what am I missing here

First off, you need to forget the idea that you can study/think/live the same way you did during pre-reqs. I was a 4.0 student during pre-reqs and cried myself to sleep every night of first semester when I couldn't climb out of the 80s. (yes, I'm OCD). My instructor told me "Get over it, no one gets an A in nursing school". That was NOT what I wanted to hear and just pushed me even harder. Needless to say, even wanting soooo badly to prove her wrong all these semesters, I have never been able to pull out an A for a final grade and I graduate in a month. Anyway, I'm just saying its very frustrating but you can't compare pre-reqs to nursing. Its apples and oranges

Ok, with the discouragement out of the way LOL...( i didnt mean that last paragraph to sound so harsh). Let's move on to studying. You need to be able to understand the concepts. Not just memorizing the facts. Nursing is about application and critical thinking. Yes, you can memorize but do you know what it means??? Can you explain what you just read to a 10 yr old? If you can't then you don't know it. Can you go a step further....for instance....If you have hypocalcemia you have tetany and cramping.....can you take it a further step and think "ok what is that gonna do to the heart?"

Next think about yourself on the floor of the hospital. You are the nurse. In report your coworker says that your pt's calcium came back at 7.2 and he is complaining of cramping. She didn't do anything about it because....well, just because she's a slacker and you aren't LOL. So what do you do? Don't know??????? you didnt learn it. You memorized.

Try taking things a step further. If you are like me, you have to visualize the scenario and that helps it "stick".

Thirdly, get to the meat and potatoes. If your textbook is anything like ours it is chock full of FLUFF and I mean A LOT of fluff. Read a couple paragraphs, don't take any notes. Read the paragraph again. Now can you paraphrase what the book said in a way that you can understand?

For example we are studying cardiac output and stroke volume and starlings law etc.,etc., What I wrote in my notes? a comparison of a stretching rubber band shooting a wad of paper across the room. Yep, very medical and very professional. But it works for me and I know what it means. Try recapping and get rid of the fluff.

Hope this helps and i didnt sound too harsh. I didnt mean to. I've been there and I completely understand how frustrating it is. And if you are anything like me, you still won't "let it go". But thats ok, just know you aren't alone :))

Good Luck!!