The Big Exam

Well, guess I better write a bit about my foreign trained nurses exam. It was quite a cultural experience. The exam was held at the University Teaching Hospital's Nursing School where I had studied a few weeks before. It was to start at 9am, but we were to be there at 8am to handle formalities. I car pooled with my friend Rachael. We arrived at 7:15. I did not want to worry about getting stuck in traffic! We didn't even move from the waiting area to the room where the test was held till 9am. While we were waiting, I spoke with several of the other nurses gathering for the exam. I had met two of them the day before when we had to go to the General Nursing Council office to pick up our letters of invitation. One, who was from the UK, was sitting the exam for the third time. The other one was of Indian ethnicity, but I'm not sure where she was from. The morning of the exam I met two women from South Africa, one from Nigeria, one from Northern Ireland and one from Zambia (who must have trained outside the country). I also got to reunite with Esther and Solange, both from the Congo, who were part of our study group a few weeks earlier.  There were a few others who I did not meet personally. We were 13 in all, 12 women and one man. I didn't meet anyone working in Lusaka, we all seemed to come from rural provinces, many working at mission hospitals.

They had assigned us seats in the big lecture hall. When we went into the room, we had to leave our books/bags down front and take only our pens/pencil/ruler and eraser to our seats along with our letter of invitation and the receipt we had paid to take the exam. Once we found our seats, they came around and checked our papers. We were assigned a number and that number was to be placed on each page of the exam booklet and on the front. Our names were not to be visible to the people marking the exams. There was then the official opening of the sealed packet, the handing out of the booklets with the test questions and the paper for writing the essays and a reading of the entire exam before we started at 9:50. I actually appreciated the reading of the exam before our time started, because it took away the anxiety of not knowing what would be on the next page. Also,with the multiple choice questions, it gave you a first read through that didn't count as part of your time, so it was quicker when actually answering the questions.

We had three hours.  The multiple choice, matching and fill in the blanks part was 100 questions worth 25% of our score. Then the other 75% was based on three essay questions. The pediatric question was compulsory and was on lobar pneumonia.  The medicine question was hepatitis A, the surgery question dealt with burns and the tropical medicine one was ascarius (roundworm).  I chose the first three mainly because I didn't want to have to draw a diagram of the life cycle of the roundworm (though I know it, I'm not much of an artist and I'm not neat, both of which are important) and it asked for three medicines you could use to treat it, their dosages and side effects. I only knew one for sure, and was not aware of it's side effects, if any. So the only drawing I had to do was of the lower respiratory tract........pretty basic, but it looked like a 5th grader had done it. The questions involved definitions, signs and symptoms, medical management, nursing management, possible complications, prevention and patient education. They broke down how the questions would be scored for you, so you knew where to place your focus. Nursing management was 50%. Two of my questions I had to come up with a nursing care plan with five nursing diagnoses. The third one I used the traditional Zambian format of describing all the elements of nursing care. The study class a few of us took part in prepared us for this. Most of the nurses taking the exam had not heard of the class and we were giving them a crash course before the exam started. I focussed hard on not using abbreviations and giving a rationale for every intervention.  These were also points they had told us in the class we took. I wrote and wrote until my hand was cramped and there were only two minutes left to go. My writing was pretty messy by the end (never a strong point of mine) but I hope I did okay. The results will probably come out when I am back in the US. They post it on a bulletin board for all to see at the General Nursing Council.

On the way home, I had to stop at the MCC office. Eric very graciously offered to take me to lunch and for ice cream as a form of celebration. Half way through lunch I came down off my adrenalin rush and was ready to go home for a rest!

After 25 years of no formal schooling or exams, this was a bit stressful for me. I have always in the past been a good exam taker, especially with multiple choice questions. This exam, however, was very different and something about knowing 50% fail the first time made it all the more intense. I feel I did my best, and we will just have to wait and see. I'm glad it is over and can focus now more on work, language study and settling in to Macha.