Yu-Han Chao's Blog, page 5
July 25, 2019
The Little Red Hen
There's a Chinese phrase, 緣分, yuan fen, which roughly translates to a cross between attraction/connection and fate/destiny. We have yuan, whether negative or positive, with our family--some believe across several lifetimes. Taiwanese parents are known to say to their child, "Ay, I must have owed you from my last lifetime."
Yuan is present between best friends, chance encounters that turn into lifelong friendships or marriages, business partners, and authors and presses. I do believe yuan is reponsible for Red Hen becoming my publisher. Here's why.
My daughter really likes the book The Little Red Hen, though she prefers the pizza-making version of it. The book was also the first book in English my father read in the Pingtung library in southern Taiwan, once upon a time, before his X contribution to my XX chromosomes had been formed. (There's also some uncertainty about whether the red chicken in question was male or female in the book, but this only makes a good story if the hen's a hen, not a...)
When I asked Red Hen Press the reason for their name, the origin story turned out to be a Little Red Hen story as well. The founders had thought, "If nobody else will do it [it being publish high quality literature that may not be mass market], then I will!"
The former incarnation of my book was contracted for 5 years before that didn't work out, and then I was on submission for a few more years, during which my mother fell ill and eventually passed. Not long after her passing, two publishers expressed interest (something like a year after my manuscript submissions), Red Hen being one of them. My first response was, Thanks, Mom, because grief can make one superstitious. As for which publisher was the one, the answer was pretty obvious due to the numerous other Red Hen references above. If my life were fiction, the symbolism would have been criticized in workshop as "overwhelmingly obvious," "heavyhanded," etc.
The entire team at Red Hen has been supportive and helpful these past few years, they made cute copies of my book, complete with sexy bookmarks, and recently I received this card and lovely signed copy of my book from the entire staff at Red Hen.
Seems like some pretty good yuan fen all right.
Yuan is present between best friends, chance encounters that turn into lifelong friendships or marriages, business partners, and authors and presses. I do believe yuan is reponsible for Red Hen becoming my publisher. Here's why.
My daughter really likes the book The Little Red Hen, though she prefers the pizza-making version of it. The book was also the first book in English my father read in the Pingtung library in southern Taiwan, once upon a time, before his X contribution to my XX chromosomes had been formed. (There's also some uncertainty about whether the red chicken in question was male or female in the book, but this only makes a good story if the hen's a hen, not a...)
When I asked Red Hen Press the reason for their name, the origin story turned out to be a Little Red Hen story as well. The founders had thought, "If nobody else will do it [it being publish high quality literature that may not be mass market], then I will!"
The former incarnation of my book was contracted for 5 years before that didn't work out, and then I was on submission for a few more years, during which my mother fell ill and eventually passed. Not long after her passing, two publishers expressed interest (something like a year after my manuscript submissions), Red Hen being one of them. My first response was, Thanks, Mom, because grief can make one superstitious. As for which publisher was the one, the answer was pretty obvious due to the numerous other Red Hen references above. If my life were fiction, the symbolism would have been criticized in workshop as "overwhelmingly obvious," "heavyhanded," etc.
The entire team at Red Hen has been supportive and helpful these past few years, they made cute copies of my book, complete with sexy bookmarks, and recently I received this card and lovely signed copy of my book from the entire staff at Red Hen.
Seems like some pretty good yuan fen all right.
July 20, 2019
Ergot, Ergo...
Ancient beliefs often linked mental disturbances to evil spirits, supernatural or magical powers. The Salem Witch Trials of 1692 in colonial Massachusetts, one of the biggest witch hunts ever, were long described as a case of mass hysteria or religious zealotry in history books. However, Linnda Caporael, a behavioral psychologist, theorized that ergot poisoning may be responsible for "bewitched" behaviors of those accused.
The fungus ergot thrives in warm, damp settings, conditions that match those of the swampy meadows of Salem, especially during spring and summer of 1691. Rye, the staple grain, may have become contaminated with ergot due to the warm, moist weather and storage conditions. As a consequence, witch hunters and "witches" who ate rye may have been at least slightly out of their mind at the time.
Ergot is not always bad, however. Like syph-curing penicillin is derived from a fungus, ergotamine, an alkaloid derived from the ergot fungus, has been isolated and made into medicine since Sandoz Pharmaceuticals in 1918. It has properties similar to several neurotransmitters, and causes blood vessels to constrict. Ergotamine is often prescribed for migraines, and can also be used after childbirth to decrease uterine bleeding. Too much ergotamine, however, can lead to blood clots and gangrene.
Ingesting ergot fungus-contaminated food can also lead to a convulsions, vomiting, delusions, hallucinations, and the sensation of things crawling under or on one's skin, symptoms historically reported in the Salem witch trial subjects. Of course, some level of hysteria and leaps of logic are necessary for these cases to escalate into a massive witch hunt, but some might find it reassuring that the extreme persecution of other human beings might be traced to a scientific cause--poisoning--rather than human nature's innate evil or blind self-righteousness.
There are still many mysteries out there, medical or otherwise, some taking place in our world right now, but occasionally, history and science toss us some bone fragments, and a few of those pieces come together almost perfectly.
"That's a fair cop."
The fungus ergot thrives in warm, damp settings, conditions that match those of the swampy meadows of Salem, especially during spring and summer of 1691. Rye, the staple grain, may have become contaminated with ergot due to the warm, moist weather and storage conditions. As a consequence, witch hunters and "witches" who ate rye may have been at least slightly out of their mind at the time.
Ergot is not always bad, however. Like syph-curing penicillin is derived from a fungus, ergotamine, an alkaloid derived from the ergot fungus, has been isolated and made into medicine since Sandoz Pharmaceuticals in 1918. It has properties similar to several neurotransmitters, and causes blood vessels to constrict. Ergotamine is often prescribed for migraines, and can also be used after childbirth to decrease uterine bleeding. Too much ergotamine, however, can lead to blood clots and gangrene.
Ingesting ergot fungus-contaminated food can also lead to a convulsions, vomiting, delusions, hallucinations, and the sensation of things crawling under or on one's skin, symptoms historically reported in the Salem witch trial subjects. Of course, some level of hysteria and leaps of logic are necessary for these cases to escalate into a massive witch hunt, but some might find it reassuring that the extreme persecution of other human beings might be traced to a scientific cause--poisoning--rather than human nature's innate evil or blind self-righteousness.
There are still many mysteries out there, medical or otherwise, some taking place in our world right now, but occasionally, history and science toss us some bone fragments, and a few of those pieces come together almost perfectly.
"That's a fair cop."
July 8, 2019
The Sleep Revolution
Many moms think about sleep...longingly, like a rose, or old lover. Very few have time to read a book about sleep, so I read one for you, Arianna Huffington (founder of The Huffington Post)'s The Sleep Revolution.
According to an Australian study, after being awake for 17-19 hours, subjects can experience levels of cognitive impairment equal to having .05% blood alcohol, just under the legal limit. A few more hours of staying awake, and that impairment rises to 0.1%, legally drunk. Huffington's book cites harrowing statistics from the CDC: drowsy U.S. drivers are involved in 328,000 accidents each year, 6400 of which result in deaths.
Driving while sleep-deprived is impaired driving.
Terrifying thought, since most new parents (especially moms breastfeeding their babies all night long) are chronically sleep-deprived.
Speaking of moms, according to Dr. William Dement, founder of the Stanford Sleep Disorders Clinic, working mothers with young children at home have seen additional 241 hours of work and commute time added to their lives annually since 1969.
Not only do women get to do it all now, we have to do it all. With less sleep and more driving.
Perhaps one of the worst afflictions is insomnia when one is sleep-deprived. So many hours have I lain wide awake in bed, hating myself before an important day. I've tried Chinese acupressure points, visualization...and if I remembered I had melatonin in a plastic drawer in the closet I would have taken that, too.
My daughter seems to have the same problem. At almost seven, she still fights sleep and wakes up freaking out in the middle of the night, crying, inconsolable, but not completely awake. Some call it night terrors. Last night she complained about bombs.
"No, bombs, no~" she cried.
"Bombs?" I asked.
"No!" Eyes open and dazed, she stops being upset for a moment to act tremendously offended. "I said b-aaaaaahms!" [balms? balls?]
I've discussed this with several OB healthcare workers, and many believe conditions of pregnancy affect a baby's temperament and sleep pattern. My last two months of pregnancy I almost never slept lying down because as soon as I lay down she kicked like she was distressed, forcing me to get up. I shared my concerns, but the doctor dismissed them every time.
"Baby's heart rate is good, kicking is good," he said.
Maybe OB medical books are different from OB nursing textbooks, which are basically A Thousand Ways to Die.
Either way, my due date came and went, and I was induced 12 days later. Everyone had walked away from my hospital room, until a nurse came back freaked out, saying the baby's heart rate was critically low for the past five minutes and as they tried to stimulate her, I was told we needed an emergency C section. When they cut me open, the cord was wrapped around her neck three times.
Does my daughter hate sleep because she was always in distress at "bedtime" or constantly in distress, period? Now that she is old enough, she clearly articulates, "Mama, I don't like night time. I don't like to sleep. I wish it were day all the time." When I asked her about the bombs/balls last night and whether she remembered wanting to be held and waking up every time I tried to sneak away, just like when she was a baby, she thought I was making it up.
Huffington's book suggests meditation, deep breathing and visualization techniques as sleep aids, but doesn't quite cover how to stay asleep. She does caution against the use of sleeping pills because people have been known to sleep-walk, even sleep-drive themselves into dangerous, sometimes fatal situations under the influence of these medications.
Sleep is important to our quality of life, yet can be an elusive mystery. Sometimes inquiry into the subject leads to more questions rather than answers.
Dream bedroom?
According to an Australian study, after being awake for 17-19 hours, subjects can experience levels of cognitive impairment equal to having .05% blood alcohol, just under the legal limit. A few more hours of staying awake, and that impairment rises to 0.1%, legally drunk. Huffington's book cites harrowing statistics from the CDC: drowsy U.S. drivers are involved in 328,000 accidents each year, 6400 of which result in deaths.
Driving while sleep-deprived is impaired driving.
Terrifying thought, since most new parents (especially moms breastfeeding their babies all night long) are chronically sleep-deprived.
Speaking of moms, according to Dr. William Dement, founder of the Stanford Sleep Disorders Clinic, working mothers with young children at home have seen additional 241 hours of work and commute time added to their lives annually since 1969.
Not only do women get to do it all now, we have to do it all. With less sleep and more driving.
Perhaps one of the worst afflictions is insomnia when one is sleep-deprived. So many hours have I lain wide awake in bed, hating myself before an important day. I've tried Chinese acupressure points, visualization...and if I remembered I had melatonin in a plastic drawer in the closet I would have taken that, too.
My daughter seems to have the same problem. At almost seven, she still fights sleep and wakes up freaking out in the middle of the night, crying, inconsolable, but not completely awake. Some call it night terrors. Last night she complained about bombs.
"No, bombs, no~" she cried.
"Bombs?" I asked.
"No!" Eyes open and dazed, she stops being upset for a moment to act tremendously offended. "I said b-aaaaaahms!" [balms? balls?]
I've discussed this with several OB healthcare workers, and many believe conditions of pregnancy affect a baby's temperament and sleep pattern. My last two months of pregnancy I almost never slept lying down because as soon as I lay down she kicked like she was distressed, forcing me to get up. I shared my concerns, but the doctor dismissed them every time.
"Baby's heart rate is good, kicking is good," he said.
Maybe OB medical books are different from OB nursing textbooks, which are basically A Thousand Ways to Die.
Either way, my due date came and went, and I was induced 12 days later. Everyone had walked away from my hospital room, until a nurse came back freaked out, saying the baby's heart rate was critically low for the past five minutes and as they tried to stimulate her, I was told we needed an emergency C section. When they cut me open, the cord was wrapped around her neck three times.
Does my daughter hate sleep because she was always in distress at "bedtime" or constantly in distress, period? Now that she is old enough, she clearly articulates, "Mama, I don't like night time. I don't like to sleep. I wish it were day all the time." When I asked her about the bombs/balls last night and whether she remembered wanting to be held and waking up every time I tried to sneak away, just like when she was a baby, she thought I was making it up.
Huffington's book suggests meditation, deep breathing and visualization techniques as sleep aids, but doesn't quite cover how to stay asleep. She does caution against the use of sleeping pills because people have been known to sleep-walk, even sleep-drive themselves into dangerous, sometimes fatal situations under the influence of these medications.
Sleep is important to our quality of life, yet can be an elusive mystery. Sometimes inquiry into the subject leads to more questions rather than answers.
Dream bedroom?
June 29, 2019
Hello Kitty Maternity Hospital
I found the Hello Kitty Maternity Hospital! It's in Yuanlin, Taiwan.
No, it's not a theme park. You have to actually get pregnant and be pretty close to popping to check in. (It's not too late, N!)
Forget anchor babies; you can now give birth in a lavender and pink millionaire mansion in Taiwan, surrounded by mouthless cats by Sanrio.
Not a bad hallway to pace up and down while you're trying to move things along during labor.
Just visualize your baby's head crowning, dilating (or ripping) you to 10 cm+ diameter while Hello Kitty wordlessly, creepily shines on you from above.
10 out of 10 pain? Distract yourself by thinking about all the cute things your visitors will buy you and your baby from the gift shop!
Preemie? No problem. These aren't actors; they are real doctors and nurses. They wear surgical masks at all times while giving each other side-eye.
You have to choose between pink or blue blankets, though. Hello Kitty no understand gender neutral.
A long-lost tradition I dared not dream of when I was oozing grape jelly from my crooked C-section site with one loosening staple while wrangling my newborn day and night in my hospital room...THE NURSERY, or "Baby Room," since we're very literal about our translations in Taiwan.
No rooming-in or couplet care here--Mama gets pampered (and so does baby, literally, in the NURSERY, by a NURSE)!
Just look at these perfect postpartum meals designed by nutritionists and specialty chefs, incorporating Chinese medicine, high-protein, low-sodium and organic ingredients. (Hey, where's the Hello Kitty fishcake?)
Looks like a department store, but is actually a hospital/nursery/postpartum center, chandelier and all (are chandeliers safe?)
If this whole finding-a-job-at-Mercy thing doesn't work out, I'm going back to Taiwan. To be a Hello Kitty OB nurse.
No, it's not a theme park. You have to actually get pregnant and be pretty close to popping to check in. (It's not too late, N!)
Forget anchor babies; you can now give birth in a lavender and pink millionaire mansion in Taiwan, surrounded by mouthless cats by Sanrio.
Not a bad hallway to pace up and down while you're trying to move things along during labor.
Just visualize your baby's head crowning, dilating (or ripping) you to 10 cm+ diameter while Hello Kitty wordlessly, creepily shines on you from above.
10 out of 10 pain? Distract yourself by thinking about all the cute things your visitors will buy you and your baby from the gift shop!
Preemie? No problem. These aren't actors; they are real doctors and nurses. They wear surgical masks at all times while giving each other side-eye.
You have to choose between pink or blue blankets, though. Hello Kitty no understand gender neutral.
A long-lost tradition I dared not dream of when I was oozing grape jelly from my crooked C-section site with one loosening staple while wrangling my newborn day and night in my hospital room...THE NURSERY, or "Baby Room," since we're very literal about our translations in Taiwan.
No rooming-in or couplet care here--Mama gets pampered (and so does baby, literally, in the NURSERY, by a NURSE)!
Just look at these perfect postpartum meals designed by nutritionists and specialty chefs, incorporating Chinese medicine, high-protein, low-sodium and organic ingredients. (Hey, where's the Hello Kitty fishcake?)
Looks like a department store, but is actually a hospital/nursery/postpartum center, chandelier and all (are chandeliers safe?)
If this whole finding-a-job-at-Mercy thing doesn't work out, I'm going back to Taiwan. To be a Hello Kitty OB nurse.
June 13, 2019
What to Expect When You're NCLEX-ing Part II: Pearson
If you missed part I about NCLEX Test Basics, click here.
1. Signing up
Pay both the Board of Registered Nursing ($300) and Pearson ($200) two weeks before nursing school finals/graduation. Somehow I missed the memo about Pearson and was so freaked out by the time I paid Pearson I took the first date the system offered me without fulling understanding how close it was (in my head it was still May-ish, but it wasn't...later, I realized my test date was my late mother's birthday). I hadn't expected to test so soon--in fact, I'd ordered an NCLEX review book that didn't arrive until the day after I took the test.
2. Showing up
I had a 1pm test slot and made my way into the test building 45 minutes early. They scanned my palms, photographed me and let me right in. This does not apply to 8am tests (and definitely don't be more than 30 min. late), but if you're testing in the afternoon, it might be worthwhile to go in early because it's unlikely all the morning testtakers took the entire 6 hours (the horror!) and if there's a seat, you're ushered in.
3. During the Test
You can have your choice of earplugs, noise-canceling headphones, or nothing. A regular pair of headphones are also available at your cubicle in case you get audio questions. There's a tutorial containing every question type for you to "practice" before the real test begins, so you will be prepared. The computer tells you that you can't go back to change answers, and can't skip any, either.
Sample "Hot Spot" Question: Where would you hear...
UWorld's format looks pretty similar to the actual NCLEX, and NCLEX content is arguably easier than UWorld and less infuriating than the ATI comprehensive test, lying somewhere in between the two platforms (UWorld & ATI).
4. Special Research Section
Thankfully, Pearson probably won't spring these awful new format questions on testtakers for real until 2022/2023, according to this article.
For now, after your official test stops, the computer will state that these next 30 questions won't affect your grade, but you will be beta-testing Pearson's new questions for them. Honestly, even after the minimum of 75 questions, who's in the mood to do this billion dollar testing company that just select-all-that-applied you to death a favor? And the questions, mostly grouped around specific case studies, are not straightforward or clear at all, and some of them, (I felt,) unreasonable.
If you just randomly click and drag-drop things on the screen, you can go home sooner and it won't hurt your grade. I did sit through them just to give Pearson a piece of my mind in the comments section.
5. After the Test
Nobody feels awesome leaving the NCLEX, but the number of questions you took may help you gauge how it went. The chances of you sucking so bad that the computer shut off at 75 (or however many you got) questions (because even 265 questions wouldn't save you) are slim. It's much more likely that the computer was satisfied with your competancy by X number of questions. The bigger the number (closer to 265) the less reassuring the odds, but people have definitely passed with 265 questions.
Very few people run out of time (6 hours) and if you do, there's still hope, and at least you don't have to beta test their crappy questions. I've definitely, due to child/meal-related distractions/procrastination, run out of time (8 hrs) and got 50% on one of those practice ATI tests we had to take in the program and had to redo the whole thing. It happens.
If your anxiety is killing you, when you get home from the test center, try the Pearson VUE Trick:
Basically, you pretend you're registering to test again (without giving the correct credit card code), and if it give you the "good pop-up," you can breathe.
The good pop-up.
Something like 86% of NCLEX testers pass on their first try, so the odds are in your favor!
6. Results
I took the test on a Thursday, checked the BRN site before bed Friday night, and saw my license number. If you're in California, you can't pay for "quick results" but you'll probably get fast results for free anyway.
You can also look yourself up on the BRN website (or have a friend do it) and if it's ready, your license is now public knowledge.
Good luck, and happy studying/guessing/testing!
1. Signing up
Pay both the Board of Registered Nursing ($300) and Pearson ($200) two weeks before nursing school finals/graduation. Somehow I missed the memo about Pearson and was so freaked out by the time I paid Pearson I took the first date the system offered me without fulling understanding how close it was (in my head it was still May-ish, but it wasn't...later, I realized my test date was my late mother's birthday). I hadn't expected to test so soon--in fact, I'd ordered an NCLEX review book that didn't arrive until the day after I took the test.
2. Showing up
I had a 1pm test slot and made my way into the test building 45 minutes early. They scanned my palms, photographed me and let me right in. This does not apply to 8am tests (and definitely don't be more than 30 min. late), but if you're testing in the afternoon, it might be worthwhile to go in early because it's unlikely all the morning testtakers took the entire 6 hours (the horror!) and if there's a seat, you're ushered in.
3. During the Test
You can have your choice of earplugs, noise-canceling headphones, or nothing. A regular pair of headphones are also available at your cubicle in case you get audio questions. There's a tutorial containing every question type for you to "practice" before the real test begins, so you will be prepared. The computer tells you that you can't go back to change answers, and can't skip any, either.
Sample "Hot Spot" Question: Where would you hear...UWorld's format looks pretty similar to the actual NCLEX, and NCLEX content is arguably easier than UWorld and less infuriating than the ATI comprehensive test, lying somewhere in between the two platforms (UWorld & ATI).
4. Special Research Section
Thankfully, Pearson probably won't spring these awful new format questions on testtakers for real until 2022/2023, according to this article.
For now, after your official test stops, the computer will state that these next 30 questions won't affect your grade, but you will be beta-testing Pearson's new questions for them. Honestly, even after the minimum of 75 questions, who's in the mood to do this billion dollar testing company that just select-all-that-applied you to death a favor? And the questions, mostly grouped around specific case studies, are not straightforward or clear at all, and some of them, (I felt,) unreasonable.
If you just randomly click and drag-drop things on the screen, you can go home sooner and it won't hurt your grade. I did sit through them just to give Pearson a piece of my mind in the comments section.
5. After the Test
Nobody feels awesome leaving the NCLEX, but the number of questions you took may help you gauge how it went. The chances of you sucking so bad that the computer shut off at 75 (or however many you got) questions (because even 265 questions wouldn't save you) are slim. It's much more likely that the computer was satisfied with your competancy by X number of questions. The bigger the number (closer to 265) the less reassuring the odds, but people have definitely passed with 265 questions.
Very few people run out of time (6 hours) and if you do, there's still hope, and at least you don't have to beta test their crappy questions. I've definitely, due to child/meal-related distractions/procrastination, run out of time (8 hrs) and got 50% on one of those practice ATI tests we had to take in the program and had to redo the whole thing. It happens.
If your anxiety is killing you, when you get home from the test center, try the Pearson VUE Trick:
Basically, you pretend you're registering to test again (without giving the correct credit card code), and if it give you the "good pop-up," you can breathe.
The good pop-up.Something like 86% of NCLEX testers pass on their first try, so the odds are in your favor!
6. Results
I took the test on a Thursday, checked the BRN site before bed Friday night, and saw my license number. If you're in California, you can't pay for "quick results" but you'll probably get fast results for free anyway.
You can also look yourself up on the BRN website (or have a friend do it) and if it's ready, your license is now public knowledge.
Good luck, and happy studying/guessing/testing!
What to Expect When You're NCLEX-ing Part II
If you missed part I about NCLEX Test Basics, click here.
1. Signing up
Pay both the Board of Registered Nursing ($300) and Pearson ($200) two weeks before nursing school finals/graduation. Somehow I missed the memo about Pearson and was so freaked out by the time I paid Pearson I took the first date the system offered me without fulling understanding how close it was (in my head it was still May-ish, but it wasn't...later, I realized my test date was my late mother's birthday). I hadn't expected to test so soon--in fact, I'd ordered an NCLEX review book that didn't arrive until the day after I took the test.
2. Showing up
I had a 1pm test slot and made my way into the test building 45 minutes early. They scanned my palms, photographed me and let me right in. This does not apply to 8am tests (and definitely don't be more than 30 min. late), but if you're testing in the afternoon, it might be worthwhile to go in early because it's unlikely all the morning testtakers took the entire 6 hours (the horror!) and if there's a seat, you're ushered in.
3. During the Test
You can have your choice of earplugs, noise-canceling headphones, or nothing. A regular pair of headphones are also available at your cubicle in case you get audio questions. There's a tutorial containing every question type for you to "practice" before the real test begins, so you will be prepared. The computer tells you that you can't go back to change answers, and can't skip any, either.
Sample "Hot Spot" Question: Where would you hear...
UWorld's format looks pretty similar to the actual NCLEX, and NCLEX content is arguably easier than UWorld and less infuriating than the ATI comprehensive test, lying somewhere in between the two platforms (UWorld & ATI).
4. Special Research Section
Thankfully, Pearson probably won't spring these awful new format questions on testtakers for real until 2022/2023, according to this article.
For now, after your official test stops, the computer will state that these next 30 questions won't affect your grade, but you will be beta-testing Pearson's new questions for them. Honestly, even after the minimum of 75 questions, who's in the mood to do this billion dollar testing company that just select-all-that-applied you to death a favor? And the questions, mostly grouped around specific case studies, are not straightforward or clear at all, and some of them, (I felt,) unreasonable.
If you just randomly click and drag-drop things on the screen, you can go home sooner and it won't hurt your grade. I did sit through them just to give Pearson a piece of my mind in the comments section.
5. After the Test
Nobody feels awesome leaving the NCLEX, but the number of questions you took may help you gauge how it went. The chances of you sucking so bad that the computer shut off at 75 (or however many you got) questions (because even 265 questions wouldn't save you) are slim. It's much more likely that the computer was satisfied with your competancy by X number of questions. The bigger the number (closer to 265) the less reassuring the odds, but people have definitely passed with 265 questions.
Very few people run out of time (6 hours) and if you do, there's still hope, and at least you don't have to beta test their crappy questions. I've definitely, due to child/meal-related distractions/procrastination, run out of time (8 hrs) and got 50% on one of those practice ATI tests we had to take in the program and had to redo the whole thing. It happens.
If your anxiety is killing you, when you get home from the test center, try the Pearson VUE Trick:
Basically, you pretend you're registering to test again (without giving the correct credit card code), and if it give you the "good pop-up," you can breathe.
The good pop-up.
Something like 86% of NCLEX testers pass on their first try, so the odds are in your favor!
6. Results
I took the test on a Thursday, checked the BRN site before bed Friday night, and saw my license number. If you're in California, you can't pay for "quick results" but you'll probably get fast results for free anyway.
You can also look yourself up on the BRN website (or have a friend do it) and if it's ready, your license is now public knowledge.
Good luck, and happy studying/guessing/testing!
1. Signing up
Pay both the Board of Registered Nursing ($300) and Pearson ($200) two weeks before nursing school finals/graduation. Somehow I missed the memo about Pearson and was so freaked out by the time I paid Pearson I took the first date the system offered me without fulling understanding how close it was (in my head it was still May-ish, but it wasn't...later, I realized my test date was my late mother's birthday). I hadn't expected to test so soon--in fact, I'd ordered an NCLEX review book that didn't arrive until the day after I took the test.
2. Showing up
I had a 1pm test slot and made my way into the test building 45 minutes early. They scanned my palms, photographed me and let me right in. This does not apply to 8am tests (and definitely don't be more than 30 min. late), but if you're testing in the afternoon, it might be worthwhile to go in early because it's unlikely all the morning testtakers took the entire 6 hours (the horror!) and if there's a seat, you're ushered in.
3. During the Test
You can have your choice of earplugs, noise-canceling headphones, or nothing. A regular pair of headphones are also available at your cubicle in case you get audio questions. There's a tutorial containing every question type for you to "practice" before the real test begins, so you will be prepared. The computer tells you that you can't go back to change answers, and can't skip any, either.
Sample "Hot Spot" Question: Where would you hear...UWorld's format looks pretty similar to the actual NCLEX, and NCLEX content is arguably easier than UWorld and less infuriating than the ATI comprehensive test, lying somewhere in between the two platforms (UWorld & ATI).
4. Special Research Section
Thankfully, Pearson probably won't spring these awful new format questions on testtakers for real until 2022/2023, according to this article.
For now, after your official test stops, the computer will state that these next 30 questions won't affect your grade, but you will be beta-testing Pearson's new questions for them. Honestly, even after the minimum of 75 questions, who's in the mood to do this billion dollar testing company that just select-all-that-applied you to death a favor? And the questions, mostly grouped around specific case studies, are not straightforward or clear at all, and some of them, (I felt,) unreasonable.
If you just randomly click and drag-drop things on the screen, you can go home sooner and it won't hurt your grade. I did sit through them just to give Pearson a piece of my mind in the comments section.
5. After the Test
Nobody feels awesome leaving the NCLEX, but the number of questions you took may help you gauge how it went. The chances of you sucking so bad that the computer shut off at 75 (or however many you got) questions (because even 265 questions wouldn't save you) are slim. It's much more likely that the computer was satisfied with your competancy by X number of questions. The bigger the number (closer to 265) the less reassuring the odds, but people have definitely passed with 265 questions.
Very few people run out of time (6 hours) and if you do, there's still hope, and at least you don't have to beta test their crappy questions. I've definitely, due to child/meal-related distractions/procrastination, run out of time (8 hrs) and got 50% on one of those practice ATI tests we had to take in the program and had to redo the whole thing. It happens.
If your anxiety is killing you, when you get home from the test center, try the Pearson VUE Trick:
Basically, you pretend you're registering to test again (without giving the correct credit card code), and if it give you the "good pop-up," you can breathe.
The good pop-up.Something like 86% of NCLEX testers pass on their first try, so the odds are in your favor!
6. Results
I took the test on a Thursday, checked the BRN site before bed Friday night, and saw my license number. If you're in California, you can't pay for "quick results" but you'll probably get fast results for free anyway.
You can also look yourself up on the BRN website (or have a friend do it) and if it's ready, your license is now public knowledge.
Good luck, and happy studying/guessing/testing!
June 8, 2019
What to Expect When You're NCLEX-ing Part I: Test Basics
Everybody's NCLEX experience is different, and we aren't allowed to discuss specific questions, but I just passed mine and will try to describe what happened generally, starting with the basics.
1. Number of questions & minimum competency
Be prepared to answer 75-265 questions on a computer. The test may shut off at 75 questions if the computer is 99% certain one has met minimum competency, or is so far below passing that there's no way to come back even with 265 questions. The majority of people seem to get 90 or more questions.
2. Content
When it comes to content areas, there are official categories about health promotion, reduction of risk potential, pharmacology, with a breakdown of percentages, but really the test is about safety and priority (which is still ultimately about safety). I got a good variety of content (almost no psych), but can't say the same for question types.
I had to answer what felt like nothing but select-all-that-apply questions (not only do you have to pick the most correct answer, you have to pick all the most correct answers!) Other types, which I hardly saw, include: fill in the black, ordering, exhibit questions, audio (didn't get one), and graphics. The new special research/case study questions at the end (didn't count towards score) were particularly unpleasant.
3. How to Answer NCLEX Questions
Remembering content from nursing school helps. On the ATI comprehensive and the NCLEX they got me on super easy gimme OB questions that I simply didn't remember. Of course you can't know everything, but at least have your normal lab levels and isolation precautions down.
Read the question and answers carefully.
Not all the questions are "fair game" (nor is real life). The scenario might make sense until things take a sharp left turn. This was supposed to happen, then that thing went wrong; what do you do now?
Eliminating the wrong answers usually helps, and if you're lucky enough to only have to select one answer, pick the most correct/least wrong one. Sometimes it really is a matter of "least wrong," because all the options are dumb, though one option is the least dangerous/messed-up.
Ask yourself, what are they asking me? Sometimes one can see right through the question and know what the test writers are "getting at," even if the questions aren't well written or b*****s just trying to trick (I mean, distract) you.
After two years of ATI and the actual NCLEX, sometimes it just feels like a lot of guessing...I mean, nursing judgment.
Part II will cover the test center experience.
1. Number of questions & minimum competency
Be prepared to answer 75-265 questions on a computer. The test may shut off at 75 questions if the computer is 99% certain one has met minimum competency, or is so far below passing that there's no way to come back even with 265 questions. The majority of people seem to get 90 or more questions.
2. Content
When it comes to content areas, there are official categories about health promotion, reduction of risk potential, pharmacology, with a breakdown of percentages, but really the test is about safety and priority (which is still ultimately about safety). I got a good variety of content (almost no psych), but can't say the same for question types.
I had to answer what felt like nothing but select-all-that-apply questions (not only do you have to pick the most correct answer, you have to pick all the most correct answers!) Other types, which I hardly saw, include: fill in the black, ordering, exhibit questions, audio (didn't get one), and graphics. The new special research/case study questions at the end (didn't count towards score) were particularly unpleasant.3. How to Answer NCLEX Questions
Remembering content from nursing school helps. On the ATI comprehensive and the NCLEX they got me on super easy gimme OB questions that I simply didn't remember. Of course you can't know everything, but at least have your normal lab levels and isolation precautions down.
Read the question and answers carefully.
Not all the questions are "fair game" (nor is real life). The scenario might make sense until things take a sharp left turn. This was supposed to happen, then that thing went wrong; what do you do now?
Eliminating the wrong answers usually helps, and if you're lucky enough to only have to select one answer, pick the most correct/least wrong one. Sometimes it really is a matter of "least wrong," because all the options are dumb, though one option is the least dangerous/messed-up.
Ask yourself, what are they asking me? Sometimes one can see right through the question and know what the test writers are "getting at," even if the questions aren't well written or b*****s just trying to trick (I mean, distract) you.
After two years of ATI and the actual NCLEX, sometimes it just feels like a lot of guessing...I mean, nursing judgment.
Part II will cover the test center experience.
June 5, 2019
ZYZZYVA = a tropical American weevil
Not to be confused with those awful Dr. Who weevils (do not Google-Image that) or the tropical American weevil (a snouted beetle), Zyzzyva is a common last word of many American dictionaries, and also the name of a San Francisco literary journal. It's pretty clever, actually, because as writers who write about our lives and our worlds, who doesn't want to have, "the last word," literally? Incidentally, the beetles seemed to have been given this name as a joke so they would be featured as the last item in field guides and manuals...holding a martini and wearing a party hat, perhaps.
I first heard about ZYZZYVA when I was at Penn State, where I learned of a thing called literary journals, to whom we sent manila envelopes brimming with hope and stories and self-addressed-stamped envelopes for the journals to, in return, stuff with the tiniest rejection slips possible. Only writers living on the west coast were allowed to submit to ZYZZYVA, so that added to their mystery and allure.
After finishing my MFA (Masters of Fine Arts), instead of moving to NYC and living the exciting (Sex and The City) life of a single female writer, I decided to do the safe thing. I took my precious one-year OPT (optional practical training) visa, became a legal assistant and translator at a Taiwanese-American-owned law firm in southern California, and moved in with my late mother and little brothers in California. One of the first things I did upon getting settled was submit a story to ZYZZYVA, because my zip code finally qualified me to do so.
ZYZZYVA editor Howard Junker called my mom's home phone (I had no cellphone) while I was at work. When my mom told me a man with a deep, magnetic voice had called asking for me during the day, I could tell she suspected he was my secret boyfriend (or something). But he was better than a secret boyfriend--he was the founding editor of my dream journal letting me know they wanted to publish my story.
They didn't want the story as is, however. It was safe, they said, and they wanted to actually see what happened with the main character, a young girl coming to terms with her blossoming sexuality. I revised per request, and the end result was the first story in Sex & Taipei City, which I kept true to the version edited for ZYZZYVA, because it felt special, even if it made me feel a little dirty. Later, Howard forwarded me fan mail from a reader specifically mentioning my story in the journal. The whole thing was a dream come true.
Ten years passed, and so did my mother.
I was busy with nursing school when my book came out with Red Hen Press, and I contacted ZYZZYVA later than I should have, but when I did, they invited me to send them a copy, and after reading it, Arianna Casabonne sent me some thoughtful but difficult questions (about sex, Taiwanese culture, and stuff). It wasn't easy, but eventually I scraped my thoughts together and sent them along. Here is the interview.
I'm super grateful that ZYZZYVA took a chance on me and helped me muster the guts to take a story beyond my comfort zone, and later challenged me with questions about uncomfortable subjects we actually need to talk about, as women, as minorities in any sense of the word, and anyone with stories and an unique truth to share.
Thank you to Arianna, to ZYZZYVA, to Red Hen Press, and everyone, for reading, for sharing, and for all of your support!
I first heard about ZYZZYVA when I was at Penn State, where I learned of a thing called literary journals, to whom we sent manila envelopes brimming with hope and stories and self-addressed-stamped envelopes for the journals to, in return, stuff with the tiniest rejection slips possible. Only writers living on the west coast were allowed to submit to ZYZZYVA, so that added to their mystery and allure.After finishing my MFA (Masters of Fine Arts), instead of moving to NYC and living the exciting (Sex and The City) life of a single female writer, I decided to do the safe thing. I took my precious one-year OPT (optional practical training) visa, became a legal assistant and translator at a Taiwanese-American-owned law firm in southern California, and moved in with my late mother and little brothers in California. One of the first things I did upon getting settled was submit a story to ZYZZYVA, because my zip code finally qualified me to do so.
ZYZZYVA editor Howard Junker called my mom's home phone (I had no cellphone) while I was at work. When my mom told me a man with a deep, magnetic voice had called asking for me during the day, I could tell she suspected he was my secret boyfriend (or something). But he was better than a secret boyfriend--he was the founding editor of my dream journal letting me know they wanted to publish my story.
They didn't want the story as is, however. It was safe, they said, and they wanted to actually see what happened with the main character, a young girl coming to terms with her blossoming sexuality. I revised per request, and the end result was the first story in Sex & Taipei City, which I kept true to the version edited for ZYZZYVA, because it felt special, even if it made me feel a little dirty. Later, Howard forwarded me fan mail from a reader specifically mentioning my story in the journal. The whole thing was a dream come true.
Ten years passed, and so did my mother.
I was busy with nursing school when my book came out with Red Hen Press, and I contacted ZYZZYVA later than I should have, but when I did, they invited me to send them a copy, and after reading it, Arianna Casabonne sent me some thoughtful but difficult questions (about sex, Taiwanese culture, and stuff). It wasn't easy, but eventually I scraped my thoughts together and sent them along. Here is the interview.
I'm super grateful that ZYZZYVA took a chance on me and helped me muster the guts to take a story beyond my comfort zone, and later challenged me with questions about uncomfortable subjects we actually need to talk about, as women, as minorities in any sense of the word, and anyone with stories and an unique truth to share.
Thank you to Arianna, to ZYZZYVA, to Red Hen Press, and everyone, for reading, for sharing, and for all of your support!
May 31, 2019
GCS = Glasgow Coma Scale
Do you want your coma scale to be high or low?
The Glasgow Coma Scale is named after two professors of neurosurgery at the University of Glasgow (Glasgow = scenic Scottish city sitting on the River Clyde). We have them to thank for mnemonics like "eight means intubate," AVPU (alert, voice, pain, unresponsive), et cetera.
The Glasgow Coma Scale, a quick assessment of a patient's level of consciousness, can be broken down into three categories: best eye opening, best speech, and best motor response.
Eyes
4 points: eyes open, tracking your behind
3 points: eyes open when you say, "Look, squirrel!"
2 points: eyes open if you stick the biggest syringe ever into a large muscle
1 point: no response regardless of anything and everything.
Speech
"Mr. D, do you have any medication allergies?"
5 points: "Why, yes, I do. Tylenol, Motrin, Toradol, and Morphine. The only thing that works for me is Dilaudid."
4 points: "Is this the planet Mars? My spaceship is forever gone."
3 points: Cat sharpie long long Jupiter oatmeal.
2 points: mmmmm ehhhhhhh mmmmm...
1 point: [silence]
Motor
6 points: runs away from you at the sight of the big honking needle
5 points: tries to take arm back upon feeling jab
4 points: arm flexes in response to being stabbed by needle
3 points: decorticate posturing
kind of like this, but lying down in bed, and your patient doesn't look like this.
2 points: decerebrate
Like this but stiffer, and your patient doesn't look like this, either.
1 point: no motion
A total of 15 points is what most of us score, maybe minus a point or two after the semester has ended and baseline functioning (beyond feeding & caring for your children/yourself) is no longer required. 9-12 points shows moderate brain injury; 3-8 points means severe damage.
So yes, you want your coma scale to be high!
The Glasgow Coma Scale is named after two professors of neurosurgery at the University of Glasgow (Glasgow = scenic Scottish city sitting on the River Clyde). We have them to thank for mnemonics like "eight means intubate," AVPU (alert, voice, pain, unresponsive), et cetera.
The Glasgow Coma Scale, a quick assessment of a patient's level of consciousness, can be broken down into three categories: best eye opening, best speech, and best motor response.
Eyes
4 points: eyes open, tracking your behind
3 points: eyes open when you say, "Look, squirrel!"
2 points: eyes open if you stick the biggest syringe ever into a large muscle
1 point: no response regardless of anything and everything.
Speech
"Mr. D, do you have any medication allergies?"
5 points: "Why, yes, I do. Tylenol, Motrin, Toradol, and Morphine. The only thing that works for me is Dilaudid."
4 points: "Is this the planet Mars? My spaceship is forever gone."
3 points: Cat sharpie long long Jupiter oatmeal.
2 points: mmmmm ehhhhhhh mmmmm...
1 point: [silence]
Motor
6 points: runs away from you at the sight of the big honking needle
5 points: tries to take arm back upon feeling jab
4 points: arm flexes in response to being stabbed by needle
3 points: decorticate posturing
kind of like this, but lying down in bed, and your patient doesn't look like this.2 points: decerebrate
Like this but stiffer, and your patient doesn't look like this, either.1 point: no motion
A total of 15 points is what most of us score, maybe minus a point or two after the semester has ended and baseline functioning (beyond feeding & caring for your children/yourself) is no longer required. 9-12 points shows moderate brain injury; 3-8 points means severe damage.
So yes, you want your coma scale to be high!
May 25, 2019
Hx = History
One can have a history of codependent behaviors, a history with a substance (under our breaths, "hx of EtOh," to avoid embarrassing anyone), or a history with a particular person. History is, as the word suggests, subjective. There's the good kind of history as well--for example, the story of Florence Nightingale, and the history of nursing graduation rituals.
This already sailor-looking cap made a lot more sense once my dear friend Meg gifted me her mother's WWII nursing cap pin (complete with lovely anchor design), which made me wonder whether the history of nursing caps had something to do with the military.
The short answer is, no. Apparently, the nurse's cap was modeled after a nun's habit, paying homage to nuns being the earliest nurses. Florence Nightingale continued the tradition of the cap by making it part of a nurse's uniform that keeps hair neatly in place. We nursing students know that Nightingale was all about keeping the environment clean and sanitary (though ironically, caps were abolished in modern day hospitals because they're not washed and can harbor resistant bacteria and virulent viruses).
Our class got to vote whether we wanted to wear caps for graduation or not. The majority ruled, "cap."
Another tradition that pays homage to Florence Nightingale is the lamp, a symbol of her rounds at night as she took care of wounded soliders. Nursing instructors (in our case, our director) pass(es) the torch/flame on, quite literally, to graduating students at their pinning ceremony.
Speaking of pins, Queen Victoria herself awarded Florence Nightingale the Red Cross of St. George in recognition for her dedication and service to injured soldiers during the Crimean War. Nightingale, in turn, presented a medal of excellence to her brightest graduates. Nowadays, we don't play favorites--everyone gets a pin. While the pin often represents the school a nurse graduates from, our class decided to each pick our own pins.
Or, if we're really lucky, we're gifted a priceless pin with a world of history and a brave WWII pioneer woman behind it.
This already sailor-looking cap made a lot more sense once my dear friend Meg gifted me her mother's WWII nursing cap pin (complete with lovely anchor design), which made me wonder whether the history of nursing caps had something to do with the military.
The short answer is, no. Apparently, the nurse's cap was modeled after a nun's habit, paying homage to nuns being the earliest nurses. Florence Nightingale continued the tradition of the cap by making it part of a nurse's uniform that keeps hair neatly in place. We nursing students know that Nightingale was all about keeping the environment clean and sanitary (though ironically, caps were abolished in modern day hospitals because they're not washed and can harbor resistant bacteria and virulent viruses).Our class got to vote whether we wanted to wear caps for graduation or not. The majority ruled, "cap."
Another tradition that pays homage to Florence Nightingale is the lamp, a symbol of her rounds at night as she took care of wounded soliders. Nursing instructors (in our case, our director) pass(es) the torch/flame on, quite literally, to graduating students at their pinning ceremony.
Speaking of pins, Queen Victoria herself awarded Florence Nightingale the Red Cross of St. George in recognition for her dedication and service to injured soldiers during the Crimean War. Nightingale, in turn, presented a medal of excellence to her brightest graduates. Nowadays, we don't play favorites--everyone gets a pin. While the pin often represents the school a nurse graduates from, our class decided to each pick our own pins. Or, if we're really lucky, we're gifted a priceless pin with a world of history and a brave WWII pioneer woman behind it.
