This

It depends. The opinion of patients is usually only important if you anger them. I managed to build great report with my patients yet when my instructor commented on the subject, she said I "charmed" them as opposed to given them good care. I did however care for a patient who refused students, but I managed to win them over and they refused all other students except me. When I looked at my permanent record, I learned that one of the staff nurses called my instructor with this information. So sometimes you might not hear about it, but it may come back to help you out like karma.

I am currently facing a similar situation myself. I've never had an issue in clinicals and in the past week I've been faced with an instructor who has made a landslide of claims against my performance, some of which are provably false. My dean came to clinicals this week to observe me. Before she left I invited her to watch me hang some medication for a patient who I'd taken care of for the past two days. I performed everything perfect, I checked the armband three times and had the patient verbalize their name and birthday. However, I was told afterward that I had failed good practice because at one point, I had left the room to walk a dozen feet away to grab some replacement tubing, and had failed to re-re-verify the patients armband. Never mind the fact that I scanned their ID before administering the med, and checked the armband before leaving the room after starting the med. After that they were talking like I'm going to be expelled? I don't understand. I had not recalled any practice rule that said "every time you enter the room" it was always "every time you give a medication." Am I just that incompetent? I've got 5 months to grad and its all in jeopardy based on hearsay and a seemingly unwritten rule.

The end-chapter summaries and quizing are excellent paraphrasing for key points, just be careful not to summarize the summary, or else your going to overconcentrate your concentrate, and then your kidneys will fail. Don't worry about how fast you read. Read at the pace that you learn, and prioritize what you need to learn vs what you don't need to learn. Here's an interesting little tidbit that should help calm your nerves: Skeptoid Podcast: Speed Reading http://hw.libsyn.com/p/5/b/3/5b301c19fff46aad/skeptoid-4229.mp3 Reading slow is not a reflection of your capabilities.

Study groups can sometimes reward what you put into them, other times they can indeed be distracting. I approach a well-organized group study as a compliment to come after self-review. I try to apply what I learn and teach it in my own words to my classmates, and if I am struggling with a concept, or to be honest, if I find a subject to be intolerably boring, I ask my classmates how they remember it. Although it has led to some interesting digressions (such as the rational for pregnancy tests on hospital admission: To determine if conception was nosocomial ^_^), on the whole I find that if I can teach a concept to a peer, then my recall is more dynamic. Captain obvious here I know, but it really does stand to reason. Nursing involves a great deal of face-to-face intervention and education, there is no better opportunity to practice and study at the same time. Also, one odd fact is that study groups provide an opportunity to learn concepts in a variety of environments, whether its a lame hipster cafe, a towering library, or next to the tech nerds in the AV room at your local academic institution. Studies have shown that we form tertiary associations of concepts to physical environments. Think about a physiological concept, and now remember why you remember it. I remember the subtleties between blood types and diseases in part because that day they double booked our classroom and we held lecture in a foreign lab. Something interesting to consider.

At the risk of gossip and staff alienation, my peers convinced me to join with about a dozen or more others who are having similar issues. We're all going to compose letters to the Dean of our nursing program with the intention of clarifying specifics rather then let good students fail out for unjustified reasons unrelated to amounts of effort and intelligence. Contrary to beliefs here on the genesis of my concerns, I'm currently passing my class comfortably, however there are many who are not. We are taught as nurses to be part of a team and to hold each other up in the times of greatest need. I passed my boards and got my practical license in spite of a fractured education riddled with false promises, as did many others, but our achievements are being used as justification to force grossly unrealistic requirements and personal commitments to compensate for inadequate instructor support. We thrive on a challenge, but without direction it is just a hostile cycle of exhaustion. Nursing is a path with many faces and not everyone is going to be the pompous ICU or cardiac cath lab nurse who projects their god complex on other nurses because of their slightly uncommon ability to follow a Resident doctors orders exactly and hold a syringe of atropine or bicarb steady during a code. They probably get their due praise in debrief to sustain their ravenous egos, and that's okay with me, but I am none-the-less skeptical of their capacity to stand in a dying strangers home as a hospice nurse and help a family tend to their insurmountable grief and sorrow. One can never be certain. I am comforted that there will always be good mentoring nurses in spite of the shortage and those of us that would rather eat our young. The real point here is I could look the other way and probably make the cut. I couldn't tell you exactly why, but I can at least say its not because I'm smarter or harder working. My peers, especially the working parents, are my heroes and I would rather stand with them. The reasoning is not entirely altruistic, as evidenced by the fact that if it were the other way around, and I was failing by a inch, I sure as heck would hope someone would stand by me. If anything though, I just hope my actions will help encourage a positive experience of unity and not sink the ship under the weight of the delusion of mutiny. Thanks for the advice all and wish me luck. Or insurance.

For me it helps to turn facts into questions. I take the books and find the subjects I'm focusing on and attack the chapter questions. Take the best ones to a study group and talk it out. Don't try to lone wolf it or else you can get sucked down one way thinking. Seize opportunities to teach others concepts you've already learned, this also helps with comprehension because your actively converting facts into concepts when you explain them to someone else. Making jokes it also probably one of the best ways to remember something. Example: why do they do a pregnancy test on admission in the hospital on admission? A: To make sure it wasn't nosocomial.

I was actually looking for an answer to a critical thinking question that involved a set of exacerbating circumstances. I find it peculiar that you have found enough time to browse forums and demean others yet you lack the ability to read information in its entirety and provide specifics. I've never spoken up about this before even after watching unfair events run their course and I speak mostly in the defense of my peers who were shafted, I'm a pretty lousy "white knight" because most of the damage has been done. I can't really respond to someone who doesn't read my posts. I never for one second doubted that nursing is stressful, and I already outlined the fact that most of my instructors are not a reliable resource for questions and help. Its very frustrating. One time I actually went and visited my old A&P instructor because I was getting nowhere with the staff, and it still amazes me that I can pick any subject out of our giant old book and she can lean into it and give me the explanation I need, whereas my instructors pick a set of individual topics from our book and that's it. They refuse to touch anything slightly outside their scope of teaching and it throws me completely off when they can't crossover grounded concepts and points with even basic details like commonly used pharmaceuticals. For one drug I'll have 3 different interpretations of what that drug is and used for and if I relied solely on the word of my teachers, you could never guess they were the same drug without the name. My peers and I lean very heavily on each other to fill in the massive holes in our comprehension, but sometimes you just need guidance, and you shouldn't have to take two hours to answer a question that could have been addressed in five minutes. My clinical instructor this term is great, but they are new to the program so they are limited in their influence and understandably don't want to rock the boat. Thank you!! It does a lot to know someones listening. My point has been grounded on the question of where does one draw the line between what works and what is ethical. I hate it when people just reduce it to "Suck it up or quit". This is not a job, this is an education. This is my entire life. We have sacrificed our work, families, relationships, and even our health to keep up with ungrounded demands that are unsupported and totally ridiculous. This isn't a demand for coddling, its about fairness and abuse of power. I couldn't agree more about the admissions process. We went through heavy scrutiny to get here to prove we take things seriously. However, what is going on here is simply a waste of potential in my opinion. Good students who would make fantastic nurses are getting tossed aside because a lack of coordination, direction, and instruction from our teachers. I don't understand our programs budget and I guess I'm interested to know how much it worth to dump so many good students over keeping a spotless pass rate. GPA in my program is quite meaningless, though I struck an average B, my biased impressions from the HESI was that GPA was a terrible predictor of comprehension and application. Nearly everyone I know who got their license over the summer was a B or C student. This year I do not know of one person who currently has an A, and we've already lost a handful of students this year who had A's last year. Thanks for all your responses, I will consider all the advice, even the condescending stuff from the Super nurses.

Thanks for the response, as stated before, its good to know that we're not alone in our endeavors. I did a quick browse using phrases like "nursing school impossible/hard/ridiculous" but it did not prove efficacious in locating something more recent, so I guess I felt compelled to play the victim, at least according to CCL RN. But on the bright side I am having a blast with clinicals this term. I was granted some independence under the guidance of one of our best clinical instructors and I've felt right at home with my prioritization and acuity. My biggest distraction is watching others struggle because I'm still with one foot in the door but I've been lucky enough to get some really great RNs who don't mind my constant questions. Sometimes I can put on a pretty good face and bluff some confidence for my patients but without those RNs taking time to teach me, I'd be toast. A round of back pats for preceptors.

That prev comment was directed to moorejulie, the header was lost when I sent it. Right so go ahead and explain that one to the working 40-hour week person minus two significant others IE dead, in the same week that you flunk out of a 3 year commitment to nursing school by a difference of about 4 multiple choice questions from an instructor who proclaims that hypoxia and hypoxemia are the same thing, or that you would not expect any dyspnea in COPD patients, and that your failure was completely intrinsic IE your fault. Please tell me exactly how you would address this persons feelings when you are in this position and what coping mechanisms you would tell them to use. In fact please go on to explain what you would do if you had found yourself in this position, because as you implied, your smarter and stronger then roughly 50 peers so I am quite interested in discovering your secret.

Thanks for your input, there's always some release in universality. Some of us students have had sit downs before, heads in our hands, trying to find the point to all this. We all can appreciate the need to weed out the dangerously incompetent like the hypo-mathematics or the overly combative students, but goes much deeper then that. Its a teaching failure, we're listening, but I'm not going to memorize the exact word of the teacher when she confuses glucagon and glycogen. The hardest thing for us to swallow was the fact that no one will really know what we dealt with. I have no right to pretend I'm better, smarter, or tougher then your nursing student a county over, but when I see my other friends from the universities having fun I can't lie that I get a little envious. 1/3rd is insanity. That erks me to a bad degree. We're not stupid! we're just not psychic. I suppose it will make me better able to cope with the stresses in the future, but I wasn't planning on acting grim and stoic for at least another five years. I guess will try to collect myself and keep going. Thanks again.

I did the research and it was implied to me through all the career councilors, newspaper articles, and defunct statistics that this program was the greatest thing since sliced butter. The orientations I attended sold us on the idea that its very hard to get accepted and the application process is very arduous, but once accepted, it was going to be a very positive and supportive experience. It was all a bogus. Once in, we hit the ground running while trying to sort out expectations from a clumsy hack up of random principles hopelessly deluded in a giant pool of supposition. My instructors didn't bother to converge ideas with each other involving overlapping material such as common drugs and clinical impressions. They were almost never available for private discussion and when they were it was kept brief and always diversionary eg. "That's not my subject." To make things worse I later found out that as a student I couldn't voice my complaints publicly about my own program. The option of talking the dean wasn't really on the table because one everyone was scared of student-staff alienation and we were all still in our first year and convinced the situation was a fluke. It was only the rate for last year, we found out after getting accepted from the second years that their numbers had taken a plunge. Rather then focus on curriculum overhaul they just multiplied the difficulty of their tests by an order of magnitude. I can still pull out pharmacology test questions from the first test we had in second quarter and stump a nurse practitioner. Another fact about the pass rate its still as is, where many students in my year did not seek LPN as well as a lot of second years who have staved off the RN for the time being. In my experience my ability to pass the nclex was dependent on my capacity to ignore or replace a large part of my lecture and theory knowledge. I had the opportunity to test this understanding with the HESI and that also factored into my decision to go through with licensure. I recall many classmates doing poorly on it and in general they opted out because of the 600 price tag was a gamble at the time. From my point of view, calling my school a -good- school because the pass rate was 100% is akin to calling a dog -obedient- after you have muzzled his snout and chained him to a fence. It kind of makes me angry too because my concerns are ignored but my achievements in spite of those concerns is misrepresented to sell my programs image, perpetuating the same problems. I didn't say all of them, but generally speaking, the better the instructor, the less influence they had as part of the whole so in the end no student had a single guide in their corner. The faculty leaders gave no support, consistency, rational, or appeal. The clinical groups were rift with problems and we were informed that our program was fighting for placement in its historic resources and losing ground to universities. This implied that our learning experience was especially scrutinized and would have lasting effects depending on how we carried our program. The rule of thumb was if you reported a mistake like a good nurse, you would face the full brunt of your student contract. The learning environment is supposed to be one where you are allowed a casual mistake or two. Our policy was one strike and your out. I can't tell you how stupid the reason was when they booted one person out from a self-reported clinical error, but believe me when I say it was minor and totally indicative that a quota of discipline was being pursued behind the scenes. I can't go into specifics, but as I said, I know for a fact that one out of every twenty or so questions they asked, they took the wrong answer out of their notes. I took them to the testing instructor for my school and they couldn't even reach the teachers to return comment. Emailing the teachers about test questions was pointless and students who did had a very hard time passing subjective clinical outcomes like communication. Its all under wraps. I studied in the main hall frequently and observed the tour guides showing off our simulation laboratories to the freshmen. We only used the sim lab once a term, yet I sat a watch as the tour guides lied through their teeth about all the time we spent in sim and all the incredible functions our simulation mannequins possessed. I also reported this discrepancy to the faculty, yet the same exact thing happened the very next day. I said that the margin of error was about 5%, and that was rather conservative. The point is I don't see the efficacy in failing someone for a 74.4% with those odds. The average hovered just above that with nary an outlier below the established margin of error. We started off first year with the ability to report errors in their tests, but by the end of the year it was basically verboten. The best response I ever got was simply reassurance from the good instructors that "I would make it", absent of an explanation. The worst were demeaning and unpredictable. One minute our books are an all-encompassing resource for my instructors to yank any agreeable citation to affirm themselves with and the next minute I'm hearing an anecdote about the dumb doctor who refused to believe something if it wasn't previously documented. Logic and reason always seem to yield to intuition in my instructors favor. My generation was not raised that way so we experienced a pseudo-ideological clash despite our schools promotion of strictly evidenced based practice. I guess I would argue that questions involved in science like pharmacology and pathophys don't stray into opinion. We recorded our lectures and those scientific concepts are the only questions I focused on for erroneous statements to pull the 5%. Now and then our outlines included reading, but it was just tacked on as a safety net to cover our instructors backs if they left out a key concept. I knew students who didn't even buy the books and scored A's where as I was struggling with low B's and consuming every assigned page of reading in addition to the lectures.We all talked about switching programs but by the time we discovered the depth of deception in our second and third term, it was too far gone for us to transfer out to something this fall. Again, its not hard for the sake of being challenging, its hard for the sake of being hard to force us into filling two molds at once. Our instructors molds, and the nclex's molds, with every and all their repercussions but independent of their guidance or help.

My ASN nursing program is two years long with LPN/LVN diploma after the first year, I'm in the fall term of my second year and I hold a license in nursing. I have come to the conclusion that my school isn't hard for the sake of being challenging, its hard for the sake of being near impossible. Last year my school had a 100% pass rate for both the LPN and RN NCLEX, although the majority of our class was a C average. I am going flat out say this pass rate has nothing to do with the quality of my program and everything to do with the unbelievable tolerance and my restraint my peers have in the face of overwhelming amounts of total BS. I can't depend on most all my instructors for anything. I feel like the butt of some hidden joke that I just can't see. The truth of the matter is, me and my classmates were baited into this program after so many promises on how great the program and its instructors were. We were selected from the best of 500 applicants and went though furious scrutiny to just make it into the program, but as soon as we really took off, we were shafted by our instructors. In a class of all 4.0 students we had around 15 people flunk in the first year, we've probably lost half a dozen this year already. I basically feel like an auto-didactic along with most of my peers because my nursing education is merely an outlet for my faculty to teach me about their own person anecdotes and opinion on how they think a nurse should act. In the rest of my free time I teach myself real nursing school curriculum to build up a real knowledge base for the NCLEX. I can't depend on any of our curriculum for any consistency from lecture to lecture or instructor to instructor. If they mess up the lecture notes they blame us for not memorizing the reading. If we memorize the reading we're told we should have stuck with the powerpoint. We have had several tests where over 75% failed and where told it was "obviously the students fault." We find errors in their tests all the time and I would estimate they fix maybe one in ten questions that they got wrong or gave us one correct choice between two right answers and no proof to back one up over the other. We've all invested 2-3 years of commitment, work, and emotions into passing this program. My instructors know this and only use it as more leverage to set the bar impossibly high. They know we have no choice but to comply and try and stay afloat, because the ONLY thing worse then this program is flunking out and having to waste a whole year and a half(or longer) to roll the dice and risk massive uncertainty on another program. There are no retakes or redos. Its pass/fail with a laughable lettergrade attached as an afterthought. I understand that certainly life is very hard, indifferent, and not always fair, but this is a binary matter of education and measurable objective skills. It should not be ruled by opinion. The risk-benefit ratio of the input of time vs the output of test scores is resting on the edge of a razorblade and I'm getting burnt out. I'm watching students deteriorate into a potentially dangerous states of mind. Two of my classmates failed for no reason beyond a bad luck of the draw and I struggled to talk them down from suicide. I'm on the brink of contacting an attorney because I'm worried that this program will push my friends into harming themselves. They are flunking people by 0.1% when I could easy browse their test questions and find a margin of error around 5%, not counting the subjective questions on transient nursing rhetoric, oops I mean nursing logic. I have seen no proof that the methods my school uses to force high NCLEX pass rates is anything more then the most reckless and diluted superficial attempt to mask the symptoms of a problem rather then treating the underlying cause. I'm afraid to talk about it even here because we're forbidden from speaking up about it and I could be axed in the flinch of an eye for violating conduct codes we're forced to sign, but I've been burning the candle at both ends for so long now and I don't know how to turn the other cheek anymore. This does not make me a better nurse. I can beat my head against a brick wall until the cows come home but at the end of the day I'm unconvinced that near-constant state of hopeless panic facilitates a good learning experience. I don't know what to do.

You may argue one way or enough that its unethical to force medical treatment on someone but as Nurses we all must hold ourselves to a higher standard of altruistic precautions even if it means a theoretically small increased risk to yourself. If you don't get your vaccines, your a selfish nurse and endangering your patients by way of the risk of asymptomatic transmission of infectious disease. Annual influenza vaccination is embarrassingly low among nurses, yet studies have shown 1/4 nurses show serological evidence of infection. Quite browsing those conspiracy theory websites and get the facts. Mark Crislip, doctor of infectious disease, puts out a lot of good expert information and opinion on vaccines, 100% free of conflicts-of-interest from pharmaceutical companies: Scheduled vaccines: http://www.sciencebasedmedicine.org/?p=186 Flu vaccine: http://www.sciencebasedmedicine.org/?p=2040 A really thorough breakdown of the REAL antigenic risk: http://www.sciencebasedmedicine.org/?p=289 And be sure to look at Dr. David Gorski's analysis of some of the biggest anti-vax hysteria: http://www.sciencebasedmedicine.org/?p=4431 Now make our profession proud and get your shots! :)

Is anyone else from a school that doesn't have any re-takes? Fail and your dismissed. They *may* allow you to re-apply for the program next year but I know that a dozen students flunked last year and we did not gain any new students. I'm not looking for sympathy or anything, I'm just surprised because my instructors told me that our way was the most common for Nursing schools.

HAha I'm gonna add that one. Implement Extraterrestrial-Contact precautions.