November 2, 2007

My Tips and Tricks for Nursing School

Oh my gosh, I don't have to study for exams anymore. Yes, I know I've said this before and I will probably keep saying it until I believe it. It's so awesome not having a test to prepare for. Ahhhhhh, sweet freedom.

Today was my precepting orientation. It went well and I can't wait until I get to handle some patients on Wednesday. (See the previous post for other updates). The floor I am working on is a women's unit which deals mostly with hysterectomy's and general gynie issues. It's a small unit, so it's a very good floor for learning. I like my preceptor..she's very patient and loves to teach. Hopefully I get as lucky when I start on my real floor.

I decided to compile a list of tips and tricks for new nursing students. I get a lot of questions about what to do and what not to do, so I'll post some here.

Inform your family that you'll need their support. Nursing school is like no other program. You will be busy, no matter how organized you are or how well you plan. There will always be something to do so getting some extra help will be a life saver.

NEVER get behind! Remember that old saying...don't put off tomorrow what can be done today? Live by this code. Stay on top of everything or you will get behind and catching up is hard to do!

Find a note taking style and stick with it. It took me almost a year to get a good note taking style down pat. I found that if you follow the same pattern it helps your learning and helps you remember come test day.

Buy a digital recorder. Instructors talk fast. They have a hellacious amount of info to teach you and really don't care if you're keeping up or not. If you have a backup (recorder) write down the time on the recorder of the info you missed and return to it later for clarification.

Understand the theory, patho and concepts. Don't memorize info unless it's required, Ex: immunizaition schedules etc... If you UNDERSTAND the material then you'll be able to answer most any test question about the topic. Example: Diabetes: know that the insulin is what drives the glucose into the cell and without it, your blood sugar will be high. When your blood sugar is high you become thirsty. One of the S&S of diabetes is thirst. If you have a test question on this topic you can think of the patho and answer accordingly. It also wouldn't hurt to learn mnemonics for certain disorders. One I clearly remember for diabetes is the 3 P's: Polydipsia, Polyphagia and Polyuria.

Make friends! Your classmates will become your family. You will see them sometimes more than your family and they will be the only ones truly understanding what you're going though. Besides, when you're sitting at home banging your head against the wall trying to understand Increased Intercranial Pressure, it never hurts to call a classmate and ask for some clarity.

Organize your time. This has to be one of the biggest issues. I always planned time for study and time for home and you have to stick to it! If you're on your "home" time, leave thoughts of school alone and save it for your "school" time.

Buy a backpack with wheels. Yea, it may look stupid and nerdy, so what! It will save your back. 300 lbs is no fun to carry around. Don't worry about standing out, most every nursing student has these bookbags. :-)~

Don't beat yourself up! I went into the program with a 4.0 and am leaving with a 3.4, and guess what? It's ok with me! Only do your best. If you fail a test... don't be too hard on yourself, just do better next time. If you fail a skill...practice, practice, practice until you are confident enough to retake it. Don't freak out...take your time. There isn't a time limit on the majority of the skills. Everyone has had days where they have felt like they's ok, but don't dwell because you don't have time to. lol

Turn off your cell phone. Instructors hate cell phones and some will make you leave juvenille as it sounds, they do. We had one girl whose phone went off during every test and it really is disruptive. Just leave it off during class.

Take pictures and journal your experiences. This is something I am glad I did. Whether you write in a diary, or in a blog, you will love having this for later. Nursing school is an experience and sometimes it's best to vent to someone. My someone is my blog. Plus, it's always fun to refer back to a year ago and read what I was going through at the time. I recommend this to everyone.

Keep all of your notes. Don't the end of this journey there is a much bigger, more important exam called the NCLEX. You will want to have your notes for reference, even if you do buy a gazillion NCLEX prep books. (grin)

Get some sleep and eat right. I wish I had followed this advice. Vending machine food DOES NOT keep your body fueled. I repeat...STAY AWAY FROM THE VENDING MACHINE!Go to bed'll regret it in the morning if you don't.

Don't miss class. In one day you could cover a variety of topics. Other's notes are nice, but if you don't hear the subject yourself, it can be harder to understand. Also..don't be late...instructors hate that and many will not let you in and will give you a 0 for the test or quiz if you're late.

Be prepared for clinical. There is no worse feeling than when your instructor asks you what a drug is for and you have no clue. Double check everything before you enter a patient's room. Drug errors are scary...cover your ass!

Know your ABC's. No, I'm not talking about the alphabet. The ABC's are: Airway, Breathing and Circulation. Airway is alywas your first check...if their airway isn't patent, more than likely they aren't breathing, now are they? Know that is it the FIRST assessment....exceptions... if your test question is about blood circulation, more than likley the answer will also be about circulation too.

Understand test questions. Nursing questions are different from any other test questions. Sometimes it will make you want to pull out your hair. Many times you will have more than one right answer, but you need to know the one that is the MOST right. Ex: A pt enters the emergency room complaining of chest pain and he states his left arm is numb and tingling. The most important thing the nurse should do first is:
a) Assess the patients arm
b) Start an EKG
c) Assess the patient's pain level and administer Morphine
d) call the doctor

All of these are the right answers, but B is the correct answer because before you do the other things, the EKG takes priority. Also notice in the question it asks what the MOST important thing that the nurse will do. Assessing the pt's pain is a nursing action, but it's always one of the last things a nurse will do. It's considered psychosocial and his physical needs outweigh the pain at the moment. (Understand Maslow's heiarchy of needs and you can answer these correctly). Call the doctor is rarely the right answer because the nurse can always do some kind of pt care before the doctor has to be called. Think about it..if a pt is having a seizure before you call the DR (which some might want to do-inlcuding me-HA!) you want to make sure they aren't going to hurt themselves or choke on their tongue. There is always something the nurse can do...according to the textbook anyway.

Understand the test questions: Part deux! Look for keywords in the stem of the question such as: All, Never, Can't, Always etc... rarely does something NEVER or ALWAYS happen. Anything is possible. Avoid answering questions with these words in them. Another lesson I learned the hard way was answers that had part of the right answer in them. Example...the pt has increased intercranial pressure. The nurse should: Raise the HOB and administer a vasopressive. Well,...yes you will raise the HOB, but you won't admin that med...just use your common sense and don't fall into this trap. They say they aren't our to trick you, they lie. Opposites....if you see opposites in the answer bank, generally one of them is the answer. Ex: answer: use cold compresses Answer 2: use a hot pack. It's is usually one or the other.

Help your classmates. If you are at clinical and you aren't that busy and you see your friend buried up to her elbows in work, lend a hand. They won't forget this. Teamwork really is the best way to work. You scratch my back....

Make clinical cheatsheets. Make a document in Word, or whatever, for your pt's meds. Put times (military) on one side and meds on the other and make boxes. This way at clinical you can keep up with your pt's meds and when they're due incase the "real nurse" (haha) has the MAR (medication administration record), which often times they do and you have to pry it from their cold, clingy, more expereinced hands.
Make a physical assessment cheat sheet. You aren't going to be able to do a top notch assessment for a long time. I am still weak in that area, but what you can do is save yourself time and face by making a cheatsheet about things you need to assess. Go from head to toe. I can't tell you how many times I went to chart and totally forgot when the last time the patient voided was....didn't I feel stupid?! Find out when the floor does routine vitals, baths, I&O's etc... You shouldn't have to be told these things twice.

If you don't know the answer, ASK! Ask as many questions as you need to, it's better than fudging and finding out the answer later.

De-stress. Don't let yourself get so overwhelmed that you need a straight jacket. Ask for help, you can't do it all. Find ways to let off steam...running, walking, a hot bath, a bloody mary. Ha! Hey, if it works...

Don't worry about your household chores. Unfrotunately, the housework takes the least priority during school. Remember, you aren't in "regular" college classes. When you get home, the majority of your time will be spent working on things for class. Let some things go...if you don't, you will be too wound up to function. I learned this the hard way too. As long as you have food to eat, clean clothes (sometimes-ha), then you are doing ok. ASK FOR HELP!

Remind your family and friends how much you love them. It's easy to get caught up in school so much that everyone else gets tuned out. Make time for them, even if it means sacrificing for school. Keep in touch with your non nursey friends. They love you too and will feel like you're brushing them off. Remind them of your time constraints and plan a day together when you can.

Take care of yourself. This is the most important tip. As stupid as this will sound...sometimes you barely have time to bathe...make time. Get a mani and pedi too! Don't forget about your health, because without it you will have nothing.

Have fun! As stressful as nursing school can be, don't forget to enjoy it. There WILL be days when you don't think you can go on another moment. You will and it will be worth it...I hope. You will be learning so much that your head will spin, but in the midst of it all there is a lot of fun involved. Make sure to take things in stride as much as possible and don't join in on the gossip.

Hope these help. I've been saving these up for a while.
Have a nice weekend, I'm spending it with my family and I can't wait!


PJ said...

Thanks for the great tips! I will be starting my ASN program at Northampton County Community college in PA. I feel very nervous about the medical math tests so I just ordered the calculate with confidence book to start looking over. Did you use this book in your program? I get nervous when I see people talking about their nursing schools try to "weed" students out! What are ATI tests?

Christy (Soulshine) ~ RN to be said...

Hi PJ. I didn't use that book.. They usually gave us practice tests beforehand and the exams were just like them, but differnt problems of course. One you do it, you'll see how easy it is. ATI tests are tests that see what you've learned so far during school. It's mandatory in our state, I think, to take them. THey vover every area of nursing. The state boards want to know if the school is up to par, basically. We have to take a bunch each semester and you have to pass. Usually, if someone doesn't pass they let them take them unitl they do. Silly, I know, but it is what it is. Yes, they do try to weed out unfortunately, but those who can't cut it, won't be able to cut it as a nurse. I'm sure you won't be "weeded" out. Just keep on top of everything and you'll manage just fine. :-)

Drofen said...

I'm so printing this out. Thank you!

KLS said...

I had read through your blog when I first found it and thought it would be a good idea to read some of it again. I love these tips and posted a link to them on my blog. Thanks, they're grrrrreat!

Rose said...

Thank you so much for all the tips and advice. I just started my clinical @ QCC and read your blog was really helpful. I hope you keep posting your thoughts...

athomedad said...

Googled head to toe assessments cheat sheet and ended up here. Didn't leave until I heard all of the music. Thanks
You should check out

Annette said...

i getting close to the end of my
1st sem. in the nurs. prog. this was a great list, very helpful and encouraging!