peacelover

First off-congrats on starting the program! Way to go! Second, do not listen to all the scary stories people tell you. The next time someone starts to relay something negative either walk away or stop them mid-sentence and ask them to tell you what they loved from that day instead of what they hated. It is tough. Tougher than pre-reqs but in a different way. You don't memorize most stuff aside from drugs and lab values. You have to know it so it might require you study a different way. that is all. It is not impossible. It is busy. A lot to do and there is no reminding. Plan your time well. Even plan study time-that way you are less tempted to play around or get distracted during study. Stay away from groups unless this is the best way for you to learn. They are wholly distracting and time-suckers. Plan some time for you so that you can decompress and reset your happy-button weekly. You can control a lot of this with your hard-work and planning. The other stuff you just have to be flexible and know it is coming at ya. You can do this-you got in a program and if you were not capable of passing you would not have been given this chance! Rock it out!

See if you can create a good list of nursing interventions you will use for those cardiac patients. Why they are important, how they help your patient, how you assess for the effectiveness of the intervention. Include what adjuvant therapy may happen. Make sure that you know they BIG ones, like when you need to call for help etc... Next, take a breath and work hard. Some of the 'you should know this' coming from the instructor is just him trying to impress upon you how damn important it is for you to know this material. Don't fight it, just go with his flow and when he says something is important commit it to your grey matter! Reading before hand and knowing what the objectives for the class are ahead of time are powerful. You can spend time then listening fully to the instructor rather than feverishly writing notes or sinking into a poo of despair thinking how bad you are going to bomb the test. Allocate time to study. Do what you can-these are things in your control so don't worry about them..the rest let go, cause worry is NOT productive in school. Of course, I know you know this already :) I personally have a bit of a rebel streak. When you tell me how I cant I will purposefully do 100% more than you told me I could not do...all the while thinking, HA! Take that! best wishes your way! I used this trick in school.

Anything is possible if you put your mind to it, I suppose. With small children it is not something I would ever do to myself. If your program is like most you must make A's in those science pre-reqs to even be considered in the program. There is also a level of expectation once in a program that you know the A&P/Micro material. They will not stop or slow down while you refresh yourself because you just crammed to pass the classes. If you think you can pull A's in all these classes(the program may tell you that you only need a C but they all weed out people by GPA and C's rarely get in any program)then go for it...I would make sure that you have an excellent support system to keep kiddos when needed so that you can study. Huge difference between studying with/without distractions :) Best of luck to you either way! :)

It is pretty common to have this feeling of 'shock' when you first move into that place as an RN from school. There are a lot of expectations that school creates for us, couple those with our own notion of what nursing 'should-be' and it pretty much ensures that there will be some level of 'Oh Crap, what is this career I have chosen?' I agree with Meriwhen,,find a mentor and hang with it for a year before you give up the education you worked so hard to get. There are so many areas of nursing that you can go into...not just what you are doing now. I floated from ICU to a psych floor the other day and was surprised at how little it looked like my usual job. Hang in there!

Sent you a PM with a helpful site...dont give up!

Hey! All books will put the same content in front of you. It depends on how you learn. Visual, Auditory, Kinesthetic? Only you have that answer and I imagine you have a good feel for it by this point. I was not a huge fan of my OB/GYN rotation. I got through it by immersing myself in the material as I did the other theory topics and using the ADPIE process to study every disease state. There are some things you just have to memorize however; the more you tie disease process to assessment data, your nursing dx and most importantly your interventions the more deeply you will retain what you read; regardless of what book you get it from. Best of luch to you-I am sure you will be awesome!

I am glad you see that you are being a bit hard on yourself. I will say though, thank you for actually caring that you do a great job and take give great care, lots of new nurses do not really even know that they do not know something. Which is an even worse spot to be in-so you are doing something right! :) Maybe it is the hit-or-miss nature of patient assignments is adding to your frustration. It is hard on a med-surg floor because you may get a hip tonight and a CHF tomorrow followed by an ETOH withdrawal mixed with a demented patient. All those difference can overload your brain when it is trying to learn. I am not sure what kind of floor you work on however; maybe it would be possible to chat with the charge nurse and tell them-'Hey, I need to get really good at CHF with complications or I really need to learn more about insulins and timings(or whatever you feel)-can you throw these all of these types of patients my way for a while so I can gain proficiency with their care please?' So your brain can focus... Maybe that gives you a chance to 'live' in the world of CHF for a few weeks straight so you can fully immerse yourself in the meds/labs/interventions/complications. If that is not possible maybe pick a particular lab value to focus on for the month. BUN/Creatinine and the ratio, when it means AKF or CKF or when it is just dehydration. What would you expect the doc to do with each, to prove each. Look at the meds that would change the ratios, that may harm the kidneys. Sometimes coming at it from the back side-lab or med first could be a better way to cover all your patients. You know, compare the same lab across your patients. Why does one have a high BUN and the other no? Just some suggestions. I think you will find that if you come at things from a slightly different angle it will get easier, faster. Focus on one thing and get good at it, instead of trying to be good at everything right now. I am sending great thoughts your way-I know you will be awesome once you get through this first few months!

It is hard when expectation does not match up with reality. I have never been scared, I think that my pre-nursing life experience helped me with confidence. I was shocked at the gaps though..you know there was just so much that school cannot possibly prepare you to face. I felt like I had slept through a lot of theory class on some days.I waited 20 years to get to be a nurse too, so I get that part. I think it is good that you have identified what is going on for you instead of just having a general yucky feeling about your job. Now that you know what is going on I think you can create a plan for it, don't you? Where do you feel the biggest fear? Patients crashing? Medications? Lab work? Missing something critical that harms your patient? Time Mgmt? Not understanding the disease processes that are showing up on your floor? You can name it, you can fix it. You got this one lock!

Take a breath and know that being nervous/freaking out is actually pretty much normal no matter HOW prepared/ready you may feel to graduate and be out there worling under your own license. A couple of things...sometime in this last semester you should have a preceptorship time, a time when you are one-on-one with an experienced nurse. Figure out the top 5 things you are MOST uncomfortable with before you head into that time with your experienced nurse and then ask for advice/instrution on how to do those things well and then take every chance you can to do those things; while you nurse buddy watches. For example, if you are really worried about getting a patient that is connected to tons of wires out of bed then tell your nurse this, watch how she does it, take notes and then do it over and over again. If IV starts give you the willies, claim this, express it and then practice it over and over again in this last semester. If you are afraid to take care of a dying person; same thing. Tell your preceptor and ask for advice then practice. You will gain confidence as you do it over and over. Most stuff doesnt actually take that long to get the hang of, and lots of stuff we make bigger than it actually is because we want to be a 'perfect' nurse. I get it, I was freaked out about turning a patient with a hip fracture to clean them so I actually volunteered to clean every patient on the floor(even those that were not mine)in my 2nd semester when I was on an ortho floor. After 5 weeks of it I got it...not the most fun thing but guess who has tons of confidence cleaning immobilized patients now? This gal! :) IF you were not a little nervous about leaving the safety of school I would be more concerned than I am about you expressing some fear/anxiety. I would not rush to get a CNA job at this point with all you have going on and with the last semester here; unless you think you want to work where there after school. I promise you will become so comfy with all these things you are worried about now in short order this last semester if you will examine how you feel so you can claim them then ask for help now, while you have a preceptor. Last thought here..you will not be 'thrown to the wolves' once you get out in the 'real world'. Your employer will not ask you to do things you are not comfortable doing; especially when it comes to patient safety, you know? So do not spend your energy worrying. Instead, have an awesome last semester and spend time with your pops. Best thoughts your way-

Just my perspective. If you are going to get into a school in DFW then you need to make A's in all of those Pre-req classes. The specs on the programs tell you that you can have a 3.0..seriously though, they have to say that. They start with 4.0's fill spots and so you can see that by the time they get to 3.0 there are few spots left. Most important, you need to actually study in a way that you remember the material; especially those A&P's because you use them every single day of nursing school. So, I think it would be detrimental in the long run to try and cram stuff in your brain, pray you make an A etc than to just take your time about it on the front side. Best of Luck to you on your journey...

I think the fact that it shook you only proves you are human. Don't be too hard on yourself or expect that you 'should' magically have had a different reaction to the situation. I wouldn't say you get used to seeing death; especially when people are on comfort care or when they decide to stop treatment. I think you just get to a place where you accept it better. I have just come to really embrace the fact that every living thing has a life cycle and that includes us. I have watched many patients suffer so much trying to live and seen the peacefulness that occurs for the patient and the family as the choice is made to stop fighting and move into the next phase of things. As for the nurse that you think was 'happy'..probably not..probalby just that persons way of coping with the situation. I am glad you are exploring your feelings and letting them out and taking the time to figure it out for yourself. Lots of nurses don't do that..so pat yourself on the back for this please.... peace-

First things first....take a breath and feel proud of the work you have accomplished! Yay for YOU!!!!! I precepted in ICU and work there now...so MUCH FUN! As far as confidence goes, I dont think your program would allow you to precept in ICU if they doubted your ability to keep patients safe...so stop focusing on the '0 confidence' thing...please :) I agree with apples here too..be open and willing to learn...do everything and anything that they offer and ask to do things they dont offer. You would be amazed at how much you can learn turning and intubated patient to clean them..volunteer for everything!!! Then, be a sponge here...take a notebook and jot notes/questions as you go, circle back to them and answer the questions you have for yourself(at least attempt to)before you take the questions to your preceptor.I cannot stress how important it is to come with 'some' knowledge-it shows your active in the process, it shows your initiative, and passion. It shows you actually care about being there..ICU nurses dig that For example, say this.." I suspect my patient is having increased ectopy because his urine output has increased____ amount from last shift...I am think we need to check his MG+ and K+ to see if we need to replace them...what do you think?" Not this..." I dont know why on earth he is having so many PVC's now..what do I do about that?" See the difference? Then listen to what they say...the time you have with these experienced nurses is like GOLD Otherwise, I would know your lytes and basic labs and what it means when they are out of whack as far as what you need to do about it... Hoping you have an excellent experience!

I am sorry you are going through all this, how tough to be so disappointed in something you worked so hard to get into in the first place. I am wondering, have you spoken to any of the faculty about your concerns? What have they said about how your perception of the test questions? I think all nursing schools are tough AND I think most of us, at some point, found ourselves thinking; 'where the heck did that question come from-I never saw that material in the textbook.' Sad, but true. I hope you can find a way to pull yourself out of the negative collective that sortof feeds off each other. There is no room for 'poor me' ot an 'us against them vibe' in nursing school. It just sucks vital energy away from you and makes you feel defeated before you even start-no good. Fact is, the school is doing something right or they would not be have a nursing program. I will say that while it might not 'look' like it you probably have gone through the concepts needed to answer these questions correctly. At least the majority of the time. For example, you probably studied about hydration and electrolytes replacement and how to best help an athlete but now they want you to take the raw data you learned and apply it to other things. That is maybe where the disconnect is at for you. In the application of one topic you did learn verbatim to another topic you did not learn verbatim. It might work for you when you are studying to really focus on the rationales or the why behind what you are doing and what you are seeing in the patient. For example, why is a correct K+ value important? Why are K+ and Na+ lost in exercise? What happens if they are lost, how does the body tell you it needs more of them? What conditions other than sweating a lot would you think might need to have these elytes replaced in? Why is it important to look at them at all? What are the norm values? What if the body has too much of them instead of not enough? In this way, looking at it from all side, asking yourself why questions you can sort of back your way into the answers on the test. The other thing I think would be good is to really take your time and look at what the question is asking you. Are you missing a piece of the puzzle in the question so that you are not looking for the right answer in the first place? Saunders does a good job in explaining how to find the critical pieces in the questions in the NCLEX RN book. If you get in the habit of working some NCLEX questions every day and reading the rationales, even if you get the question correct, you will improve your test scores. Last, do you have a mentor program at your school where you could be tutored by other students that are having more success? Maybe you could approach an upper classman and ask for guidance in a positive way? Probably way more than you wanted here, I just want you to know you dont have to give up... Peace-

Ultimately, you are studying to learn how to keep patients safe and alive. So, study with this in the forefront of your mind. To heck with the focus on grades one way or the other. Don't let that keep you from being motivated to do a great job.

First semester is a bit overwhelming at times. Have you been able to determine how you learn best yet? If you are a visual learner then maybe you need to draw out the concepts and connect the dots between them to retain the knowledge. There is a series that puts the basic concepts into pictures that is helpful to some folks. Not sure the exact title but if you search 'memory notebook nursing' you will find it. Are you spending enough time studying? I found that I had plenty of material to study and no matter what I looked at it was basically the same info just presented a bit different. It was really the way I was studying that I had to change rather than going to get different material to study. That gets expensive, quick! Have you ever used to nursing process to study? For example, if you are studying CHF..pull out of your text what things you would look for in your Assessment of that patient, include all bits of data, s/s, lab values, subjective things, patient presentation/lifestyle/comorbities and then come up with nursing diagnosis that go with what you assessed, then plan your care, intervene and evaluate what you did based on whether or not the problem was resolved. Link in your brain when you would know things improved or conditions associated with CHF would be changed by your interventions..what would you actually see in your patient as a result of your actions? What other conditions would that touch? Draw some tables that compare like diseases so you can see how hypoxia could be an issue in many disease states, what you could do that would work in all cases and what is specific to each disease. Focus your time on connecting as many forward and backward dots as possible between s/s, interventions, etc.. Ah, that was probably way more than you wanted to know. Best of Luck to you! Don't give up!