I put this list together in hopes that it will provide comfort to someone experiencing uncertainty or difficulty along their pathway to learning and reaching their goals. I applaud your persistent determination.
Some of these tips were passed on to me from others, while many are those I have picked up through careful observation on my own. I am in my 5th of 6th semesters into an ABSN program. The topics I will discuss include challenges regarding the following: Motivation, Assigned Readings, Lecture, and Clinical Rotation.
Motivation
Take a deep breath and briefly focus on what initially inspired you to enter nursing school. In the simplest terms, we all aspire to help others but there are often very deep-rooted, personal explanations for what specifically moved each of us to enter the profession.
For example, one of my classmates was a long time caretaker for her grandmother who decided in her last days to leave the hospital and receive only comfort care at home; she was by her side when she passed away. Another student, impressed by the nurses who compassionately cared for her mother during breast chemotherapy treatment; she was at the time a history major, but these interactions so moved her that she could not see any other profession for herself, except to be a nurse. Others advancing their education, strive to provide for their children or families better than they are able to do now.
If you are just entering or newly entering nursing school I suggest putting together a motivation board, Pinterest board or other like illustration, representative of your inspirations. You can look at this when you feel like you are broken down, taking crazy pills or about to lose it. These can be inspirational quotes, pictures of loved ones, cartoons, aspirations for where or who you want to be, or just a bunch of funny memes that mirror your sense of humor.
This idea came to me based on my experiences with my 2nd semester physical assessment professor. Each class, she began with quotes from a little book she carried around discoursing the feats, values and accomplishments of past nurses. Sometimes it would be audio of a thankful patient experience or a video that made me tear up (such as this gem about empathy from the Cleveland Clinic entitled Empathy: The Human Connection to Patient Care. I highly recommend watching it if you have not already seen it).
I loved her approach because she really taught me how to forget about the grades, the tests, piles of readings and assignments, the pressure and expectations and just remember (even for a minute) why I applied to the school of nursing to begin with. Without recognizing and taking the time to focus on your inspirations, you will be utterly buried in an avalanche of "to-do" with no end in sight.
Assigned Readings
This advice came to me from a seasoned nursing professional the week before I entered nursing school. I enthusiastically sat with my first semester syllabuses and a heap of rented books in front of me at my local coffee shop, opened to page one and just started reading and reading...and reading. A man approached me and started to open his wallet and I thought to myself, 'Great, he is going to try and sell me something". What he pulled out was his California Board of Registered Nursing License. He said, "It looks to me like you are a nursing student. I am a nursing instructor at [the local community college] and I wanted to give you a tip about reading for nursing school that I wish someone would have given me". As it turns out, he was just 'paying-it forward'.
He went on to suggest the following: Do not read all of your assigned reading!
- Start by reading the 'Learning Outcomes' or 'Learning Objectives' section that is located at the beginning of each assigned chapter (e.g., most objectives start with words such as describe, discuss, recognize or list),
- Skip to the back of the chapter and read the entire 'Summary' section,
- Next, skim the chapter and read all of the headings, subheadings and bolded vocabulary words,
- Prioritize what was unfamiliar to you or weak areas that were discussed in the summary and go back into the chapter to find out that information,
- Once you have done this, evaluate your knowledge by taking any available chapter quiz questions,
- If you did not do well with those, go back to that topic.
The Goal
If you comprehend and have completed the Learning Outcomes/Objectives at the beginning of the chapter you have accomplished much of what you need to know about that topic.
What more, if you can teach what you learned to another student, you are even better off. So, if you are able to create a study group, I highly suggest it. In doing so, you could potentially split up the required material so that each person follows the 6 previously mentioned reading tips for their assigned reading; in essence, becomes an 'expert' on that topic and is responsible for ensuring the group understands the objectives when they meet as a group.
Lecture
Sometimes you have instructions that you love and a lot of what they say makes sense. Other times you have instructors who just do not present the information effectively. In any case, do your best overall to understand CONCEPTS. I have seen too often, many of us (myself included) try to get through nursing school by doing the following: feverishly type down every note or comment mentioned throughout a lecture, print out a 142-pg PowerPoint presentations and try to scribble down notes in the margins, memorize big fat stacks of flashcards - No. As hard as it may be, just don't do this.
A lot of lectures include the 'Learning Outcomes/objectives' section on the first slide of the PowerPoint but I've noticed that this particular slide is usually rushed through or skipped completely. Utilize these as a guide. These should be the purpose or focus of what will be discussed, what knowledge you are responsible for, and key words you should be listening for. If you have anything printed out in front of you, it should probably be those objectives. Then, when the lecture ends, ask questions geared to getting any of those listed objectives clarified which you missed or were unclear of.
In a discussion of issues in nursing education and practice-based competency outcomes, DiVito-Thomas (2005) made this statement about the preceding predicament, "The outcomes approach requires a mental shift from trying to memorize voluminous readings and class notes (resulting in frustration and the attitude of "just tell me what I need to know") to actually learning to think like a nurse, to integrate information in problem solving and decision making and providing competent patient care" (as cited by Cherry & Jacob, 2011). This 'mental shift' is not easy; I personally still struggle with this all the time! It is something you will need to acknowledge and face if you want to be even remotely confident and competent when you finally enter the workforce.
Clinical rotation
Just a quick note about skills lab before I discuss clinical rotation. Usually, you have a couple days or weeks of skills lab on campus before you actually get to orient and go to your actual clinical site. Generally speaking, you practice nursing skills (e.g. bed bath, tracheostomy suctioning, foley catheter insertion, sterile field set- up, etc.) in the lab with a partner or group of classmates and then your competency must be first signed off by your instructor before you are able to go to the clinic site for the semester (sometimes this requires a remediation if you do not pass the skills test or mock medication administration tests). This process can be intimidating for some students. Similarly, to the aforementioned tip of a study group, I suggest finding a reliable partner or group to get together and mock-practice your skills with. Practicing with a peer or family member can help you feel a little better about the whole testing stress. Yes, I admit I mitered the corner of my bed with a classmate in it, I don't know how many times the first semester, because I was afraid I would fail out of nursing school for not being able to make an occupied bed. The goal is to feel comfortable and confident when someone is breathing down your neck or watching you perform these skills through two-way glass.
At the clinical site, you should use up all of your time to the fullest - it's all valuable even when it doesn't feel like it sometimes. Some placements will provide you with a lot more opportunities than others. You really have to advocate for yourself and be assertive. If you have down-time, find out who is in charge (Charge Nurse, Nursing Manager, anyone really) and ask for things to do. When you are assigned to a nurse for the day, after introducing yourself, let them know what you already know, what you hope to accomplish that day and any skills you are looking to perform. If your patient is taken care of at the time, you can even talk to other nurses for opportunities. Unlicensed assistive personnel (UAP), such as nursing assistants or CNA's are wonderful resources too - they can assign you tasks to keep you busy and if you help them out, they will usually be open to showing or teaching you new things. You can even use these opportunities to network. If there is a unit or facility you are interested in working at, talk to the nursing manager about your intentions to apply there after graduation and make yourself available and noticed on the floor as a dedicated and hard worker.
Another suggestion, sometime towards the beginning of the semester, let your clinical instructors know that you appreciate constructive criticism. So hopefully they provide you with as much valuable feedback as possible. Throughout each day, keep a running list of potential nursing diagnoses in your head that could apply to your patient. Run these past the nurses that you are working with to see if they think you are on the right track or ask for suggestions. This will help you later on when you are at home writing your nursing care plans.
I really tried to make these study tip suggestions (and other recommendations) thoughtful and I hope that they serve someone during a time when they need it most.
