Inquiring Minds

nurseprnRN, BSN, RN · Dec 18, 2014

It's a different kind of education than you've ever experienced. We hear from students all the time who got As and Bs in their prerequisites and then had a terrible time in their nursing classes, and this was a hard transition. I've said this many, many times: The hardest part about learning to be a nurse is learning how to think like one.

You will be held responsible for maintaining a good working knowledge of everything you learned in all your prerequisites AND the previous nursing semesters, unlike your high school classmates who are majoring in English-- they finish the course, take the exam, sell the book, and move on. You will never be able to do that.

You will learn to think like someone who can take in a situation using a good assessment strategy, then bring to bear all that you know to plan how someone will receive nursing care (not just deliver medical care), from you and others to whom you will delegate some aspects of care. This critical thinking is not dependent on any other specialty, although we work collaboratively with all of them. You will not be able to rely on physicians for every bit of your direction; only a part of everything you'll do will be delegated in that way. Physicians have a medical plan of care, and we are responsible for implementing some of it (not all-- dietary, therapy, radiology, pharmacy...) The rest will be nursing, nursing, nursing: assessment, diagnosis, planning, delivering/delegating, reevaluating, and reassessing... making (not choosing) nursing diagnoses and planning to deliver the nursing plan of care.

YOU will be responsible for owning and growing your own nursing practice by using your wits and knowledge and skill. Remember, if caring were enough, anyone could be a nurse. It isn't. Welcome.

classicdame, MSN, EdD · Dec 18, 2014

You have to learn a new language and a new culture. There is a LOT of information to learn in a reasonably short period of time. It has to be your major focus till you graduate. But then you are very proud of yourself because you know you were challenged and you met the challenge!

mrsboots87 · Dec 18, 2014

As a current nursing student, I couldn't agree more with what the previous posters said. The program requires an entirely different way of thinking than your traditional classes. If you learned your A&P and did well in your pre reqs, then the content of nursing school isnt terribly difficult to learn. It's being able to retain everything you learn to use later. You have to be able to apply multiple subjects to one scenario to provide the best care for your patient. And NCLEX style questions are a beast of their own. Memorization will not help you unless you know how to apply what you have memorized to a given scenario. And in that case you would have learned and not just memorized facts. And you have to be able to take things you learned in your first semester and apply them to things in ALL remaining semesters. Each semester builds on the last. I havnt found the program to be incredibly difficult, but I also have a pretty good understanding of physiology and study A LOT to make sure I understand the best I can. I could imagine that if I didnt study a lot, that this course would probably be very difficult. So plan for it to be very time consuming, but rewarding if you give it a chance.

Backwardo · Dec 18, 2014

I just finished up my first semester. Maybe it's because I'm a newbie to nursing school, but the most difficult thing for me was the volume of work. I had 6ish hours of clinical look up on Sundays (including filling out 15 pages of information on my patient, going home and creating two care plans, and preparing a proper SBAR report to give to my instructor), on top of my medication and diagnostic worksheets I had to do for clinical (usually takes at least 3 hours). I had an exam every Wednesday morning at 0800 (and only 4 hours total of lecture to prepare us for the exam, the rest was up to us). We had 1-2 case studies due Wednesday morning. ATI videos to watch weekly (long, LONG ATI videos)... Math packets due every week. It was just a lot of busywork. Important busywork, but busywork nonetheless. I had to make time to study and I also took A&P at the same time, so the fall semester was a little overwhelming.

I didn't struggle much with exams. My lowest grade was an 80 and I received that when I had a lecture and lab exam in A&P that same week. I practiced out of three different NCLEX books to prepare me for the tests and maybe I was more adjusted to the style of questions... It's also entirely possibly that all the busywork forced some knowledge into my brain and made me more prepared. :lol2:

BertG77 · Dec 18, 2014

The information or material is not challenging it's more how the info is utilized or put into practice. The info becomes a reference for critical thinking, which I would say is most important thing I learned this (my first) semester. My instructors constantly emphasized that we were getting to hung up on stuff we 'know' (second guessing ourselves) or at least SHOULD know in order to effectively hone our critical thinking skills. So, there is a ton of factual information to learn: disease processes, skills, techniques, medication dosage calculations, medications and their effects/contraindications and side effects, etc, but also how to assess patients, meaning what to ask (subjective) and what to look/listen for (objective). The critical thinking comes into play when you have to lump all this data together and figure out what as a nurse you're going to DO for the patient. It's kinda awesome and terrifying at the same time.

ComeTogether, LPN · Dec 20, 2014

Thank-you, especially GrnTea, for the answers! I am so very excited to start, it seems like I have wanted this forever, and having it be so close is surreal. I've always found that I need to understand how things work in order to remember them, so hopefully that will help me. It certainly sounds like I need to brush up on my A&P, so I am glad that I asked!

Thank-you all, again!!

MurseJJ · Dec 20, 2014

I agree with what everyone has said, especially GrnTea (I love your posts). I also just finished my first semester of nursing school.

Yes, I think you should briefly review your anatomy and physiology if you have the time. They will both come up again in your nursing curriculum, as I'm sure you can imagine. Fortunately, most of the textbooks for your courses will include relevant reviews of anatomy and physiology. Anatomy will be especially important in your health assessment course, since you need to know where things are, what they are called, etc., to be able to physically examine them and appropriately document that assessment. My health assessment lab professor (who was also my fundamentals clinical instructor) said that nurses tend to not be good at remembering the anatomy.

As already mentioned, your nursing courses will teach you a different way of thinking that you may not be used to. This can be somewhat of a frustrating thing for many of us. The classic statement made about nursing exams is that often, all of the answer choices will be right. You have to choice the most right answer. I found that in my prerequisite course exams (which I fortunately got all As in), I used less "brain power" than I had to in my nursing exams (specifically the fundamentals course). You really have to "think", and "think like a nurse". Yes, you have to memorize a lot of facts, values, etc. But your exams will primarily focus on the application of the material you know to situations. The answer to a question will often be related to prioritization, as well as what you as the nurse can do/address.

The material itself isn't that difficult, at least to me. It isn't anymore difficult than material covered in anatomy, physiology, microbio, etc. In addition to the different way of thinking, it's also the volume of information you must know in a relatively short period of time. When you get your fundamentals textbook, you'll be looking at over 1200 pages of dense, small print, plus lots of charts. And that's just one course. In addition to the lectures and exams, you'll also have skills checks, where you demonstrate how to perform various clinical skills. In my first semester, we started off very basic, with hand hygiene, bed making, patient hygiene, etc. It then progressed to things like wound care, vital signs, medication administration (oral, nasal, eye, ear, IM, SC, ID, suppository), foley catheter care, mobility, oxygen administration, etc. You have to practice these skills outside of lab, then do the skills check. We also had a skills practicum, where you picked two skills out of a hat to demonstrate, without help/prompting by the faculty. We also had our clinical rotation, which was at a rehab facility from 7am-1pm (we'll be doing full days starting next semester in the hospital). We also had things like clinical papers, care plans (...), and a presentation at a senior day center on medication safety. That's all just for one class (fundamentals). Pharmacology you'll be memorizing lots of drugs, not just brand/generic, but also what they do, mechanism of action, side effects, interactions, nursing implications, anything interesting/unique about them. In health assessment lab, in addition to weekly demonstrating of assessment skills, at the end we had to do a full head to toe physical assessment on a classmate, without any material.

This all may sound overwhelming, but it is very doable. It may be overwhelming at times (for me I was also working 30 hours/week...let's just say that I'm starting a new job with less hours in a few weeks). The key is time management/organization. Plan out each day of your week, including where you'll be, what you're going to study, etc. Do a little each day. Stay positive! There are going to be people around you that will be constantly complaining, and it'll be very contagious. Just stay positive, and keep telling yourself you're going to be a nurse. That's what I did (and do). I would always tell myself before a test or skills check that I'm going to be a nurse, I'm going to be an expert clinician one day. It was like a mantra, haha.

Good luck in your program! Just remember to stay organized, do a little each day, stay positive, and you should do well!