Nursing school vs. actually starting nursing

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I just started nursing school this month and all the info I am learning about disease pathology, acid-base balance, etc. seems overwhelming.

I am wondering what is the role of the nurse exactly when she/he finds out that a patient has a problem with acid-base balance or a lab value that is abnormal?

Are we supposed to know by memory most of the pathologies associated with certain abnormal lab values..(ie if a pt. has high CO2, they can have resp. acidosis which can be manifested in various diseases, etc)...or can we look up info we don't know while we are working?

I guess I am wondering how much info we really have to memorize or 'know' what to DO when we see an abnormality..or do we always call the doc, etc?

Do nurses carry PDAs with info they can pull up about diseases, etc. or procedures to do in certain cases?

Or are we supposed to know Most of this stuff by graduation. It just seems like so much info to me.

How do first year nurses know exactly what to do in emergency situations..if it's something they didn't encounter in nursing school clinicals..do they always need to ask a superior..if they are available?

I guess I'm just a bit nervous of how it will actually be when I start nursing.

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How do first year nurses know exactly what to do in emergency situations..if it's something they didn't encounter in nursing school clinicals..do they always need to ask a superior..if they are available?

Remember in any emergency situation it is always the ABC's first.

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Specializes in Telemetry/Med Surg.

Whew....well it is a lot of information and the more you use it, you will get used to seeing what's in normal limits and what is not.

One piece of advice I can give you is to learn and try to retain everything you learn each semester because the subject will always resurface in following semesters. For example, learning acid base balance in freshman year, I kinda forgot the values, etc. only to have it reappear again in junior and senior year.

Good luck to you. :)

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Specializes in Pediatrics Only.

In any situation thats abnormal, its best to CYA and notify the doctor. If you are not sure, there are so many other nurses around to help you.

I can tell how nervous you sound from everything you wrote- and yes, the first year is nerve-racking! When you decide to work in a hospital setting, you are never alone. You have your own patients, but hopefully, you are part of a team with all the other nurses and they will help you.

Never be afraid to ask questions- if you dont, thats a bad thing. New nurses dont know everything- its impossible too. There is too much to learn that is crammed into 2 or 4 years of schooling.

A PDA is a great thing. I use mine all the time to look up drugs, always have a calculator on hand to do drug calcs, and there are tons of programs you can put on there, such as an acid base one to help you determine what is wrong with the patient. You can look up as much information as you want while working. Remember its better to not know something and to ask or look it up, then it is to guess and risk something happening.

On a side note- I'm still considered a first year nursing student. I graduated in May 2005 from an RN, BSN program. I worked in a hospital for 3 months on a Ped/Med Surg floor ( + 1/12 years previous to that as a nurses aide), and now I'm doing Pediatric Private Duty nursing - which requires a LOT of assessment skills, and knowledge. I know some people dont go into the hospital setting right away and dont mind doing hospice or another aspect of nursing - but I beleive that the hospital is the best place for a new nurse to start off, and it helps to strengthen your clinical and assessment skills so that you can become a better, more independent, nurse.

One last thing- any hospital you go to, you need to make sure you get a good orientation. Not just one or 2 weeks, but like, 8-12 of being with a preceptor so that the preceptor can help you along the way so that you do become a better nurse!

Good luck! And remember, you just started nursing school- you will get more confident as the semesters pass!

-Meghan :nurse:

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Meghan,

Thanks for the info and encouragement.

It just seems so much info to learn and I wonder how do we actually apply it at work. Our Patho instructor has been giving us case scenarios of pts. problems and we have to determine what possible disease he/she has. I just thought it was the doc's job to diagnosis a disease. There are so many different diseases that can have similar symptoms, that I wonder how we could actually know what disease it is.

I guess the instructor is just giving practice excercises, so we can get an idea of the type of symptoms we will encounter. But I got scared thinking that as nurses we are expected to 'know' what the pt. has..or what exactly to do if we see something abnormal. I know we can ask nurses for help..but I know there will come a time when we are no longer 'new' nurses and expected to figure things out ourselves.

But since there are SO many diseases and similar symptoms, I just thought it's impossible to figure everything out without looking up some info.

Our instructor is teaching us to caluculate meds w/o using a calculator since she said nurses can't use one. I was wondering how true that was, since some of these calculations can take a while to figure out by hand..esp. if a person has forgotten how to convert fractions to decimals, etc. I thought calculators would be used for less errors possibilities.

Thanks for your words of encouragement.

In any situation thats abnormal, its best to CYA and notify the doctor. If you are not sure, there are so many other nurses around to help you.

I can tell how nervous you sound from everything you wrote- and yes, the first year is nerve-racking! When you decide to work in a hospital setting, you are never alone. You have your own patients, but hopefully, you are part of a team with all the other nurses and they will help you.

Never be afraid to ask questions- if you dont, thats a bad thing. New nurses dont know everything- its impossible too. There is too much to learn that is crammed into 2 or 4 years of schooling.

A PDA is a great thing. I use mine all the time to look up drugs, always have a calculator on hand to do drug calcs, and there are tons of programs you can put on there, such as an acid base one to help you determine what is wrong with the patient. You can look up as much information as you want while working. Remember its better to not know something and to ask or look it up, then it is to guess and risk something happening.

On a side note- I'm still considered a first year nursing student. I graduated in May 2005 from an RN, BSN program. I worked in a hospital for 3 months on a Ped/Med Surg floor ( + 1/12 years previous to that as a nurses aide), and now I'm doing Pediatric Private Duty nursing - which requires a LOT of assessment skills, and knowledge. I know some people dont go into the hospital setting right away and dont mind doing hospice or another aspect of nursing - but I beleive that the hospital is the best place for a new nurse to start off, and it helps to strengthen your clinical and assessment skills so that you can become a better, more independent, nurse.

One last thing- any hospital you go to, you need to make sure you get a good orientation. Not just one or 2 weeks, but like, 8-12 of being with a preceptor so that the preceptor can help you along the way so that you do become a better nurse!

Good luck! And remember, you just started nursing school- you will get more confident as the semesters pass!

-Meghan :nurse:

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Thanks for the words of encouragement. I am just overwhelmed right now, but I guess you're right and I will get used to it.

Whew....well it is a lot of information and the more you use it, you will get used to seeing what's in normal limits and what is not.

One piece of advice I can give you is to learn and try to retain everything you learn each semester because the subject will always resurface in following semesters. For example, learning acid base balance in freshman year, I kinda forgot the values, etc. only to have it reappear again in junior and senior year.

Good luck to you. :)

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Specializes in Education, Acute, Med/Surg, Tele, etc.

The answer to your question about can you reference values and what not while you are on the floor...yes, usually there are books available, and heck, on crazy days it is almost essential for me to re-look up things I know I know but am to overwhelmed to remember at that point. LOL! If you don't see a book you like, bring yours and keep it in your locker or what not... Don't let that be a huge fear factor...the more you work with these things the more familiar you will be with values, just learn your basics, try to remember them, and don't scare yourself out of getting that info out of the brain when the time comes! LOL! (Nursing Made Incredibly Easy series of books on these subjects are AWESOME! Go get them...helped me big time! Funny, down to earth, and give you great techiques and storys to remember them by).

And a fun piece of advise for you about emergencies...I did ride alongs as a student nurse with paramedics and it was the BEST! Getting to see what to do in emergencies takes much of the initial fear and puts it into perspective! Best thing I ever did in nursing school!! Most ambulance companies will allow a student RN ride along...it is just good PR and knowledge for both sides!

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Specializes in Education, Acute, Med/Surg, Tele, etc.

While I am thinking of it...back to emergencies. A little pearl of wisdom I depend on that helps me!

If a person is not breathing and has no pulse they are dead, so anything you do to help after that point is a bonus in this very grave situation (yes pun intended to a point there...LOL!). Also, depending on the situation...in a code situation or other emergencies...a nurse can hit the call light or a Code light and people come a running...so it isn't like you are alone! You will have help!

I can't say that of other patients I have had that had less symptoms but still had a very serious acute situation brewing~! And in those cases...good assessment skills and asking for help from others is a good thing!!! You don't go into this all knowing everything!

And don't freak out...that patient needs your brainpower! I once had to do CPR on a patient and the nurse doing compressions was so nervous she actually STOPPED for a moment because she lost count of her compressions! NO! That doesn't matter...as long as compressions are being done, that is a good thing! I wound up taking over and doing one man because she was so freaked out! And she cried for days feeling so upset about it...Save yourself that, and just stay as calm as you can and follow your ABC's and CPR :)...at least in these cases we have a protocol to go by!

Most of us initially feared these aspects, and some of us still do even with experience! This is very normal, and knowing that potential limitation in your own personality is a good thing...can't fix something you don't know is broken! Try to gain experience in it during clinicals if possible (like watch a code in progress), ride along with paramedics, do a stent in the ED, and talk to other healthcare providers that have 'been there done that' for great advice! The more experience, the less scary it is...trust me! :)

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Specializes in Acute rehab/geriatrics/cardiac rehab.

MiaNJ - take it one day at a time. It's hard to worry about nursing school and what you will do when you graduate. Concentrate on what you need to know right now and you won't feel so ovewhelmed.

Yes nursing school is a lot of information. After that there is the NCLEX to pass, and then that first year of work. Right now, concentrate on getting through nursing school. :)

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Specializes in Geriatrics, Cardiac, ICU.

Why on earth wouldn't a nurse be allowed to use a calculator at work?

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hang in there.... it will get easier. I know what you mean about being stressed. I just started my senior year in a BSN program. It is a lot to know! I suggest making notecards for things you need to know and just keep going over them. Don't just try to memorize things; concentrate on really understanding the process... it will most definitely come back to haunt you in future courses!! Just try to study over your notes everyday a little... you will be surprised by how much you remember!!

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Ooo, this post has made me feel SOOO much better...haven't started nursing school yet but this is the sort of thing I worry about....my "secret fear", if you will.... :uhoh3: :imbar :uhoh21:

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