Thinking Like a Nurse (Long...sorry!)

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Specializes in OR.

It's so difficult! I'm a second semester nursing student struggling with how to answer test questions. I came into nursing school knowing it was going to be tough. I knew I was going to have to learn a completely different way of thinking. I just didn't realize it would be so difficult to grasp!

I'm not doing terribly -- I'm still well above the didactic score I need to stay in the program. But going from A's on my tests (even in my 1st semester!) to fighting for (and working even harder to get) B's is really messing with my self-esteem. There's something I'm not getting, something that isn't clicking, and I feel like if I could find that magic puzzle piece, nursing school would be much, much less frustrating for me.

When I sit down to take a test, I'm confident in my knowledge of the material. I have studied the chapters in the text, used all available resources, and am still finding some of those test questions may as well be written in ancient Greek for all the sense they make to me.

For example: on my last exam, one question asked which assessment was the priority. I had it narrowed down to the possibly cancerous lesion or the possibly highly contagious skin condition. I chose to assess the contagious one, thinking that the cancer, though life-threatening, only directly affects the patient, whereas the contagious condition would affect the patient and all those around him or her. Of course, I chose the wrong answer.

In hindsight, I understand why my reasoning was incorrect, and that's good. At least I am learning from my mistakes. But what else can I do to learn how to not make those mistakes in the first place? I read my textbook, I do the practice questions for each chapter (thoroughly reading all the rationales), I do questions in the Med-Surg Success book (while reading all the rationales), and I have an app I do practice questions on. What am I missing? What am I not doing that I should be doing? I'm spending a lot of time stressed and frustrated and, frankly, worrying that my brain may not have the correct wiring for this. Old dog unable to learn new tricks and all that.

Any suggestions? Words of wisdom?

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If you never made mistakes about nursing, you wouldn't need to be in school to learn nursing. There now, better? ;)

There are many threads here you can search on "learning to think like a nurse." Most of them end soon after several people share their experiences about how one day something just clicked. You are thoughtful and doing well on knowledge (cognitive) and probably the manipulative stuff (psychomotor); the affective side will come along. Really. Let it flow. Your brain is fine.

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Specializes in Complex pedi to LTC/SA & now a manager.

Try the Prioritization Delegation & Assignment book by Linda LaCharity. It helps with developing those prioritizing & critical thinking skills as well as NCLEX RN prep. Or any of the NCLEX prep resources with questions & rationale.

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You already have the knowledge. What you are missing is to add critical thinking to that knowledge. Always keep in mind that patient safety and wellbeing are the most important part of a nurse duties.

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Specializes in Neuroscience.

Going from an A to a B isn't the end of the world. If you understand where you went wrong with the answers, then you'll be better prepared for the next exam. I got a B on an exam that I studied all weekend for. Getting a B on a test doesn't mean I don't have a mastery of the material, it means that I had a great understanding of content asked in 45 of the questions, and a general understanding of the 5 I missed in the content of 50 questions they choose for an exam. An exam that spanned 17 chapters and over 25 different concepts.

So? I would rather have knowledge over everything than the one thing covered on page 254 in a tiny little paragraph that is not paramount in the overall grand scheme of life.

Brush yourself off. Understand why you missed it (which you do) and don't allow it to get you down. If you get through the program and pass the NCLEX, you're already thinking like a nurse. Just not the perfect nurse in a hospital named "Utopia General". You've got this.

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I feel your pain...I have taken just two test for two classes and didn't pass either....not happy camper right now but I'll build a bridge and get over it!

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Specializes in Pediatric Hematology/Oncology.

I am in second quarter right now as well and have had conversations with my instructor about how frustrated a lot of the other students are with the material. It is definitely frustrating trying to pin down nursing knowledge and then apply it in a way that means "thinking like a nurse." I was really surprised at some of my cohort mates and how they dropped so quickly from being successful to struggling within a few weeks. I have not had the same problem and I know I have been really lucky.

I've been thinking about when they ask me what I do as far as what is possibly different from what they do that is allowing me to keep my head above water. I feel like at this point, a lot of it is still trying to get the factual information pinned down. There is a problem with this -- a lot of what we are learning now in 3 years' time may be outdated for NCLEX. The thing that really stood out to me when the program began was the emphasis on developing critical thinking abilities. Yes, it helps (A LOT) to know every minutiae of medical knowledge but without having the flexibility to apply it in a way that allows you to reach logical conclusions, it means nothing. If you have a moment, think about what you can do to become a better critical thinker -- what can you do to build your logic foundation?

Also, be patient with the select-all-that-apply and highest priority questions. Those take a lot of practice...and then some more practice. And then start over again and practice some more. That's the one thing that got things going my way. I had to confront getting comfortable with being new to "thinking like a nurse" and learning how to apply it academically -- even if it meant getting all the answers wrong. The ATI modules we have give rationales for the correct and incorrect answers and the general consensus among ALL students in the nursing program at our school is that you can learn the most from the rationales for incorrect answers. So, if you have those resources or can tap into them, I definitely recommend approaching it from that angle.

Anyway, it sounds like you're already doing a lot of the above so keep at it and don't get discouraged -- it will come. Good luck!

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Specializes in OR.
If you never made mistakes about nursing, you wouldn't need to be in school to learn nursing. There now, better? ;)

There are many threads here you can search on "learning to think like a nurse." Most of them end soon after several people share their experiences about how one day something just clicked. You are thoughtful and doing well on knowledge (cognitive) and probably the manipulative stuff (psychomotor); the affective side will come along. Really. Let it flow. Your brain is fine.

Very good point, GrnTea. Very good point. I actually did do a search for those threads. Since they were mostly older threads, I suppose a small part of me was hoping somebody might have a new idea. I do understand that it will come as long as I keep working, so that's exactly what I intend to do. No shortcuts here!

Try the Prioritization Delegation & Assignment book by Linda LaCharity. It helps with developing those prioritizing & critical thinking skills as well as NCLEX RN prep. Or any of the NCLEX prep resources with questions & rationale.

Thanks for the book recommendation! It's on my list to buy as soon as I have the money. I do have Saunders, and we have Kaplan online with our program, so I will continue to utilize those resources.

Going from an A to a B isn't the end of the world. If you understand where you went wrong with the answers, then you'll be better prepared for the next exam. I got a B on an exam that I studied all weekend for. Getting a B on a test doesn't mean I don't have a mastery of the material, it means that I had a great understanding of content asked in 45 of the questions, and a general understanding of the 5 I missed in the content of 50 questions they choose for an exam. An exam that spanned 17 chapters and over 25 different concepts.

No, it isn't the end of the world, and I'm fine with it. It may not have seemed that way, but I really am. I'm not as concerned now about the grade itself as I am about making sure I grasp what I need to. I appreciate your perspective on what that B really means. It helps.

Brush yourself off. Understand why you missed it (which you do) and don't allow it to get you down. If you get through the program and pass the NCLEX, you're already thinking like a nurse. Just not the perfect nurse in a hospital named "Utopia General". You've got this.

Consider me brushed and not down about this. I'm just trying to make sure I'm doing what I am supposed to be doing, and it looks like I am. With that fear off my shoulders, I can continue to concentrate on getting this thing called nursing school figured out.

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