Is it normal to go from straight As in prereqs to b- grades in nursing classes

Anna Flaxis, BSN, RN · Oct 3, 2012

Yes, it is normal. Nursing courses are much tougher than straight ahead science classes, as it should be. If you make it, you're going to have lives in your hands. If you can't make it in nursing school, you shouldn't be a nurse. No matter how nice, empathetic, caring, compassionate, and personable you are, if you can't think your way out of a paper bag, you have no business providing bedside care. Yes, people skills are important, and the best nurses possess both a higher than average intelligence and better than average interpersonal skills; however, I don't care how nice you are, if you can't think, I don't want you taking care of me or mine.

Guest343211 · Oct 3, 2012

Yes, it is normal. Nursing courses are much tougher than straight ahead science classes, as it should be. If you make it, you're going to have lives in your hands. If you can't make it in nursing school, you shouldn't be a nurse. No matter how nice, empathetic, caring, compassionate, and personable you are, if you can't think your way out of a paper bag, you have no business providing bedside care. Yes, people skills are important, and the best nurses possess both a higher than average intelligence and better than average interpersonal skills; however, I don't care how nice you are, if you can't think, I don't want you taking care of me or mine.

My answer to this has always been that it's not an either or kind of thing. If you CARE, you will make it your business to know your stuff. At the same time, knowing your stuff does make not caring or being compassionate OK. It's both not either/or. I have worked with people that know their stuff as nurses, but were far from compassionate or caring--or they simply pretended to be compassionate when certain others were around. This is BS to me. You either care or you don't. You care enough to learn and keep learning, and you can enough to develop a caring, empathetic approach and are genuine about it.

If someone is say a surgeon, I may overlook the empathetic aspect b/c the immediate need is the insight, adeptness, judgment, and overall skills for the surgery. He or she may or may not be managing the patient for a while. So yes, it would be good if he or she had some empathy and understanding too.

But if you are functiong as a nurse or in a pt-mgt, primary care role, yes you need to be competent, bright, and caring. End of story. Of course this is just one nurse's opinion.

Anna Flaxis, BSN, RN · Oct 3, 2012

My answer to this has always been that it's not an either or kind of thing. If you CARE, you will make it your business to know your stuff. At the same time, knowing your stuff does make not caring or being compassionate OK. It's both not either/or. I have worked with people that know their stuff as nurses, but were far from compassionate or caring--or they simply pretended to be compassionate when certain others were around. This is BS to me. You either care or you don't. You care enough to learn and keep learning, and you can enough to develop a caring, empathetic approach and are genuine about it.
If someone is say a surgeon, I may overlook the empathetic aspect b/c the immediate need is the insight, adeptness, judgment, and overall skills for the surgery. He or she may or may not be managing the patient for a while. So yes, it would be good if he or she had some empathy and understanding too.
But if you are functiong as a nurse or in a pt-mgt, primary care role, yes you need to be competent, bright, and caring. End of story. Of course this is just one nurse's opinion.

I'm not sure where I said it's either/or, or that caring is not important. In fact, I specifically stated "the best nurses possess both a higher than average intelligence and better than average interpersonal skills". I think we are in agreement that nursing, at least good nursing requires both qualities.

However, if you stand by the bedside wringing your hands instead of starting compressions, I don't really give a rip how much you "care". If you see a K+ of 2 and fail to notify the physician, it doesn't matter to me how much you "care". You can be as sympathetic and sweet as can be, but if you can't function at a basic level of competency, then all the caring in the world matters not to me.

Of COURSE caring is important. I would rather the nurse taking care of me cares than not. However, just caring isn't enough to make a person competent as a nurse. One must also possess the aptitude. Aptitude + caring attitude makes for the best nurses. I won't argue with that.

Just as you have seen nurses lacking in compassion, I have seen nurses lacking in brain power; nurses that make me wonder how in the world they ever passed the NCLEX, let alone haven't killed anyone (yet). And the only reason they're still practicing is that they're "nice" and the patients don't want to get them in trouble. But they are far from safe.

So yes, I agree, it shouldn't be either/or. All I was saying is that nursing school is tough for a good reason. Wouldn't you agree with that?

Nurse Kyles, BSN, RN · Oct 4, 2012

I think it is normal for your grades to take a dip initially. As you learn to study and apply your knowledge, your exam scores should increase. To study for tests, make sure that you are practicing NCLEX questions. Does your school provide any NCLEX question data bank (such as NCLEX 4000 or the Kaplan program?) These types of programs help you learn how to answer NCLEX questions and apply your knowledge. My program implemented Kaplan my very last semester, and I wish I would have known about the Kaplan NCLEX Decision Tree much sooner. I would purchase the Kaplan RN course book, which you can get for pretty cheap on ebay. This book puts all the need to know information into outline format. Read the reviews on this amazon link. Even at $42 it is totally worth it, and an invaluable study tool! http://www.amazon.com/Course-Preparation-NCLEX-RN-Examination-Edition/dp/B007IECFNQ/ref=pd_sxp_f_i It also has the Kaplan decision tree, which really is helpful on the NCLEX and NCLEX type higher level application questions. Good Luck!

CT Pixie, BSN, RN · Oct 4, 2012

I was an A student for my pre-reqs, now I'm holding steady to an 83 average (need 80 or better to pass). It's very humbling! I strive to the highest grade I can get but in the end, I need an 80, I won't beat myself up if I don't get an A.

QuarterLife88, MSN, RN, NP · Oct 4, 2012

I got all A's in my pre-reqs and one A minus. In nursing school I've gotten mostly B pluses one A and a stray A minus in lab sections. I'm all right with my B plus average gpa. In the pre-reqs there were 50-100 pts per exam so you could get a lot wrong and still well. In nursing school you may only have 25-30 pts per exam with only 175 - 200 pts for the WHOLE course. It's very easy to have your grade drop if you miss a few. It's very easy to fail. I don't get worked up about it. I passed, it's done.

LaRoseRN · Oct 4, 2012

Hey there,

Like you, I was a straight-A student until nursing school and I struggled to keep my scores up in the beginning. My program demanded an 80% or higher to pass and I was just getting by. I think a dip in grades is a very normal experience for a lot of nursing students.

Nursing courses are just different than the standard prerequisites. At one point, I developed some pretty bad test anxiety because it was such a different testing format than what I had been used to (I learned NOT to drink coffee on test days because it heightened my jitters! Totally different approach than regular school...) I felt like I studied and studied and studied non-stop, all the time. I knew a lot of information, but as posters have noted previously, nursing school is about applying that information towards critical thinking in assessing and treating a patient. Different from straight memorization and regurgitation. When all the answers are right, which one is the MOST right? Here I thought I was such a stellar student, but I kept over-thinking everything and tripping myself up. Geez.

The good thing was, I got better at it. I worked on strategies for cracking the nursing school-type test questions and soon brought my grades up to high B's and A's again. Whew! It was certainly a very humbling experience, nerve-wracking, and very satisfying once it all began to click. I was so proud when I graduated.

Study groups are great, regularly checking in with your instructors, voicing your concerns, and being proactive about getting the help you need will also serve you well.

Good luck!!

PacoUSA, BSN, RN · Oct 4, 2012

I was a straight-A student in prereqs, and got 3 Bs in nursing school. Still passed NCLEX without a hitch and got a job right after graduation.

My patients could care less that I got those 3 Bs.

Stephalump · Oct 4, 2012

Well, nowadays most nursing students had A's in prereqs and most nursing students do not have straight A's in nursing school. So yes, it's completely normal. As everyone else has mentioned, prereqs and nursing school are different. All most schools require are basic, entry level courses. Some people can't meet the challenges those courses bring and some succeed. Those who succeed go to nursing school where the bar of difficulty is raised. So what happens? The curve reappears. Only a few make A's and most everyone else falls in the B/C range. If you continue in your education it'll start all over again.

Which is my long-winded way of saying: yes, it's normal :)

Guest343211 · Oct 4, 2012

I'm not sure where I said it's either/or, or that caring is not important. In fact, I specifically stated "the best nurses possess both a higher than average intelligence and better than average interpersonal skills". I think we are in agreement that nursing, at least good nursing requires both qualities.
However, if you stand by the bedside wringing your hands instead of starting compressions, I don't really give a rip how much you "care". If you see a K+ of 2 and fail to notify the physician, it doesn't matter to me how much you "care". You can be as sympathetic and sweet as can be, but if you can't function at a basic level of competency, then all the caring in the world matters not to me.
Of COURSE caring is important. I would rather the nurse taking care of me cares than not. However, just caring isn't enough to make a person competent as a nurse. One must also possess the aptitude. Aptitude + caring attitude makes for the best nurses. I won't argue with that.
Just as you have seen nurses lacking in compassion, I have seen nurses lacking in brain power; nurses that make me wonder how in the world they ever passed the NCLEX, let alone haven't killed anyone (yet). And the only reason they're still practicing is that they're "nice" and the patients don't want to get them in trouble. But they are far from safe.
So yes, I agree, it shouldn't be either/or. All I was saying is that nursing school is tough for a good reason. Wouldn't you agree with that?

B/c true reasoning and understanding is not achieved by taking extremes. I have heard sooo many nurses say knowledge is the key thing. No, it is what you do with the knowledge and how you do it that is the key thing. This tells us then the knowledge is a prerequisite to the real issue of practice and how one practices.

People that don't know what they are doing, in general, haven't taken the time to understand that compassion means rightful application of knowledge. That is the real issue.

What we hear in discussions is "I'd rather have this than that." No, that isn't the real issue; for if you care, you will learn and know how to apply--and you will do this for the core reason, at least ideally, that you care. The two are tightly linked--really merged. True care = knowledge and the right application of knowledge. If nurses lack knowledge to practice safely and effectively, they really need to ask themselves how much they care. Of course no one wants a buffoon as a nurse or doctor. That is a given.

And yes. I do agree about nursing school. In fact, I think it should be a heck of a lot tougher. I think objective measures should be used in the evaluation in school and through a nurse's practice. . .but just try getting employers to embrace this across the board.

SarcasticLVN · Oct 4, 2012

Oh ya the actual nursing classes will require memorization but critical thinking is the main thing. Need to teach your brain how to critically think because that's what nursing is all about! I got all A's in my program except OB and Peds lol.. Not my specialty. b's are great! All that matters is you keep your grades up and think like a nurse :)

Rosa_G · Oct 4, 2012

Totally... Its a learning process... I also started studying the topics and then once I had the topic down- usually summarized onto large index cards, then I would start testing myself from NCLEX review books.. Saunders is good... Lippencott sp? too.. Those helped me to think in NLCEX / Comcept mode... versus memorization mode. Keep your head up...

Our class also started a facebook page to share ideas files study suggestions ETC. If you don't have one in your class - I would totally suggest starting one up.. Its not like med school where we are fighting to be one of the 50% that will make it through and we compete against each other. W/ RN its more of a teamwork thing - So support each other it will make life in nursing school soooooo much easier..

:-)