Quest5

I read and reread your post and I can say with certainty that it is not your experience, intelligence, or knowledge that faculty are responding to, it is your sense of mission and passion (which is not usual in an average nursing student). The nurses at work get it and are supportive but they know you better. It’s likely you’ve not found a faculty member who will understand you and help you channel that passion. Since you are receptive to counseling, may I suggest you contact your school’s counseling service for support? You may want to ask if they know of any faculty who would be a good mentor, someone you could trust with your story. I would suggest you view the faculty less as targeting/ ignoring you and more as concentrating their efforts on classmates who understand less or are less successful than you. Find a mentor, even if it is a RN or NP at work. With the support of someone understanding who can help guide your interactions and reactions, your concerns about the majority of faculty will fade. If there’s no one like that in your program or facility, let me know by replying to this post and we’ll work on making contact. ‘Stay positive, please.

‘Hope this reaches you before your final and that you can implement some of the strategies in time to be successful. (If not, and you have the chance to repeat the course, please consider trying them next semester.) First, use the instructor-defined objectives of each unit/ module to guide your studying (but not as essay questions) and the nursing process (ADPIE) to link concepts. Next, understand how you learn: your learning style preference (search online for a free quiz) and your ideal study cycle. Your primary and secondary learning style preferences will show you the most efficient type of tools to use as you study. Your maximum study time without a break should be based on the amount of time you can focus without forgetting parts of the first sentence or concept. The average adult can go about 35 min., but I’ve known successful nursing students who never got past 10-15 min. Add an appropriate break of about 2-10 min. during which you do not study but do something different, e.g., a few exercises, start laundry or dinner, etc. The focus time and break equal one study cycle. Usually a 45-min. study cycle can be repeated up to three times (2 hrs. 15 min) without a major break of up to 30-minutes. Try to limit yourself to two successive periods with a 20-30 min. break between them for a total of 2-2.5 hrs a day. Working more efficiently will produce better results in less time than hammering yourself for 4 hours straight. Third, make sure your flashcards are actually flashcards, e.g., one thought per card such as the drug category of a medication or a nursing consideration. Yes, you will make many more cards but since a flash card means 10 sec. or less for question and response, it will be more efficient. A 3”x5” card with multiple sentences is a notecard, not a flash card. Be conservative in the use of this tool; while ideal for lab values, vocabulary, and medication memorization, the majority of nursing knowledge tested on exams involves comprehension in support of analysis and application, not regurgitation of fact. ‘Best wishes for your success this semester!

I’m concerned that you are missing several key issues in your analysis. Program 1 has a matriculation rate that suggests good support of all admitted students; the matriculation rate for Program 2 (and their better NCLEX-RN pass rates) suggest their emphasis is on their pass rate and “weeding out” the weaker candidates in their cohorts. (Knowing WGU well, I don’t think that’s the best option for you currently.) One reality of all undergraduate nursing programs is that the strength of the cohort helps each student, no matter what their GPA, to successfully complete the program. In a program that loses nearly half of each cohort by matriculation, it is easy to imagine in Orientation you will hear “Look to the left and look to the right…” and know that nearly every other person will be gone. Keep in mind you will one of those to the right or left of someone equally sure they will be retained. The biggest focus/ fear of everyone in that type of cohort quickly becomes “Am I next?” not “Am I learning to a good nurse?” If you opt for Program 2, try to find some graduates/ current successful students and ask them about their experiences from application on. Personally, I’d recommend Program 1 from the likelihood of better cohort experience and better overall program support. ‘Best wishes for your success, no matter what your choice.

I’m in absolute agreement with other replies that emphasize using the course resources. Know your syllabus as well as possible. Understand that even if “Objectives” seem generalized for courses after first semester, taken in combination with your lecture notes they do help you eliminate what won’t appear on your exams. “Objectives” for students translate into course “Outcomes” for faculty for curriculum and accreditation purposes.

Please remember your Student Services Counselor (SSC) is a critical link in your chain as outlined in the University Appeal Procedures, p.130, of the current GCU University Policy Handbook. The policy doesn’t seem to offer much relief on just a brief read-through, but including your SSC in the process is clearly a step you must not omit. Approach your SSC with a positive, responsible tone. You can never tell when someone in that position has really good insights about how to address such a situation to your benefit. Assume the best and be persuasive, not pushy, and factual, not emotional. ’Best wishes for your appeal!

There are many excellent comments here so I have only two points to add. First, find out if your nursing program has a retention coordinator, someone whose job is to help students complete the program and pass the licensure exam. If so, introduce yourself as early as possible and ask for support. It may involve study skills, time management or simply someone who will listen to you vent. I tell the students I work with who share your concerns is that the most expensive thing in nursing school is Pride if it stops you from asking for help. Second, please realize that 15-30 minutes of review time sandwiched into your day as often as possible can be very effective at reinforcing content and promoting comprehension. I’ll stop here except to say it can be done with good support, a realistic attitude, and attention to detail in all the aspects you’ve mentioned.

In addition to the above excellent recommendations, don’t forget to stay in touch with the clinical instructors you had in nursing school, not just the program and lecture faculty. Even if an instructor’s clinical area is not of particular interest to you, they often know of opportunities on other units. If it has been a while, remind them of your name and the clinical group, plus the year and semester you were with them.(And if the experience was a good one, ask for a reference.)

Not”silly” just evidence of culture shock. Yes, make note of what you see that you want to include in your practice…and what you do not. When I was a new RN my Mum told me “Never give anyone a stick to beat you with”. I think you know what she meant by that. Other commenters have said it well: please, change what you can when time and experience give you the chance and until then stay strong in your truth. ‘Best wishes for a year that gets better!

What a fantastic post! I’ve mentored more than a few male nursing graduates/ RNs I know would readily agree with you 100% but who may not have been able to express it as well. I hope your future plans include precepting new nurses or nursing education. You have a perspective and gifts that should be shared!

Congratulations! That’s superb! ‘Best wishes for your continued growth and success in 2021!

I agree with many of the suggestions made in earlier posts, especially that you consider opportunities such as LTC and Dialysis. It’s also possible you may not be marketing yourself well. My experience has been that the typical new grad RN resume many nursing programs may recommend does not adequately capture the older graduate’s experiences and skills. A career counselor at your college can often help you translate that background for your resume in terms of new grad RN / nurse residency jobs as it’s likely you have some experience that can be reframed to appeal to recruiters/ unit managers, e.g. evidence of maturity, leadership, and communication skills, although you may need to supply the counselor with new RN position descriptions. Be sure to list that you are bilingual because even if you have an accent the obvious can be overlooked. (In interviews you can mention the percentages of the local population who share that language if you do your research and can quote recent census data.) Be positive and persistent and do consider expanding your job search horizons; not everyone gets an acute care hospital position right out of the program. I have mentored several bilingual/ multilingual ADN grads, who began in LTC or home health, who took advantage of every training opportunity offered, including beginning their BSN programs, during their 1-2 years in that first job. When they moved into experienced RN positions in hospitals, each of them progressed rapidly because they’d used the time to build superior skill sets. Best wishes for your success!

I'm glad to hear that you will get some help. Remember, the good things, i.e.the critical thinking skills you learned, will always be yours, no matter what your career choice. I do hope you will stay in nursing. It is no longer an absolute requirement that your first job in nursing is in an acute care setting; many nursing articles have been published about alternative pathways. So take heart, you need not give up nursing and healthcare. As part of your plan, please investigate these other options. You are clearly courageous enough to make a difficult personal decision, so I'm sure that with a little more time and less pressure you will find the setting that is absolutely right for you.

Thank you, TheCommuter, for the WGU update! I'm delighted to hear they've made it easier for the ADN RNs to make use of this great opportunity. I've been recommending WGU for years. This will eliminate one of the main reasons I've heard in return for not enrolling.

Whatever your decision, and only you can make it, please consider getting some help recovering from the stress. It sounds as if you have been through an emotional wringer, something intense enough to leave scars. If that is so, simply changing careers or jobs won't null the effects of this experience. It need not involve medication or a long time, perhaps just someone unrelated to you in any way, to listen to all the details in a safe place where you can disclose the full scope of what happened, without anxiety or worries about judgment. Plan to take care of your mind as well as your career/ employment. Not doing so can result in a obviously inappropriately intense response the next time one is subjected to major stress, the level that can happen in any job. Take it from someone who saw a close friend hit full meltdown without warning. Prevention is always easier than belated cures.

A mentor ship in the ED can be a fantastic opportunity to work on assessment skills, to use non-medication comfort measures and to participate in interventions with a wide range of patients in a comparatively short time. Be prepared to be on your feet the entire period, so show up well rested and no yawns, or complaints. Have all the necessary paperwork available for your mentor. Technology is great but any personal cell phone use is inappropriate; HIPPA regulations can be a challenge in an ED, so if you see people you know at all, respect their privacy without exception. No names, no photos, no recordings, no matter how spectacular or news-worthy. Try to act as a professional at all times. The schedule in many EDs is usually unpredictable but there are some generalities. Some days and times are usually busy, so if you're worried, try to arrange to start on a less active time but remember, chances are you will need to follow your mentor's schedule, one that may have been set a month or more ago. If you have contact information, try to call your preceptor before your first shift to confirm what is expected of you and some minor administrative details, like whether you will have a secure place for your things, meal breaks, etc. If you are allowed to do so, ask to visit the ED in advance or to arrive early, just as you would to get a clinical assignment during other semesters, to find who is who and out where everything is located, including the small things like bedpans, urinals, linen, portable ECG, crash carts, etc. Should your first hours be hectic you will feel less lost if you have a clue where to find things and who does what. Until you really have a sense of what is expected of you, stay out of the way during emergent care of critically ill patients. Don't take it personally if you are spoken to sharply in the heat of a moment. The ED can be highly stressful even for experienced staff. Asking questions will be expected, but pick your time and place. Especially if the ED has curtained cubicles, remember that sound carries, so be cautious about discussing anything where you may be overheard. Patients in the ED are often frightened so simple things, even a warm blanket or a pillow, if you can find one, mean a lot. Don't offer false reassurances and don't assume that a patient wants you to discuss anything about anything with anyone, family included. Make the most of the many learning aspects available in an ED, including triage, urgent care, pediatric emergencies, communication with inbound ambulances, cardiac/ respiratory emergencies, etc. The variety can be amazing. In the unlikely event that things are slow for more than 15 min., resist the temptation to sit down. If there is nothing you'd like to discuss with your preceptor, volunteer for tasks. Simple things like ensuring all cubicles are ready for patients, including the code/ trauma rooms is a chance to become more at ease in the ED. Checking supplies on code/ crash carts will teach you the variety of supplies required rapidly. Learn to use the equipment, especially portable ECG and cardiac monitoring; even if you have some experience with these, there are always opportunities to become more adept. Stay awake, attentive, and professional. It is acceptable to be anxious, but not to be frozen with fear. When in doubt ask if you can assist. If confronted with the horrific, keep control of your emotions and your face by remembering that the patients/ family/ friends are far more scared than you and are watching to see their worst fears confirmed! Should you feel faint or about to vomit, get out of the patient care area or anywhere you might obstruct movement. Of course, if you must leave the unit, let someone know and come back without delay. Lastly, bring your sense of humor. ED humor is sometimes a little off-beat but it cuts the stressors to manageable size. Don't consider telling any stories or jokes to your class mates later, as chances are they will seem inappropriate or unfunny. You may feel you are there purely by chance, but that is rarely so. You are nearing the end of your entry-level education so you have the knowledge to be successful during this mentorship. Make the most of the experience. It may lead you to a career in the ED, or not, but at the very least it will give you greater confidence in your abilities and skills. 'Best wishes for a great time! (By the way, my senior practicum in the ED some years ago led to my selection as one of only two new RNs in the department's first new grad program. I felt empowered, confident and blessed that I had that experience my final semester.)