Scrubs Alternatives: Aligning your purchases with your values

A popular scrubs manufacturer released and took down an ad this week due to its controversy and social media backlash. The advertisement featured a female DO in pink scrubs reading a book, “Medical Terminology for Dummies” upside-down. I completely missed this ad until I saw a post by the medical blogger, @RealDoctorMike, criticizing the company: https://youtu.be/aqj7T-wes2c #WomenInMedicine

As a consumer, I realize where I spend my money makes a difference. Who and what I support with my purchases matter to me. I don’t have the opportunity to research all businesses I interact with, but I try to act according to my values when I’m informed.

If you’re considering buying scrubs and want an alternative to the ones offered by the manufacturer who posted the inflammatory ad, consider Sway Scrubs. Sway Scrubs (swayscrubs.com) launched this year and is a female, Black-owned business. I have no affiliation with Sway Scrubs but have been considering purchasing their scrubs to support more minority-owned businesses. Plus, they have cute designs, so I’m eager to try them once I decide to buy more scrubs!

Image from swayscrubs.com

Since graduating from nursing school and looking for jobs, I’ve held off on buying more scrubs if my future place of employment has specific uniform requirements. I own two pairs of Code Happy scrubs outfits because that is what my nursing program offered. I’ve worn and would recommend Code Happy scrubs. I would purchase them again because they fit my short, stout body well, and the price was reasonable. I’m so vertically-challenged that when I order petite-sized pants, I usually have to alter them. I was honestly shocked that I didn’t have to hem the Code Happy petite pants – the drawstring waist and ankles make all the difference!

Below is a pic of me in my Code Happy scrubs during Nurse’s Week this past Spring. The hospital was celebrating healthcare workers as heroes – hence, the Wonder Woman statue in the back. Women in healthcare are heroes – many are pioneers or have had to endure extra criticism just because of their gender. Women in healthcare should be celebrated and respected. We need to encourage diversity in healthcare and recognize the importance of each team member in caring for patients or clients. Titles of DO, MD, RN, LPN, CNA, RT, Housekeeping, etc. should not change how others treat you. Titles may indicate the scope of practice and education, but it shouldn’t dictate how or if others treat you with dignity and respect. Also, an inclusive culture welcomes and encourages all genders into both medicine and nursing. 

Here is a snapshot of me in Code Happy scrubs during an Advanced Med-Surge clinical. I liked how the Code Happy scrubs fit my hard-to-fit body, but I also liked all the storage. As you can see, I took advantage of all the pockets my scrubs offered!

Unfortunately, a favored scrubs manufacturer created an ad that belittled female healthcare workers and DOs. Thankfully, the company has since removed the ad, and hopefully, an educational moment occurred for the company and others. We all have biases, but our actions and lack of awareness may promote others’ disadvantage. We can evaluate how such prejudice affects others through the language and images we use and the businesses we support. Are we empowering others or tearing them down? Are we causing division or uniting others in healthcare? Are we supporting companies that align with our values? As I’ve yet to purchase scrubs beyond nursing school, I would love to hear your recommendations for scrubs or your experience with other scrub manufacturers!

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Update: As soon as I posted this, I noticed @nurselifern pointed out the same company created a similar ad poking fun at male RNs. A male RN in one of their ads was also reading a “…Dummies” book upside down! I’m really shocked this wasn’t uncovered or discussed sooner. We need to support diversity and inclusion in healthcare! I’m amazed that a company that caters to healthcare professionals and relies on their support could spend time, money, and resources to insult and belittle them in their marketing campaigns!

Donating Blood during the Pandemic

Last month, I convinced a former nursing school classmate to join me in giving blood. She had never donated before, so I was so excited for her, but I was also happy someone was willing to join me! Is it sad that the only time I feel I can be “social” during the pandemic is when I’m doing things like going to school or donating blood? If you’re like my friend and have never given blood or wonder what blood donations are like during a pandemic, this post is for you!

Donors receive gift cards and discounts.

Aside from supporting someone else’s life, donors got perks such as gift certificates and discounts to restaurants or retailers like Amazon. Depending on the blood drive, donors can be entered into prize drawings or receive items like water bottles. Donors typically get water, juice, and snacks after their donation, too. Recently, the American Red Cross announced they would test blood donations for COVID antibodies – this free antibody test is a significant new perk in donating blood!

Blood donors get free COVID-19 antibody testing.

My friend and I were both eager to get the COVID antibody test for free. We knew of healthcare workers and personally worked with a nurse who showed no COVID symptoms but tested positive for antibodies. “Antibody testing may indicate if the donor’s immune system has produced antibodies to this coronavirus, regardless of whether an individual experienced COVID-19 symptoms. A positive antibody test result does not confirm infection or immunity” (redcross.org). Regardless, we wondered if we would have positive antibody results and secretly hoped we were one of those asymptomatic people with possibly protective COVID antibodies.

Make a donation appointment early – appointments fill up quickly.

Before the pandemic, many blood drives accepted walk-in donors without appointments. Now, anyone donating must make an appointment ahead of time. Many drives fill up for several weeks or even a month in advance.

There are many blood drives – make an appointment for a location/date/time convenient for you.

We found a blood drive and made a donation appointment at a beachside hotel in Marina Del Rey, here in Southern California. I decided to pick this hotel in particular, because I liked their restaurant and knew they had a scenic outdoor dining patio. I figured I could brunch with my classmate as a mini celebration to her inaugural blood donation but also to us graduating from nursing school. We had not celebrated our graduation together in-person due to the pandemic. We had spent enough time together at clinicals and lunch breaks in hospitals during the pandemic, however, that we thought an outdoor post-graduation brunch would pose minimal risk.

The blood drive was at a hotel right on the marina. It was in a ballroom with windows overlooking the beach, in an area separate from their dining patio.

Save time and use RapidPass for pre-donation reading and screening.

To save time completing questionnaires and screening questions before the actual donation, donors can answer health history questions and complete the pre-donation reading using their computer or mobile phone the day of the donation via the RapidPass application. Travel, medications, and certain kinds of activities may make people ineligible to donate blood. Doing the pre-donation reading via RapidPass may help a person discover whether they should donate blood before showing up to a blood drive.

I used RapidPass (https://www.redcrossblood.org/donate-blood/manage-my-donations/rapidpass.html) to minimize the amount of time I had to sit and wait in a room filled with strangers. While appointments ensure spacing between donors and minimal crowding, I still felt uncomfortable at the prospect of spending an hour in an indoor, enclosed room with random people. (I don’t know why, but I never had this concern during clinicals at hospitals. Maybe it’s because I had to be at my clinicals, but blood donations are entirely voluntary). Upon arrival, I showed the registration volunteers my photo ID and RapidPass confirmation barcode. After that, it was a quick process for the temperature and hemoglobin screening before my actual blood donation.

Wear a mask. If you are sick, visit a doctor or stay home.

The American Red Cross requires blood donors to wear a face cover or mask and keep their mask on upon their arrival and during their appointment. They also screen donors to ensure they are not running a fever or exhibit other symptoms. My temperature was taken twice by two different people before I gave blood. The registration volunteers asked me to use hand sanitizer, and everyone wore masks and displayed proper hand hygiene. I appreciated all the precautions during my appointment.

Although donors get free COVID antibody screening, if people are sick or have COVID symptoms, they should get screened for COVID and diagnosed elsewhere. “The Red Cross is not testing donors to diagnose illness, referred to as a diagnostic test” (redcross.org). If I had an active infection, I wouldn’t want to risk exposing blood drive volunteers, staff, and other donors to my illness, even if I thought it was only a cold. I would hope others would do the same and quarantine themselves according to CDC recommendations if they were sick.

Hemoglobin levels will be tested and must be normal.

Before every donation, the American Red Cross gathers a drop of blood by pricking a potential donor’s finger and tests that sample for hemoglobin levels. The process is very similar to the point of care glucose testing I did during clinicals. I tried giving blood in August but could not since my hemoglobin levels were too low, which was likely caused by low iron.

Because the American Red Cross no longer accepts walk-in appointments, anytime a potential donor is turned away from giving blood that same day, the Red Cross cannot quickly fill that newly-vacant appointment. The pandemic has severely impacted the usual avenues of blood drives at schools, offices, or churches since these groups have not been meeting in-person or on-campus. To ensure I could donate and not waste a donor spot, I decided to take some iron supplements a week before my September donation appointment. Luckily, it raised my iron levels high enough that I was able to donate blood. I only needed one finger prick to show my hemoglobin was within normal limits! There have been times when I required a second sample to qualify as having normal hemoglobin levels. Or, like in August, the second sample confirmed that I was below normal limits. (For additional information about iron levels and blood donations, check out: https://www.redcrossblood.org/donate-blood/blood-donation-process/before-during-after/iron-blood-donation/iron-informationforallblooddonors.html)

Masked and lying down while donating blood.

After all the screening questions and tests were complete in a makeshift cubicle area, the staff person led me to the room’s blood donation section. While you donate blood, you lie on a cushioned table that is as comfortable as the doctors’ offices’ exam tables. I was fascinated by the venipuncture and blood donation process and asked the person who collected my blood if she had any tips. Unlike some of my personal experiences during nursing school, she was confident in poking me and didn’t struggle to find a vein. Poking people all day for the past ten years made her skilled at venipuncture – I hope to be just as confident and proficient someday! (Tip: go for a vein you can feel, not one you can only see)

Full transparency: the collection needle is big.

I will not lie – seeing the needle they used to collect my blood was a little intimidating. I had never been afraid of giving blood before, but it had been a while. I had never seen or used a needle that huge (16-17 gauge) on a person or mannequin in all of my nursing school! The needle they used reminded me of a draw needle (used to draw up medication from a vial, typically more massive than any injection needle I ever used on any patient). Because a pint of blood is needed instead of merely test tube quantities, the collection needle needs to be big enough to allow for decent blood flow. Otherwise, the donation process would take much longer.

Once the needle is in, it typically takes no more than 10-15 minutes to donate blood. Some old co-workers I know would try to race each other and see who could fill up the bag and donate the fastest. I think their donation took only 3-5 minutes on one occasion. However, I was in no rush and was honestly just happy to be out of my house and around people.

What my arm looked like later that evening, after removing the bandage. I got a minor bruise at the puncture site. This small bruise didn’t hurt and disappeared after a couple of days.

After the actual donation, prepare to rest for 10-15 minutes before leaving

After my donation was complete and they bandaged me up, they invited me to sit and relax in the snack area . There is usually a table of juice and snacks like granola bars, trail mix, or crackers and cookies at every blood drive. Donors are encouraged to sit and rest and snack on something after their donation, before they leave. This also allows the staff to observe donors for any reactions to the donation.

I had a friend who wanted to skip sitting and resting after her donation and ended up fainting as she walked out the door. If you feel light-headed after donating blood, sit down and let someone know! Blood loss and dehydration can cause people to experience orthostatic hypotension or dizziness upon standing or changing positions.

It’s essential to hydrate just as much after a donation as much as it is before donating blood. The hotel restaurant was having a happy hour in their outdoor patio that afternoon. As tempting as it was (I haven’t been to a happy hour since before the pandemic), alcohol is not recommended after donating blood. I stayed hydrated!

Snack selection and view after my blood donation.
In addition to my snacks, I got to appreciate a clear sunny day, palm trees, and a beach view for my blood donation

You may need to modify activities after your donation.

Like alcohol, strenuous exercise is not recommended the same day after donating blood. If you think you need a high-intensity workout the day of your donation, do it before giving blood. Years ago, when I had daily running routines and ran marathons, I would schedule my workouts before donating blood or use a donation day as a rest day. Give your body at least the evening to recover from donating before resuming working out heavily. [Un?-] fortunately, regularly working out hard-core is not something I’ve been doing recently, so I didn’t have to reschedule anything.

While you can probably resume your workout schedule the next day after a donation, your body still needs time to recover from the entire process. For some donors, iron supplementation is recommended after donating (https://www.redcrossblood.org/donate-blood/blood-donation-process/before-during-after/iron-blood-donation/iron-informationforfrequentdonors.html). Regardless of who you are, to allow enough time for proper recovery, whole blood donors must wait 56 days between donations.

Make a plan to donate again!

I’m not eligible to donate whole blood again until next month; I plan to donate once 56 days have passed since my last donation. My friend wants to do it again, too. Donating blood helps replenish an impacted blood supply. It is an easy, smooth process, I get to ask highly experienced professionals about venipuncture tips to support my nursing practice, and I get to invite friends to join me! Plus, my friend and I like the idea of regularly getting a free COVID-19 antibody test!

I encourage you to donate!

To find a blood drive near you and sign up for a donation appointment, please visit: https://www.redcrossblood.org/give.html/find-drive

#Maskne – Acne in Pandemic

I’ve been suffering from breakouts on my face. Even as an adult with aging skin, I periodically battle acne, but feel like it’s been especially pronounced recently. In some ways, my reusable cloth mask is a nice way to hide my recent acne breakout, but I realize it might also contribute to it. Recently, the term #maskne has been used to describe acne appearing around or underneath masks. However, I am a mask-wearing advocate and believe a mask should be worn during this pandemic when in public or around others outside my household. Outside of staying home more and un-masking, here are some things I’ve done to address my #maskne:

1. Wash my reusable masks or change them more frequently

Reusable masks should be washed after every use. My usual routine at the start of this pandemic would be to handwash my only reusable mask with a laundry bar soap as soon as I was home for the day. Four to five months into the pandemic, I started to get lazy and would re-use an unwashed mask if I only wore it briefly the day before. I recognize this is poor hygiene and have resumed ensuring my face covering is washed before wearing it, even if I wore it for only 30 minutes the day before. Also, now that I have more face coverings, I throw them in the hamper to eventually be machine-washed with my weekly load of laundry.

Lagarto is the name of the bar soap I use to for hand-washing my mask. I bought this on a trip to Spain to do laundry while traveling. It worked well and came in a 3-pack, so I took it home with me and still use it for hand-washing clothes!

Another thing is it’s been a lot warmer since the pandemic started. We have had heat-waves where I’ve been continuously sweating, and my cloth face covering would absorb my sweat. I’ve had to replace my face covering multiple times daily to ensure it was clean; I didn’t want to have a dirty piece of fabric resting on my face all day. When a reusable face mask is soiled, stop using it and wash it!

2. Change my toothpaste

Before masks ever became a standard fashion accessory, I would periodically suffer from adult acne. I would breakout, particularly around my mouth. I read a blurb in a magazine stating that ingredients in one’s toothpaste can cause breakouts and skin irritation. After reading that article, I switched up my toothpaste and noticed a considerable improvement in my skin. I would rarely break out around my mouth.

To celebrate my recent graduation, I went on a road trip vacation with my family. Unfortunately, I did not pack my usual toothpaste. Complacency got the best of me, and I didn’t think it would matter for a 3-day getaway. I got a zit by my upper lip and then a pimple on my lower lip shortly after our trip. I’ve since switched back to my usual toothpaste.

I also started washing half my masks by hand to see if it makes a difference compared to my machine-washed masks. Just as personal care ingredients can cause skin irritations, detergents’ ingredients can irritate the skin, too. It’s for this reason that there are non-allergen and fragrance-free detergents. If your skin is breaking out by your cloth mask and you clean the mask regularly, try washing with a different detergent.

3. Use acne patches or dots

When I was a teenager, acne dots or patches did not exist. The popular anti-acne products back then were Sea Breeze, Clearasil, Clean & Clear, and Neutrogena. I only discovered acne dots or patches recently and started using them about a year ago. Some patches contain medication (like salicylic acid, a typical anti-acne ingredient), and some are merely hydrocolloid patches. In nursing school, I learned hydrocolloids are used to treat some wounds. My acne can sometimes be painful and feel like a wound! I never had the opportunity to perform wound care on a patient using hydrocolloids, so I think it’s neat that I get a sense of what hydrocolloids are like when I use these patches on myself.

Somehow, I have started to accumulate acne dots and patches. Some I forgot I purchased while others I bought while traveling. I think they work, but they are all a little different, and they each have their merits.

I love these patches or dots because they protect the pimple or zit from further irritation. If I have a pimple and wear an acne dot, I don’t have to worry about fabric or skin rubbing up against it and further aggravating my pimple. It’s pretty much an adhesive disk applied to the skin. One drawback of using these is it’s been challenging to get them to stay on my skin when I’ve been sweating.

4. Relax

I get acne due to hormones – stress or menstrual. During nursing school, I drank mostly caffeinated beverages, ate quick-to-eat not-so-nutritious food, and periodically got less than 6 hours of sleep. Poor diet, lack of sleep, and project and exam stress would undoubtedly affect my skin and cause me to break out.

I never drank so much coffee until I started nursing school. Now that I’ve graduated, I try not to drink coffee daily. The pandemic and not wanting to go out frequently have also forced me to better plan my meals. Since I’ve graduated, I get more sleep and have been trying to relax more by catching up on tv shows and doing things I enjoy while I quarantine at home. However, I continue to feel a little anxious because I still need to take the NCLEX and find a job amidst this pandemic.

I don’t think that I will ever eliminate stress or anxiety, but I don’t want to either. I believe stress can sometimes be a good thing, giving the motivation to move forward, improve oneself, or providing an impetus for change. On the other hand, too much stress or high stress for too long can lead to health problems; I recognize this and try to lead a more balanced life.

Even with efforts in reducing stress, I still periodically get acne due to hormones associated with my menstrual cycle. There’s not much I can do about it, according to my doctors. This week, I tried washing with Panoxyl (thanks to recommendations by YouTube bloggers Cassandra Bankson and Dr. Dray) and targeting specific areas prone to breakouts. I have yet to determine if this acne wash truly helps since I just started using it, but it feels good that I’m at least trying to care for myself and try something new.

Since many variables can lead to “maskne”, it’s hard to say that there is one sole cause or solution. So far, doing all of the above has improved my skin. One pimple has disappeared altogether while the other is shrinking and less painful. I’m not the only one suffering from #maskne; I want others to realize their mask may not necessarily cause their breakouts. Instead of reducing mask-wearing, try switching masks or washing masks more frequently. Change toothpaste, soap, or detergents. Treat breakouts when they occur, and practice self-care by reducing stress and anxiety. I encourage others to follow public health recommendations and WEAR A MASK around others. We are still in a pandemic – with acne or without, I’m wearing my mask!

#LAProtects Get your free downloadable print of the above poster at https://corona-virus.la/la-mask-print-project

How I Scored in the 99th Percentile for TEAS – and how you can too!

If you’re pursuing Nursing, you may have heard of the TEAS because some Nursing programs require applicants to take it and submit their score as part of their application. TEAS, or the Test of Essential and Academic Skills, is a standardized, nation-wide exam administered by Assessment Technologies Institute (ATI). Like many nursing programs, my BSN program uses the TEAS as a screening tool for their candidates. The minimum TEAS percentile my program considered was 80. However, some of my cohort classmates shared that they scored 95-99 percentile overall on their TEAS, well above the minimum for my school. If you want to apply to a competitive program and be an attractive applicant, you must do well on the TEAS. For this post, I’m sharing my tips for how I scored in the 99th percentile when I took the TEAS in Fall 2018.

My Biggest, Most Important Tip: Know Your School’s Requirements!

My most important tip is to know your school’s requirements. If a school in which you’re interested in applying is offering a Nursing forum or information session, attend the session to understand the admissions requirements and clarify questions you might have. Some schools do not require the TEAS for admission. Other schools do not require the TEAS until you submit an application and they give you an invitation to take the TEAS. Some schools require the TEAS but will only allow students to take it once in a six month period. Some programs will not take your best TEAS score in their application timeframe; they will take the first score in the allowed timeframe. Understand your prospective school’s admission policies.

One other perk I discovered while attending Nursing School Information sessions before taking the TEAS is one school offered a discount code for ATI TEAS study packages. However, the biggest reason to attend an information session (or speak to an admissions officer) is to clarify admissions requirements and any stipulations the school or program may have regarding the TEAS exam. This is particularly important if you’re applying to multiple schools since each have their own admissions policies.

Tip: Complete your Pre-Requisites

When I took the TEAS, I had completed all my Nursing School pre-requisites (except for Philosophy and Religion). My Anatomy & Physiology and Chemistry prerequisites definitely prepared me for the exam. Completing my pre-requisites was particularly helpful because the TEAS emphasizes Science. (The TEAS covers Science, Reading, Math, and English and Language Usage. For more information, visit https://www.atitesting.com/teas/register/). I had taken the pre-requisites within the year so a lot of the material was recent for me, and I was grateful that the exam material was a review of what I already learned.

If you’re not done with your pre-requisites, do not get discouraged – other students online said they took the test and did fine without completing their pre-requisites. However, they spent a lot of time teaching themselves and learning the material for the first time.

Tip: Use a study guide practice exam to focus your efforts

I invested in the yellow Mometrix study guide since it was so highly recommended by people online. My time was limited, and I had no intention of reviewing and reading the entire study guide. Instead of studying each chapter, I took a practice exam in the book to identify my weak areas so I could focus on them. I only reviewed the topics or areas where I scored low from the practice exam. After I felt I studied sufficiently, I would take another practice exam. I would continue to use my lowest scores (and wrong answers) to guide me on what I should study. After studying some more, I would take a different practice exam. I would continue this process until there were no more exams in the study guide to take.

My answer sheets for all my practice exams. I would time myself and give myself the same amount of time as the TEAS for each section. I would then review my incorrect answers and study those topics a little more.

Tip: Use your library to access study guides for FREE

I eventually ran out of practice exams in one book, so I used multiple study guides to prepare for the TEAS. My library had TEAS study guides available both online as ebooks and hardcopies. Take advantage of your public library since it is typically a FREE resource! Research availability and reserve your TEAS study guides early because these books can be in high demand! There was a waitlist, but I was able to place some study guides on hold and have them sent to my local branch weeks before my TEAS exam, which gave me plenty of time to prepare.

Tip: Use study tools according to your style of learning

Take advantage of any or all the tools that will help you learn or retain the material you need for TEAS! I know I’m a visual and kinesthetic learner. Flash cards are often an effective way for me to study. I do well when I write/design my own flash cards and study from them. I kept my flashcards from Anatomy & Physiology and used some of them again when studying for TEAS. Another study tool that I thought was helpful was “The Anatomy Coloring Book”. I actually used this during Anatomy & Physiology pre-requisites. It helped me learn and understand various systems of the body. I think it’s a great resource to have regardless of the TEAS, and I even referred to it recently while in Nursing school to review the kidneys and urinary system for Pathophysiology.

Other learning tools I found useful were YouTube videos from Khan Academy and
Armando Hasudungan (a doctor who is also an incredible artist). Many students today use YouTube to supplement their learning, so take time to explore which channels best complement your learning style. Another popular tool is Quizlet, where you can create and share electronic flashcards and quizzes for yourself, but also where you can view other people’s flashcards and study guides. (WARNING: Be cautious when using shared content or YouTube – sometimes material other students post is not the most accurate).

Now that I’m in Nursing school, I watch the YouTube channels for NRSNG and RegisteredNurseRN. While these are resources geared for Nursing students, take advantage of their Anatomy & Physiology reviews in preparation for the TEAS. If you are an auditory learner, you could also listen to NRSNG Radio.

Since starting Nursing school, I have also discovered Picmonic – a great tool for visual learners and for folks who can use stories and pictures to remember concepts. It would have been nice if I knew about them earlier because they have lessons for Anatomy and Physiology! You can try Picmonic for free with one lesson per day. If you want to view more lessons, a subscription fee is required.

There are many tools beyond study guide books to help you prepare for the TEAS – take advantage of them and use the ones that suit you best!

Tip: Invest in practice exams from ATI

While the study guide practice exams were certainly helpful, I found the ATI practice exams to be a little more detailed than what was in the Mometrix or McGraw Hill study books – which helped me on my actual TEAS exam. The practice exams also summarize the areas needed for review and provides a study plan. The review topics correlate directly to chapters in the ATI Study Manual (which I did not have), but still gave me enough information for me to focus my review using the materials available to me.

The online ATI practice exams are structured the exact same way the computerized TEAS exam is structured – with flags, countdown timer, and calculator embedded into the exam. Like the online exam, you can flag questions you would like to review in your practice exams before submission.  The actual TEAS test and practice exams allow you to easily revisit flagged items at the end of a section so you don’t have to toggle back and forth through all the other questions. I’m the kind of person who always double-checks my exam and doubtful answers prior to final submission, so I found the flagging feature helpful. I also liked that the practice exams were modeled after the actual computerized TEAS exam, so I had an idea of what to expect on exam day.

Tip: Find out if your TEAS exam will be computerized or not. 

The TEAS was offered at one of the universities to which I was applying via computer. For my TEAS, I was in a computer lab with a proctor, and each student had a computer. What’s nice about the computer version is the sections can all be taken at your own pace, within the allowable timeframe. Currently, students get 64 minutes to complete the Reading section, 54 minutes for Math, 63 minutes for Science, and 28 minutes for English and Language Usage. Each student gets the same amount of time to complete each section. However, if you finish a section early, you don’t have to wait for the time limit to end before moving onto the next section. The times are all tracked on your computer so you can’t exceed the alottment, but you can easily move on once you’re done with a section.

Some people I know hate taking tests via computer, so they purposefully signed up for a test center offering the paper version of the TEAS. (However, if you plan to continue with Nursing, I believe the NCLEX is on computer, so you might as well get used to computerized tests)! It’s always good to minimize surprises on test day, so find out if your exam is offered on paper or computer to set expectations. Plus, if you take a paper exam, you’ll need to find out what kind, if any, calculator you’re allowed to bring!

Tip: Follow ATI on Facebook

ATI offers live video tutoring sessions for the TEAS. They also offer TEAS workshops via Facebook. If you can’t join live, you can view recordings. This is another FREE tool I recommend you use to prepare for the TEAS.

Tip: Do NOT take the TEAS as practice

I discourage students from taking the TEAS for practice. For some Nursing programs, you are unable to retake the TEAS until six months after your prior TEAS. Some students think they will take the TEAS for practice and simply retake it if they do not do well. They may come to find this is not possible for the program to which they are applying. Use the study guides and ATI practice exams for practice – not the TEAS! Your goal is to do well when you take the TEAS the first time. Save yourself the agony from having to study again and save money on your test registration fees! It is possible to take the TEAS once and do well. I did, so I believe it’s possible for anyone.

Personally, I relied on doing well on my TEAS (and pre-requisites) because my undergraduate GPA was low. It was so low, it fell below some school’s admissions requirements. I got a 4.0 GPA on my pre-requisites, but I knew I also needed to do well on my TEAS to get into my accelerated BSN. I guess it worked, because I got into my top choice nursing school! If I did it, you can too!

Hopefully, my tips and experiences are helpful and encouraging. I didn’t number them because I don’t think any one is necessarily more important than the others (except for knowing your nursing school’s requirements – definitely do this first)! If you have found something useful in this post or on my site, please share it with others! If you’ve taken the TEAS and have other TEAS tips to share, I welcome them! Please also let me know if there are other topics you’d like for me to discuss. Thanks for reading!

Clearance Checklist Complete!

This list makes me giddy…and is a sign that I’ve completed my background check & clearance for school!

I’m a checklist person, and this list is so satisfying!   Anyone else use checklists and feel happy when all tasks are completed?  Completed checklists instill a feeling of accomplishment and productivity for me.  I love the visual cues and color-coding, too!  No “Incomplete” reds or “In Review” yellows here! I mean, just look at all that “Complete” GREEN!

My to-do list for my background check and clearance for my nursing program is finally complete! Some of the things I had to do or submit before school started were a criminal background check, drug screening, immunizations and titers (immunization records were not enough), CPR/Basic Life Support Certification, Hospital Fire & Life Safety certification, physician’s physical examination and respirator clearance, and HIPAA Certification. I had many items on my list already done since I volunteer at a local hospital, but there were many school-requirements not needed by my volunteer program or that were about to expire.  Even if I had the task or item complete, it took time to scan and upload all the documentation and more time for the background-check company to review and “approve” the submission.

TIP: Gather and electronically scan all your immunization records because immunization requirements (or waivers) are standard for working in a hospital setting.  Have your certifications available too.  An instructor advised me that I would need to provide these items regularly since each hospital/clinical site has their own clearance process and some things must be done annually or periodically as a healthcare worker. Having these records readily available and organized saves time and allows self-tracking of upcoming expiration dates. 

If you already collect and organize your documentation, I’d love to hear what organization system you use! How do you keep track of tasks you need to accomplish? Share your tips in the comments below!

Comfort Wisdom

Taken by #thematurestudentnurse from the trails surrounding Baldwin Hills Scenic Overlook (Culver City, CA)

I enjoyed spending time with a friend hiking some local hills this morning. It was perfect weather and we got to enjoy some pretty wildflowers and scenic views.  I so appreciate carefree timelessness with friends. I don’t often have a lot of free time being a wife, mom, volunteer, and student pursuing a second career. However, I recognize how restorative it is for me to spend time connecting with others and exploring my neighborhood.

What nourishes or comforts you? It’s important to understand what brings you joy or soothes you. Identify what that is and make a list you can reference periodically.  In times of stress, you can choose healthy coping mechanisms from that list or at least be aware of what you can do to nourish and restore yourself. In “The Gifts of Imperfection”, Brene Brown refers to having this list as comfort wisdom. Brene Brown asks her readers to distinguish between what we use to numb ourselves versus what comforts and refuels us.  It helps to have this self-awareness, particularly because it’s easy to confuse numbing or escape for comfort.

I developed my “comfort wisdom” list years ago after taking an online Oprah course with Brene Brown, compliments of my employer’s women’s resource group. The list of what comforts me still applies today.  At the top of my list is “intimate sharing and time with loved ones”. Also included is “travel & exploration” and “hikes, walks, and exercise” among other activities. I am grateful I was able to incorporate multiple items from my comfort wisdom today, particularly before I begin an intensive nursing program.  I’ve discovered I have more joy and peace in my life when I use my comfort wisdom.

Identify and develop your own comfort wisdom.  Once you make that list, regularly incorporate items or activities from that list into your life.  You may find you have to schedule time for it.  My friend and I planned this hike over a month ago and even had to reschedule a couple times due to illness and then out-of-town guests visiting, but we were committed to spending time with one another.  Everyone has their own comfort wisdom; something that refuels me may not refuel you.  As an extrovert, I love hanging out with groups of friends and meeting new people.  In contrast, my introverted husband would be exhausted doing the same thing.  Honor yourself by using your comfort wisdom and refueling periodically – I know it’s a practice I’ll need to do for myself in nursing school and in my future career! 

Called to a New Plan

I went to church Sunday morning with my family and saw the devotional booklet “Our Daily Bread” offered in the vestibule. I hadn’t seen one in a while, but became familiar with them through my mother and relatives from the Philippines, who used them regularly as a daily devotional. The booklet highlights a bible scripture each day and provides a reflection based on that reading. Feeling like I needed to focus more on my spirituality beyond church (it’s so hard sometimes to focus in mass with a rambunctious defiant toddler!), I grabbed one. The bible passage and reflection for that day (April 28, 2019) spoke to me. Because of that, I wanted to share it and invite you to read it at https://odb.org/2019/04/28/gods-retirement-plan/# .

At this moment in your life, what might God be calling you to do for His greater purpose? What new plans has He placed in your path?

Our Daily Bread (April 28, 2019)

The reflection was a great reminder of my second-career journey. Becoming a nurse is the new plan God has placed in my path. I feel I am called to become a nurse to better utilize my talents for His greater purpose. Do you ever feel like you’re on the right path because of the all the “signs” God places before you? You may not have the sign of a burning bush like Moses, but do you feel called to do something, even though you’re uncertain of how exactly you’ll accomplish what you sense you must do? Are you continuously driven towards a vocation without knowing how or if you can really make it happen? And, somehow, a path reveals itself? I feel this way about Nursing – really, I do!

Every step of the way, I feel like God has aligned things for me to allow me to get into Nursing school. If I had waited even one month to look into pre-requisites, I wouldn’t have been able to take the classes I did or complete them before the application cycle. If I had waited one week before researching how to get volunteer clinical experiences, I wouldn’t have become a COPE Health Scholar in a local hospital. If I were in a different volunteer program, I wouldn’t have been able to take patients’ vitals, witness biopsies, circumcisions, C-sections, vaginal deliveries, or perform chest compressions on patients who have coded. God placed people and experiences in my life, to allow me to grow in my compassion, abilities, and skills as a future nurse. Somehow, things aligned or confirmed and re-affirmed my choice to purse a career change. God placed the desire in my heart to consider nursing years ago, but He did not call me into action until now -when I have the social, emotional, and financial support I didn’t have before. His timing was perfect. I prayed to be able to serve God in whichever way He willed, and nursing is where I have now been lead. I have a peace and joy in my heart when I think about my [future] career, but I am still open to God’s vocational plans for me in my life.

Are you called to something new or to continue when you were about to quit? I encourage you to be open to new possibilities or to where God might be calling you. Explore what or where that is, and if you’re called to act, pursue it whole-heartedly. Like Dr. Warwick Rodwell discovering the ancient statue in the Lichfield Cathedral in the “Our Daily Bread” reflection, you could be surprised with the treasure you uncover.

My Five-Step Guide for Selecting & Taking Nursing PreRequisites

When I decided to become a nurse, I researched various nursing schools and programs and quickly discovered before I could even apply or be eligible to attend a program, I needed to complete pre-requisites (classes required BEFORE Nursing school entry).  The nursing programs I considered required anywhere from 7-12 pre-requisites.  Common pre-requisite courses include Anatomy and Physiology (with lab), Microbiology (with lab), and Chemistry.  However, some schools require Public Speaking, Ethics, Religion, or other courses unique to their program. 

While some schools take into consideration courses completed as part of a bachelor’s degree, other nursing schools do not accept any courses if they were not completed within the last 5 or 7 years.  So even though I took numerous chemistry classes as part of my Chemical Engineering degree, since it was greater than 5-7 years ago, I had to retake chemistry!  Overall, while I was annoyed at first, (re-)taking chemistry was helpful because it introduced me to some cool classmates and teachers and provided a nice review to help prepare me for the TEAS (more on that in another post!).

It is CRITICAL for applicants to know what schools and specific programs they wish to attend because pre-requisites vary – even within the same school – across different programs.  As I shared, I took Chemistry with Lab at my local community college to satisfy a pre-requisite requirement for a state university.  However, the community college offered two different Introductory/General Chemistry courses and some nursing programs require the Introduction to General Chemistry course instead of the Introductory Chemistry course.  After spending an entire summer in Introductory Chemistry lecture and lab, my lab partner discovered the course we completed was not eligible as a pre-requisite to her desired nursing program.  The community college guidance counselor had told her that the course was accepted at her school of choice.  Even the course description for our chemistry class stated “This course is designed for Nursing and other Allied Health majors”.  Unfortunately, when the class ended, my friend discovered that her program did not accept the chemistry class we worked hard to complete. 

She called me in a panic when she learned of the news because I planned to apply to the same school.  My heart stopped when she told me – I had spent so much time researching the classes I was taking and ensuring they counted as pre-requisites – could I have been mistaken?  My ability to apply to nursing programs in the Fall was contingent upon the completion of my carefully scheduled pre-requisites.  After some back and forth, we discovered the accelerated BSN program at the state university accepted the chemistry course we completed, while the traditional BSN program (at the same school!) did not.  I felt terrible for her.  Fortunately, she did well in our class, so her GPA was not adversely affected, and I’m sure the knowledge she gained will only help her when she takes the other General Chemistry course.  She shared she was in no rush to apply to nursing programs, so having to take an extra chemistry class did not affect her plans too much. 

Unlike my friend, I couldn’t afford taking classes that did not count as pre-requisites.  I was working hard to complete as many pre-requisites as possible in order to apply to Nursing programs by Fall 2018.  It was tricky and definitely not easy, but I completed thirteen pre-requisites within a year while either working or volunteering.  I got accepted into three different accelerated Nursing programs, so my hard work and meticulous planning paid off.  Below are some steps that I recommend and used myself to navigate what pre-requisites to take for nursing:

Step 1:  Identify the specific nursing programs in which you are interested in applying. 

Knowing where you plan to apply dictates which pre-requisites to take and possibly when to take them.  Many programs will not allow you to apply unless you complete all science pre-requisites.  Some programs will allow you to apply without completing pre-requisites so long as you show progress that you will complete the rest of the pre-requisites before the program begins.  However, even if you can apply to programs without completing all pre-requisites, having more pre-requisites completed (and obviously doing well in them) makes you a more attractive applicant than others who have not completed their pre-requisites.

Step 2: Understand the pre-requisites for each nursing program and list them in a spreadsheet

I listed all the programs in which I was interested and listed all the pre-requisites required for each program.  Like a typical nerd-engineer, I created a spreadsheet with this information.  By doing this I was able to quickly identify which program had the least or most requirements and which programs had overlapping pre-requisites. I also used the same spreadsheet to compare program costs, duration, and other entrance requirements.  It gave me a good overview that I could reference periodically.

a snapshot of my pre-requisites spreadsheet

Step 3: Before taking a class, check with your prospective program if they accept the class as a pre-requisite

Of course you can take pre-requisites from the college or university which offers your prospective nursing program.  Doing so guarantees that your program will accept your pre-requisites.  To save money, however, many opt to take their pre-requisites elsewhere, such as a community college.  Or, some students, like myself, may need to take pre-requisites at a college that offers evening and weekend classes to accommodate work or family schedules.  If you take a class offered elsewhere than the college where your nursing program belongs, ensure the classes transfer and can count as pre-requisites for your program.  

Some colleges have links or list what classes they accept to fulfill pre-Nursing requirements.  Others will allow you to specifically contact them to ask if a class meets their requirements.  Contact the program administrator or director to inquire if they accept a class as a pre-requisite.  Be prepared to share the accredited school’s name where the class is offered, the course name and number, the number of units, and course description.  You can also follow this process to verify if any previous course you completed counts as a pre-requisite.

I recommend verifying pre-requisite equivalency and printing out proof of this for each class taken as a pre-requisite.  Sometimes  equivalencies change, but at least you’ll have evidence that the class you took was considered equivalent when you took it.  Plus, doing this for myself gave me a quick reference and peace of mind in moments of doubt and panic (like when my friend contacted me about our chemistry class).

TIP: Keep your pre-requisite syllabi.  My Anatomy & Physiology II professor recommended keeping syllabi from all my pre-requisites.  Luckily, I didn’t have to resort to using any past syllabi, but having syllabi is helpful to have on-hand in case your prospective school wants to review a class you took and needs more than the general catalog description.

TIP for Californians: Use http://www.assist.org . It’s a helpful website “that shows how course credits earned at one public California college or university can be applied when transferred to another”.  If you plan to apply to public college or university in California for your nursing program, you can verify if the pre-requisites you are taking at a California public college/university are accepted by your program.

Step 4: Determine where and when the classes are offered, and create a corresponding class schedule

I created a GANTT chart outlining when certain classes were offered and the schools that offered them.  This was important in realistically understanding the earliest I could apply to nursing programs and how much it might cost me to complete all the pre-requisites.  I knew I wanted to complete 13 pre-requisites in one year, but not all classes are offered throughout the year nor do they perfectly stagger with one another.  I had to figure out if I could take classes online (some nursing programs do NOT accept online courses for certain pre-requisites), which schools offered the courses I needed, and when my schedule would allow me to take in-person classes.

After considering my budget and schedule, I limited myself to taking pre-requisites at my local community college and at National University.  Both are great options that I recommend to others.  At the community college, I appreciated knowing exactly what courses transferred from the college to other state schools via assist.org and the extremely affordable tuition.  Some community college courses even used free online textbooks! At National University, I liked the small class size, that each course was only 1-2 months, the evening and weekend schedules for in-person classes, and the fact that most all my classmates were pre-Nursing.  In addition, most of the National University students had worked before or were currently working, so could appreciate pursuing Nursing as a second-career. 

I evaluated each of my pre-requisites and figured out when they would be offered at either the community college (preferred, cheaper choice) or National University (approximately 10 times the cost of community college courses).  Some classes offered at the community college (Anatomy & Physiology) required pre-requisites (Biology), so it was easy to choose National University for such classes.   Using the GANTT chart, I calendarized each pre-requisite class I planned to take, the school offering the class, and the specific discussion section(s) I wanted, once the class schedule became available. 

My GANTT chart for Nursing Pre-Requisites

Step 5: Execute according to your planned schedule, and adjust as needed.

As soon as I was able to register for classes, I immediately enrolled prior to the semester, quarter, and/or month.  I never had a problem getting into the classes I needed.  (Although, a friend shared whenever she had the issue of being wait listed at her community college, she would still attend class and eventually get enrolled).  I also captured the anticipated nursing school application deadlines in the GANTT chart, so it would be clear which pre-requisites would be completed before applications were due. 

By creating my GANTT chart, I could get a sense of my anticipated course load throughout the year and see where my classes overlapped. I was able to see that I had the opportunity to take the Chemistry class earlier than I originally planned as well as some Philosophy courses (pre-requisites unique to one program).  Instead of taking Chemistry in the Fall semester, I took it in Summer. This allowed me to squeeze in an extra Philosophy class in the Fall and gave me a good review of Chemistry before taking the TEAS in November. (TEAS TIP: Completing your pre-requisites before the TEAS makes TEAS preparation easier)!

Due to work and my overall schedule, more often than not, I ended up taking condensed courses.  Even though National University offers classes that are only 1-2 months in duration, the community college also condensed classes.  Classes normally a semester long were only 4-6 weeks when I took it.  I would not have purposely scheduled my pre-requisites this way, but 1) it allowed me to complete thirteen pre-requisites in only one year, and 2) this prepared me for the rigor I will likely experience in my accelerated Nursing program.

While my schedule was rigorous, I had the full emotional and financial support of my family. With their support and understanding, I was able to study enough to get A’s on my pre-requisites while either working or volunteering in a hospital. My undergraduate GPA barely met minimum Nursing school requirements, so I knew I had to do well in my pre-requisites to stand a chance in getting accepted into any prospective programs. With God’s grace and a lot of hard work and effort, I was able to excel in my pre-requisite courses which helped me get into several accelerated Nursing programs.

Overall, you will need to decide what you can or cannot handle and what resources you need to stick to your schedule. Keep in mind that many nursing programs will not consider applicants with C-grades for their science pre-requisites. Additionally, accelerated nursing programs are extremely competitive, so having a good GPA on pre-requisite courses is advantageous. Maybe you’ll need to cut back on work hours or find childcare to give you time to study. If neither is possible and you’re drowning in schoolwork and unable to do well, perhaps consider a lighter course load. Not only do you want to complete the correct pre-requisites, you want to do well in them, so adjust your schedule accordingly!

Pathways to Nursing

If you have wondered about becoming a registered nurse (RN) but have not started to really look into it, you may not know what kind of education or degree you need to become an RN.  There are various pathways to nursing.  Each individual must consider which path is best for his or her unique situation.  However, all pathways (in the US) eventually lead to the National Council Licensure Examination (NCLEX), which is the exam that ultimately determines whether or not someone becomes a registered nurse.  Regardless of your background or degree, all aspiring RNs must pass the NCLEX in order to become a licensed registered nurse.  Now that you know the NCLEX is the common gateway to obtaining an RN license, let’s discuss the three pre-licensure degrees you could obtain prior to taking the NCLEX: the Associate Degree in Nursing (ADN), the Bachelor of Science Degree in Nursing (BSN), and the entry-level Masters Degree in Nursing (MSN-E).

Rn_degree

ADN

You do not need a BSN in order to become a nurse; you may become an RN with an Associate’s Degree.  Many ADN programs are only a couple of years long and are a fraction of the cost of BSN programs.  Unfortunately, many ADN programs are known for their two-year waitlists and are just as competitive to enter as any other nursing degree program.  If you can get into an ADN program, however, this is a great affordable option to become a nurse.

Many wonderful and established nurses I know have ADNs.  Numerous facilities and hospitals do indeed hire new-grads with ADNs.  However, certain hospitals have (or desire) magnet status and require a large percentage of their nurses to have a BSN, and thus prefer BSN graduates.  Other hospitals may require nurses with ADNs to pursue a BSN  within a certain timeframe from their date of hire or require 20 years of experience for ADN graduates.  Some hospital nurses with ADNs acknowledge that they are able to work in their hospital or hold their supervisory role because they have many years of experience.  They notice that most of the new hires in their hospital are BSN graduates.

ADN to BSN

As a result of this push to have a nursing workforce filled with BSN degree-holders,  there are many RN to BSN programs designed specifically for nurses with ADNs.  There are hospitals that will reimburse or partially pay for their nurses with ADNs to pursue BSNs.  If you do not mind working while going to school or extending the time you spend in school to get a BSN, getting an ADN first may be the most economical way to eventually getting a BSN.  It is not necessary to have a BSN to work as a nurse, but having an advanced degree may make you a more attractive candidate when applying for competitive jobs against those with similar work experience.

BSN

If you decide to get a BSN directly, you can apply to traditional 3-4 year programs.  Program costs vary and depend on whether or not you attend a public or private school.  There’s a general sentiment that nursing programs in public schools have lower acceptance rates than their more expensive private school counterparts.

If you have a bachelor of science in a non-nursing field, consider applying to an accelerated BSN program, which lasts only 1-2 years. The shorter program time can be worth the cost if you start working as a nurse sooner.  Your opportunity cost of income lost while you are in school could be minimized with a shorter program length.  However, such condensed programs are intense and “accelerated”, as their name implies.

MSN-E

If you have a non-nursing bachelor of science degree, you also could consider applying to entry-level Master of Science in Nursing (MSN-E) programs, which are typically two years duration.  Maybe you don’t want to spend time getting a bachelor degree in Nursing; you’d rather go straight into a master’s program because you ultimately desire to be an advanced practice nurse.  If you want to be a nurse educator or clinical nurse leader, many entry-level master’s programs are perfect for you.  However, if you want to become a nurse practitioner, entry-level master’s programs that I’ve reviewed are not applicable towards becoming a nurse practitioner – a second graduate degree would be required.

If you want an MSN, do not feel pressured to obtain one immediately.  You can become a registered nurse with a lower degree.  Just as ADN graduates can get their BSNs after becoming an RN, BSN graduates can also further their education after obtaining their license to get advanced degrees in nursing.

Begin with the End

It’s important to think about your longer-term goals as you consider the various pathways to Nursing.  Always “begin with the end in mind”, as Franklin Covey suggests.  If you want to work in a magnet hospital as a new grad, perhaps you will want to bypass the ADN option for nursing.  If you want to work as an RN as quickly as possible, consider the ADN or accelerated BSN options.  Take into account private schools without waitlists.  Research the job requirements for RNs at the places you would like to work or the requirements for your dream nursing job.  Job postings typically list education and experience required for each position and can give you an idea of the degree(s) you should target.

Very simply, an RN is someone who has passed the NCLEX with either an ADN, BSN, or MSN-E.  You now know there are many degree programs that can lead you to become an RN.  Knowing what you want to do as a nurse, how quickly you want to get there, and how much you are willing (or able) to spend will help decide which route may be best for you.  Regardless of what route you take, please ensure the nursing program you choose is accredited.  Good luck on your journey!

Disclaimer:  I speak only from my own personal experience and am not an expert in all things Nursing.  If you know of other pathways to nursing and becoming an RN, I would enjoy your feedback.  I invite readers to share any information or comments that would be helpful to others!