Friday, August 21, 2015

2 Years.

2 YEARS. Wow 2 years. Yep it still feels epically shitty to write that... you know as I sobbed into my husbands arms tonight I asked him whether he thought this would get easier or not...

"Do you think 10 years from now it won't hurt as bad..." "I don't know babe. I don't know."

The tears fill the void of something so huge it's unexplainable. A complete void in my life... a deep crevasse so long you can't see the end and you wonder what else it can swallow whole. I thought when cancer reared it's disgusting head in a hospital waiting room 4 years ago that this was the extent of the ugliness it bared. Little did I know that this ugliness would reach farther into my life and the future than I could've ever imagined. Don't get me wrong, every day life is far beyond cancer. The piece that it stole will never be replaced but the shattered brokenness is slowly less jagged and rough. The majority of days are vastly happy and full of exuberance and LIFE. Take that cancer you asshole.... LIFE..... did you hear me????

LIFE!!!

But there is no denying the hurt and void from a person so missed it must be viscerally obvious to those around me. Is it not? My Dad was a damn rockstar, he had plenty of faults but he owned that shit. At least to me, he owned it. I resonate with his life philosophy. I am surely no perfect peach here, I am sassy, feisty, smart, gregarious, full of piss and vinegar at times (of which I am NOT ashamed), stubborn, sensitive, shy, and highly complicated just as my father. He had a certain way about him, you were either on one side of his coin or the other and I probably sat on a random 3rd side of that coin.... he and I got each other.  We surely were together in some previous lifetime which makes his absence all the more devastating to me and my family.

He will NEVER know my third son. It rips my heart apart to type that. It's so cliche to say things like "of course he does, he's always with you" well goddammit if that were true things would feel much easier. Let me be the first to enlighten everyone, how the heck do we know he's still around... I think I know, I think I believe it, I tell my kids I do but death means that you're in another place that no one, no where, actually knows about. Comforting is not exactly how I'd describe those sentiments although you'll hear me tell myself that very thing on nearly a daily basis. It's clinging to hope of some sort... it wouldn't be human to give up on that idea right??

2 years. How has it been 2 years since I watched a hoard of firemen carry my frail father up flights of stairs to his final resting place with a smile as I greeted him "you're home Dad. you're home." His look conveyed that he understood what was happening. He knew he was coming home to die.... gee what a wonderful thing to behold. His saving grace, I'm sure, was his pure exhaustion with the circumstances.... despite my profuse protest in his medical care at the end I was not the power of attorney.... I can't elaborate on that at this point, it's too much... but the end result is that my Dad made his way home where he wanted to be to spend his final days with us. I was there every. single. day. It was 5 days from the moment he left the hospital until I received the phone call that he had gone Home.

What would he be thinking today if he were here... what would he think of my crazy 3 boys... of little baby C??? Would he like our new house... What input would he have on the engine swap for the S10...What jokes would he crack about my nephew and watching my brother as a Dad... Would he want to teach my boys to ride motocross like he did... Would he be at their T-ball games.... Would he be there to witness me graduate with my masters degree...

I have 2 years + a lifetime of questions to ponder, scenarios of what-ifs... a void to fill that can never be filled. I have lived an experience that I wouldn't wish on my worst enemies and survived a loss that many peers, family, and friends will one day experience.... yet I feel I have no wisdom gained from my shitastic experience.... What do I tell them if and when they reach a similar fate... it sucks. Less than encouraging. 2 years in and it still feels like a dagger to the heart.

I guess my only silver lining thus far is that the hurt must equate with the loss. I lost an amazing man and that is a level of hurt that won't soon be gone.

This August 22nd... I toast to you Dad... to the Mad Max rockstar that you were... for the zero apologies you made for being you... to the influence you had on me and my life.... to the gene pool you left my awesome dudes...

I CAN'T WAIT for the day I see you again old man!!!! I can't flippin wait. You better pick my butt up on your Dyna and ride me off into the sunset. I love you. I miss you.I miss you every day.

Until then,
Baby Cakes.
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Friday, August 14, 2015

WGU: Single Term Tricks of the Trade


I am frequently asked how I was able to complete the WGU so quickly and whether I have any advice for upcoming students. I can tell you exactly what I did to study and finish however keep in mind that this is what worked for me during my enrollment. You may study differently, your courses may be different, etc.

Below are my tips along with my insight into EACH course that I completed (I left a couple out that were missing pre-req's like speech but the general courses are here)

A note on the gist of things at WGU:
Learn to be flexible. Things change frequently with WGU- courses, course requirements, etc. During a single term I didn't have any course changes but I know several students who have been enrolled for a few terms who have had changes throughout their enrollment which has caused frustration here and there. Just be prepared for it. Focus on ONE course at a time. Usually any changes are typically in your favor, they'll adjust cut scores for assessments or they'll do things like cut down hours on your practicum (I WISH this happened for me... I did 90 hours and they switched it afterwards to 45). Try to be patient and if any changes adversely affect your progress be sure to speak up for yourself, typically you are able to argue your right to continue just as you enrolled without the changes if you choose.

OA's versus PA's
OA's are objective assessments, these are multiple choice tests that are pass fail based on cut score (which by the way equates to a "B" grade or competency level at a traditional school). You take these via a testing center or via a web cam in the comfort of your own home where you are actually proctored by real people. A little weird to get used to but once you work out the occasional kinks of the web cam this is great. The way the new software works you don't even have to schedule your exams out ahead of time you can literally jump on any time you'd like and take the exam at will. Highly convenient.

PA's are performance assessments, a nice way to say "papers or presentations". These in my opinion are horrid. It ends up being a BIG long redundant paper (some 35+ pages for example) that cover a million areas on a rubric that demonstrate your knowledge and competency on that particular course. Each course has a completely different set of rubric requirements, some have power points associated, some like Biochem require you to make models & drawings, but in the end it's essentially paper writing at it's finest. I loathe PA's which unfortunately make up 90% of the MSN program. (BSN is roughly 50/50 ish).

Which order to take the courses in
I tried to decipher each course when I started to see which I thought may be the best to take first, come up with my own schedule of completion, etc. I learned after speaking with my mentor the first time that while you can technically take the courses in any order you'd like there is a "typical" way of doing things and in the end I went along with this. No need to make waves if this was a good way of completing what I needed to do. Most mentors will suggest that you take Health Assessment and Care of the Older Adult first along with possibly Community and Population Health. (Course numbers will change but typically the course names do not, so learn both). This order was fine to get me into the groove of things.

My Personal Course Timeline:

I ended up taking each OA with about 2 days of prep time ending with the 3rd day testing. I outlined my schedule ahead of time to give myself 2 days of study on the material (granted I had small kiddos at home so a "full" day of study is relative). The 3rd day I spent the morning reviewing and cramming again and the afternoon taking the exam. For each OA my usual method of approach included skimming the Course of Study to find relevant points. Checking the course community gave me a lot of insight on what to study in fact many courses have their own "study guides" compiled by the course mentors that will really help you focus in on what is required for the OA. Outside of good documents like practice exams and notes that you can find in the course community you can see questions and answers from the mentors to other students which usually end up being your own questions. Browsing over these things in the community will give you a good vibe on how the OA is going to go.
UPDATE: Specific course communities apparently don't exist anymore to my knowledge... I'm not sure why they did this?? Instead on the right hand side of your course of study there is now what's called "course chatter" which serves a similar purpose but in my opinion is no where near as helpful. That said it is somewhat helpful if you can navigate around to find important documents and frequently asked questions. Do this before reading through your course of study, you can waste an awful lot of time if you actually go through the COS page by page, reading by reading, DON'T. Get the overall gist of things by surveying the course chatter first, also check out some of the online discussion boards especially Facebook, this will provide great insight as well and THEN you'll know what to study.

PA's were a little bit different story. I devoted one week to each PA, some went a little bit quicker, others a little longer but overall this was a good yard stick. I spent the first day pulling up the rubric and task instructions and outlining my paper. Then I would browse around the course of study to see where I could pull info for the paper that would meet the rubric requirements. Lastly, it was a matter of filling in each section of the rubric.

A guide to PA's.

DO NOT. I repeat DO NOT over-do the PA's!!! The task instructions can sometimes derail you into going overboard on what the task is actually requiring. At the end of the day you are being graded by the RUBRIC. Literally. Your course grader is given a copy of the rubric and your paper and that is ALL they grade from. So if you run off on a tangent in fluff that has nothing to do with a rubric requirement good for you but it will not really help your cause in the end. Keep It Simple. Answer the rubric questions/req's and be done with it. By outlining your papers based on the rubric sections you set yourself up to stay on topic, to the point, and you make it 10x easier for your grader to grade.
That being said when it is time for a PA. Pull up Taskstream so you can see the task instructions and rubric right there in front of you. Outline your paper with your name and course information at the top and block out each line of the rubric A1----- A2c----- B----- C----- etc. Fill it in as you go. IF YOU need to reference the course of study materials to fill in the paper sections do it as you're writing, do NOT go through and read a bazillion pages of text ahead of time, only scout out what you need to finish. Plenty of areas on rubrics and even whole PA's are based on your opinion requiring no real text involvement. If anything the interwebs are your friend to find info concisely to include.

Powerpoints: If and when your course includes a power point, a random tip, you can use Google Drive to create a powerpoint without buying the software. You can also get Microsoft Office for free with your WGU student email (instructions to follow). Label each slide of the Power Point in accordance with the rubric, again makes it easier for your grader. KEEP it simple! No need to get all fancy and put pictures and 70 slides with fancy transitions and music to convey a simple requirement.

Taskstream Grading:
Not the quickest thing on the planet, thankfully they now show you the "queue" which they didn't have when I was doing it, at least now you can guesstimate how many days of grading you're in for although I'm not sure that helps you ha! Stalk away or just sign up for text notifications on your work.

Message Boards:
USE THEM! I used the RN to BSN Facebook page ALL the time to bounce ideas off of others and to help others. It is priceless insight that you'll gain there.Utilize the search feature on the page to check previous posts about the same subject matter. No one here is going to give you answers to your tests... I mean c'mon people (and YES people really do get on there thinking they may get this info??wth?) but they will help you troubleshoot things and give you similar tips to those you're reading here.

Pinterest:
I used some pinning to save important things I wanted to reference later, not a ton of info here but feel free to check out some of the things I compiled or start your own board to keep organized.


********COURSE BY COURSE TIPS & INSIGHT******


Health Assessment:
This should be no issue for anyone with prior medical experience. If it's been a while since you studied or Nclex'd be sure to brush up on your typical assessment stuff. I personally went through the chapters in the Course of Study and took the practice exams at the end of each which helped. This is going to be pretty typical black and white knowledge along with the application of "critical thinking" just like a good old NCLEX. As for your video, many people (including myself) put off the video part because, well it's weird to video tape yourself for someone to analyze... awkward. Take it from me, it isn't hard at all, just get it overwith! My best advice, print off the list of things you're supposed to do in your video and put it in a binder to use WHILE your taping yourself. I literally checked off each thing as I did it to make sure I didn't miss anything. I brushed up on assessment techniques via good old YouTube (since there are some interesting ones to cover that you don't normally do... hello jugular vein distention measurement???) and then did it.

Care of the Older Adult:
Again basic knowledge of elder care here, this will closely mimic your gerontology nursing class from back in the day. BUT, this is the one OA that I failed!! I was shocked. A little tidbit, outside of your general elderly medicine, variables, assessments, etc make sure you READ IN DEPTH on the dang Medicare and insurance crap... for some reason my assessment was about 70% Medicare questions (and I KNOW my insurance stuff, so this was excessive). Otherwise hope your version of the test isn't so pigeonholed into this arena. This is supposed to be one of the easiest and most remedial of all of the BSN courses.

Community & Population Health:
If you're planning to finish your BSN in a single term, better get this one going immediately. You cannot log practicum hours for your final practicum until this course is done. This one was my first PA course. It consisted of 4 "tasks" ie. 4 papers of various requirements. I did what was recommended and that was to finish the tasks in backwards order, so task 4 then task 3, saving task 1 for the end. Reasoning was that task 1 is pretty intense and long and it helped to get a few other writing tasks under your belt before jumping into that one. You get to see how the whole grading thing and Taskstream work along with getting used to the rubrics. The long paper is ultimately a set up of your final practicum, you research your specific community and look for deficits and things that you can essentially work to research more for the final practicum where you log all of your hours.



Applied Statistics:
Some people struggle with this one, not sure if that is because of the newer version of stats or just different learning styles. I thought Stats was not too bad. I read through the community advice to focus on Chapters 1-4 knowing them like the back of my hand. I read the chapters, took each quiz at the end and re-read areas that I missed on the quizzes. Lastly, I printed the course study guide (probably housed in the "course chatter box" now) which was compiled by the course mentors and made sure I knew all 100 of those questions very well. In my opinion the OA was identical to this practice study guide.

Nutrition:
I don't have the best advice for the nutrition OA simply because I know nutrition very well. I had 3 nutrition courses in my undergrad prior to this one and it's a lifestyle thing I've always been educated in. So that said, this was a very easy exam, basic principles of what to eat for certain populations ie. pregnancy, wound healing, etc. Which foods are high in specific nutrients, that kind of thing. A patient post op with renal complications should eat which choice of meal, etc. One area I remember being a little trickier was the vitamins and minerals, I had quite a bit of content on this which seemed a tad unbalanced, worth brushing up on.

Biochemistry:
I was a huge fan of Biochem! Some people hate it but I thought it was a welcome relief from multiple choice tests and paper writing. I mean how can you go wrong when your homework consists of making chemical models out of legos or candy... or k-cups ha! You don't need some fancy molecule kit for this one, using items around the house is perfectly fine as the course mentors will tell you. The subjects are quite complex that you are learning here, very detailed... especially DNA transcription and translation. In my opinion I had to actually pay attention to the content and videos to truly understand what I was doing and it was fine. It's mostly YouTube videos put on by the mentors that are easy to follow and the Thinkwell Guy. I LOVE the Thinkwell Guy, he's like an older version of Bill Nye the Science Guy talking about way more boring things but he makes it slightly entertaining :) Enjoy biochem, it's the only course in the whole shabang that is set up like this.

Professional Roles & Values:

This one is very blah. A good one to get over with, it's not hard it's just very boring. The whole course is essentially about nursing theories, how to decipher them, ethics, professional accountability, playing the role of a scientist, detective, and manager, ugh... You will end up writing about various aspects of this in your portfolio but no need to over-do this one, just study what you need and get done with it.

Info Management & Technology:
The exam for this one was pretty challenging I thought. I figured it would be a general application of how technology systems integrate into medicine, it was NOT. This was a very detailed exam asking you to know the differences between certain technology systems, how to troubleshoot them, how they apply to different facility uses,etc. Lots of informatics specifics, electronic record ins/outs, HIPPA regs, etc. I did much better on the pre-assessment than the actual OA for what it's worth, the only course this happened.

Evidence Based Practice aka The Beast:
This one sucks, it really just sucks. The only thing worse is having to do it AGAIN (for the most part) in the MSN program... dreadful. There are a couple of tasks for this one. First you learn about types of research and write a paper about that while you classify a few examples into the type of research the represent. Then you take some case studies and write about them. And then you're ready for the BEAST. For the last task, you are picking a problem to research, compiling this research into an annotated bibliography, summarizing your findings, discussing how this can relate to your current place of work, how you'd present it to the big wigs there, etc. That's the simple version. The extended version is that it is LONG, monotonous, repetitive, and annoying. My best advice for this one is to do it all in one or two sittings. Find your research during one and write the ENTIRE thing during the next, don't stop and start this one or you'll never finish. Pick a topic that is SIMPLE, use the examples you find in course notes or message boards. DON'T try to reinvent the wheel or impress your graders by finding some fabulous specific NEW idea that is actually interesting to you, they won't care. You won't find your articles, you'll want to punch yourself later for doing this. Stick to the tried and true- handwashing, CAUTI, actually just those 2, pick one of those and you'll do fine.


Organizational Systems & Leadership:
This one will sneak up on you. You read the rubric and think it's not too terrible, 2 tasks. The main drudgery with this one are the IHI Modules. No idea how to explain those to anyone who hasn't read through a couple so I won't bother. Just remember this, log in, start the modules and skip to the tests. Don't sit there through all of them intently or you'll be there for 57 weeks. Seriously they are awful and there aren't any shortcuts other than skipping to the tests, taking them, if you fail skip back to the end again and take it again until you pass. You can't finish the BSN without doing these dang modules, you'll need your IHI completion certificate for your portfolio. Your big paper consists of completing a LONG root cause analysis with all the components.... not my cup of tea. You'll be glad when this one is done.


Leadership Experience:
Leadership is the whole point of the BSN as most BSN-RN's are more in management and they have to "lead" people. The paper here consists of an investigation into a specific problem at your workplace that you intend to research and propose a fix for. Your fix will explain a lot of things including a cost scenario and you'll present this whole thing for your "key stakeholders" at work. You'll need them to sign off on your presentation. It isn't a bad task but it can be a bit tricky to coordinate this "presentation". Again pick a simple solvable problem, you don't need to show them how to travel to the moon just pick something common and relevant- staffing shortages, technology deficits, etc.

Portfolio:
I thought this one was odd, almost like putting together a resume for your school experience, a lot of kumbayah this is what I learned, this is how I grew as a professional... weird. Nonetheless, super simple task. You're basically reviewing a lot of your coursework, including excerpts from some of them and writing a synopsis of their relevance to your career.

Community Health Practicum:
The dreaded practicum. You are now at the end and revisiting that very first community health project you did. You'll take the problem topic you chose and now spend a bunch of hours out in the community investigating it so you can write about it in depth. I had 90 hours to do and I did this whole course in about 2-3 weeks time. I spent about one full week making site visits around everywhere I could possibly think of to log time, each day about 6-8 hours of traveling around and then about 1 full week to write the whole thing. A bit of fudge factor in between. If you start early getting on everyone's calendars for meetings this won't be too hard to do in a short amount of time,otherwise better plan on 4-6 weeks of consistent work on this one, especially if you can't devote a block of time for a week to knock out those hours. I specifically picked access to mental health resources and found a TON of resources, had no trouble getting my info or hours. There are a list of topics to choose from, as I've said a dozen times don't reinvent the wheel, pick one and go. Don't overcomplicate it. As soon as you're done with Community Health 1 jump on these hours and start looking ahead.



That's the long and short of it.... those courses can seem to be quite overwhelming but they're doable. Get a schedule together with a goal of completion for each one. Allow time for grading and revisions... taskstream graders aren't exactly the quickest, my longest paper took nearly 7 full days to post! Always keep about 3 courses in your field of vision if you're planning to accelerate so you can work on them somewhat simultaneously but pick one at a time to finish, then go to the next. One day you'll turn around and your circle will be completely BLUE! YAY.


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Sunday, June 28, 2015

WGU: After the RN a tale of the BSN and MSN journey


So what have I been up to since the dreaded CPNE which led to the dreaded NCLEX waitfest which led to the Colorado RN licensing extravaganza....??

Oh you know just keeping on with the glutton for punishment theme. I have migrated myself to WGU, Western Governors University to pursue my goals of getting my BSN and now MSN.

A little synopsis. I researched every school known to man prior to jumping into my BSN after being burned by Excelsior. I surely wasn't making the same mistake again! I wanted to push through and get that BSN at a minimum because I knew as life went on it'd be more critical to work and I'd also find more and more reasons to postpone the idea. I am a professional procrastinator of course. Western Governors University ended up being my top choice for a few reasons.

1. Work at your OWN pace. Not a "pretend" work at your own pace but a REAL work at your own pace place! It really is, I can attest to that now.

2. Cheap. I mean I hate to say put it that way but a degree on the cheap sounded appealing especially when I was **thisclose** to signing up with Regis University for the exact same degree in which I'd pay triple the money (and couldn't work at my own pace).

It was  a pretty simple choice after some investigating. I also really liked the idea of a "flat fee" cost scenario versus a pay by the credit hour scenario which is common at almost every other university out there. More bang for your buck I guess should you choose to take advantage of it.

The short story.
I completed my BSN with WGU in 3 months for a flat fee of one term/6 mos which put me out about $3500.

I had 38 competency units to complete which was 16 classes.

I spent the first 3 months of my 6 month term laying my Dad to rest doing zero work for obvious reasons. I spent the last 3 months actually completing the work.

It was not the hardest thing I've ever done, the CPNE was. The BSN just took dedication and determination. It was more drudgery than difficulty.


The common questions/concerns...

Are there clinical hours involved?
No.

Will my Excelsior nursing credits transfer in?
The short answer is yes. All of my prior credit transferred in with no problems. You receive a block of credit for your RN license and they evaluate each additional course from there. If there are courses that do not apply to the BSN curriculum you will be required to take/re-take those courses. DON'T freak out about this. Even if you end up with an additional class or few remember they are not extra costs, they are built into your term, typically you fly through these classes in a couple weeks each. You have to remind yourself this doesn't work like a traditional college where each additional course is an additional 3 credit hours to complete and pay for which pushes you into one semester after another.

What about Nutrition?
EVERYONE is required to retake nutrition. WGU has their own "version" that they want you to have, no amount of bellyaching to admission will change this. I had 3 different versions and none of them were good so I had to retake it too. It wasn't a big deal. At. All.

You have to take Statistics?!?OMG?
Yes. yes you do, unless you have it within the last 5 years. I had it but it was past 5 years and I flipped out about stats. I thought it was going to be HELL. It wasn't. Their version of statistics is how the information applies to nursing concepts and nursing management. There is no math. You don't need a graphing calculator you don't complete math equations. Stats is simply an overview of what information can be gathered USING statistical measurements, what those types of measurements are called, and how they apply to healthcare. So woosah the stats.

Will the pass/fail 3.0 gpa ruin my future plans?
Since it is a competency based program you either pass or fail, there are no A's B's or C's. Therefore the maximum gpa for completion is a 3.0. Many people flip out thinking this will RUIN their chances of future schooling, entrance into NP programs, blah blah. I can tell you since I was a tad skeptical myself that I finally researched said future schooling and NP programs. I looked at them ALL. All of the ones I investigated required ONLY a 3.0 gpa. And this includes prestigious universities like Duke, Johns Hopkins, Columbia, etc.

Check it out for yourself
http://nursing.duke.edu/admissions/frequently-asked-questions

http://nursing.jhu.edu/academics/programs/masters/nurse-practitioner/family/

http://nursing.columbia.edu/admissions-and-financial-aid/how-apply/ms-programs

If you are concerned with being competitive in such a program you can simply take additional coursework through a local university to boost your gpa or take the GRE. Don't fret about the gpa thing, it is truly a non issue. I have spoken with more than a handful of folks who completed the program who are actively enrolled in various FNP programs around the country with no issue.

How quickly can you complete the program?
I was told at admission that the average time to complete WGU's RN to BSN program was 18 months, aka 3 terms. There are dozens of us who have done it much quicker obviously but there are many many more that don't. You have to evaluate your own personal strength as a student, a distance learning student to make that assumption. Keep in mind there is zero hand holding with the program, if you do not succeed by teaching yourself information this may not be the program for you.

Should I do the BSN or just go for the MSN?
This is a highly personal choice. This is also somewhat dependent on the current curriculum as it frequently changes here and there, nothing major but there are changes. I did the BSN and figured if I wanted to later I could do the MSN but didn't want to jump all in right off the bat. That was a dumb decision, I should've just done the MSN. Here is why- I ended up going right into the MSN program anyway and I could've saved myself 5 classes if I'd done it straight thru. You end up repeating some courses with minor tweaking when you do it in a two step process, on top of that there are a couple of classes you are required to do for the BSN that you don't have to do if you go straight MSN. The beauty is you can stop at your BSN if you choose to. You can get your BSN degree once you finish that coursework and quit if you really want to, you don't have to wait until the end of the MSN program. This is definitely the way to go in my opinion.


So if you're considering pushing on to another set of letters behind your name I can't recommend WGU enough. I liked it enough to move forward with my MSN. It delivered as promised and was truly self paced, it was easy to navigate, the support I received was fine, and once again it was CHEAP.

For more info on my tips for completing your degree in a single term along with other WGU posts head over here.

***Disclaimer, I am NOT affiliated with WGU, I don't work for them or get compensation from them for saying any of this... incase you were wondering ***

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