6 months in med surg...uncomfortable

RookieRoo · Jun 3, 2015

I think you should stop focusing so much on how to think like your instructor and instead, just concentrate on learning the material. On the NCLEX you will not be able to think like the creators of the test to know the right answer... you will just need to know the material. By all means try audio books if you think that will work for you. FYI, I learn the same way and reading the book while taking notes works beautifully for me. I would also use this break to review some of the systems you feel shaky on.

Natasha A., CNA, LVN · Jun 4, 2015

AGE87 thanks. I'm trying the audio books. I realize I need additional help to see if I'm note taking the substantive content that's necessary and if I am spotting the key issues and facts. I'm currently looking into a tutor for one-on-one feedback to help me learn HOW to take nursing school exams, how to read the exam questions,how to spot the exam issues, and how to provide the proper exam answer. My goal with the tutor will be to get a perspective on how the questions are written, see how the answers are formatted and see the content of the answers.

a classmate told me to start a reading schedule to break the chapters up.

Plutonium261 · Jun 7, 2015

One of the issues I see with your critical thinking is a similar issue I originally had when I started out in my RN program and going from thinking like an EMT to thinking along the lines of an RN, and that is an issue of being task oriented. We become so use to being task oriented and doing "things" that need to get done instead of thinking about the patient's problems and what needs to be done in order to correct or help correct the problem. As a CNA there are specific things or steps you learn to do for each situation, on top of being very limited to what you are able to do per scope of practice. If this happens do this, otherwise alert the RN (or LVN). As an LVN (which if I'm not mistaken is what you are currently working towards) you are a higher level nurse, actually licensed, and so need to think at a higher level and thus more critically. It's not just about facts and things being black and white anymore. You need to, or need to learn to, think abstractly or outside of the box a little. So when you get a question regarding what to do for a respiratory patient who's having trouble breathing you need to know that chances are you need to first sit them up. Semi-fowlers is really just another name for sit them up right, so if you see one of the answers is to put that patient into a recliner or a chair of some kind (to sit them up) (and I'm not sure what any of the other answer options were), that's what you need to do.

You have to get it out of your head of trying to think like your instructor or the people writing the exams, and just learn the material itself. Learn the clinical manifestations and the nursing interventions for those manifestations and you will be so much better off. You sort of answered one of your own questions with stating that when you are taking notes in class to also write different examples for different interventions. That's a great idea, and one that I use while taking notes. If you continuously write different examples down for different things it will help your mind get in the habit of thinking of multiple options or interventions in the moment during clinical rotations or on exams. Go out and buy a book or two on NCLEX style questioning to help with this as well. There are plenty of them out there, and they have rationales to help you understand why an answer is what it is. As far as being a slow reader, that's unfortunately something that you should really just practice and practice some more. There is so much material to learn and so much reading to do in any nursing program, whether it is an LVN or an RN program, and/or throughout your career as a nurse. This especially goes if you are ever planning on furthering your education and becoming an RN (ADN, BSN, or MSN). There is a lot of material and reading to do. Learn to like reading now. I wish you luck with all your studies.

Plutonium261 · Jun 7, 2015

P.S. I'm in an accelerated BSN program and we also only get a week off every ten weeks, and I usually use this time (after I take a few days off to myself and my family) to try and brush up on some of the things I was weak on during the previous term. It is a perfect time to reflect and work on your time management and/or the way you study and your study habits. Work on it now while you have time so when your term starts back up you are a little more prepared and ready.

Natasha A., CNA, LVN · Jun 7, 2015

One of the issues I see with your critical thinking is a similar issue I originally had when I started out in my RN program and going from thinking like an EMT to thinking along the lines of an RN, and that is an issue of being task oriented. We become so use to being task oriented and doing "things" that need to get done instead of thinking about the patient's problems and what needs to be done in order to correct or help correct the problem. As a CNA there are specific things or steps you learn to do for each situation, on top of being very limited to what you are able to do per scope of practice. If this happens do this, otherwise alert the RN (or LVN). As an LVN (which if I'm not mistaken is what you are currently working towards) you are a higher level nurse, actually licensed, and so need to think at a higher level and thus more critically. It's not just about facts and things being black and white anymore. You need to, or need to learn to, think abstractly or outside of the box a little. So when you get a question regarding what to do for a respiratory patient who's having trouble breathing you need to know that chances are you need to first sit them up. Semi-fowlers is really just another name for sit them up right, so if you see one of the answers is to put that patient into a recliner or a chair of some kind (to sit them up) (and I'm not sure what any of the other answer options were), that's what you need to do.
You have to get it out of your head of trying to think like your instructor or the people writing the exams, and just learn the material itself. Learn the clinical manifestations and the nursing interventions for those manifestations and you will be so much better off. You sort of answered one of your own questions with stating that when you are taking notes in class to also write different examples for different interventions. That's a great idea, and one that I use while taking notes. If you continuously write different examples down for different things it will help your mind get in the habit of thinking of multiple options or interventions in the moment during clinical rotations or on exams. Go out and buy a book or two on NCLEX style questioning to help with this as well. There are plenty of them out there, and they have rationales to help you understand why an answer is what it is. As far as being a slow reader, that's unfortunately something that you should really just practice and practice some more. There is so much material to learn and so much reading to do in any nursing program, whether it is an LVN or an RN program, and/or throughout your career as a nurse. This especially goes if you are ever planning on furthering your education and becoming an RN (ADN, BSN, or MSN). There is a lot of material and reading to do. Learn to like reading now. I wish you luck with all your studies.

Thank you Plute62 for this amazing post! You have hit the nail on the wall when you mentioned "task oriented" thinking vs critical thinking. I do have a habit of not separating facts vs inference What I am learning thus far is that I need to strengthen my critical thinking, critical reading and critical listening. I have set up an appointment with a tutor who is also a lvn instructor from a different school and hopefully she will be a great fit. Far as you stating that in nursing school, learning the black and white can get you so far....yes, I am seeing that lol. and once I learn how to analyze hypo nclex questions with the tutor for understanding the key concepts and how to apply concepts to new hypo questions, I should hopefully start to see the light at the end of the tunnel.

I already have nclex books and although I do practice on my own, I need additional feedback besides writing the rationales because i'm learning that its the bigger picture that matters.

I have given up so much on learning how to think like my professor and more toward taking an exam and figuring out where the exam questions were from lecture or book or both,etc. what is the rule of each question and why important, etc. most of my previous exams I started to see a pattern of my professor testing us in inference of maslow hierarchy physiological needs point of view. I started seeing the key concepts related to activity, airway, food, elimination, , fluid balance and test us from difficulty swallowing, or positioning, any type of life threatening outcomes