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Discussion

Need help ASAP please!

Can someone recommend a good book or resource that takes the knowledge base learning of nursing school and helps to apply it as far as application? I have always been a good student and started the program with a 4.0. Learning the material is not the problem, its using the knowledge in the way a nurse would. My instructors are teaching us the knowledge but they aren't showing us how to apply the knowledge and then we are getting tested as if we should just know. I need help or I am not going to make it past this first semester. Please let me know if there are any resources you recommend for taking the knowledge to the next step and actually applying it to patient care.

I appreciate your help!

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    • Featured Replies

    Critical thinking skills....NCLEX format questions. :-) I say buy an NCLEX book and practice, practice, practice.

    It has been several years since I was in nursing school....I'm sure someone can recommend a good study guide.

    Good luck and hang in there.

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    • Expert

    Well no they don't teach you how to apply it. That's where you have to do your part.It also comes with experience.

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    • Author

    Why wouldn't they teach us how to apply the knowledge? Isn't that the point of being in nursing school? If they don't teach us how to use the information then how can we take care of our patients?

    I did buy the Saunders NCLEX book and I am working through that. I guess I am looking for something that says "If the patient has this wrong with them, the nurse will want to do this, that, and the other." Is there nothing out there like this?

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    this is where critical thinking is important.. not all patients that present with the same signs and symptoms have the same underlying problem and not everyone with a specific disease process present the same.

    Not everyone that has difficulty breathing is going to have COPD and not every COPD pt will have difficulty breathing..

    it is up to us to determine what is going on based on signs and symptoms and how best to intervene.. And this is the basis of the application style questions..

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    Why wouldn't they teach us how to apply the knowledge? Isn't that the point of being in nursing school? If they don't teach us how to use the information then how can we take care of our patients?

    I did buy the Saunders NCLEX book and I am working through that. I guess I am looking for something that says "If the patient has this wrong with them, the nurse will want to do this, that, and the other." Is there nothing out there like this?

    Nursing and medicine is not, in general, cookie cutter where you can apply a simple algorithm and be done with it. Yes, there are algorithm's in medicine but it still requires critical thinking on the part of the practitioner. Thus, that is why nursing and medicine are not practiced by robots and drones. Most any med/surg nursing textbook will give you a list of things to do for certain conditions (ex. if a patient is having a seizure protect the head, turn them on their side, etc..). The application of the material is where you come in, you need to make that bridge from the information given to the application of that information in the safe care of your patient(s). If you're having difficulty with that then you should sit down and speak with your Professor(s).

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    What about a care plan book? Or reading in your fundamentals book where it has care plans. Hesi case studies, and Critical Thinking Cases in Nursing by Winningham. I don't mean to oversimplify, but these helped me. Hope it helps you, first semester is stressful.

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    • Expert
    Why wouldn't they teach us how to apply the knowledge? Isn't that the point of being in nursing school? If they don't teach us how to use the information then how can we take care of our patients?

    I did buy the Saunders NCLEX book and I am working through that. I guess I am looking for something that says "If the patient has this wrong with them, the nurse will want to do this, that, and the other." Is there nothing out there like this?

    it's not that simple. Each patient and each scenario is different. this where you have to use your judgement and critical thinking skills. There is no cut and dried procedure for all patients and trust me, your patients will not be anything like the textbook cases you will study. plus each patient has their own unique medical history so each patient will have to be assessed as an individual.

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    For applying material I really find that two things work: visualizing the patient, and talking about the material.

    I do not really use any resources for this because im too poor to buy extra books but you can take everything you learn and draw a picture in your head of how that situation would present to you (this is easiest done if you have a lot of clinical i think) from there you can ask yourself "using my nursing process what am i going to do about this and in what order and why"? thats basically how the nclex based questions want you to think.

    The other thing that helps is discussing the material with another class mate, just going through it with someone else how they would approach it vs how you would all strengthens you on the test.

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    You need to check out the nursing book section at B&N. There are many books that give information on taking care of patients. A care plan book will have tons of information on how to take care of pts and why. There are other books like "Survivors quide to Critical care and ER nursing". Good job for being proactive on learning.

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    Learning how to apply that knowledge will come with time in nursing school. For your exams you should focus on the pathophysiology and how to apply the nursing process to each diagnosis. That means what you want to assess, the goals, interventions, and last but not least evaluation. :)

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    Why wouldn't they teach us how to apply the knowledge? Isn't that the point of being in nursing school? If they don't teach us how to use the information then how can we take care of our patients?

    I did buy the Saunders NCLEX book and I am working through that. I guess I am looking for something that says "If the patient has this wrong with them, the nurse will want to do this, that, and the other." Is there nothing out there like this?

    This sounds suspiciously like the dreaded care plans! Seriously, developing your nursing care plans [when the time comes] is where you will start to take the facts you have learned and apply them to real situations with real patients. You are only first semester, so you are at this point only really learning the fundamentals that every thing else will build on throughout the course.

    Be patient...you will learn one step at a time, building your knowledge base every step.

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    • Expert

    ABC (airway patent, is pt breathing? does he have a pulse/circulation?

    Care Plans

    Nursing Process

    Use all of your senses (sight, smell, hearing, touch, etc.)

    Consult with others (peers, doc, etc. - your Instructors for now)

    Doctors' Orders

    Policies of the facility and of your school

    Laws in your state

    Possible Scenario for you: You see that a pt falls out of bed. BEFORE YOU MOVE HIM: You assess that he is alert, he seems to know his name but can't tell you why he fell. His limbs appear to be in normal alignment. You see no bleeding or OBVIOUS injury or APPARENT broken bones. He's on his back. There are no bruises on his chest or abdomen - yet. VS are pretty normal. AS A STUDENT: what do you do next? (plan and action) Get your Instructor. Don't leave him if you can help it. Or have someone else stay with him, you go get the Instructor (or another nurse if you can't find the Instructor quickly). Then follow the lead of the Instructor or nurse.

    What they will do is just what you did - inspection for injuries, assess neuro status - orientation/confusion, pupils, handgrips, and moving all limbs as before the fall - and VS, & get enough help to get him back onto the bed. They will notify the doctor, do an Incident Report, chart on him, notify the family or guardian, re-assess the pt soon (like within 15 or 20 minutes), evaluate for pain, do another set of VS, gently wake him if he appears to be asleep, chart again, and make a point of rectifying any hazardous situations and putting the call light, TV remote, water, Kleenex, urinal, etc. within easy reach. You can also ask the Pharmacist to advise about any meds that might be contributing to disorientation, weakness, slow pulse or low BP and inform the doc to see if he/she thinks new orders are needed. Are labs WNL? If not, which ones are out of whack? Why might this be? You should let the doc know about these, too.

    Try to only call the doc once, so that means you need to gather all the information first. (VS, neuro check results, any apparent injuries, most recent labs, input from Pharmacist, also input from staff or others (roommate, visitors, housekeepers, etc.) who know the pt or saw/heard anything related to this incident.

    Is the pt scheduled for surgery or a procedure that now needs to be postponed? Notify the surgeon/others, like Radiology if the pt's scheduled MRI is going to be postponed.

    You can never do too many VS, you can never do too many neuro checks. Does the pt have a glass eye? Was he blind or deaf to begin with?

    Learn by watching what other nurses do.

    Suppose a pt has a seizure. What is your course of action as a student? What does your care plan book say to do? What does the Policy and Procedure Manual of your hospital or nursing home say to do?

    If a woman comes into your ER and is having what she says are labor pains, what do you do as a student?

    A woman c/o chest pain in the waiting room of the clinic where you are a student. What do you do?

    A pedestrian is hit by a car. You are a student. Now what? Does your state require you to help? I would call 911, I would not move the person unless not moving him will cause further injury (like drowning, getting run over again, or something else very serious). I would get someone else to direct traffic, someone to try to prevent the driver from leaving the scene. Try to keep the victim warm, still, NPO, and talking/alert/conscious. Pray for 911 responders to arrive quickly. Are there any other victims?

    Try to practice scenarios like this with other students. I think you'll be fine. Why do you think you won't make it through the semester?

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