Day to day.

I'm procrastinating. In seven days, I'll take the CCRN exam, and test my experience...or should I say, knowledge, about critical care nursing. I feel about 73% ready. I'm shooting for 80%. All I need is 75%.

It's been an interesting experience, studying for this test. I've gone through a few stages. The first, was, like this one, a reluctant stage. I studied in clusters, not really paying attention to any particular area, just looking over things. I took test questions, but found myself stumped - not because the questions were difficult, but because I simply hadn't been exposed to quite a bit of the information. Car accident with left shoulder pain? Hm, sounded like an MI...nope. Clear as crystal: spleen rupture. Never came across that in my little world of MICU. Which vessel was occluded when said leads were changed with ST elevation? Ha! My extent of cardiac nursing goes from looking to enzyme levels and handing the ECG to the resident. Not that we don't deal with these kind of things in our unit, it's just not a regular occurence that I'm expected to know the specific effects of a RCA occlusion. Needless to say, I don't think this stage was my best.

Second stage: reading. A friend loaned me a book, and I read the entire thing. The questions made sense! Of course, I understand now the intriciacies of Guillian Bare syndrom and Acute Lymphocytic Anemia -- the questions aren't very complex, they simply require an ability to recognize familiar facts. This was the most beneficial stage, clinically speaking. I started to recognize things that I hadn't before -- a patient with severe mitral regurge became short of breath when hypertensive -- of course, keeping his blood pressure low helped his breathing! A PE here, a case of liver failure gone bad there...things became clear to me -- from textbook to real life.

Third stage: one week from the test, and I'm just plain unmotivated. There are still things I need to commit to memory -- those walls of MI throw me every time. And balloon pump wave forms, and pacer codes are still vague. Cranial nerves? The worst. I need to just sit down and memorize, but I'm at a loss for motivation.

Either way it goes -- whether I pass or fail -- it has helped me clinically. This wasn't what I expected. When I studied for the NCLEX, everything I knew was book knowledge. Now, it's the opposite. Transforming experience into test questions and answers is difficult...hopefully my thinking cap works next Tuesday.