I love the television series "Grey's Anatomy". It brings back many years of memories from working in the emergency room to the operating room and then to finish the shift in the recovery room. But there is a beginning to this career and it's called "State Boards".
No, I didn't ever fail state boards, I had to take it several times along the way in my career. As an LPN, it was one day of horror at a vocational tech school in Chicago. Nothing was allowed in the classroom with you. No purse, no coat, no thing of any kind to distract you from the test. They gave you pencils to fill in the circles and there was only ONE right answer. Not an almost right answer. If the right answer wasn't there, you would mark NONE OF THE ABOVE. So you sat and pondered for minutes on end which was the right answer when none of them were correct. I never thought I would pass. My teachers and I fought religiously over the proper care of my patients. I surely was going to flunk........I passed. Phew! Way back in the old days you received a number grade.
Next set of courses were to help you make more money, Intravenous Therapy, EKG. Critical Care LPN, Phlebotomy, Pharmacology and something called a Wang Computer class.
RN school was next. I got to Clep out of the first 1.5 years of the 2 year Associates program. That was a blessing in disguise. So here come the state boards again. 2 days at the Chicago Hilton Hotel. You would think it was in a nice room. Hell NO. It was in the hotel dungeon! If you didn't make it in that room by 9:00a.m. the doors were locked and you flunked that portion of the test. I am not a morning person. I was there by 8:30 a.m. A few of my classmates had gotten drunk the night before so they never made it on time. My best friend, kept me up all night chain smoking, while studying to the last moment possible. I figured if we didn't know it by now, we didn't know it and so I tried to sleep.
So here we are in hotel dungeon. Two days in a row. Our class went from 160 students down to 60 when I started 6 months before this date. 100 either flunked out or were singled out. I put my heart into my research papers, but could care less about my tests. A month after state boards I visited the college. The dean of nursing was told that 11 students from my class had flunked and was sure my name would be on that list. By this time, you only got a pass or fail letter. My letter said I passed. I wish I still had that letter today to prove to myself that I had the heart to push myself to do my best and that best got me thru a lifetime of one fantastic nursing career.
Nasty nursing student who hated me because I never really had to study kept whispering to me over and over again in the dungeon to let me share my answers with her. Wow, she got caught and flunked state boards. After she was kicked out, I had the whole end of the table to myself in peace and quiet. This started the first hour of the first day of state boards. What a way to lose the grade, or just flunk out of state boards for another year.
So now I had my RN, an Associate Degree in Nursing (ADN) and started out right away in Critical Care. I had it made. Or so I thought until someone told me we were signed up for Advanced Cardiac Life Support course (ACLS) and I had to study for that. I went to St. James Hospital, Chicago Heights, IL, with 4 of my co-workers including my nurse manager and all of us were in shock during this course, not to mention sick to our stomachs. Ah yes, everytime since that I've taken that course, I dread the oral exams. I know what to do when I have to do it in the emergency room, but damn to tell someone what I am supposed to do in a one on one getting diaphoretic and wanting to projectile vomit on the pretty walls, is not my idea of a good time.
I have since passed ACLS every two years for the past 20 years or longer. And every two years I have not eaten anything that would make me want to vomit in someone's face under duress stress.
Well, someone later suggested I get my trauma nurse practitioner because I lectured on motorcycle trauma prevention. So, right after getting my RN, off I go to Cook County Medical Center and spend another lovely year stressing myself out for yet another degree. I however got to fly in helicopters from Loyola Medical Center to University of Chicago and back learning about helicopter medicine. Then to ride the Loomis Street and 79th Street Ambulance to do my 16 hour ambulance training, and to finish off working in Cook County Hospital emergency room for 6 months sewing up pigs feet for practice, to intubating corpses, to inserting right internal jugular Intravenous lines. I learned all kinds of new language that I'd never heard before and the words weren't very pretty. I learned why emergency room's are not clinics and why the poor and uninsurable really need to be included in the Medicaid program.
Again it's time for trauma NP boards. One full day of paper testing and one full day of DOING! 90 second physicals over and over again. Intubating, again with the right internal jugular intravenous lines, and suturing with perfection on real live humans; with someone standing right behind me watching my every move. Another pass or fail day. Only you know the answer before the day is over, face to face.
So, I passed as an ADN with a Trauma NP. This was before the laws were changed to masters degrees for NP's.
If you move to another state and you don't have a Masters in Science in Nursing (MSN), you have to get an MSN to continue to do your job that you've been doing all along as an ADN. UNLESS, you test out again.
I hate paper testing. I hated those little circles. I hate to have to study over and over again to make sure I know all of this stuff I have done for years in my career.
So my last test in nursing, was my one hour physical exam of my student partner at the University with the professor watching my every move. And this brings me to me watching "Grey's Anatomy" tonight.
I watched the Medical Board show of "Grey's Anatomy" tonight. I remember doing my physical exam on my student, and being interrogated by the Gastapo more or less like these doctors go thru. I had been a nurse for over 30 years, and to have some cocky old fart whose nursing ideas went out in the 1920's, stand and argue with me about why I practice the way I do and if I thought my ideas were better than hers, made me both want to laugh amd cry.
I was not a Kepner. Religion never played a part in what I have done except when it came to the dying patient. I was married for my first set of tests in state boards. I had a child by the time my second set of state boards came around. So I didn't dwell on religion nor sex while trying to not stress out during testing.
I would never have been late like Karev only because the thought of flunking anything due to being late,is NOT me. Although I still would have argued my reason for being late, had it happened.
My parents are not in the medical profession so trying to live up to their medical expectations like an Avery were nothing that would bother me. I just wanted them to be proud of me for torturing myself all those years of hard study for their approval.
I might have been like Grey, as I had a daughter, but she was out of school by the second time. The first time, I had no children. However, if I were that sick I would have mentioned it at the beginning to let them know their questioning wasn't making me vomit but my child had given me the flu and I didn't want to wait another year to take state boards. So I would have just kept talking thru the vomiting.
But I would be a Yang. I would argue why I do what I do, because if I've been doing it and it worked, then I would brag more or less about how well my procedure helped my patient. Yes, I would be just like Yang.
In fact, my whole nursing career has been just like that! I have made it a point to be knowledgeable at everything I do. I'm not the type of nurse who believes in mistakes, as my license to me is more valuable than my birth certificate. Being a nurse has always been my livelyhood. The thought of harming a patient just never comes into my mind. Not even a combative patient. Not even an enemy of mine. I could never, would never ever dream of harming any patients of mine on purpose. I've taken more than 100 courses in medical practices, not only for my continuing education units, but it led me to more availability in jobs. I became able to jump in, take over and just do.
I became certified so I can work in multiple areas of nursing. Being certified in multiple areas of medicine gives you more choices in job placement, and if an emergency arises, one can work in any unit of a hospital, facility or travel position as needed. More certifications mean more money. And isn't that why most people go to college so they can make money?
State boards are behind me. But I'm not finished learning. I may be disabled and retired, but not dead. And ACLS is on my mind, just to think I could still pass the excruciating terror of the face to face oral exam without projectile vomiting thoughts.
To others it's like jumping out of a perfectly good airplane, or to me, just flying in one. But to some state boards are the worst experience compated to that airplane ride.
Rebel Ruthi Ranting & Raving
May 3, 2012