I had graduated. Before I knew it, I was in my very first hospital orientation, and it was two more weeks of classroom learning. Learning hospital policies etc… the studying started again.

The NCLEX-RN began to loom like a shadow….a big scary nightmare-inducing shadow. Dreams of failing it scored my sleep.  My fellow graduate-nurse buddies and I obsessed over and speculated on it…how many med calculations did so and so get? How many questions did it take to pass? How the hell will I go through with this? The Nursing Boards are a HUGE DEAL. Your life depends on it. Everyone knows the story of the graduate nurse who got her new job at the hospital, and bought herself a fancy car as a reward for finishing school. Then she took her NCLEX. And failed. She lost her new job, her paycheck, her car, and her sense of self-esteem. Yes we’d all heard of her and by whispered fears and nightmare study sessions we tried to ensure that we do not become her.

July 24, 2006 at 0830 I entered the test center. At 0910 I re-emerged into the summer heat feeling like I’d been hit by a truck.  My ENTIRE nursing education…all the labs, objectives, skills, vocabulary, notes, math and meds….all had been boiled down to one test WHICH TOOK LESS THAN HALF AN HOUR. The test itself is all computerized, and the number of questions you get is based on the answers you provide. The minimum number of questions are 75, and the maximum is 265. You can pass with any amount of questions. And you can fail that way too. I got the minimum number of questions. The computer shuts off when its decided that you either passed or failed. Turning off at 75 means you did very well, or really bad. The questions in the test seem to get harder and harder. When after my 75th question the machine clicked to grey and I realized it was over, I put my head down on the desk for a minute. That was it???

All the studying and I had four medicine questions about the same med and NO MATH? And almost all the rest of the questions were priority…no disease specific stuff, no peds, no OB, just almost all priority.
I came out feeling, and dreading that I had failed. I was completely convinced of my failure. I tried not to cry as I stumbled out. My mouth was dry going in…no gum, no mints, and no water bottles allowed. As I stumbled out of the test center is was watery in panic-induced nausea.
Oh my god I wanted to cry. Or laugh. Or sleep. Instead I went out to breakfast with a friend of mine who is already a nurse, and she commiserated with me and told me of her experience, when the exams were several days of written answers. Somehow that sounded better than what I’d just gone through.

That’s it. No more tests. Pass or fail. Thoughts of the student loans that I would have to pay off while flipping burgers at McDonald’s because I have failed the licensure exam hovered in my thoughts.

I went home and started checking the web for my results. The BON in my state posts pass or fail within 48 hours. Sometimes earlier (unusually) but mostly right at 48 hours, or at 10am, whichever comes last.
The first day of waiting I immersed myself in work. The second day I tried not to be sick I checked the site every 15 minutes from 8am on. By 0930 it wasn’t up and I thought okay, I really did fail. I will never be a nurse (By the way, you can retake the test if you fail, you just have to wait for a period of time.)  At 10am I decided to use the phone-in system. It would cost $10 but maybe it would have a result. My poor husband, who was at work and fielding my 10minute phone calls all morning, suggested checking the internet one more time. I did. My results were there. With a license number next to my name.

I PASSED. I was a nurse.

A real, live Registered Nurse. A PROFESSIONAL.

I could wear white pants and a stethoscope and not feel like an imposter. I had been deemed legally competent to practice nursing.

The feeling of knowing you passed your boards is like a weight falling off your shoulders. Literally. You don’t have anything left to study. You have no need for the $150 of exam review books that you’d been reading for the last several months in preparation. You are a veteran, a survivor of the NCLEX-RN. You went in the door of that test center a graduate and came out a nurse.

 Some people celebrated it with parties and drinking and fun. I went to work and began to sign RN after my name with great joy. Then it hit me.

Oh. My. God. I. Am. A. Nurse.

I am a licensed healthcare professional. I have been trained to assess you, and I am responsible not only for providing you with basic nursing care to meet your needs, I also will be providing you with specialized care. I know how to insert a catheter into your bladder and an IV into your arm. I know how to run the IV fluids and I know the reason for using normal saline vs lactated ringers and I can tell you if you ask me. I know the side effects and uses of all of the 15 medications I am giving you and I will tell you if you ask. I can give you a shot if I have an order for it. I also assess your spiritual, mental, and emotional health. I can talk to the doctors about my concerns and the doctors take me seriously as a peer. (Well, most of them) The new doctors ask ME what they should do for you and I can give them ideas, all the while reminding them “Well, I’m not a doctor and can’t prescribe but I have seen drug XYZ used in this case before” or “Did you want me to do ABC for this patient?” I am responsible if the aide/tech doesn’t complete her work and I am responsible to see that you have a safe stay in the hospital and that no matter how bad a shape you were in when you got here, when you go home you will at least not be in any worse shape.

I hug you when your mother dies. I hold your hand when you are taking your last breaths. I bandage your feet. I teach you how to breastfeed. I let you cry when you need to and I hug you until you stop. I laugh with you. I cry with you. I make you do things you don’t want to do, knowing that later you will thank me, and you do. I sneak you a cookie when it’s late at night and you have the munchies and hospital jello just isn’t doing it for you. I wipe your bottom when you can’t reach it and I hold your hair while you puke. I pack your wound and I measure how deep it tunnels. I change your bandages, your dressings, your diapers and your peri-pads. I sit with you and hold your hand where there are no words to say.
I do what it takes to make you well and failing that, I make you comfortable.

I am your nurse.

As I sit here tonight, thinking about my new job and all the new things I will see and learn….I start looking back to the time before I was a nurse, before I’d had this training and this knowledge base. Going to nursing school, graduating with good grades, and doing it all while raising two kids and having a husband who’s health is sometimes a question mark.
I followed a home care nurse around the worst parts of the city and into roach-infested apartments. I stood for 8 hours in a freezing operating room, watching gallbladder after gallbladder come out.  I suctioned trachs, flushed IV lines, gave shots and pills, fluffed and turned. I changed elderly adults soiled briefs, cared for people with ORSA, MRSA, VRE, scabies, lice and C-diff.  I did psych where the patients scared the hell out of me. In maternity I saw babies born. This was all stuff that I never dreamed I would be doing.
And I learned. Like a sponge, you learn to soak it all up. Don’t miss anything and write it all down. You never know what will show up on the next test. And then the final exam of the final semester comes almost before you know it. Dread and trepidation keep you up at night, along with the thought that if you don’t know it by now you never will. That final time you close your textbook and put away your notebook…you sigh and leave home for the final exam.

They were still giving out the grades immediately when I took my final. That was the last time they did it. I was the first or second person done with the test. I looked around the room, not believing that I was actually done. I didn’t check my answers. You learn by the middle of the first semester to go with your gut, and take your first answer. It’s always the right one. It was a 100 question test. When I finished I took my test up. I passed! I was done. 
I. Finished. Nursing. School.

I hugged the instructors and danced out. Apparently someone after me did not pass, and either fainted or freaked out (depending on who is telling the story) and now no one gets their grades in the test room. Now they all have to wait 24 hours until the grades are posted.

Pinning came a week later, and the ceremony was great. There was a slide show, and awards. We were each pinned by a member of the faculty, and then we took a class picture. 77 of the original 99. Not too bad.
 
And then there was a huge moment of nothing….I had this sinking, lost feeling. School was over. I’d graduated.  And I had nothing to do for two weeks until my new job started.

I felt lost while. I don’t know why. I had a couple weeks of just being ahead of me. No studying, no getting up at the crack of dawn for clinical, no tests. It was odd. I slept a lot. Probably a minor depression. On one hand I was glad for the rest, on another, well, I wanted a party or something. 

So I bought new wall-to-wall carpeting.