Senior checkoffs are when you demonstrate your nursing skills in a simulated hospital room, on a mannequin that breathes and has a heart beat, on the other side of a one way mirror with an instructor watching your every move. And you must finish everything in 30 minutes. The skill you have to perform is on a random card that isn't drawn until right before you begin your checkoff. The process of preparing for this day is long and tedious. You must practice all of the skills that you have learned in the lab since day one of nursing school...multiple times. You must practice these skills until they become second nature. You must know when to stop and go home and rest for the night because you are making dumb mistakes while you are practicing. I began practicing during the first week of May, right before my last complex test. I took a week off after my complex ATI final just to give myself a break.
During the next three weeks, my husband I and I figured out that I spent no less than 64 hours in the lab practicing. This does not include the time that I spent at home studying about the skills and watching instructional videos to refresh my memory about how to do the skills. This was also in addition to working my last few shifts at KSU as a lab assistant and working at Northside at my extern job. I had some pretty great study partners during this time. We had some serious moments as well as some delirious moments! And definitely some awesome memories! We had all practiced as much as we could, and felt that we were as ready as we could possibly be.
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After the last day of practice, I went home and did my best to decompress. I had dinner with my husband, got my supplies together and laid everything out with my uniform for the next day. I had so much stuff to put in my pockets!! And I had to wear my "friend" socks. My friends know what that means. ;-)
I read my Bible and was reminded that I can do all things through Christ, and that God would never leave me or forsake me. I knew that the Lord would be with me every step of the way. But even though I knew that, I was still extremely nervous. My time was scheduled for 9:20 the next morning. I said a prayer and went to sleep.
I set my alarm and planned to leave in plenty of time to get to school at least an hour before my time slot. I got in the car and immediately the nerves began to set in. I called my friend Robin and she helped me to calm down before I arrived at school. I got to school and pulled in the parking deck. I sat in my car for a few minutes and prayed again before I walked in the building. I sat down and waited for my turn. It appeared that the checkoffs were running a little behind, but I actually got called back at 9:05. Walking down to the simulation rooms was like walking the green mile. I think I quoted scripture to myself and prayed the entire way. I was scared to death. I wanted to pass on the first try. I walked in and the instructor that was checking me off was my clinical instructor. I felt a tinge of relief that it was her. When I drew my card, she could see that I was really nervous. She looked at me and said, "Come on Teresa, you're okay. It's me!" I laughed a little and we got started. She acclimated me to the room and I began to think about what I needed to do.
I had drawn a dressing change and a PRN medication for pain. I had to do an assessment of the patient, look up pertinent information about the medication, draw up the medication, give the medication, and do the dressing change. When I was preparing the medication, I had to break an ampule that looks like this:
I hate these things! But I broke it cleanly and began to draw up my medication after I had calculated the correct amount. The plunger in my syringe was stuck so I had to get another one. After I finally got my medication drawn up I was ready. My instructor came in and checked my medication and then I got the rest of my supplies for the dressing change and the medication administration and went to the patient's bedside. My instructor's voice came over the speaker and told me I was doing great. That gave me the boost of confidence that I needed. I did the rest of my assessment, gave the medication and started the process for the dressing change.
For a dressing change, you must be wearing sterile gloves. Putting on sterile gloves can be an exercise in patience. I had grabbed two pairs in case I contaminated the first pair somehow. It was a good thing I did. When I put my first hand in, the fingers of the gloves were stuck the paper but I finally got it on...with my thumb in the index finger slot, and my ring and pinky fingers both in the pinky finger part of the glove. The thumb of the glove was just hanging in mid air. I should have started over then but I thought, "I can still do this." I got the other glove on with no problem, but in the process of trying to fix the first glove, I managed to contaminate myself. I verbalized that I had done this, ripped off the first pair of gloves and started over. The next pair went seamlessly. I did the dressing change and was cleaning up when my instructor came in and asked me if I wanted to know my score. I told her, "I don't know, do I want to know it?" She smiled and said yes, you did great and gave me a 10 out of 10. I was so relieved. All of the hours of practice had paid off and I had passed my skills checkoff.
The Drug Test.
You get two attempts to pass with a score of 90 or better. 20 questions. You can only miss two. Unfortunately, I did not pass the first time. I missed three. Rounding rules. I had done the math correctly, but I did not round the final answer correctly. Rounding rules. Seriously!! I was so mad at myself. I had a meltdown. If I didn't pass it the second time, it meant no graduation in July. I would have to withdraw from the class and retake it later. Possibly much later. Like next Spring because the next class is already full. Two days after my senior checkoff, I took the second drug calc test. It was scheduled to begin at 1pm and there was an input error and the computer wouldn't allow us access until 2pm. The stress was building and again, my friends prayed me through. I left the school and went to visit my daughter, son-in-law, and granddaughter for a couple of days to get away from all of the craziness that had been going on. I finally got news that I had passed the drug calculation test around 11pm that night. I have never been so excited to see an email.
I give God all the praise and glory for the things that have been accomplished. He did not leave me. He did not forsake me. He did exactly what He said He would do, and was with me every step of the way. I know without a doubt in my mind that I could not do this on my own. By the Grace of God, I passed all the tests that were set before me this past week.
I also must say a special thanks to my family and friends. To my husband, thank you for keeping up with the housework and putting up with my nervous breakdowns. To Reychel, thank you for feeding yourself, being my encourager and also for putting up with my nervous breakdowns. To Elizabeth, thanks for being real with me and loving me even though I say things I don't mean when I'm under stress. To Deedra, thank you for being there for me and listening to me have a meltdown. To Robin, thank you for always saying what I need to hear. To Kathleen, thank you for not posting on Facebook that I had failed a drug test with no further explanation! And to anyone else who has prayed for me, encouraged me, and pushed me through the last several weeks, I love you all very much and thank God for you every day.
I'm very excited to be beginning my practicum this coming week. I have already talked with my preceptor and can't wait to meet her. I believe the next few weeks are going to be the best part of my nursing school adventure. I'm looking forward to it!! :)
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