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How do you think like a nurse?

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by Born2Care4All Born2Care4All (New Member) New Member

1,814 Visitors; 32 Posts

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I have successfully completed my first semester of nursing school. I did good an A in assessment and clinical but I barely got a B in theory. At final evaluations my instructor told me that I could do better in theory if I began to "think like a nurse when answering test questions "...I was so excited that I got a B in the class that I left without asking her to explain what she meant. It seems like I can narrow down to two questions but they both seems right and for some reason I as always choose the wrong one. Am I the only person that does this? Any suggestions on How I can do better?

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3,108 Visitors; 41 Posts

What I learned my first go round was RATIONALES, RATIONALES, RATIONALES.....thinking like a nurse involves RATIONALE, the who what when where and why of a situation.

Example:

Leaving without asking her what she meant, is NOT thinking like a nurse......going back and asking her what she meant (in a NICE way)...IS.......CONGRATULATIONS though you are definitely on your way!!! Keep us posted :up:

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rubato works as a RN.

15,582 Visitors; 1,111 Posts

I do it too, but as the semester progressed I got a lot better at picking the right answer. I think a lot of it comes down to knowing, in each nursing situation, what your priorities are. When is it a priority to look at vitals, when is it a priority to call the doctor, when is it a priority to handle it yourself, etc..... Everyone hypes up the "critical thinking" skills that nurses have, but it's true. You need to see through all the extraneous information and look at what's important. You'll get the hang of it, I'm sure. :)

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Shorty11 works as a RN in MICU/CCU.

6,811 Visitors; 309 Posts

I think it comes with practice... and experience. I agree with the previous two posters.

Critical thinking skills, rationales, and prioritization.

Think about the why at all times. Why is this the priority? Why is that the right answer and not this one?... the rationale behind it.

You will improve the farther you progress in the program. I had a hard time at first too.

Go over questions that are similar to the type you have struggled with. Think about the criteria you used to eliminate some of the answer choices and try and take it one step further to narrow it down to THE answer. I like to practice questions with a book like Saunder's NCLEX Review. Rationales are provided for why the right answer is the right answer, and why the others aren't. It will start to click with some practice. Best of luck!

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895 Visitors; 13 Posts

I really struggled with this in nursing school and I ended up failing out of the program because of it. I got my LPN and working as a nurse for a year before I went back in.

The class I failed the first time (critical care.. last semester), I got an A in the second time. It was due to the experience working as a nurse has given me... it gave me that "insight" I suppose. Working as an LPN not only gave me a boost of confidence (stopped second guessing my answers), but it also helped me to say, well what if this happened to me on the floor.. what is the first thing I would do? What is the most important?

I agree with the others, priority is how to think like a nurse. You have to put yourself into the situation and think about it as if you were working with a real patient in clinical. My instructor once said to me... what is going to kill them the fastest? ABCs and all that.

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3,188 Visitors; 185 Posts

To think like a nurse, you must be able to apply ABC, Maslow's Hierarchy, Nursing Process, priorities, infection control, and all what you learned in Med Surg, Pharmacology,Maternity, Pediatric, and Psychiatric Nursing. Connect your vast knowledge in all the subjects above and deliver a safe nursing care.

Go over some NCLEX books to help you think critically.

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1,814 Visitors; 32 Posts

Thank you all for the responses! I am going into med/surg rotation next semester and I look forward to be able to build on what I already know but I must admit I am scared to death. "The terror" has sunk in from upper levels telling me that they failed this semester because of the same thing THEORY.

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2 Articles; 13,797 Visitors; 11,114 Posts

I counseled a student who was dead certain sure that a number of her exam questions had TWO correct answers and she was being unfairly penalized because her faculty wasn't giving her credit for her choices. There were, to her mind, TWO "best answers." Alas , she was wrong on every single one. Perhaps an example will help explain what "thinking like a nurse" means.

 

1). You are working in an outpatient setting and a woman who is well-known to you comes in with yet another set of injuries from her husband in a fit of rage. She says she will not leave him, she loves him, he is so sorry, gave her flowers, and promises he will never do it again. What do you say to her?

 

(two of the four answers are totally wrong, so you can eliminate them ... so you have to choose between these two)

a. "And yet you are here again. Let's try to think of a way to keep you safe."

b. "The research shows he will do it again, and it could be worse next time. You have to leave him."

 

Both look like "good" answers. Both are factually true and contain a second phrase. Which to choose? Well, we know (or will know) that the nurse's job is not to direct care but to help the person along the path to wellness using specific kinds of interventions. Which one of these answers does that? Right, A, because the nurse does not deny the patient's decision (patients are allowed to make bad decisions even if we don't like them) but points out a fact known to the patient ("And yet you are here again") and then offers to engage her in a way for her to make choices about how to plan a way to improve her health (".. a way to keep you safe"). The patient can then discuss options along those lines-- how to recognize the cycle of abuse, how to see when his behavior is beginning to escalate, keep a bag packed, have a cell phone, keep a little money for travel, know the women's shelter hotline phone by heart, how not to internalize his abuse as her own fault, whatever....

 

While choice B is factually true (he probably will beat the crap out of her again, and it likely will escalate), it denies her feelings and desires (she loves him, she has decided not to leave him), and tells her what to do (even though she has already said she won't). So it will make the patient shut down and not hear another word the nurse says. She's not going to leave him. Saying this offers her nothing she can use. It does not recognize the ultimate nursing value of patient autonomy and does nothing to take the patient along the path towards health.

 

That's thinking like a nurse. For starters.

 

Alas, my client was wrong on every single such question. She glommed onto the factually-correct answer, but just did not recognize the example of a higher level of engagement a nurse owes a patient. It was just a teeny bit beyond her. She truly did not get why her "factually correct" answer wasn't just as good as the higher-level one, the best answer. That's why she failed her last semester.

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2,363 Visitors; 27 Posts

All I can tell you is that as a student, DO NOT THINK FOR THE EXAMINER. This means that you should use the situation given by the exminer, don't add or subtract any thing. In clinicals, look for abnormalities i.e. when looking at a patient, look for anything that's not right, say he walks one sided, ask yourself WHY. That will guide you to ask more questions (assessment) to findout HOW & WHEN. Good luck

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463 Visitors; 1 Post

my name surendar kumar can any 1 tell me that how can find nursing books online

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10,173 Visitors; 520 Posts

my name surendar kumar can any 1 tell me that how can find nursing books online

You'll get more answers by starting your own seperate thread. For books, check Amazon.com

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DnvrOutdoorsRN has 5 years experience and works as a CTICU RN.

1,594 Visitors; 28 Posts

This takes practice! I'm a newly graduated 2nd degree BSN nurse. The first true nursing test I took in fundamentals, I think I barely passed with a 74. I was flustered and confused. I walked up to the professor after class and before I even spoke, she could tell what I was going to ask. Her advice:

- Don't assume anything that isn't written, adding information to the question.

- Rule out answers that don't fit the situation.

- Nursing tests are not designed to trick you.

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