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1) Figure out if the exams are based mostly on lecture or mostly on reading.
Ideally you'll read everything, listen to everything, and manage to do it all efficiently. There will be times that won't work out because life gets in the way. I found that in many classes, the material from the lecture was the material emphasized in exams. The reading was meant to enhance understanding and more thoroughly explain what was covered in lecture. You'll find out if this is true for each class when you take the first exam; after that exam take a look at your lecture notes and see how many of the questions came from that versus came from the reading. Focus your studying for the next exam accordingly.
2) Audio record the lectures.
It can be really hard to try to listen, process, and take excellent notes simultaneously - you are guaranteed to miss something. If your instructor allows (always ask first), audio RECORD the lecture. This lets you focus on either a) listening in class, or b) taking notes in class, depending on your preference. After class, listen to the lecture a second time, and either review your notes as you listen, or take notes (with the luxury of being able to back up and re-play sections of the recording if needed).
3) Make use of low-quality study time.
Nursing school tends to be fast-paced, and you may have limits on when you can get high quality, planned-ahead, no distractions, quiet environment time to go over the material. The GREAT thing about audio recordings of lectures is you can use them to add some low-quality study time into your routine. Listen to lectures while you make dinner, while you're on the bus, etc. It really helps maximize your time with the material when you have days on which you can't carve out high-quality study time. If you can't audio record, flashcards that you can carry around can also be useful for making some use of low-quality study time.
4) Make an outline of your notes so that the information is organized in a way that makes sense to you.
If you have powerpoint slides from class, EDIT the slides so that what is on them is condensed or the wording changed so it matches the way YOU would explain the same material to someone else.
5) There is SOME material you have to memorize.
Unless you are EXCELLENT at memorizing, you are better off learning to logic your way through as much of the material as possible:
a) For any of the physiology or pathophysiology concepts, try to find a real life non-nursing example that illustrates the idea. For instance, for a surgical transplant patient post-operatively, why do you need to keep blood pressure in a certain range? Generally for two reasons: to ensure adequate perfusion to the newly transplanted organ (low limit of blood pressure) and to ensure the anastamosis sites don't tear apart (high limit of blood pressure). A real life example is a garden hose that has been run over by a lawn mower, and patched with duct tape. If you need to water your garden with that hose, you need high enough water pressure to get water to your plants, but low enough that the tape doesn't pop off with water shooting out of the hose. When you understand WHY you need to check various things and can relate that to something that is either very obvious to you or that you already know, it's much easier to remember WHAT you need to check.
b) When you get to pathophysiology, fall back on what you know from physiology. Think through everything the organ or system is normally supposed to do. In general you can assume that the pathophysiology will involve some failing of those functions. For example, kidneys filter the blood and remove waste products, play a role in managing blood pressure, and play a role in erythropoiesis. So, in kidney pathophysiology, you should expect problems with filtering (buildup of waste products like BUN in the body or substances like protein that should have been kept in the body appearing in the urine), changes in urine output, problems with blood pressure that the body will attempt to correct however it can (heart rate, heart contractions, vascular resistance), and problems with red blood cell production. Using this approach means you may only have to memorize HALF as much material.
6) If you are a procrastinator, don't try to make yourself spend hours at a time studying.
Set aside hour-long or twenty-minute blocks of time to study that are separated by doing something else. Shorter sessions are often more manageable to get through, and knowing it will only be a short study session makes it easier to pick up the book or notes and actually start studying.
7) SCHEDULE relaxation time when you will absolutely NOT be studying.
Whether its setting aside time for friends, or to go to the gym, set aside time that you can count on to keep yourself balanced.
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