Grades in nursing school vs. success as a nurse?

Nurses General Nursing

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Hi All,

I'm new here. I wanted to ask a quick question on behalf of a friend of mine, who is currently finishing up her second to last semester of nursing school.

She's a smart woman, who got mostly A's with one or two B's on her nursing school pre-requisities. And she puts in the effort - when she describes to me what she does every day, I don't see how she (or anyone else) could possibly spend more time studying and practicing.

Unfortunately, whereas during the beginning of nursing school, most of her exams she was scoring in the A-/B+ range, her grades have steadily declined to the B-/C+ range. At the same time, her frusteration levels have been going up - she just isn't getting a corelation between her effort and academic success. Every time she gets results from an exam and they're less than what she hoped for, she says to me "I guess I'm just not cut out to be a nurse".

Not being a nurse, I've tried to give her the best advice I can, which is this - I have to think (or at least hope) that nursing school is a barrier to entering the nursing profession, but that once overcome, the "real" knowledge is going to come from on-the-job experience. That several years down the road after she graduates, the grades she received in nursing school will have little bearing on how good of a nurse she is, just so long as she tries her best and her grades are enough to graduate.

I'm of course trying to encourage her to do her very best and to get the best grades she can in nursing school - I'm not encouraging her to just try and just skate by. I'm just trying to help her not to get too discouraged or to despair too much, to tell her that yes, she really can do this, even if she's not getting A's all the time.

But I think both she and I would probably feel a lot better if any of you who are actual practicing nurses could tell us that there is really something to the advice I'm giving her, that I'm not just talking nonsense, if indeed that was the case. So I'd really appreciate hearing feedback on this from some of you.

Thanks very much for any help!

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I agree that one shouldn't try to skate by and you should encourage your friend. One should learn as much as they can and be the very best student they can be. Killing yourself for an A is not productive either. Doing your absolute best, whatever that may be at any given time, is what's productive and will lead to success.

You're going to find all kinds of nurses: those whom made poor grades but are excellent bedside nurses, those with good grades and "book sense" but not common sense or compassion.

Most of us are between the two extremes, we make decent grades and we're excllent nurses.

Specializes in med/surg.

You were spot on when you said that the real knowledge comes from on the job experience. She will gain a base of knowledge in school but wont really apply it until she is out there practicing. I would just like to add a few thoughts on this.

1. Some of the best nurses I know (I have been on the floor for 7 years as an LPN and am just about to finish my first semester of RN school) were C students. Tell her not to get all hung up on the letter grade.

2. School is most certainly jumping through hoops, learning the basics, and you will be surprised what you really do end up knowing no matter what your grades reflect.

3. Sometimes the answer is not the most correct but the least wrong. You can usually narrow things down to two answers, then have to decide what they want you to choose. Remember the question is a big part but Airway, Breathing, Circulation and Maslow's heirarchy etc always apply as well. My point here is that even if it is a mental health test, if your question is asking which of four patients you should see first, the one who cant breathe will always come first. Every time.

4. Relax. Make sure that she is taking time to recharge herself. Sometimes taking 2 hours to watch a movie is more important than studying. Not every night but once in a while. If she is constantly pushing then she will run herself dry and wont be able to get ahead at all.

And tell her I said Good Luck!!!!!!

I used to obsess about my grades in nursing school.

Now as a RN, I obsess about not making any mistakes that will kill someone.

Grades don't mean anything in the real world of nursing. You can have straight A's in nursing school, pass boards with 75 questions, and can't connect the dots as RN and end up making a mistake that will kill someone. Too much book smarts and not enough common sense.

Then you can be a C student in nursing school and actually "get it" as an ICU nurse so much that the doctors respect your opinion and nursing judgment. I work with a nurse who says she was a C student in nursing school, but YEARS of experience as an ICU nurse you would think she should be an instructor. She is well respected and the resource person on our unit.

When it comes to the real world of nursing, nursing school is a walk in the park!

I have to say that I was not the best student in my BSN program. I worked and had a social life but still studied my butt off-I don't do well studying to just pass the test. The whole picture-essay-type tests work better for me or an oral "putting it all together" test. I recall taking a test like that (esay) for a post-cardiac rotation and getting an A-the instructor wrote a note of how well thought my answer was-it involved the teaching,tests,complications, etc. for a particular procedure. I'm sure she was shocked by my performance on that test :redpinkhe

My GPA was 3.0 upon graduation. I passed the NCLEX the first time-there were a few straight A students in my class that did not pass their first NCLEX exam(various reasons) and they also struggled putting the whole picture together during the live clinicals.

That was 18 years ago and I am now pursuing an MSN in Education (who would have thought!) with all A's.

I took great care of my patients while doing direct patient care. Grades do NOT tell the whole picture-I should have been a mediocre nurse if there truly was a correlation between grades and being a nurse. Never thought I was mediocre and was told otherwise so I guess I'll believe it.

School is tough-maybe she could study with others so she is aware of what is expected with a certain instructor(those that are getting the A's)-is she studying the right content? Flashcards worked well for me for some concepts.

otessa

Specializes in Surgical Nursing.

Nursing school is incredibly tough. They make it this way in an attempt to prepare you for a tough job. While nursing is rewarding there are many times when our job is pretty hairy.

I'm a new grad and I have to say at this point I'm finding my job a bit more stressful than school.... Except that when I leave I don't have to go home and study.... I think that getting through nursing school is a huge accomplishment no matter what the grade may be.... In fact one of my classmates (who I know will make an EXCELLENT nurse) didn't make it through school her first time... Tell her your friend not to give up. Nursing school is the way it is for a reason...

Also.... I believe (although I've got less than a year's experience) that the type of nurse you are improves with experience. There are all types of nurses out there and they've all got different experiences. You just can't get that in school.

You're friend's concerns are valid. I think that her drive to do well in school shows that she cares about what she is doing. It means more to her to do well than to just skate by. She will make a wonderful nurse.

Specializes in Long-term care, home health.

My best friend had a hard time in nursing school, and was on "probation" for borderline grades. She failed her state boards the first time. But she FLOURISHED as a nurse when she got out in the real working world! She is an excellent nurse with great patient teaching skills. So great grades do not necessarily make a great nurse. Some people just do not "test" well on paper, but have excellent practical skills.

Specializes in Critical Care, Education.

hmm - I am really bothered by the OP's assumption that nursing school may actually be a barrier to actual practice as well as some responses that tend to indicate a disconnect between knowledge and practice -- that 'book learning' does not equate to clinical proficiency.

I would like to offer a different perspective. In order to become a proficient nurse, one has to have the 'intellectual horsepower' needed to learn a wide range of fundamentals. It is also necessary to learn how to learn because nursing requires a lifelong commitment to the acquisition of new knowledge. We are engaged in a practice profession, so there is also a requirement not only to become adept at physical tasks, but also to be able to continually analyze an ever-changing patient/situation and apply reasoning skills to determine which - among many options - is the best one to take. And we have to do it all very quickly. If you aren't able to sort through the old brain and pull up the appropriate 'book learning' when you need it, your reasoning will be flawed.

Looking back, I can think of very little in my basic nursing education that I have not had occasion to apply at some point in my career. Of course, I didn't always realize it at the time but it turns out that all that 'stuff' was necessary.... well, maybe not nursing theorists.

"hmm - I am really bothered by the OP's assumption that nursing school may actually be a barrier to actual practice"

I think I probably chose my words poorly. I only meant that nursing school must be completed before one can become a nurse, not that it is in any way unnecessary.

I would say that in my own career, even though my profession does not necessarily require a degree, I did indeed earn a relevant degree. And I would say that I definetly learned some fundamental things in school, but after many years of experience, I feel that the knowledge I most need to do my job I did not learn in school - rather I gained it from actual work, and that knowledge that I gained complimented and built upon what I learned in school. I probably wouldn't have been able to be successful in my industry if I didn't learn many things in my degree program, because I wouldn't have had the background knowledge to learn what I've learned and apply it. On the other hand, I can assure you that when I left school, while I certainly had a good understanding of many concepts, I in no way understood every single nuance of the cirriculum, there were certainly some areas where I was weaker than others, and my grades were decent but not stellar. But I did learn what I needed to to be successful, despite that. So my post was meant to ask you all for your insights in terms of how similar the nursing profession is in those regards.

Didn't mean to offend, only to verify assumptions that I knew I was making without necessarily having the best basis for doing so.

Specializes in Med Surg, Ortho.

I will tell you that in my opinion, I think a lot of the 'real' knowledge does come from actual job experience. I'm not saying there isn't much learned in nursing school, because one learns very much in nursing school. When I started working, it was so much different than school. However, there were a lot of situations that come up that I remember learning in school but it sure doesn't take making an A or B in these classes.

I was an A student in my prereqs and it was all I could do to keep at least a B. A lot of students I graduated with made Cs. Almost half our class failed completely. So you tell your friend that grades don't make the nurse.

I've seen people make straight As but don't have a lick of common sense.

The only thing I would suggest for your friend is to tell her to read her chapters in her nursing books. There are a lot of things that can be learned about nursing by reading the books and some times these will not be covered on a test or in a review.

But seriously, she needs to quit being so hard on herself. I'm sure she will make a great nurse.

Specializes in med-surg 5 years geriatrics 12 years.

I worried constantly about grades in the beginning until a friend pointed out that if you graduate with a 4.0 you are magna cum laude and if you graduate with B's and a few C's they call you" nurse ". Some of the best nurses I know got decent grades. The grade itself does not always indicate how well you use the information floating around in your brain.

In the working world, patients, family of patients, MDs, and fellow nurses never ask about your class standing or GPA working in nursing school. Same as MDs. You're a nurse, doctor, etc. What counts is what you can do on the floor.

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