What's harder?

Welcome to AllNurses. There are a TON of threads on these subjects. I would suggest searching and looking around on the site a little bit more. You may find that your questions have already been answered in a different thread. Best of luck to you.

I'm a new nurse who has been working for ~3 months now in a CVICU. IMO, at least from a new grad perspective, being a nurse is a lot harder than nursing school. Although there's no exams, papers, and mandated studying, etc. I still have to "study" in a sense as nursing school doesn't prepare you for the complexity in an ICU - it basically just presents you with a generalized basic knowledge base. In addition, as a student in clinicals, you are not ultimately responsible for patient care. As a nurse, you are responsible for your patients, and any error you make has the potential to have fatal consequences. I can't speak about the floor, but in an ICU the level of critical thinking required transcends that required for NCLEX and nursing school - there's no multiple-choice options to choose from when something starts to change or go wrong with your patient, you have to think about 20 things at once, you have to know your patient's baseline for all pertinent data and note any changes and troubleshoot when said changes occur. Furthermore, there are many other things going on - you need time management, prioritization, the ability to communicate effectively and competently with other members of the healthcare team as well as families. I could go on all day, but at least for me personally, I feel like nursing school was just the basic foundation in order to start as a nurse and not kill someone on your first shift; after you graduate is when you actually learn to be a nurse. Finally, depending on your specialty area, there will be many things to learn. Not only are many new grads lacking basic nursing skills (even as simple as proficiently using the infusion pump, hanging IVs, drawing labs, etc), but there are many advanced devices and equipment that nursing school barely touches on. For example, on my unit, we see a lot of LVADs (HM II and impella), CVVH/CRRT, pacemakers, A-lines/central lines/swan-ganz catheters, ECMO, vents, etc. These devices just add to the already overwhelming amount of information you have to learn and skills you have to master.

School is harder. When I come home from work there's no homework or term papers to worry about.

They're both pretty rough in different ways. I vastly prefer work to school, but the pressure is on at work because you are ultimately responsible in a way that you're just not in school. But, questions are still okay. Learning is still okay. Teamwork is still okay. And getting paid is nice!

I think it depends on where you work-- geographic location, facility, type of unit. As others have responded here, there are no tests, so that removes one burden. However, the responsibility is tremendous. And the better you know your background information, the better it is for you and the patient.

Also, there are some positions where there will be tests and studying continuously. For instance, where I work almost every new inpatient nurse (some departments are excluded, like NICU for instance) has to take an EKG course and pass the final. Then they are tested every quarter via Healthstream to make sure their EKG skills stay sharp.

I think that much of it depends on how long you've been a nurse.

Nursing school and your first year of bedside nursing are both notoriously difficult because there's a very steep learning curve. School is difficult because you have to master whole new foundational knowledge of health assessment and intervention (patho phys, pharm, A&P, nursing fundamentals), while simultaneously getting a handle on the elusive NCLEX-style question. Your first year as a nurse is difficult because you have a whole new skill set to master (assessment, commonly used drugs, IV starts/wound care/stuff you do with your hands).

Working at the bedside gets easier over time. You get past that steep learning curve, and after a couple of years you become more confident. You know your common diagnoses/prognosis/lab values, you develop muscle memory for your physical skills, and you develop a sixth sense for abnormal assessment findings. You constantly continue to learn, but you become more comfortable in the role. In that sense, I think it becomes much easier with time.

Being a nurse is harder, coming from a new grad. I would love to answer some nursing school tests these days. Lol.

Nursing school does not prepare you to be a nurse. It prepares you to take NCLEX. That's all. You learn to be a nurse on the job.