Help with getting through the last year of school. Need advice.

ZanatuBelmont · Jul 14, 2009

As I am entering my 3rd and 4th semester of my nursing program, I am feeling more and more frustrated with being sure that I can actually survive and do good as a nurse. The nursing program I am in considers it's 3rd semester as the most difficult, and since I did struggle with my 1st and 2nd, I am not ready to face another year of torture. I truly enjoy helping, caring, and nursing patients from giving meds to changing briefs, but I feel like I am at a mid-college crisis.
Some of my friends who have graduated in other majors, tell me that they have also gone through the same feelings while they were in their last year of college as well. They, too, were also unsure of their abilities, but sometimes I doubt that they understand how stressful it is to be a nursing student. Our final exams are comprehensive every semester - unlike a certain other major that only has 2 chapters to review for a final; our dosage calculations exams determine if we pass the semester or not; and the pressure is enormous!
What I am asking is - are their any other graduate nursing students - who felt the same way I am feeling now. Any words of encouragement and how can I cope with this?
Kim

I think during NS we are built up to believe we have to be a superhero and make no mistakes our first six months working, but that's just not how it is. There are times I hear people discussing something (an illness, for instance) and what they intend to "do" about it. All of the sudden I have a "click" inside and I start going through these different priorities for care, comfort, and health maintenance in my mind. I imagine it will be similar on the floor as a nurse - you know, having that "click."

Unfortunately for all we learn in NS we know very little, but we are more prepared when we think. The information you have learned is in there, somewhere, in a dusty filing cabinet. I imagine when you're on the floor you'll naturally "go" the right direction and instinctively ask for a second opinion from another nurse, worried more about your patient rather than your image as a "competent nurse."

Try not to beat yourself up. You have two semesters and all you can do is learn the most you can. You'll never be "ready" for the floor, but one step at a time you will become confident. And remember, if you've taken nothing out of nursing school besides ABC's and how to maintain a patent airway, then you're already ahead of the game.

h1hasinai · Jul 14, 2009

Hey Zanatu,

Thanks for your reply. It helps a lot to have any encouragement - it seems I need it constantly when I am not even in school. The places where we seem to have a break is when I seem to freak out the most!

Kim

Daytonite, BSN, RN · Jul 14, 2009

kim. . .if you are thinking that rn nursing is primarily about helping, caring, and nursing patients from giving meds to changing briefs you got incorrect information. rns are problem solvers and managers of patient care. of course, part of the reason you need to know how to give meds and change diapers is in order to collect information in helping you to make some of those decisions. most of the academic (book learning) part of nursing school has primarily been all new information that you have had to learn and a lot of it has been thrown at you in a short period of time. much of it you had very little foundational experience upon which to layer it. that is why it has been so stressful for you--and for most every other nursing student who has gone through an rn program. in addition, you are being asked to begin critical thinking through problems in nursing using something called the nursing process (based on the scientific process) which you may have never heard of before and which doesn't make a lot of sense at the moment. however, it is important to how we rns function in our daily jobs.

when you were learning how to tie your shoelaces (if you can remember back that far) did you feel like quitting every time you couldn't get the sequence of how to tie the laces correct? when you were learning how to keep your balance and ride a 2-wheeler bike did you feel like quitting every time you lost your balance and fell? when you were learning how to drive a car how many times did you make errors, get scared and think that you would never become a good driver? did you quit or are you still driving? why?

the very unique thing about nursing (and medicine, for that matter) is that what you are learning about disease, its treatment, nursing problems and their resolution is greatly enhanced by actually having patients in the clinical area that experience these problems and being right there and involved in the management of them. your experience as a student doing this will be limited to observation and discussion at best. so, you have to read about them over and over--talk about them with your fellow students--look for patients at clinicals where these things might have happened and ask the staff nurses what went on. in other words, nose around and ask questions. watch the rns and look at what they are doing at their jobs. i was told very early in my course of study by staff rns that the rns run the units and are the final word on what goes on with the patients. they demonstrated it every day. rns are managers and supervisors of patient care and in order to be that we have to know about the medical diseases and conditions patients can get, how the docs test, discover and treat them and how nurses assist the docs in the treatment as well as treat and assist the patients in their response to their medical situation. it's a lot to be aware of, but that is why we are managers and supervisors of patient care and not just med passers and diaper changers. to help you study use the critical thinking flow sheet for nursing students and read about the nursing process to help you understand what critical thinking is:

http://www.mac.edu/faculty/nursingdepartment/200%20level/nursing_process.htm#return%20to%20top - the nursing process - a short introductory tutorial of what it is
http://www06.homepage.villanova.edu/elizabeth.bruderle/1103/nursingprocess.htm - the nursing process

feelings are ok to have and i understand that you are feeling a bit bummed right now. however, let me remind you that nursing is a career based on science and cool, rational thinking. when you graduate you will get a degree in the science of nursing and not the feelings of nursing. you need to keep asking yourself why questions in relation to what is happening to patients and their disease process and treatment. ask yourself why we do the nursing treatments we do. ask yourself why a doctor orders the things he does. being able to answer those why questions is the reason we rns are at the top of the nursing chain. once you learn that you can always make room to be compassionate and kind to patients, pass medication, change diapers, help coworkers, etc. i started in nursing school knowing absolutely nothing about nursing process, how to manage patient care or supervise--but i learned--and so can you. you just have to be persistent. thousands before you and i mastered how to do it and thousands after us will master it. even after i was out of school there was always something i was looking up in a book and reading to find out more about. your learning and desire to understand the why of what is going on with your patients as a nurse should never end after school is over.

the nursing process is nothing more than problem solving. an analogy to the real world. . .

you are driving along and suddenly you hear a bang, you start having trouble controlling your car's direction and it's hard to keep your hands on the steering wheel. you pull over to the side of the road. "what's wrong?" you're thinking. you look over the dashboard and none of the warning lights are blinking. you decide to get out of the car and take a look at the outside of the vehicle. you start walking around it. then, you see it. a huge nail is sticking out of one of the rear tires and the tire is noticeably deflated. what you have just done is step #1 of the nursing process--performed an assessment. you determine that you have a flat tire. you have just done step #2 of the nursing process--made a diagnosis. the little squirrel starts running like crazy in the wheel up in your brain. the spare tire needs to be put on the car. (your goal) "what do i do?" you are thinking. you could call aaa. no, you can save the money and do it yourself. you can replace the tire by changing out the flat one with the spare in the trunk. good thing you took that class in how to do simple maintenance and repairs on a car! you have just done step #3 of the nursing process--planning (developed a goal and intervention). you get the jack and spare tire out of the trunk, roll up your sleeves and get to work. you have just done step #4 of the nursing process--implementation of the plan. after the new tire is installed you put the flat one in the trunk along with the jack, dust yourself off, take a long drink of that bottle of water you had with you and prepare to drive off. you begin slowly to test the feel as you drive. good. everything seems fine. the spare tire seems to be ok and off you go and on your way. you have just done step #5 of the nursing process--evaluation (determined if your goal was met).

VickyRN, MSN, DNP, RN · Jul 14, 2009

Awesome post, Daytonite! :)

h1hasinai · Jul 14, 2009

Boy, you are one mean and rational cheerleader. :cheers: Thanks for the analogy - and I swear you could be one of my professors because she told me a very similar story with the flat tire.

I forget that I do have the ability to perform a nursing process and do it almost immediately without being aware of it.

Muchas gracias!

Daytonite, BSN, RN · Jul 14, 2009

hang in there!

the only real mistake is the one from which we learn nothing.

education is a progressive discovery of our own ignorance.

likatutata · Jul 15, 2009

my program is pretty much the same way...3rd semester is the killer. i just finished it.

going into third semester, i had doubts if i was smart enough to do it. i didn't know if i wanted to do it...i thought maybe i'd be happier if i just quit and sat for the LPN boards. but i decided to tough it out and see how the semester went. i'm not going to lie, it sucked. there were times when i thought about dropping out and taking the LPN exam. but my fiance convinced me to stick it out and i passed with a B average.

you can do it. it's only 3 months...3 difficult months, but it will be over before you know it!:heartbeat:heartbeat:heartbeat

ZanatuBelmont · Jul 15, 2009

Daytonite, that was an excellent response. I never looked at it that way. I've been asked many times what nursing "means to me." I always replied with the typical "compassionate care" reply, but looking at it from a scientific perspective makes more sense and, to be honest, changes my view of nursing into a more professional one. I wish my instructors would have put it as you have. There are times I feel like I've learned more from this forum than I have in class and studying the books. I don't know if that's good or bad.

Daytonite, BSN, RN · Jul 15, 2009

Daytonite, that was an excellent response. I never looked at it that way. I've been asked many times what nursing "means to me." I always replied with the typical "compassionate care" reply, but looking at it from a scientific perspective makes more sense and, to be honest, changes my view of nursing into a more professional one. I wish my instructors would have put it as you have. There are times I feel like I've learned more from this forum than I have in class and studying the books. I don't know if that's good or bad.

It is just another viewpoint to add to your perspective that you carry within you. It helps define how you will practice as a nurse. If you like it, you take the parts of it you like and carry them on with you. You leave those that aren't a fit for you behind. That is what makes each of us unique. Now, go forth and spread your uniqueness with others.