How To Survive (and Thrive) In Nursing School

86toronado, BSN, RN

While there are some great answers from some wonderfully knowledgeable and patient nurses out there, I thought a how-to guide with every tip and secret I can think of, plus some more that I've only read about, would be an excellent resource for student nurses to have.

Do These Things Before Nursing School

STEP 1 Get A Job In Healthcare!

You can be a CNA, a patient care assistant, a unit clerk, or even a patient transporter with little to no experience needed. Be sure to mention on your job application that you are considering going to nursing school, hr people love that.

There are many reasons that this is the first thing I tell people who ask me about becoming a nurse. First and foremost is that no matter what you may think you know about being a nurse, there is nothing like observing what nurses do from day-to-day in the real world rather than on tv to help you decide if it's really for you. Consider it an anthropological study. Every different field from banking to food service has its own culture, it's own set of unspoken rules. The sooner you learn what they are, the more likely you are to be successful down the road as a nursing student and as a nurse.

Other great reasons to get a healthcare job before nursing school?

Um, let me see...

Professional contacts, possible tuition assistance, and oh let's not forget having a paycheck while in school. Don't tell me you don't have the time either. You can work per diem most places by just putting in a couple of shifts per month.

STEP 2 Get Your Prerequisites Done Before Your Nursing Courses.

The requirements vary from school to school, but even if your school will allow you to take Microbiology, etc. While you are matriculated as a nursing student, it's just not a good idea. Your grades in one course or the other will suffer. Believe me and the others on this website when we say the nursing school will dominate your life. (I will give you some good ways to keep it from doing so later on, but for now, just believe us)

Getting Started As A Nursing School Student

STEP 1 Go To Class. Pay Attention. Remove Distraction.

It sounds so very simple, yet for so many reasons, just doesn't happen. Let's go over some big-time distractors, and what to do about them:

Mobile Phone. If you really can't sit in a lecture hall for two hours without texting or updating your facebook status, then for heaven's sake leave the phone in your car! If you need your phone with you for emergencies (and by emergency, I mean actual blood, tears and vomit do not count) then leave it in your bag on vibrate. You will hear it.

Friends. You've gotta have them, but you don't have to sit with them during class. If your friends tend to goof off and talk during lecture, do one of two things. Either sit somewhere without them or get them all to sit in the very front row of the lecture hall with you. No one goofs off in the front row.

Sleep. I have a friend who failed her third semester of nursing school because she just couldn't stay awake during class. She was working full-time night shift, so it was a tough situation. But everyone has obstacles they must overcome to be successful. If you can't stay awake during classes, here are some suggestions: try and switch to a class that better reflects your sleep schedule. My friend requested evening classes but was told there was no space. You know what? The lecture classes were so big that no one would have noticed an extra face in the crowd once or twice. She could have easily gone to the evening lecture if she fell asleep during the day one to find out what she missed. Another good option is tape recording the lectures. Actually, this is a good idea even if you aren't a sleepy head. Record the lecture and play it back in your car, on your headphones while working out, etc.

In my experience, 50-75% of the material covered on exams is covered ad nauseam in lecture.

STEP 2 Read Smart. Read Efficiently.

What you really need to get out of the reading are the nursing responsibilities. While it's great to know the in-depth pathophysiology of the diseases you are studying, you are going to nursing school, not medical school. The things you will be tested on are the nursing diagnosis(s) associated with the disease, the nursing interventions, and the patient education required.

TIP: Get some little tiny post-it notes and label the pages in the reading that cover these, and refer to them PRN.

Get some NCLEX review books now. "but I'm not even close to graduating yet" trust me. They're like cliff's notes for nursing. "but I don't have the money to buy extra books right now" buy them used on eBay, borrow them from someone at work (see #1 in pre-nursing section) who's already passed NCLEX , or just go to Barnes & Noble and sit and read them there. Once I discovered these wonderful books, I rarely even brought my actual textbooks to nursing school anymore. They're much lighter to carry around and they cut out all but the most important things that a nurse needs to know for each disease process. They are, in short, a godsend.

STEP 3 Study NCLEX Questions.

Answer a set number of questions, then go back and review the rationales for the ones you got wrong. Figure out why you got it wrong, go back and study the material again if you need to. Repeat. Plan on doing 100+ questions a week during your first year of nursing school, and increase it during your final semesters. By the time the NCLEX rolls around, you should be doing at least 500 practice questions a week.

There are tons of resources for them online, and most of the review books that you will be getting anyway come with cd's that have thousands of them. Don't believe your teachers when they say they write all of their own questions. They are getting their questions or at least the basic formats for them from these very same resources. Nursing school questions are unlike anything you've ever experienced before. I hear from people all the time that they aced their prerequisites and are barely maintaining a C average in nursing. It's because the questions are different, and the very best way to know how to answer them is practice.

Surviving Clinicals

STEP 1 Be A Goody Two Shoes.

Not in a brown nosing, teacher's pet sort of way, but in a way that shows that you are a professional who knows how to behave in a professional setting sort of way. I hated going to clinical when I was in nursing school. I was out of my element, I didn't know where things were, I didn't know who people were, and I wasn't familiar with the facility's documentation system. And I'm just not a morning person in general. But I treated it like a job. I showed up at least 15 minutes early every morning to get my assignment and ask the night nurse (If I could find him or her) how the patient's night went, what was new, and get report. And you know what? Because my instructor knew that I could be counted on to do these things, by the end of the semester not only was I getting the choice assignments, I was also the one sent to help out other students with things they were unfamiliar with when the instructor was too busy. I also usually had my care plans and other paperwork done before I even left for the day, because I was able to use the time in the morning to get it started.

STEP 2 Be Nosy.

Find out what is going on on the floor that day. Are there any bedside procedures like a tee, or a PICC line placement being done? Even if it's not on your patient, ask if you can observe (check with your school's policy, and get the patient's permission of course). Be nice to the floor nurses, tell them you are interested in learning just about anything, and if they invite you to help them out or watch them do something like an iv started or a dressing change for god's sake don't say "I've already done/seen that." even if you have.

STEP 3 When You have Downtime, Help Your Fellow Students.

Not only is it just the right thing to do, but you may also find that you learn something, or see something you hadn't seen before just by going in a room to help another student do a bed bath. And next time you are in the weeds someone will owe you a favor!

STEP 4 Go To Class and Pay Attention.

Being comfortable touching, talking to and just being around patients is one of the biggest obstacles that many nursing students have to overcome when they start their clinical experiences. If you have already done that, it will be that much easier for you.

The Final Act: Being a Graduate Nurse

For those of you who are still with me, bravo! I never anticipated this article becoming this long. But anyway, here's how to get started as a graduate nurse:

STEP 1 Start Applying To Jobs Early.

This has become so much more important with the economy in the toilet like it is now, but even in the good times, if you are going to be a may graduate, start applying no later than February. That's right, I said February. Facilities only have so many resources to train new graduates, and so will orient them in stages. If you are counting on having a paycheck coming in June, you want to be one of the first new graduates hired. If you heeded my pre-nursing advice and already have a job in a healthcare facility, consider it a foot in the door, but don't count on being hired by that facility. Apply early, follow up, and above all, be professional. Have your resume and cover letter proofread by as many people as you can. Ask your instructors and nurse managers if you may use them as professional references. Dress appropriately for the interview. If you have difficulty knowing what appropriate is, look at what your nurse manager wears to work. If he or she wears khakis and a button-down, you should wear khakis, a button down and a jacket. Always go one step above what is expected.

STEP 2 Prepare Yourself For Interview Questions.

Know where you want to work, and why you want to work there but be flexible with your expectations. If you want to work ICU or another sought-after specialty, have some good reasons why you want to do so, and also some good reasons why you will be the best candidate for the job. Don't say "because I need the ICU experience to get into nurse anesthetist school". And if you are interviewing for a med-surg job when what you really want is labor and delivery, be honest without being too honest. A great phrase is "I want to work on this unit because I know that having a solid med-surg background will serve me well in whatever specialty I go into eventually"

STEP 3 Take The NCLEX As Soon As Possible.

You are already doing 500+ NCLEX questions a week. You already have all of the review books. You have essentially been studying for this test for the past two (or four if you are a BSN graduate) years. You are ready. If you don't believe me, take a review class. If you want to pay for Kaplan or something like it, by all means, do so, but there are plenty of other options. Many healthcare facilities offer free review classes to their new graduate nurses, so that is something to look into before you pay for one yourself. What you should definitely not do is wait. Statistically the longer you wait to take the NCLEX the higher your odds are of not passing on the first try. It's true, look it up. Take it within three months of graduation at the longest. And don't listen to everyone who tells you it's the hardest test they ever took. For me, it was the easiest test I'd taken in two years.

That is it. I have spilled my wealth of knowledge regarding nursing school, and everything that comes before and after. If you really do take my advice, I don't think there is any way you could not be successful. And for my parting words, I will quote my friend Abby, who once told me that "c equals degree man, don't sweat it!"

Check out this video on Career Specialty - Which option is best for you?

mommajoz · Feb 16, 2011

Thanks for the article! I could not agree with you more about the NCLEX books being like cliff notes for nursing... they are a true life-saver.

CeilingCat, ASN, RN · Feb 16, 2011

In retrospect, I'd say step #1 is to pick the RIGHT nursing program to go to. Some aren't a good match for some students. Some aren't so good overall. Some expect students to teach themselves almost everything. Some have huge class sizes, which may overwhelm you. Judging a school based only on nclex pass rates doesn't mean much -- some bad schools know how to look good simply by aggressively weeding the class size down to only the top students. Talk to multiple previous grads of that school and current students, if you can. Visit the school(s) during session. Check out the instructors reviews (eg. ratemyprofessor.com) and anything else you can find out about them. All it takes is a single aggressive instructor who feels their mission is to weed out people they don't like, and you may find yourself failed out of a clinical rotation based on very subjective grades. Just because a school has a wait-list to get in does not mean it's good. By the time you add everything up plus interest from a loan, your nursing education could be a $50,000 or more investment... so take the time beforehand to research it as much as possible.

FreudianSlip · Feb 16, 2011

Well written and insightful. In my opinion, the things that I see students struggle the most with is not preparing their life to accomodate their education. Nursing school is an all consuming lifestyle that requires that you put your life "on rails" ,so to speak, so that it will run mostly smooth without a lot of chaos and drama. If you can do that, you will actually enjoy some aspects of your education. Without that, it can become to some students one disagreeable chore after another. Nothing is worse than seeing a student show up to clinical with a look of dread (or worse, boredom) because they would rather be elsewhere.

ojcrush · Feb 16, 2011

Love the article, 86toronado. Always looking for tips and advice from a seasoned nurse/student! Keep it comin'!! Getting on Amazon tonight to buy a current NCLEX book. I'm an LPN to RN transition student and had used an NCLEX book in the past, very helpful. I hadn't thought of using it as cliff notes or study guide.

Did you do a nurse grad externship or student nurse internship? Do you have any suggestions on how to find a nurse mentor while in school, someone to ask "real nursing world" questions?

StudentNurse2011 · Feb 16, 2011

Awesome article; thanks for the tips!

May I add an addendum to Academic Tip #3?

One of my nurse friends suggested that for the 1st 2 semesters of nursing school, I should study from an NCLEX-PN book. The last 2 semesters, study from an NCLEX-RN book. It saved my life. Between the NCLEX books and ATI study guides, I very rarely picked up a textbook - and did very well in school.

86toronado, BSN, RN · Feb 17, 2011

ojcrush said:
Love the article, 86toronado. Always looking for tips and advice from a seasoned nurse/student! Keep it comin'!! Getting on Amazon tonight to buy a current NCLEX book. I'm an LPN to RN transition student and had used an NCLEX book in the past, very helpful. I hadn't thought of using it as cliff notes or study guide.
Did you do a nurse grad externship or student nurse internship? Do you have any suggestions on how to find a nurse mentor while in school, someone to ask "real nursing world" questions?

Thanks for all the great comments, keep them coming. To answer your question about the externship/internship, I did do an externship through my nursing school during my final semester. I also ended up working on that unit when I graduated, so my time with my preceptor was nearly 6 months altogether. So I guess you could say she became my mentor when I was a new graduate, although by working in the field throughout nursing school I had lots of help along the way.

From the seasoned nurses on my unit, I got tips on staying organized (when working ICU, always label your IV lines near the patient, as well as on the pump. During a code you don't want to get the wrong one). While the recent new graduates had lots of great advice on school issues (when in Mrs. L's mental health rotation, never wear denim pants, even if they look professional, she will send you home and mark you absent).

DizzyLizzyNurse · Feb 17, 2011

I'm only half joking but did we go to nursing school together? I failed out of my third semester because I couldn't stay awake in class because of my full time midnights job and was told I couldn't get into afternoons because it was too full......???? I did make it to afternoons and graduated in December.....

I agree with helping your fellow students and they'll help you back but also assist the aides and nurses if you can during clinical. They will LOVE you for it. They are more likely to hunt you down to show you something 'cool' or teach you something if you have a few minutes.

86toronado, BSN, RN · Feb 17, 2011

DizzyLizzyNurse said:
I'm only half joking but did we go to nursing school together? I failed out of my third semester because I couldn't stay awake in class because of my full time midnights job and was told I couldn't get into afternoons because it was too full......???? I did make it to afternoons and graduated in December.....
I agree with helping your fellow students and they'll help you back but also assist the aides and nurses if you can during clinical. They will LOVE you for it. They are more likely to hunt you down to show you something 'cool' or teach you something if you have a few minutes.

You can't be the friend I'm talking about, because she's still in school, hopefully graduating in May... she got a job where she only works weekends, and is doing much better, although they still haven't let her into evening classes

Totally true about helping everyone on the floor out... that is the best way to see new things, and to get the unit staff to like you... that and donuts I mean.

tokidokifantasy · Feb 19, 2011

Thanks OP, I couldn't agree more. Every time I get my test back, regardless if it's an A or B, I learn some valuable lessons from it. Last test, I got a B, and I realized the biggest mistake I made was not having a healthy breakfast. My brain was not functioning too great that day, I answered all hard questions correctly and missed all easy questions. LOL!! Eat healthy breakfast really helps, I blame it on the sugar in the soymilk that day. It was too sweet! =)

heather.f · Feb 21, 2011

Thank you so much for all the great tips... I have been guilty of slumming at the local Barns n Noble at the NCLEX section already, though most was nonsensical to me - I have not started school yet. I am due to start school in Aug and definitly need all the tips and hints I can unearth. I have a 400mile commute and 4 children (all under 7) at home to contend with while going to school. I fully agree about the point of helping others being a great learing tool - 2 semesters of my wait list time I was a cadaver lab TA, great refresher.

USMLong · Feb 22, 2011

I took notes! Thanks!