 2012 14:28:55 +0000

blog post by Susan, MSN, RN, NCSBN

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Andrea and I attended the National Student Nurse Association mid-year conference in Memphis. We met a lot of really great nursing students and nursing instructors. We gave away hundreds of t-shirts, promoting our Twitter account. In addition to Facebook, Andrea posts our question of the week, study tips for NCLEX, and something brand new that we are calling “Pharm Friday” using our Twitter account. As the t-shirts said, “follow us” at NCSBNLearnext. More about this in just a bit…

Some students who stop by our booth don’t know what NCSBN Learning Extension is. Sometimes, since both Andrea and I get really busy, it’s just not possible to tell everyone about all the great features about our website. So I thought I would take this opportunity to write a short blog and highlight some of the really great things we have to offer.

NCLEX-related

First, and perhaps foremost, related to our 2 NCLEX review courses (RN & PN) are the following features:

Question of the week – answer the new interactive question every Monday on our website (or on Facebook!)
Question of the week widget – download the question of the week directly on your desktop
“Countdown” widget – download this widget and start counting down the time until your NCLEX exam… or customize it for another date (like the end of the semester)
Student discussion boards – share information, give and receive support other online learners
Pharm Friday – Follow our #pharmfri tweets to stay informed and to reinforce and/or learn fun facts about pharmacology

CE-related for all nurses (and nursing students)

Once you visit our website, it will become apparent that although a great deal of emphasis in on NCLEX, we have so much more to offer. There is a long list of CE courses. Many of the courses relate to ethical and legal issues that every nurse should know and understand as they progress in their professional careers.

I would highly recommend that students or new nurses sign up for a Nurse Practice Act course if one is offered by their state (use the link to see if your state is on the list.) It's always a good idea to be informed about the state laws that regulate your day-to-day nursing practice and understand what it means to be a licensed nurse.

CE-related for nursing faculty

Of course I would be remiss if I didn’t bring up our 2 CE courses for nursing faculty members:

Test Development & Item Writing
Assessment of Critical Thinking

Both of these courses were written by people who work in the NCLEX department and who know a thing or two about assessment and evaluation. Recently updated, these courses are a must for anyone considering taking a certification exam.

Now it’s your turn

We have a lot to offer nurses, nursing students, and even nursing faculty. Check out our website, Facebook page or, as our t-shirts say, follow us on Twitter to take full advantage of all we have to offer.

Do you have any great ideas you would like to share with our online community? If yes, we are offering people the opportunity to be guest bloggers – email Andrea with your ideas at aplatt@ncsbn.org.

Lastly, we are preparing for another fun project related to our question of the week – follow us to stay up-to-date on this and other projects we are developing to help nursing students be successful on NCLEX!

Be sure to stop by and see Andrea and me at the NSNA's Annual Convention in Pittsburg (April 11-15)!

Discovering the Truth About UAPs and CNAs (2 Comments)

Tue, 06 Dec 2011 13:44:54 +0000

blog post by Susan, MSN, RN, NCSBN

All truths are easy to understand once they are discovered; the point is to discover them. ~ Galileo

I’ve previously written about unlicensed assistive persons (UAP), most recently about medication aides. Still, I receive a lot of questions on this topic, including these:

“What’s the difference between a UAP and a CNA?”
“Can a UAP and a nursing assistant do the same things?”
“How is a UAP qualified to take pulses?”

I’m sure that I, too, would be confused about all this if I hadn’t taught nursing assistant classes for many years. To make a long explanation short, let’s just say that a CNA is a more specialized type of UAP.

So many names…so confusing

A variety of nursing assistive personnel, who are also collectively referred to as UAP, are trained to assist nurses in providing patient care activities. You may be familiar with these more common titles:

patient care technicians (PCTs)
nurse aides
certified nursing assistants (CNAs)

Usually, the title of UAP usually depends on the health care setting. For example, UAP who work in long term care (LTC) or skilled nursing facilities are called CNAs. In the hospital setting, UAPs are more commonly called PCTs.

Regardless of the setting, UAP learn about how their work supports the role of the nurse. And discovering what UAP, and specifically CNAs, can and cannot do will only help to make you a better nurse. So let's start with the basics and go on from there.

CNAs are UAP…

UAP is an umbrella term, used to identify anyone who is trained to assist a nurse. As I have written before, a medication aide (MA) is a type of UAP. A certified nursing assistant (CNA) is another type of UAP.

But not all UAP (including MAs) are CNAs. Read on...

CNAs working in Long Term Care

Unlike other nursing assistive personnel, all nursing assistive personnel who work in a long term care (LTC) facility that accepts Medicare and Medicaid must be CNAs – it’s the law.

The Omnibus Budget Reconciliation Act of 1987 (OBRA 1987) mandated the Nurse Aide Training and Competency Evaluation Program (NATCEP) to establish minimum requirement for nurse aide competency within certified nursing facilities (142 CFR §483). This Federal law stipulates that CNAs must:

Successfully complete a training course that includes (a minimum of 75 hours of) theory and (at least 16 hours) supervised practical training or clinical
Pass a certification exam
Have their names listed on a state registry

Mandated training for CNAs

So what exactly can CNAs do to assist the nurse? Well, Nurse Aide Training programs are required to provide instruction in the following areas:

Basic nursing skills - for example, how to take and record vital signs and measure height and weight, as well as recognizing and reporting abnormal changes in body functioning
Personal care skills – such as bathing, grooming, dressing, toileting and skin care; transferring, positioning and turning
Mental health and social service skills – so that they understand how to respond to a resident’s behavior
Care for cognitively impaired residents – so that they understand how to adapt care for someone with dementia
Basic restorative skills – or supporting the resident in self care, and maintaining range of motion
Resident’s rights – providing privacy, maintaining confidentiality, and promoting the resident’s right to make personal choices, and to be free from abuse, mistreatment and neglect

UAP in Hospital Settings

Many acute care settings require their UAP to be CNAs. But since they are unlicensed workers, and therefore have no scope of practice, they can be trained to do more than what they learned in their basic Nurse Aide Training programs.

This helps to explain why a nursing assistant who works in a hospital can perform fingerstick testing or even assist a resident with simple oxygen administration… unlike CNAs working in LTC.

Now it’s your turn

Did your nursing program require you to first be a CNA? Do you think this will help you to be a better nurse?

How well prepared are you to work with CNAs?

Avoiding Brain Freeze (2 Comments)

Mon, 28 Mar 2011 20:21:06 +0000

blog post by Susan, MSN, RN, NCSBN

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"When I sit down to take my state boards, I get stupid."

Information fatigue: stress caused by overload of information and trying to assimilate the information. (dictionary.com)

Does anyone really believe that more always equals better? For some things, this adage certainly applies, but only to a point.

Exercise is good, but too much or too often can lead to injury.

We need food to sustain us, but too much is not healthy.

And with messages from our IT reminding me that my e-mail mailbox is full, I am acutely aware that more is definitely not better.

So, how about when it comes to studying for the NCLEX? Does the turn-every-stone philosophy really work? Or is focusing better?

Too many choices?

In her recent article in Newsweek, I Can’t Think, Sharon Begley says that we often think having more choices is better. But, in reality, people who overdose on choices/information (which is far too easy to do in the Google, Twitter and Facebook age!) can suffer from a type “info-paralysis,” where the information center of the brain goes into overload. The resulting anxiety and frustration can cause them to make more mistakes.

Seems to me, that this holds true for NCLEX preparation. As I read your discussion threads, many of you talk about the dizzying array of study options and products available. You go on to say that you study any and every resource you can get your hands on.

One person wrote about, “…studying/preparing for my nclex for almost half a year now, 8 hours per day.”

And even though you feel as if you are as well prepared as possible for NCLEX, many of you also write that when you, “…sit down to take state boards [you] get stupid.”

I'm sure you will be relieved to know that this is not an attack of "stupidity". (And calling ourselves stupid isn’t exactly a confidence builder!) Sounds like what you are really describing is a symptom of information fatigue or info-paralysis. And there are some simple solutions!

Preventing brain freeze

So how can you better manage the large amount of information you need to know/remember for your NCLEX? Here’s a short list of questions to ask yourself in order to prevent brain freeze…

What do I want to learn? Write down the topics you want to focus on for each time you prepare to study.
How many hours per week will I study? Set a reasonable goal, and then “chunk” your studying to focus on what you really need to know. Be careful not to endlessly review facts and concepts you already know.
Do I need a break? The human mind learns by connecting new ideas and information with existing memories and experience. Incorporate study pauses to close your eyes and daydream or meditate…and don’t forget to get a good night’s rest.
Who can I study with? People are one of your best resources and can help keep you on track while stimulating you with great ideas.
What are my best study resources?

When you are a student in one of our review courses, you can also write to me for help - I welcome your emails or discussion questions (it’s just all those other emails that make me crazy).

Now it’s your turn!

Have you ever experienced information fatigue or brain freeze?

How are you keeping your focus while preparing for your NCLEX?

Giving Thanks

Wed, 16 Nov 2011 14:40:55 +0000

blog post by Susan, MSN, RN, NCSBN

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How a grateful heart can increase achievement (and help you conquer NCLEX jitters)

We can only be said to be alive in those moments when our hearts are conscious of our treasures. ~ Thornton Wilder

I went back to work when my youngest daughter was about 6 weeks old. Since there was no opening in the unit I had worked on before maternity leave, I accepted a part time position in pediatrics. Although it wasn’t my first choice of where I wanted to work, I was just glad to have a job working day shift.

One of the best things about working in peds was that I was always so grateful that my own children were happy and healthy. Working as a nurse not only gave me a different perspective about children, but also about being a parent and even life itself. I was beginning to tap into the power of gratitude.

Not sweating (all) the small stuff

Later, after I had just begun grad school, a book by Richard Carlson was released: Don’t Sweat the Small Stuff and it’s all Small Stuff. Now, I don’t know if I would consider everything small stuff! But those words helped me to look at things differently as I tried to juggle work, school, and raising a family. It reminded me that obsessing over the minutia of daily life was simply counterproductive and could keep me from treasuring the really important stuff and realizing my goals.

It turns out that gratitude is an important part of achievement. A 2003 research study by Robert Emmon, PhD and Michael McCullough, PhD, found that people who keep a journal of things that they are grateful for, “were more likely to make progress towards significant goals in their lives (personal, academic, health) than those who did not.”[1]

Reflecting on your treasures

Many of you who are taking our review courses are busy preparing for the one thing that stands between you and becoming a nurse - NCLEX. You write about using several resources, studying hours upon hours every day, answering hundreds of practice questions just so you can be successful on NCLEX. So many of you write that you are convinced you will never succeed at NCLEX and may never reach your goal of becoming a nurse.

So this is exactly when you need to take a step back and reflect on all the successes you have had in your lives. Maybe even start a gratitude journal!

You might start with how special you are to have been selected to enter into and later graduate from a nursing program! Then take some time to give thanks for life experiences (both positive and negative) that have added to your repertoire that will make you exceptional nurses. Don’t forget to be thankful for those people who’ve helped you along the way, including instructors and fellow students.

What I’m thankful for

As we prepare for Thanksgiving here in the U.S., I have been thinking of stuff, both big and small, for which I am thankful. I am looking forward to having my children home for the holiday, and for way too much food and too little time to spend with family and friends.

It can get a little crazy preparing for the actual day, but when it finally arrives, I know it was all worth it. I hope that you all can understand that the craziness of preparing for NCLEX will eventually come to an end and this preparation will be worth it when you are officially nurses.

Now it’s your turn

For the last few weeks, we have asked people to submit to tell us what they are thankful for. Use this link to read about what you and others have written on Facebook… or you can respond to this blog and tell me what you are thankful for.

Happy Thanksgiving, everyone!

[1] William Hale, PhD, UCS/CBH, “The Power of Gratitude,” Western Reserve University March 2007 mind body connection. Found at http://studentaffairs.case.edu/counseling/mindbody/newsletter/0307/.

Normal or Therapeutic? - NCLEX Prep, Question 2 (1 Comment)

Mon, 22 Aug 2011 18:51:39 +0000

blog post by Susan, MSN, RN, NCSBN

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Your most asked questions about NCLEX prep, Question 2

Question Two: Therapeutic lab values… and how are they different from normal lab values?

As I wrote in part one of this 3-part series, I’m tackling some of the most frequently asked student questions. Last time I wrote about isolation protocol. This time I’m tackling therapeutic lab values - specifically therapeutic lab values for blood thinners. (Stay tuned for Question Three about triage for disaster victims.)

Therapeutic Lab Values: Used to look for the presence/effectiveness of specific drugs in the blood.
Normal Lab Values: The range of results expected from lab tests without influence from a therapeutic drug.

Back to the basics!

When it comes to preparing for NCLEX, I often suggest that students have a basic understanding of normal PT (and INR) and APTT lab values and how these are different from therapeutic lab values (used with anticoagulant therapy). Usually this prompts a question like, “how are they different“?

Before I talk about therapeutic lab values, let’s start with the basics. But before I do that, let me emphasize that lab values vary slightly from lab to lab. When students write and ask which lab values they should memorize, I usually suggest they go with what they learned in school – why get confused with all these other numbers?

Labs for bleeding and clotting times

Let’s look at the three tests used to determine bleeding or clotting times:

Prothrombin Time (PT) — this blood test measures how long it takes blood to clot and can be used to check for bleeding problems.
An abnormal PT/INR can be caused by liver disease; injury; lack of vitamin K; or treatment with blood thinners.
QUIZ YOURSELF: Which blood thinner are we talking about here? (answer below).
International Normalized Ratio (INR) – is a standardized way to report results of bleeding time. It is used in place of PT; in fact, some labs will only report INR.
Activated Partial Thromboplastin Time (APTT)* — this blood test also measure the time it takes your blood to clot and to help diagnose bleeding problems.
An abnormal APTT can be caused by bleeding disorders (such as hemophila); liver or kidney disease; or treatment with blood thinners.
QUIZ YOURSELF: Which blood thinner are we talking about here? (answer below)

Therapeutic Lab Values

Let’s look at these same lab tests once again.

PT & INR — If you answered warfarin (Coumadin) to the first question above, you were correct! How much warfarin the person is prescribed depends on the prothrombin time (or INR). The therapeutic value of PT is about 1.5 to 2.5 times the normal value; the therapeutic value of INR is 2 to 3 times the normal value.

Test	Normal lab value	Therapeutic lab value
Prothrombin time (PT)	11 – 13 seconds	15.5 – 35 seconds
International normalized ratio (INR)	0.8 – 1.1	2 – 3

APTT — If you answered heparin for this test, you were correct! As with the PT/INR test, the heparin dose is changed so that the APTT result is about 1.5 to 2.5 times the normal value.

How can you remember if APTT is used for heparin or warfarin? I always remember APTT has 2 “sticks” (the T’s), and there are 2 sticks in the “H” in HEPARIN… it’s stuck with me all these years.

Test	Normal lab value	Therapeutic lab value
Activated Partial thromboplastin time (aPTT)	30 – 40 seconds	45 – 100 seconds

Applying this information

So, let’s say you are caring for a client taking warfarin (for example, following total hip replacement surgery). This means that when you look at the labs for this client, you want to see longer bleeding times or, essentially “abnormal” values. The idea here is to prevent blood clots from forming.

For heparin therapy, you are caring for a client who is on IV heparin (admission diagnosis is deep vein thrombosis). When you look at the labs for this client, you also want to see longer bleeding times.

Keep in mind that if the number is too high for either client, you should start watching for signs of spontaneous bleeding and the dosage should be decreased. Another key point to remember, these tests should be done at the same time of day every day while the client is hospitalized.

QUIZ YOURSELF: What are the antidotes for reversing the effects of heparin? And for warfarin? (Watch for the answer below.)**

Now it’s your turn

Are there any other topics you would like me to discuss in an upcoming blog?

*Are you wondering if it's PTT or APTT? PTT was first used in the early 1950’s and was replaced by APTT in the 1970s.

** The antidote for reversing the effects of heparin is... protamine sulfate. The antidote for reversing the effects of warfarin is... vitamin K. Did you come up with the correct response without looking?

Medication Aides, Part 2

Tue, 25 Oct 2011 20:29:44 +0000

blog post by Susan, MSN, RN, NCSBN

They’ll get by with a little help

“RN delegation must be grounded in the fundamental principle… to protect the health, safety, and welfare of the public.” ~ Amy Vogelsmeier

In one of my last blogs (Medication Aides, Part 1) we looked at the results of NCSBN’s First National Survey of Medication Aides. In this study, many medication aides reported that they were in over their heads and were doing things way beyond their scope of practice.

Hey, but wait a minute…

If med aides are unlicensed assistant persons (UAP), and…
If unlicensed assistive persons don’t have a scope of practice,
Then, what’s going on here?

Let’s quickly review some basics about medication administration and then look at one possible solution to help med aides so that they can be safe practitioners.

They need your skill and knowledge

I’m sure most nurses would say that there is a great deal of skill involved with and knowledge needed to safely give medications to others. And I would bet that every nurse would say one of the first things they learned about medication administration was the 5 Rights*:

Right person
Right medication
Right dose
Right time
Right route

So, if it is our duty and responsibility as professionals is to ensure health care quality and patient safety, what can a nurse do to help med aides provide safe care? Well, I do not pretend to have all the answers, but I think one thing we can do is to be more effective delegators.

They need your direction

Delegation: Having the authority to direct another individual to perform nursing tasks and activities to direct another individual to perform nursing tasks and activities they would not otherwise be assigned. — NCSBN

Many believe that nurses don’t delegate because they don’t understand what it means to delegate. Before you delegate any nursing activity or task, you must first consider these guiding principles of delegation (which are similar to the 5 rights of medication administration):

Right task
Right circumstances
Right person
Right direction/communication
Right supervision

They need your accountability

But delegation involves more than just telling someone to do… something. We need to remember that delegation requires both accountability and responsibility. In other words, in order to ensure that safe care is delivered:

Nurses are responsible to consider staff competencies and the condition of the client before we delegate a task, and…
Nurses are accountable for the safe completion of the task.

I would like to point out that, according to many Nurse Practice Acts, a nurse can rescind a delegation if it becomes apparent there is a problem. Moreover, nurses cannot be fired for refusing to delegate (if there is a legitimate reason).

Always remember, we are entrusted to protect the public’s health and welfare and must take any necessary steps to ensure this.

Now it’s your turn

Nurses must be aware of their role in the safe administration of medication and understand how and what can be delegated to UAP.

Do you feel adequately prepared to delegate to unlicensed assistive persons, especially medication aides? Do you understand the role of the medication aide?

For more help…
Delegating Effectively — If you are unsure about your role in delegation, you might consider taking our wonderful CE course.

Nurse Practice Act— Be sure to read your state’s act for legal information about delegation.

Working with Others: A Position Paper — Gives a more detailed account of delegation.

*Did you know that many resources now recommend using the 10 rights of medication administration? These additional rights include:

6. Right documentation

7. Right client education

8. Right to refuse

9. Right assessment

10. Right evaluation

Medication Aides, Part One

Tue, 11 Oct 2011 19:34:25 +0000

blog post by Susan, MSN, RN, NCSBN

"And everyone knows I’m in over my head, over my head, with eight seconds left in overtime.” —The Fray

One of the perks of my position is I get to attend conferences and learn about advances in the profession. Recently, I went to the Long-term Care Conference: Regulatory Perspective and Future Implications, sponsored by NCSBN, where one of my colleagues gave a presentation about the results of a medication aide survey (conducted by NCSBN).

The full results of this important study have just been released* and I got permission to share some of the highlights... information I think is important for every nurse to consider.

First, I want to focus on results of the study and what the medication aides are saying about their training and job responsibilities. In another blog, we’ll consider how we as nurses can (more) effectively work with this level of health care worker.

One thing is for sure…whether it comes to love (the Fray) or administering medications, it is never a pleasant thing to know you’re in over your head, wondering if your circumstances will catch up with you!

Training and work settings

Medication aides (or med aides) administer certain categories of drugs through specific routes, as authorized by state law and delegated to them by a nurse. Seventeen states and the District of Columbia use medication aides and a lot more states are passing legislation to use these aides, to help already overloaded nurses.

The First National Survey of Medication Aides tells us that:

Most med aides work in a nursing home or assisted living setting
Most (but not all) med aides are first required to be CNAs
Most med aides were educated by their employer
The average number of training hours was 56

What is troubling here is that training is employer-based and only 56 hours long. And seriously, is 56 hours enough to learn everything you need to know about passing meds? Many of the med aides who responded to the study didn’t think so.

Consider further the implications of only 56 hours of training to prepare someone to pass medications for a population as vulnerable as the elderly living in long term care facilities.

But the real question is ~ are we pushing med aides past their abilities and expertise? Read on…

Passing medications… and then some

As expected, medication aides stated that they could administer many oral or topical medications. But some medication aides reported that they also administer the following medications (and no, I am not making any of this up...):

Intravenous medications
Controlled substances, including Schedule II narcotics
Chemotherapeutic medications

In many cases, med aides administered medications when the supervising nurse was unavailable to monitor the progress and/or the effect of the medication.

Like nurses, many of the med aides reported that they were pulled away from passing meds to do other tasks, like answer call lights, check bed/chair alarms, and assist residents.

Worried about being disciplined

Maybe because they were often pulled away from med passes, a significant number of med aides indicated that they were afraid of being disciplined for administering medications late. (This was of greater importance than any of the other rights of medication administration.)

Many also reported that they thought some of the tasks they were required to perform were beyond what they should be doing… that they were in over their heads.

Now it’s your turn

I was just wondering how many of you reading this blog are employed as a medication aide? The data from the study implies that there is a disparity between what med aides should be doing and what they are being required to do.

If you are a medication aide, do you feel you were adequately prepared to pass medications? Do you feel a gap between what you were trained to do and what you are required to do?

If you are in or have completed nursing school, does this information give you a different perspective about med aides?

* The First National Survey of Medication Aides is published in the October 2011 issue of the Journal of Nursing Regulation.

Available on Learning Extension - for $15 and a 3-week subscription, you can earn 1.6 contact hours by reading and completing a posttest for this article from the October 2011 issue of the Journal of Nursing Regulation: Medication Administration in Nursing Homes: RN Delegation to Unlicensed Assistive Personnel.

Changes to NCLEX-PN Test Plan (3 Comments)

Mon, 18 Apr 2011 13:57:18 +0000

blog post by Susan, MSN, RN, NCSBN

A “standard” is something set up and established by authority or general consent as a measure of excellence or quality ~ Merriam Webster Online Dictionary

I’ve already started getting emails from panicked students who are preparing to take the NCLEX-PN®. Basically, everyone wants to know if our review course will prepare them for the new exam.

And, my answer is yes and no — yes, it will prepare you for the NCLEX (National Council Licensure Examination), but no, it’s not a “new” exam.

Just like with the NCLEX-RN® last year, there are changes to the 2011 NCLEX-PN Test Plan that went into effect April 1.

Wondering exactly what this means? Read on for clarification and for some tips for making the most of your preparation…

A higher passing standard

First of all, the passing standard has been raised slightly, which means that you may find the test just a bit more difficult to pass. Before you panic, understand that raising the passing standard doesn’t necessarily mean the test content is harder. You just have to answer more questions correctly to pass.

You’ll be relieved to hear that the format of the Test Plan remains pretty much the same, with only a few minor adjustments. Here is an overview of some of these changes.

Give a little, take a little

With respect to the percentage of questions on the exam, there will be slightly more emphasis on some areas of the test plan, with a corresponding decrease in emphasis for other areas.

The following areas of the test plan now have slightly more emphasis on NCLEX:

Coordinated Care
Safety and Infection Control
Pharmacological Therapies

There is no change in the percentage of questions from the category Health Promotion and Maintenance. The remaining categories will have slightly less emphasis.

Other changes

Some of the other changes involve renaming things. For example, “Disaster Planning” has been changed to “Emergency Response Plan” and “Substance Related Disorders” is now “Chemical and Other Dependencies.”

You can read about some of the other changes in NCSBN’s Frequently Asked Questions About the 2011 NCLEX-PN Test Plan.

I like to think of these changes as a reflection of the standard of nursing care we aspire to year round – a standard of excellence and quality. And high standards benefit our profession and our patients!

Preparing for the new NCLEX… and a high standard of practice

My advice as you prepare for the NCLEX:

Move quickly! — Take the exam as soon as possible after graduation, while the information is still fresh in your mind.
Better prepare — If your school requires you to take an exit exam before you are allowed to apply for the NCLEX exam, use the results to identify areas of weakness.
Check out our Web site — See what other students are writing about NCLEX and how they are preparing for their big day!

And, of course, I would be remiss if I didn’t put in a plug for our PN Review course, which has over a thousand practice questions, including those dreaded alternate item type questions.

Now, It’s Your Turn!

Do you feel prepared for the new 2010 NCLEX Test Plan? What worries you the most?

Intelligent... By Design

Wed, 28 Sep 2011 18:21:10 +0000

blog post by Susan, MSN, RN, NCSBN

The most intuitive NCLEX Review

“Quality is never an accident; it is always the result of intelligent effort” ~John Ruskin

Every now and then I do an online search to see what other options beside NCSBN's Learning Extension are available for NCLEX review. Today, I used the keywords “studying for NCLEX” and got 320,000 results! I looked at a few of the websites and wondered how anyone can decide which product to use, especially since each of them state that their product is…simply the best.

At least one of the websites was all about degrading other review products while promoting its own review. A few of the websites had free “sample” questions. One website offered NCLEX secrets! Many resources offered a money-back guarantee if you didn’t pass NCLEX after using their review, saying that their product will help you “ace” the boards (which makes no sense, since NCLEX isn’t graded).

There was even one website that talked about the traumatic experience of taking NCLEX and included some seriously negative adjectives throughout the text, like “hate,” “tormented,” “spine-chilling.” I was depressed just reading it!

More comprehensive

Now, don’t get me wrong, there are lots of really good resources available to help prepare you for NCLEX. Each of them has different strengths and proven track records of helping nursing students prepare. So, although I don’t know who the best is, I can tell you that Learning Extension offers a high quality product with lots of fringe benefits for a very reasonable price.

Whether you are taking the NCLEX-PN or NCLEX-RN examination, our courses give you access to content organized according to the latest NCLEX Test Plans. Furthermore, we are constantly updating and revising content to reflect current nursing practice, through contributions by nurse educators from across the county. In fact, we often use student input to make improvements in the courses.

Do you need some more convincing about how great our courses are? Here are some of the exciting features you'll get when you sign up for one of our review courses:

Help with questions — If you have a question or need clarification about the correct response to a practice question, an instructor (that would be me!) is available to help you. Although I don’t claim any insider secrets, I do have great information to share.

Online community — This rich learning resource connects you with other students just like yourself, who are there to study with you, support you, and answer your questions.

24/7 access online — You control when and how you want to learn. You can read through the review material and then answer the practice questions, or you can simply answer questions.

Bonus tools and tips — Enjoy relaxation techniques, study tips (including lots of mnemonics), and links to additional information and resources (including Epocrates for drug information and Merriam Webster’s online dictionary).

NCLEX-style learning — You can test your knowledge through 1800 intelligent questions, all written in NCLEX-style. In order to answer these questions, you will need to analyze information and apply nursing knowledge, and not simply recall facts.

If you have any doubts about how good our questions really are, don’t take my word for it – read what former students have written on the Learning Extension discussion boards.

It’s your turn

If you are reading this blog entry, I’m guessing that you have probably purchased a subscription to one of our review courses.

So, how did you decide to sign up for our course? And, if you have used any of the other review resource(s), how does our course compare?