Mid-Semester Reminders

About this time of the semester the days tend to run together starting with an early alarm that reads something like 0500 and clinicals that start shortly after that. I remember what that was like and, in fact, am reliving those times now as I am working full-time and taking a graduate statistics class while studying for the GRE. While late nights and early mornings are all too familiar for many nursing students, I want to encourage you to not lose sight of the One Thing, the thing that is necessary. Now is not the time to neglect our quiet time with the Lord. I know it's hard to find time. Believe me, I'm right there with you, but think about all the other things we miraculously always find time to do...ahem...like check Facebook, Instagram, and other social media outlets. I know I have come home after a long shift at the hospital, done both of those things, and then realized that I hadn't read my Bible yet. It's times like these that I have to examine the quality of time that I'm giving to the Lord. Am I giving Him my best? Or my left-overs? Let's strive to give the Lord our best in our time. When we put Him first, He promises to reward us and to take care of the rest.

"But seek first the kingdom of God and His righteousness, and all these things will be added to you." ~ (Matt. 6:33, ESV)

Why I Love Charge Nurses

When you graduate from nursing school you have a few months that you spend with a preceptor, but then you are released and are virtually on your own, or so it feels much of the time. During my orientation, I was intimidated by my charge nurses. I erroneously thought that they were too busy and important for me to bother. Boy was I wrong! If you need help or simply have a question, your charge nurses are your biggest resource. I love all of the charge nurses I work with. They each have their own special gifts, and all are extremely helpful.

Charge nurses typically have many years of experience and are the "experts" Patricia Benner describes in her book, Novice to Expert. They are the nurses you can call when you need a second opinion before you call Rapid Response to come for a nurse consult or page your physician about a change in patient status. As a new grad, I know that I, and other new grads, sometimes need this second assessment by a senior nurse to validate our own assessment and give us confidence before we recommend the physician to escalate care.

My advice to recent grads in the December 2014 class who are becoming the latest proud group of RNs to graduate from Liberty University is to make friends with your charge nurses. Your charge nurses are the ones you can call when you are swamped with STAT labs, meds, patient care, and have no way of getting it all done yourself. Charge nurses want you to succeed as much as you do. Don't be afraid of asking for help. One of the most important lessons you will learn as a new nurse is, when you need help, ask.

Note of Encouragement: To Nursing Students

I can hardly believe that Christmas break is over and school is back in session. I remember the mixed feelings of excitement, dread, and anticipation which would overwhelm me at the beginning of each semester. Before life gets crazy, I would like to encourage some LU nursing student out there who is reading this right now to keep first things first. I know it's easy to get caught up in the busyness of school and clinicals, but always remember why you are here. Seek Him. Know that He loves you.

I know sometimes being driven and a go-getter can be lonely and sometimes discouraging when we find ourselves falling short of what we hoped for and expected of ourselves. One of the biggest lessons and best pieces of advice came to me by the mouth of Ms. Drohn after I felt that I had failed and the world was ending because I realized I wasn't perfect, which sounds as ridiculous as it was. She told me that there is only One person who's perfect, and if you're Him we've got bigger problems on our hands. Now that made me smile through my tears, but it really is true. Perfectionism is a good thing insofar as it pushes us to excellence, but it can be a burden and a hindrance if it causes us to rely on ourselves instead of Him alone who IS perfect. Now I don't know if any of that is helpful for you, but if it's not maybe you'll be able to use it to encourage someone else in your program.

Keep up the good work, LU nursing student! You can do all things through Him who gives you strength. Lean on Him. He has you in His hands.

Q&A with an LU Nursing Grad

Recently I was contacted by Emily, a current junior in the nursing program at Liberty. She had a lot of great questions that I remember asking some of the seniors when I was a junior. I’m sharing them here in the hope that they will help other nursing students with similar questions.

Q: What advice do you have for applying to externships?

A: My advice about applying to externships is tailor your resumes and cover letters to each application. Use some of the key words that they use in the job posting in your resume/cover letter. Be concise but show the nurse recruiters why you're the best. I would also recommend using Liberty’s Career Center as a resource. You can electronically send your resume into them for critique and even schedule a mock interview.

Since you are filling out applications now, this will probably apply more to your future applications to new grad jobs, but I would recommend seeking out opportunities to serve (CSER is a great option) that will look good on your resume (esp. those related to nursing). It's rewarding in two ways. First you're serving God, which is the most important, but second, serving without pay is something unique that shows that you want to give back to your community not just be a consumer. Employers want employees with a service mentality because they know that A) it makes them look good B) you get personal satisfaction from helping others, which causes you to C) be a better employee as a result (less burn-out). Some service opportunities I would suggest are volunteer nursing lab worker, Patho/MedSurg tutor, and community nursing educator (I taught a class on drug addiction to women at a local Teen Challenge in my community).

When you are in your interview, be confident. You can look on the Liberty Career Center website for typical questions that interviewers ask and then formulate some responses. Think of a 7 or so nursing or work-related stories that highlight some of your personal qualities that they are seeking (compassion, caring, integrity, critical thinking, ability to work with difficult people, etc.). Once you get to Leadership (NURS 490), you will learn how to write a “critical incident” that highlights your skills and abilities which are exemplified in a particular patient care situation. This seems like a difficult assignment sometimes, but it helps you to go through the process of picking a situation you experienced and then examining it for every area and decision you made that shows that you are a caring, compassionate, hard-working Liberty nursing student who has what it takes to be the best nurse/nurse extern--one that they would love to hire.

Q: Can you tell me about the process of getting into the Adult CCCP?

A: First of all, once you've completed your application, Mrs. Akers, the director of the Adult Critical Care Certificate Program (CCCP), will be speaking with your clinical instructors about you and getting their feedback about your performance in the clinical setting. This is when having established a strong relationship with your clinical faculty really pays off. They will be able to tell her your strengths and weaknesses. (FYI when I was in the running for the program, taking part in the Richmond program was an extra point in the point system for calculating who is selected).

When I applied to the program, I had to submit the last patho of the semester. I didn't realize this at the time, but those who read the pathos submitted in the application really pay attention to these pathos. My understanding is that they look for attention to detail and overall comprehension of the material.

After the preliminary selection is made, a list will be posted in the nursing office of those selected for panel interviews. You will have to sign up for a time slot. I remember everyone (including myself) kinda freaking out about the interviews for the Crit Care program. But remember to take a deep breath and relax.

This is a professional interview so you will want to dress like you are going to a job interview for your first real nursing job. (I think I wore slacks, heels, and a nice blouse). One of the most helpful things I did was go to Mrs. Akers alone and talk with her about the questions I had about the program prior to the interview. She is super sweet and caring and loves talking to students about her passion for critical care nursing.

I don't know if Mrs. Akers and Dr. Kennedy will offer this to your class, but even if you don't make it into the first selection of those in the Crit Care program, there are usually those who don't get a high enough grade in NURS 460 and have to drop out of NURS 465 (which is the CCCP class). If you're put on the waiting list, you can still get in if there's an opening. Also, last year Mrs. Akers and Dr. Kennedy taught an ACLS class for those who were interested and got an A (and maybe even a B) in NURS 460.

Lessons from a Blind Beggar with Big Faith

Lately I've been reading through My Utmost for His Highest by Oswald Chambers, an excellent book full of meaningful insights and challenges from the author. One of the Biblical events brought to life in this book is the story of the blind beggar who called out after Jesus as He passed by (Luke 18:35-43). Despite the crowd’s rebuke that he should remain silent, the beggar was persistent and kept calling after Jesus, and, instead of giving up, he “shouted all the more” (Luke 18:39b). According to Chambers we must be like this beggar and “Persist in the disturbance until you get face to face with the Lord Himself; do not deify common sense. When Jesus asks us what we want Him to do for us in regard to the incredible thing with which we are faced, remember that He does not work in the common sense ways, but in supernatural ways” (p. 60). 

  

Reading this was a challenge for me to not stop with ordinary prayers with easily attainable outcomes, but to ask God for the seemingly miraculous or unattainable things. Don’t get me wrong, I believe the Lord wants us to ask Him for the small things, but I think He also wants us to have faith like this blind beggar and ask Him for the seemingly ridiculous and impossible thing, that we may experience His supernatural power in our lives. According to Chambers, “If it is an impossibility, it is the thing we have to ask” (p. 60). The blind beggar, when asked by the Lord, “What do you want me to do for you?” (Luke 18:41), asked Him for the impossible—to receive his sight. And he did!

According to Chambers, “Faith is not in what Jesus says but in Himself”. I thought this was so true and fitting for many of us today when we stare into the blackness and mystery of the future, shrouded by uncertainties and unknowns. There is only one thing that is certain and in which we can hope—the character of Christ, a man who never changes, more than that, a God who never fails or forsakes us, His beloved. It is my own self-will that causes me not to trust Him. My worry is only evidence of the immaturity of my trust in Him and my forgetfulness to remember Who He is. 

Today, let us remember the goodness and faithfulness and promised provision of our God and pray for what we think are impossibilities.

References

Chambers, O. (1997). My utmost for His highest. Uhrichsville, Ohio: Barbour & Co

NCLEX Scheduling Information

When you schedule your NCLEX, there are three main steps you need to take (possibly more depending on the state). The three steps are register online with the State Board of Nursing with which you wish to be licensed, register with Pearson, and get fingerprinted. In North Carolina the cost of registering to be considered eligible to sit for boards was $75 and is done through Nurse Gateway, which is the portal used to register and check the status of your application to become an RN. The cost to actually take the test at one of Pearson's testing centers was $200. For the background check, the cost of the background investigation was $38, and the cost to have my fingerprints taken with the LiveScan (a requirement of the NC state board of nursing [NCBON]) was $10 at the nearest LiveScan equipped police department in NC. For more information about testing in North Carolina, see the NCBON website and check out the information listed under the licensure/listing tab.

Once you have filled out all your information online or on paper forms (depending on your state protocol), routed your official transcript electronically or through the mail (NC requires electronic for out of state school applicants such as Liberty), registered with Pearson Vue, and submitted your fingerprints and release of personal information, you will await the approval to test (ATT). Once you receive your ATT, schedule your test RIGHT AWAY! I, unfortunately, waited about 30 hours to schedule my test after receiving my ATT because I wanted to take more practice quizzes and see how I was doing before scheduling my test  date. I had no idea that test dates were filling up quickly, and I was forced to wait several more weeks than I would have liked to test.

The story of my NCLEX is to be continued...I test on June 16th.

Springboarding Your Worries

A couple weeks ago my mom sent me a text with a great reminder about trusting the Lord and not worrying. It said something along the lines of "pray as much as you worry." What she meant by that is to turn your worries into prayer. I like to think of this as a springboard. When you're worried that your patient won't make it or you won't make it through nursing school or through the midterms or whatever you're worried about, redirect your attention off of yourself and your own inadequacies and focus on the Lord and His all-sufficiency.

This is illustrated by a passage I was reading last night in Psalms. The passage describes what Anne Shirley would call "the depths of despair". The psalmist was in a dark time when everyone seemed to be against him—even the Lord (Psalm 88:7). Even so, he remembered the "steadfast love" and "faithfulness" of the Lord and cried out for His mercy (Ps. 88:11). While the troubles of life were surrounding Him, he recollected the "wonders" of the Lord (Ps. 88:12). He cried to the Lord daily and spread out his hands to the Lord (Ps. 88:9) even though the Lord's wrath laid heavy upon him (Ps. 88:7).

When I read this passage, I was so impressed by the psalmist trust in the goodness of the Lord despite his depressed circumstances that I was challenged to examine my own heart and the way I respond when I am faced by trials. This man was desperate for the Lord and expectantly asked the Lord for renewed favor. How much more should we trust our Lord in every circumstance? Like the psalmist, we should see trials, troubles, and even potential troubles that we worry could happen as opportunities to come before the Lord in prayer.

Here are some scriptures to remind us of the God we serve and the power of prayer:
"Cast your cares on the LORD and He will sustain you; He will never let the righteous be shaken" (Ps. 55:22).

"But He said to me, 'My grace is sufficient for you, for my power is made perfect in weakness.' Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me. For the sake of Christ, then, I am content with weaknesses, insults, hardships, persecutions, and calamities. For when I am weak, then I am strong" (2 Cor. 12:9-10).

"Confess your faults one to another, and pray one for another, that you may be healed. The effectual fervent prayer of a righteous man avails much" (James 5:16).
 
"Delight yourself in the Lord, and He will give you the desires of your heart. Commit your way to the Lord; trust in Him, and He will act. He will bring forth your righteousness as the light, and your justice as the noonday. Be still before the Lord and wait patiently for Him; fret not yourself over the one who prospers in his way, over the man who carries out evil devices!" (Ps. 37:4-7).

Perfect Peace

How many of us wish we lived in "perfect peace" all the time? I know I do. Isaiah 26:3 says, "You keep him in perfect peace whose mind is stayed on You, because he trusts in You." Now that's a promise! Over the past few days the Lord has been convicting me that I often allow myself to become distracted by the "cares of this world" (Mark 4:19) that easily crowd out thoughts of my Savior. Instead of continually renewing my focus on Him and devoting myself to Him "in body and spirit" (1 Cor. 7:34), I all too easily allow my focus to drift away from Him to things like homework, clinicals, and grades. 

I know that it the middle of the semester, and that this can be a difficult time with Mid-Terms and exams that just don't seem to end in Nursing School, but I want to challenge you, as I am challenging myself, to remain focused on the Lord. I was reading in My Utmost for His Highest by Oswald Chambers this morning, and Chambers challenged his readers to "use your imagination to put yourself before God" (p. 42). What he meant by that was to use your imagination (your thoughts) in a way worthy of the Lord (Phil. 4:8-9). Instead of our imagination living in a starved state because it is set on thinking about whatever our empty impulses desire, we can instead set our thoughts to contemplate the majesty and the wonder of God. Where can we look for our inspiration? The beauty of sunsets artfully painted by God, the trickling or thundering waterfall pouring over the side of a cliff, the majestic scene of mountains overlaid with clouds of water vapor, the starry host of heaven twinkling in an inky sky--these are all launching boards for our imaginations to imagine God--to consider and meditate on His power, majesty, and grace in saving us mere humans. 

When setting our mind on Christ our King and Creator, we have no reason to fear the future, to worry about what will come our way, or to think for a moment that He might not come through for us this time. Instead we can rejoice with the psalmist who realized the majesty and the wonder of God and found "perfect peace" in Him. Psalm 8:1-4, 9: "O Lord, our Lord, how majestic is your name in all the earth! You have set your glory above the heavens. Out of the mouth of babies and infants, you have established strength because of your foes, to still the enemy and the avenger. When I look at your heavens, the work of your fingers, the moon and the stars, which you have set in place, what is man that you are mindful of him, and the son of man that you care for him? . . . O Lord, our Lord, how majestic is your name in all the earth!"

 

Maternal Child Critical Care Program:Perspective of a Graduate

Warning: to all readers, if you are reading this I assume that you understand that you are about to enter the nerd-dom of Maternal Child Critical Care Certificate Program (MC-CCCP) NOT the original of adults in CCCP. This is the world of patients the size of teacup poodle puppies. This is NOT the world of ER re-runs and those ever-popular shots of scrub-bedecked heroes running down endless halls and pumping with all their might on the chests of unresponsive patients. This is the world of two-finger compressions, micro-changes in IV calculations, tiny bodies that require exquisitely careful care and much peace and quiet, inexpressible joy, broken hearts and messed-up homes. Welcome to MC-CCCP.

As noted, this is not adult CCCP. When I took it last year, we did not operate or run codes like the CCCP students. We spent more time in lecture and with guest speakers and less time running mock codes than our “adult” neighbors last year. Most of our practice was self-taught, with us designing and running our own scenarios. Considering the feedback we got from instructors after we all passed NRP and PALS, we were a pretty demanding set of self-teachers! All that to say, if you take MC-CCCP, you need to be motivated to learn. Like all of the nursing program, you get results in proportion to the effort you make.

If you do persevere and learn, it is a program you will never forget. I had the incredible privilege of working in a NICU. It was a small one and by weekend #2, my instructors were turning me loose to do basics on my own (with them only a few feet away in the tiny department). By the last weekend I was essentially put in charge of the patients assigned to my instructor and myself. I had the joy of watching the light bulb come on in a tiny child’s mind as he finally understood the idea of nursing from a special preemie bottle and took a giant step toward going home. I got to share that joy when his mom came to see him. My heart broke as I cared for and loved on babies only to meet their families, people unprepared for this responsibility. One had not even wanted the babies in the first place and could not make it into the department without crying. Then there was the one father who could win a smile from his tiny daughter and make her calm down and go to sleep against his chest, staying as long as he could just to be with her. Above all was the wonder and joy of working with some of the most beautiful creations God ever designed and sent to give us a taste of what unconditional love is and demands.

        

Fun epilogue: I do not currently work with any of the patient populations we covered in MC-CCCP. God has placed me for a time in long-term care and rehab. However, the skills of MC-CCCP have shown up here too! I was trained to face the worst, which makes it easier to prioritize and keep a levelheaded approach to a constant deluge of problems of all sizes. There are also basic concepts that apply to everyone: everyone must breathe, their hearts must pump and blood must circulate. And everyone is hungry for unconditional love. 

The above post was written by Elizabeth Houser, RN and graduate of the MC-CCCP

Critical Care Certificate Program

Over the past year I have received numerous questions regarding the Critical Care Certificate Program (CCCP) from nursing students at Liberty University. Most often these questions revolve around what the program is and how it benefits students interested in critical care nursing.

The Critical Care Certificate Program gives students the advantage of taking three American Heart Association tests that nurses normally will not take until they have already graduated. These three tests are Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Neonatal Resuscitation Program (NRP). Taking these tests before graduation allows Liberty Nursing students to achieve more qualifications for a nursing job than most new nursing grads, in effect, giving students an extra advantage. This is particularly helpful for positions, such as those in an intensive care unit (ICU) or emergency department (ED), that require these certifications be acquired soon after being hired.

Another advantage of the CCCP is the numerous hours that are spent in simulation, running code blues, interpreting EKGs, selecting and administering the appropriate drugs to the simulation patients, performing CPR, delivering breaths with an Ambu bag, and practicing recording drugs and interventions given during a response to cardiopulmonary arrest. This provides the opportunity to learn in a low-stress environment by working through real-life scenarios that allow you and your peers to learn from your and others' mistakes as well as successes.

I am currently in the Adult CCCP and loving it! We start each NURS 465 class with two hours of lecture, break for lunch, then come back and run mock codes for three hours. An added benefit is NURS 465 (for the Adult CCCP) counts for the nursing elective required to graduate from Liberty's Nursing Program.

Another advantage of being a part of the CCCP (both Maternal/Child and Adult) is you will be given preference during selection for Leadership. This means that your requests for Leadership clinicals will be looked at first before your peers who are not in the program. The reason for this is that you will need to complete 140 hours of Leadership (NURS 490) clinicals in a critical care setting, such as an ICU or ED, which is greater than the 90 hours of Leadership required of your peers. If you get into the Adult CCCP, you will also have the opportunity to shadow in a critical care setting of interest to you such as the CVOR, flight nursing, EMS/fire department, etc. These are great observational opportunities that you may never have again after graduation.