A Letter to My Difficult Patient

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Dear Difficult Patient,

Before you scream at me for not being in your room on time...

Before you throw me your food tray for not giving you your pain medicine when you ask for it...

Before you try to hit me because you're withdrawing from your addiction...

Can you try to understand that I am trying the best that I can? 

Can you see beyond yourself that I have FOUR other patients in need?

Can you just bear with me at all, for we are short-staffed today?

Can you stop calling patient relations because nothing makes you happy?

Would you try to understand that I am trying the best that I can?

Would you believe me when I say that I really care about you?

Would you stop cursing me out if I give you what you want?

Would you appreciate me after I give my all to you?

Will you understand then that I am trying the best that I can?

 

Sincerely,

Your Nurse

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The Secret to Passing Your NCLEX: A Free Case Study Inside!

There are affiliated links below that I get paid for. Please refer to my policy page for more information.

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So the time has come for you to take your NCLEX. You got your authorization to test (ATT) and you’re probably wondering what’s next.

WELL, It’s time to prep!

Before you take your NCLEX exam... take the time to really see if you're ready. There is a BIG difference between being "ready" and being "confident." Honestly, you can be confident all you want, but when you step in front of that computer, you may realize that you weren't ready at all. Being "ready" is knowing and accomplishing the unexpected. This means your mind knows how to tackle 265 questions, knows when to take breaks, knows how to critically think through your case studies. And if you're ready... you just know.

I would advise scheduling out at least a month or three months from the moment you get your ATT. You wouldn't want to schedule too far out because you might easily forget material or not know how to apply it. In the midst of it all, you'll probably start looking for NCLEX prep plans and freebies that your school offered and this is where I step in to offer one of the best NCLEX preps out there.

Why Brilliant Nurse?

Flexible

Brilliant nurse's NCLEX-RN FastPrep has 3 different plans according to your needs. For any of these programs, use the coupon code 'DLMJOURNEY' and get 20% off any of the plans below!

Whichever one you choose, you will have access to more than 2000 NCLEX-style questions and rationales. You'll also have access to case studies, content, and your personalized statistics! If you're always out and about, don't worry! Your program is mobile accessible so you have it while you're on the go.

Individualized

NCLEX test prep will personalize how you decide to study. You are able to create customized practice tests  and increase your pass rate.

Q&A with Rationales

As stated before, you questions and answers are what you're here for. You have access to 2000 NCLEX-style questions and rationales. You will get access to their case studies that features questions to optimize critical thinking and prioritization skills.

Here's the freebie!

Click on the link below to get an example of NCLEX-RN test prep case study

Get Started Now!

Get your NCLEX-RN fast prep today and pass your NCLEX on your first try!

HAPPY NURSING!

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Top 5 Best Nursing Scrubs!

This post may contain affiliate links. See my policy page for more information.

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There are tremendous amount of brands out there and we all look for different things. Depending on your facility or institution, some may be strict on what you're allowed to wear. But overall, I assume we all want the same thing! 

We will be examining each brand by the following common denominators:

We want scrubs that are fit, comfortable, inexpensive yet... fashionable!

Here are my go-to brands for the best nursing scrubs... as of 2018.


1. Jaanuu

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I've recently been obsessed with Jaanuu and I'll tell you why in a little bit. But let me start off with stating the facts.

Jaanuu is made up of the finest fabrics. Every thread is sewed to be soft and flexible to optimize comfort and functionality. If we're looking for the fit, comfortable, and fashionable... you got it all in one brand!

Click to tweet: "Jaan," means "life" in Hindi. Bring life to your scrubs with Jaanuu.

Here are the four categories:

  • Fit: true to size, shape revealing, torso length is shorter than your average scubs, not a lot of options for petite/tall
  • Comfortable: Fine fabrics (some pieces have flexible material), soft texture, covers appropriately.
  • Fashionable: modern and runway inspired, each piece is unique according to collection. #1 at fashionable scrubs HANDS DOWN!
  • Inexpensive: Each piece is between $42-50 so definitely much more expensive than your average scrubs. But that's just it! Jaanuu is not your average scrubs!

Now, let me help you upgrade your scrubs by making it inexpensive!

With the coupon code: DLMJOURNEY25

get 25% off your purchase!


2. Grey's Anatomy

Ahh... this is my go-to brand. You can never go wrong with Grey's Anatomy... literally. Each piece has a soft, consistent texture and they are cut in a way that fits any body shape. It's true to size, each piece is not too tight and not too loose, it's just right.

So here are the four categories: 

  • Fit: true to size, shape revealing, everything is available for petite/tall
  • Comfortable: soft texture, covers appropriately
  • Fashionable: design is functional, yet stylish!
  • Inexpensive: each piece on Amazon is usually between $20-30 and definitely worth it!

Here are the pieces that I love, love, love and bought for myself:


3. Healing Hands by Purple Label

Just as good as my Grey's. This is my other go-to brand if I want to change it up a bit. Healing hands by purple label has different scrub tops that are stitched to show off your curves, yet soft and flexible (similar to legging material) to optimize functionality! 

Here are the categories:

  • Fit: true to size, shape revealing, everything is available for petite/tall
  • Comfortable: soft texture, fabrics are more flexible, covers appropriately
  • Fashionable: design is functional, stitching is great, but average looking.
  • Inexpensive: each piece on Amazon is between $20-30. Some pieces may be cheaper than Grey's Anatomy!

4. Wear Figs

Unfortunately, I won't be able to provide pictures from Wear Figs since I am not affiliated with them. I do not benefit from including their brand into the post, but I want to give credit when it is due. Wear Figs would be #1 in the comfortable category because their fabrics are consistent and SUPER soft! It's stitched to fit snug, but is not form fitting. If you're into functional and comfortable scrubs or you're interested in getting that 'Surgery/OR' look, this is your go-to brand!

Here are the categories:

  • Fit: true to size, loose (but fit), not shape-revealing, not a lot of options for petite/tall.
  • Comfortable: super soft texture, covers appropriately, #1 in this category.
  • Fashionable: design is functional, colors are more vivid, you get the 'Surgery' look!
  • Inexpensive: Tops are $38-44, Bottoms are $48-54. Pretty expensive, but worth it.

Get your FIGS now!


5. Cherokee

Cherokee scrubs is #1 in the inexpensive categoryThe fit and comfort will vary according to the collection that you purchase.

Here are the categories:

  • Fit: may not be true to size, shape revealing according to collection, everything is available for petite/tall
  • Comfortable: texture can vary according to the collection. 
  • Fashionable: design is functional. Some can vary on the cut
  • Inexpensive: each piece on Amazon can be as cheap as $12-25. The cheaper and older collection, the poorer the quality.

Or get your scrubs from Lydia's!

20% Off Cherokee Scrubs at Lydia's

Summary

#1 in the category:

Fit: Jaanuu

Comfortable: Wear Figs

Fashionable: Jaanuu

Inexpensive: Cherokee

Jaanuu and Wear Figs have limited options for petite/tall, but have the best quality scrubs. 

Overall Winner:

Hope you guys enjoyed this article! What is your favorite scrub brand? Let me know in the comments below!

Happy Nursing!

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The Ultimate Guide to Nursing School

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Like any of the other posts that I’ve published in the past, nursing school is one of the toughest professions out there. Supposedly... there is a mythical passing rate of 50% for nursing students. There is no reference to help support my previous statement, however, I've come across surprising numbers. A graduating nurse reported to me that their nursing program started out with 125 students and only 55 graduated! Those numbers are significant and understanding why those numbers exist is critical when entering the program.

I’ve also stated in the past that nursing school was a tough journey for me as well. There has been several times when I questioned and doubted myself. There also has been times when I felt like I wanted to quit. But I knew if I worked and study hard, and put all of my effort into nursing school, it would be the biggest and most rewarding accomplishment I would ever experience.

If I look back at nursing school, one of the hardest things for me was finding resources. I would frequently log into Pinterest and try to find some nursing guide to help me throughout struggles and I would find none. Because of my struggles and the lack of resources, I decided to come up with the ultimate guide to surviving nursing school!

Getting Into Nursing School

Retention rate 

Percentage of students who are still enrolled or have graduated one year after enrollment:

  • BSN: almost 90% (2006-2007)*
  • ADN: about 80% (2006-2007)*
  • 2-year institution: about 65% (2006)*
  • 4-year institution: about 75% (2006)*

These statistics aren't that bad, right? These rates to me conclude that there are more students that stick it through the program than drop out and quit.

Competition

How competitive is nursing school? Too competitive. But understanding why is also important. Nursing is competitive because of the type of education being taught and the limited amount of space available. Honestly, I only remember the basics of what it took for me to get into nursing school so I had a co-worker/friend, Andrew Burkart, who is an aspiring nurse fellow who recently applied to various nursing programs, help me tremendously to write up the admission process. **Be mindful that we both live in the DMV area.**

Along with his advice and my further research, we have included the following recommendations to be current as possible. With that being said, there are various things to be mindful of before you apply:

  • Competitie GPA:

Andrew emphasizes the need for good grades. Most nursing schools have a minimum requirement GPA of 3.0 in science courses. To be in good-standing with the rest of the competition, it would be ideal to have an overall GPA above 3.5. 

  • In-county status:

For those who are applying for their Associate Degree of Nursing, this may not be a written requirement, but in-county status may be a factor as well. If you live in a county where the community college resides and you do not qualify for their in-county tuition, that means you will be on the low priority list to be considered. For instance, if I live in Prince George's County, I have a higher chance of getting into to Prince George's Community College rather than getting into any other college. Hopefully, that makes sense.

  • Competitive TEAS score: 

Keep reading!

Entrance exams

  • TEAS:

TEAS stands for Test of Essential Academic Skills. It is a test that nursing programs use to be considered for admission. The higher the score, the better... and in turn increases your likelihood of being considered for the program.

I did not have to take this test when I applied so I do not know what the TEAS are like. However, I have partnered with JobTestPrep.com to be able to provide you offers and deals to help you prepare for this exam. I have personally reviewed their products and I believe that you would highly benefit with their study tools.

Signup with Job Test Prep!


Preparing For Nursing School

Are you ready?

Read my articles on what to expect in nursing school and what nursing school did not warn me about.

Scrubs

  • Be mindful of your institution's policy through your own student handbook. 
  • If you're an amazon shopper, here are some scrub brands that are affordable and fashionable. These are my go-to brands because of their fit and style:

Grey's Anatomy

Healing Hands By Purple Label

Jaanuu

A little bit more pricier... but these scrubs are to die for! It's re-imagined, modern-inspired scrub.

Stethoscope:

Littmann and MDF


Surviving Nursing School

Plan

  • Get organized!:
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Get a planner and note your due and exam dates! It may be also beneficial to get a two separate bags: one for lecture and one for clinical. Make sure you have all your supplies ready for whatever you have ahead of you.

  • Be on time!
  • Try to not miss any dates for either lecture and clinical. It's hard to make these days.

Exams

  • Nursing exams are different from what you're used to. 

When I say 'different', I mean that nursing exam questions are not designed to be concrete. You're probably used to exam questions to have one answer. Nursing exam questions require you to know your content and know how to apply that information into patient scenarios.

For example... a typical Human Anatomy Exam Question will be: "The pituitary gland secretes what kinds of hormones?".. then you pick A, B, C, or D and only one can be right.

BUT a Nursing Exam Question may look like this: "The nurse walks into a patient's room to find the patient's trash can on fire and the patient is sitting on the chair across the room. What is the nurse's best action at this time? 

A. Pull the fire alarm

B. Remove the patient from the room

C. Pull the fire alarm and get the fire extinguisher.

D. Confine the fire by closing all the doors and windows."

All of these answers look correct, right? But if you've learned the content about RACE (Remove the patient from the area, Alarm the sound, Confine the fire by closing all the doors and windows, and Extinguish/Evacuate) you would be able to direct to the right answer, which is B. 

  • Practice, practice, practice, practice! QUESTIONS!

Buy Success books for Q & A!

Lectures

  • Record your lectures and listen to them while you're driving or doing errands
  • Print out material
  • Reinforce your notes by re-writing or re-typing your notes (I prefer typing)
  • Know your material before entering the class (Reinforcing your notes)
  • Join study groups
  • Study by yourself and test yourself!

Clinicals

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Going to your clinical site can be quite overwhelming.  For those of you who are just beginning your nursing school years, each institution has a requirement amount of clinical hours, where each student will have to attend a specific facility to follow a staff member (either a Registered Nurse [RN] or a Certified Nursing Assistant [CNA]) and learn under them.

A clinical site can vary according to your lecture or theory class. This means that if your lecture is about the Medical-Surgical specialty, your clinical site will probably be at a hospital setting at a medical-surgical unit. The amount of hours for each clinical specialty can vary according to your institution. For instance, our psychiatric clinical rotation required us to complete much less hours than our medical-surgical rotation.

Articles: 


Graduation

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  1. Apply for graduation/NCLEX (mid-semester)
  2. Purchase cap and gown (mid-late semester)
  3. Make sure you pass! (end of semester)
  4. Buy cap decorations (1 week after finals)
  5. Take grad pics (1 week after finals)
  6. Create & design invites (1 week after finals)
  7. Make an invite list & send invites (1 week after finals)
  8. Party Ideas (can be done whenever)
  9. Purchase dress and shoes (1 week before graduation)
  10. Graduate & Party time! (graduation date)
  • Apply for graduation/NCLEX - Every school usually has their own due date on when to submit an application for graduation. Ours was in the middle of the semester, which was nerve wrecking since we were all still trying to pass this one last class. But make sure to submit yours by their due date and when approved, make sure you get a copy! Some institutions help with the process of applying for the NCLEX. My institution provided us with the Board of Nursing applications, we filled it out and they submitted it for us. This also has a due date before the semester ends. They don't send the applications until after graduation date.
  • Purchase cap and gown - This was also offered early, way before graduation date as well. I'm not sure how early other institutions are, but I know this process can be intimidating to complete. I say that because some people do not want to purchase a cap and gown until they're sure that they passed the class. But during this process, positivity is so important. I would purchase the cap and gown regardless of an unknown outcome, unless you have solid evidence that passing is inevitable. Some institutions may even run out of stock so whenever available, be positive, know you will graduate, and purchase your cap and gown! :)
  • Make sure you pass! - If you don't pass, unfortunately there will be no graduation.
  • Buy cap decorations and decorate - Usually done in the end, when it is definite that you will be graduating. Go on Pinterest for inspiration and start decorating yours!
  • Take grad pics - This is optional. I chose to do it with the help of my brother. It's something fun to do. I used my grad pics for my invitations.
  • Create & design invites - My institution provided cards where we can print our invites with their logo embedded on it. But you can get creative and make your own!
  • Make a list & send invites - start sending!
  • Party ideas - I used Pinterest to help me plan mine. 
  • Purchase dress and shoes
  • Graduate! & Party! - go and walk! Don't forget to party!

Now for the NCLEX...

If you read the first step of the nursing graduation list, you will see that it's NCLEX time. Whether or not your institution helped with the application process, you have to apply to take the NCLEX through the Board of Nursing. You have to fill out the application process and make sure that you have everything you need according to the state that you're applying to. Once submitted, follow up with the Board of Nursing. If your school sent out the applications for you,  follow up with the school and then the Board of Nursing. Once the Board of Nursing has confirmed that they have received it, give them 4-5 days to process the application. Within 1-2 weeks, you will receive your ATT (Authorization To Test) code via e-mail. Once you get this code, follow their directions and schedule your NCLEX date whenever you're ready to take it.


Understanding the NCLEX

NCLEX is the be-all of becoming a nurse. This is ultimately what you are studying for during nursing school.

What is NCLEX:

  • NCLEX short for the National Council Licensure Examination that is mandated by the National Council of State Boards of Nursing (NCSBN). ***
  • It is a 75-256 exam question that is based on computerized-adaptive testing (CAT)

How does that work? When you answer a question right, it only gets harder. Not very motivating, huh? It reads how well you answered the first question and then delivers a second question that gives you a 50% chance of getting the answer right. It is thought to become easier once the computer recognizes your ability to answer the question.

  • The computer will shut off once you are done. Some people stop at the minimum of 75 questions, some take the whole 256 questions! (Like me)
  • The computer will shut off once you reached the maximum amount of hours. You have 6 hours to complete the exam.
  • Pass/Fail:
 You can daily with 75 questions if you're below the pass line. You could pass with 191 questions... you'll just never know.

You can daily with 75 questions if you're below the pass line. You could pass with 191 questions... you'll just never know.

Let me end the myths here now.

Just because your test closed at 75 questions does not mean you did soooo good that you passed the test. This could also mean you failed. 

Just because your test closed at 256 questions does not mean you did sooo horrible that you failed the test. This could also mean you passed! (Take it from me). 

 

How to tackle the nclex:

A lot of students do this differently... some like to take the test as soon as possible so that the information is fresh in their mind. This is true, however, this always does not work on people's favor. I'll explain why.

First...

Sign up for NCLEX-RN Fast Prep by Brilliant Nurse!

#1 in Nursing Test Prep - Houston Chronicle.

It is a 30-day program and you'll have access to daily test prep and practice assignments. If you sign up with the link below, you will get a 20% off for this NCLEX plan for only $60!

If you're interested on their 3 month program, use the coupon 'dlmjourney' and get 20% off!

Why Brilliant Nurse? Simple. Their philosophy "is to engage students in active learning using practice assignments, detailed answer rationales and clear case studies to have the readiness needed on exam day (Brilliant Nurse, 2018)."

You need to train yourself to be able to answer 256 questions a day. This is the ultimate goal.

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  • Set out for a month to take your test from the day that you get your Authorization To Test (ATT).
  • Practice questions. Refer to the schedule to the right if necessary.
  • Read rationales and understand.

Tips:

  • Medications are mentioned in generic form only.
  • For calculations, you may be asked to record with decimals.
  • Don't forget to round calculations if indicated.
  • Study content sparingly. Studying too much content and not applying the content into NCLEX questions will not help.

Articles:


References:

  • *National Nursing League: http://www.nln.org/newsroom/nursing-education-statistics
  • **Andrew Burkart: an aspiring nursing fellow (Instagram: @andrewburkart)
  • ***National Council of State Boards of Nursing: https://ncsbn.org/nclex.htm
  • There are various affiliate links and partnerships above that I get paid for, but I have personally used them and/or highly recommend them.
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Top 10 Rules for Nursing Clinicals

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Every university and/or facility will be different from what my recommendations are below. But I have gathered input from my own school and different students that have shadowed me to make up these universal rules for your nursing clinicals.


"As nursing students, you have fresh, nursing knowledge so be proud of it."
-dlmjourney.

But first, let us understand: Why are professors strict during our nursing clinicals?

 

When you enter an institution, you are the guest. You are a representative of your school and you must represent with pride and confidence. It is also important to remember that in order for you to learn under a hospital/facility, your school has a partnership with them. This means that they have a mutual contract that allows nursing students to learn the ways of the institution and its paid for!

20% Off Dickies Scrubs at Lydia's

You might be wondering why I added ‘it’s paid for’ from my previous statement. Statistics state that the average cost per new graduate hire is $41,624 (Nurse Economic$, 2007). A facility will cover these costs for a new grad nurse because it benefits them in many ways… the main reason is that they get a new nurse to work for them! Now as a student, you get to learn from a facility as if you were a new grad hire and it may or may not benefit the facility, so the expenses of teaching you is covered regardless. Long story short, as students we should be grateful that we have these partnerships in place.

 


In no particular order, let’s get started…

  1. Know your Student Nurse Handbook

    • Every facility is different and have specific rules. The handbook usually includes what is expected from you, maintaining school integrity, scrubs, etc.
  2. Look presentable!

    • This is so important. Remember… you are a representative of your school! Here’s the run down:

      1. Don’t be scared to do your make-up.

      2. Fix your hair up, not down.

      3. You can get a manicure, but no acrylics.

      4. Murses… keep your beard nice and tight.

      5. Keep your scrubs wrinkle-free and appropriate.

      6. All nature of body cracks should be covered appropriately.

  3. Be on time!

    • You should never be late. This is pretty self-explanatory.

  4. Be prepared!

  5. Be respectful!

    • This is self-explanatory as well. Be respectful to the patients, staff members, and to each other.

    • Be mindful of your tone and voice. I’ve come across a particular group of nursing students who came into the unit arrogantly yelling as if they’re coming to party, making their presence known so loud that it woke up our patients. This is rude and disrespectful. Don’t do this!

  6. Know what you can/cannot do!

    • Schools are very particulate and your clinicals are driven by what skills you’ve been checked off on. Some schools will let you do IVs, some won’t. Before getting excited to do particular skill, go to your instructor first! Get it approved and your instructor may do it with you.

  7. Be an advocate!

    • Let’s face the reality… As students, you have fresh nursing knowledge so be proud of it. If you come across a questionable nursing practice, bring it to your instructor’s attention. Be confident on what you’re questioning, explain your reasoning, and your instructor will report it to the chain of command.
  8. Learn!

    • This is the perfect opportunity to import what you know into clinical practice. It is during clinicals where you can make correlations and rationales for medical diagnosis. This is the only place where you can practice and understand what you’re doing before you get into the field.
  9. Help others!

    • Let’s face another reality… some nursing students thrive and some do not. Help each other as much as you can.
  10. Finish on time!

    • You should never be late with turning in your assignments and required paperwork.

References:

Nursing Economic$ (2007). A Magnetic Strategy for New Graduate Nurses. [PDF] pp.6-11. Available at: https://www.nursingeconomics.net/ce/2009/article020612.pdf [Accessed 27 Mar. 2018].

DISCLOSURE:

There are some affiliate links above that I get paid for, but they're are all products I highly recommend. I would not put anything on this page that I haven't verified and/or personally used.


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Nursing Cheat Sheets: Get a Freebie!

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It’s definitely what you think! There will be no cheating tolerated in nursing school!

My nursing cheat sheets were these one page sheets that each contained a specific medical diagnosis and included the symptoms, labs, images, and nursing interventions. YES, all of it in one page!

I used to make these nursing cheat sheets all throughout nursing school and it helped me out so much when I was always on the go.

Think about it!

How often are we always on the go to clinical or lecture? How convenient would it be to have a sheet that you could just pull out of your pocket and use to study?

That is exactly what I did! I took my nursing cheat sheets everywhere I went. I took it when I went to clinical and if I had a patient with “XX” as their medical diagnosis, I would pull out that my cheat sheet for that.

Here is an example of a cheat sheet on “Hypoglycemia”:

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Want your own sheet?

Sign up below to get a free document that you can print out and use for yourself!

 
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What Is My Nursing Philosophy?

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When it comes to patients, nursing is advocating for their well-being. We treat the body as a whole. 

I wrote a Nursing Philosophical paper for one of my nursing classes back in the day and this is how I opened the discussion:

What is the definition of nursing? The American Nursing Association (ANA) defines nursing to be “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.” (What is nursing, n.d.) Similar to the ANA’s definition, the International Council of Nurses (ICN) also defines the term nursing as the "promotion of health, prevention of illness, and the care of ill, disabled and dying people." (Definition of nursing, n.d.) The International Council of Nurses (ICN) states that individuals of all ages, families, groups and communities are entitled to collaborative care whether these populations are sick or well. These definitions from both organizations emphasize the main purpose of what nurses do and defines the act of nursing to be universal. As nurses, it is important for us to evaluate our own personal values and understand the importance of providing holistic care.

Putting all dictionaries and research to the side, I conclude nursing to be, not only an act of something good, but a duty to what is a necessity. My whole philosophical nursing ideal was focused on Jean Watson's Theory of Human Caring and it's easy to conclude: in order to care for a person, you have to see the person as a whole. You have to tend to all the needs of the patient: emotionally, physically, socially, and spiritually.

There are various generational issues that have had a big impact on the image and profession of nursing. The nursing profession is often affected by the image that it stands for, but in reality, several barriers have caused our image to be invisible. Generational issues such as nurse being dependent on physicians and hospital policy, being threatened to lose their job, or having the historical role of being a handmaiden has made the nursing profession silent and less independent. Because of these factors, it has caused nurses to be fearful, insecure, and timid of their profession. 

It is evident that the general public are unaware of what type of education it is required for nurses to acquire to be a registered nurse and what it takes to stay knowledgeable with the latest news with evidence based research. The media has also played a big role in making the nursing image be a profession of taking care of others, but without having the possession of intelligence, critical thinking skills, and competency to meet the patient's needs. The "sexy" nurse, for instance, have been a negative stigma that has been associated with the nursing profession for years and it is still be portrayed to this very day.

Despite the generational issues associated with the nursing image, the nursing profession still ranked as number one in the annual list of occupations that portrayed honesty and ethical standards (Finkelman & Kenner, 2016, p. 31). It is a necessity for nurses to know the importance of showing one’s voice and to speak out. Nursing is a complex professional that requires caring hearted individuals with great knowledge to advocate for patient needs. We must take part in being involved within the inter-professional care team and to not be fearful to do so.

References:

Finkelman, A. W., & Kenner, C. (2016). Professional nursing concepts: Competencies for quality leadership (3rd ed.). Burlington, MA: Jones and Bartlett.

Buy the book I used here:

Disclosure: There are some affiliate links above, but they're are all products I highly recommend. I would not put anything on this page that I haven't verified and/or personally used.

How To Manage Your Time: Nursing For Day Shifts

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There are some affiliate links below, but there are all products I highly recommend. I would not put anything on this page that I haven't verified and/or personally used.

What is a typical day shift like for nurses? How do you manage your time well enough to be able to leave on time? Unfortunately, there is no definite answer to this. We first have to look at the nursing day as a whole, not just one aspect of it. We have to consider what we can do to make the day go by easier and to do this effectively, it might be easier for nurses to figure out what we can "get out of the way" rather than focusing on completing a certain task.

*please note: some of my tips are according to my facility. Please acknowledge your facility's policy prior to adhering to what is recommended by this article.

Understanding workload and a typical day

But first... lets understand workload. Workload is the amount of work done by someone on a daily or shift basis. Workload can be broken up into the following

Frees up Workload:

  • Dialysis patients
  • Patients going to surgery
  • Patients going off to do a procedure

Add-on to Workload:

  • Type of patients
    • Alcohol withdrawal
    • Delirium/confused
    • Elopement risk
    • Bipolar/Schizo
    • Pain-seekers
    • Hospice
  • Condition of your patients
    • Vital Signs (VS) unstable
    • Actively dying (under hospice)
    • Agitated (or angry family)
    • Labs unstable (electrolyte replacement, blood transfusions, uncontrolled blood sugar)
  • Specific patient scenarios:
    • Transporting a patient down to surgery
    • Difficult admissiondischarge

Expected Workload:

  • Admissions
  • Discharges
  • Transfers
  • Medication Administration
  • Assessments
  • Multi-Disciplinary Rounding (MDR)
  • Documentation
  • Tending to needs of the family
  • Answering/making phone calls from everyone
  • Adhering to orders
  • Nursing interventions
  • Fixing "cleaning-up" orders
  • Assisting with ADLs
  • CNA duties (when they are not available)
  • Tele strips

A Typical Day Shift (Ideal)

Schedule:

0600 - 0700:

  • Look up your patients (including vitals and trends)

0700 - 0800:

  • Get report.
  • Give report to your clinical technicians (CT).
  • Start pulling up insulins and give along with your 0800 meds

0800 - 0900:

  • Start giving your meds. As you're giving your meds, start doing your assessments.
  • Document your assessments.
  • Sometimes, I will not start 1000 meds until I have finished documenting the assessments I have done already.

0900 - 1100:

  • Start 1000 meds.
  • It is important to round with your doctors so that you will know what the plan of care is for your patient.
  • Finish documenting.
  • Help your CTs with activities of daily living. During this period, you will be able to do your skin assessment.

1100 - 1200:

  • Start your insulins and 1200 meds.
  • Get everything done to make it to mid-shift huddle.

12:00 - 1300:

  • Look at your vitals.
  • Finish up with 1200 meds or documentation.
  • Make it to huddle and give your charge nurse report.

1300 - 1400:

  • Go eat.
  • Once you're done, start giving your 1400 meds.
  • Start charting careplans and tele-strips.

1400 - 1600:

  • Be available for your patients (tend to their needs)
  • Look at your 1500 vitals (the last set of vitals for your shift): make sure they are stable.
  • By 1600, your charting should be done.

1600 - 1800:

  • Start looking at your blood sugars for your last insulin coverage.
  • At 1700, start giving your 1800 meds.
  • Look at your IV bags: replace them if they're about to be empty
  • Start letting your patients know that we will be giving report soon.
  • Tend to their needs now so that nursing report is uninterrupted.

1900 - 1930:

  • Start giving report
  • Leave

Tips on managing your time:

Come in early and look up your patients. People might think I'm crazy for coming in an hour before my shift, but looking your patients before you start is so helpful. I come in an hour early, look at everything for my patient, and get report. When I get report, everything is just a reinforcement and all of the information sticks better.

Get organized. I have stated this multiple times throughout my other articles. Get all of your materials together. The best practice is to have your stethoscope around your neck, your preferred assessment sheets, and your favorite pens all prepped for the day

Here are some of the stuff that I have that you all may be interested in having as well:

 

 

Get charting done as early as you can. In that way, you can focus most, if not all, of your energy into nursing.

Real-time charting. What does this mean? This means you are charting as you go. Once you’re done performing your assessment, start charting it. You won’t have to spend the last minutes of your day charting or trying to remember what to chart. 

Clean up your orders at the beginning of your shift. Cleaning up your orders can be a pain. Sometimes you come into a shift and you see duplicate orders or orders that you feel like were unnecessary. Doing this early on clears up confusion and decreases errors.

Tag team with a buddy. The buddy system has been out and about in nursing practice for a long time. People think it’s minuscule... but if used appropriately, it can be quite effective. Your “buddy” is that one person during your shift that covers your patients during your break, signs you off for your high risk meds, and other nursing tasks. Of course, you will do it for the other person as well. 

Rounding with your MDs. It would be best to round with your docs to be updated with the plan of care. During this time, I like to address and clarify nursing orders. I also like to get orders as early as I can so that I don’t have to page them last minute.

Anticipate the expected. Consider the following scenarios:

  • If you know your patient is going to dialysis, call the dialysis unit in the morning and get a time on when they're going. In that way, you can manage your time around that time
  • If you have a patient who's getting pain medicine every 2 hours and has been getting it consistently with no plans of weaning off at this time, get ahead of their pain. Don't wait until the patient calls you during your lunch.
  • If the patient is going down for surgery and has an order for telemetry, ask the doctors if the patient can transport off monitor. If not, tell the receiving unit if they can assign a RN transport.
  • If the patient has been nothing by mouth (NPO) all day for a surgery, order them a lunch or dinner tray any way. In that way, if the surgery gets pushed back or cancelled and the patient gets that diet order again, you're already prepared.
  • I can keep going... I'll stop here. You get the drift, right? Try to get ahead if you can predict the future.

Tag team with your certified nursing assistant (CNA). This is pretty much one of the most important aspects of effective teamwork. Teaming up with your CNA increases your productivity. You can tag team those patients with their activities of daily living, ambulation, heavy patients, etc. The more you get them involved in understanding the plan of care for the day, the better. They can even anticipate the expected with you.

Get your supplies together. Put some flushes, line caps, and alcohol pads in your pockets. Start your day.


Disclosure: There are some affiliate links above, but they're are all products I highly recommend. I would not put anything on this page that I haven't verified and/or personally used.

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What Nursing School Did Not Warn Me About

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watch the new video!

Nursing school was one of the most hardest journeys I've ever dealt with in my life. Believe it or not, I've had far more heart breaks from nursing school than any of the guys that ever tried to break my heart (lol just kidding). The time I spent listening to lecture audios, participating in study groups, and practicing endless exam questions was a sacrifice I knew I had to overcome to get those last two credentials (RN) after my name.

Once I graduated and entered my unit, I did not imagine that nursing is as difficult as it is studying for it (I'll explain this later). I was having lunch with my girlfriend from nursing school the other day and realized how nursing has changed our lives. It has changed our personalities, our personal lives, the way we move, the way we think... and at the end of the day, we came to the conclusion that nursing is not only one of the hardest professions to study for, but it is one of the hardest professions to deal with of all time. What makes nursing one of the hardest professions?


Nursing is physically demanding

 Pic from pinterest.com "nursing humor"

Pic from pinterest.com "nursing humor"

We, nurses, hear 12-hour shifts and assume we have the best hours. But little did we know how easy it became for 12 hours to turn into 14-15 hour shifts. Some nurses work their shifts with 3 days in a row, allowing them 4 days off at a time.

Seems like a great deal, huh?

But working three 12-hr shifts can be very exhausting. Things to keep in mind why nursing is so tough:

Please be mindful that my experience comes from a medical-surgical (med-surg) standpoint

  • You're on your feet for 12 hours
  • You're constantly walking
  • You're working with total-assist patients
  • You have 5-6 patients (all of them could be totals)
  • You don't get to eat a reasonable hour
  • Some do not eat at all
  • You're assisting with activities of daily living
  • Your charting your whole day
  • You're making phone calls

Nursing is mentally draining

When you're on the floor (either at bedside or as charge), you are continuously using your critical thinking skills to make the appropriate decisions for your patient. This embodies the act of patient advocacy and promotes their safety.

As the bedside nurse, you are:

  • making sure you're applying the 5 patient rights to medication administration
    • You're assuring that medications are appropriate for the right patient, given at the right time with the right dose through the right route.
  • continuously making decisions for the patient's safety
  • admitting, receiving, and discharging patients
  • prioritizing your care
  • answering phone calls from different doctors and other staff members
  • taking and doing physician orders
    • not only does this include orders from internal medicine MDs, but other specialties as well (cardiologists, oncologists, etc.)
  • dealing with over-involved families
  • taking verbal (possibly physical) abuse

Nursing is emotionally disturbing

With nursing, you will always be dealing with issues that could impair your own values and beliefs. You will be faced with traumatic situations that you might find disturbing and are usually based on the type of patients you deal with.

From a med-surg standpoint, we deal with all kinds of patient. The difference between med-surg and other floors is that we do not specialize in anything specific. We will take care of you no matter what condition you're in.

And what we tend to forget is that every patient has a story... 

  • some are homeless with no families
  • some were/are mentally and physically abused
  • some come from broken families

And we deal with traumatic and emotional situations...

  • loss of a patient
  • verbal and physical abuse
  • IV drug users
  • alcoholics
  • advanced dementia
  • so much more (these are just to name a few)

Nursing will have you question your drive or determination and easily replace it with disbelief and lingering guilt. We tend to blame ourselves if something goes wrong or if a patient is not happy. But what we have to remember is that we, nurses, are all human as well... we are not perfect and we certainly cannot make everyone happy.

Nursing is time consuming...

As stated before, 12 hours easily turn into 14-15 hour shifts on a busy day. You work random days every week and you may very well will be missing certain special occasions and holidays to meet staffing needs. You are also obligated to work weekends and no one is exempt from this.

At times, it gets difficult to do the things that you want or need to do on a daily basis. You come in for your shift at 7 o'clock in the morning and you may not leave your shift until 8 o'clock. Sometimes it can even be later depending on how well you managed your time during the day.

When you do get home, you are physically exhausted to a point where you cannot get any chores done. I, personally, have no children or a husband to worry about at this time in my life so I do not have to tend to anybody else but me. But sometimes, I wonder how some nurses do what seems like the impossible to me. How do nurses strive to meet all ends of their activities of daily living and still find the time to tend to the needs of the family? Because we're great at what we do... that's why. To this very day, it still amazes me how nurses make everything possible. 

Despite of all the negativity, nursing is still the most rewarding profession.

Sometimes I do wish that somebody warned me about the 'other side' of nursing, but would have I picked any other profession even if I knew that nursing can be quite difficult?

Absolutely not.

I would not trade my experiences as a nurse for the world. Nursing has made me become who I am now. I am smarter, stronger, faster, more driven... not just with nursing, but with life. I met some of the most wonderful people and listened to their stories that are beyond memorable. When the day gets rough, sometimes you just have to sit down and remind yourself what nursing is. Nursing is a profession that embodies the act of human caring... It is a profession that advocates for patient safety and well-being... better yet.. It is a profession, in which a patient gives you a hug and says, "Thank you for saving my life." 

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Hey Nurse: Finding Your Specialty

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 Pic from Pinterest.com

Pic from Pinterest.com

So you passed your NCLEX… what's next?

Get a job!

We all know the there are a lot of job opportunities for nurses, but there are a lot of questions you have to ask yourself before you start applying for different jobs.

The questions I provided for you are only half the questions you could ask yourself for you to find your specialty. But to be honest, most nursing students know what specialty they want to get into before they even graduate. Try to make the most out of your clinicals and explore your inner feelings about a specific specialty.

From a personal standpoint, when I first started nursing school, I wanted to be an emergency department (ED) nurse. I wanted to experience the adrenaline and get into that fast-paced, high-intense environment. I wanted to see traumatic situations, similar to scenarios that you see in movies and TV shows. After doing my rotations, I found out how much I hated it. It's very different from what I expected and I felt like I got more patient interaction when I was on a medical-surgical unit. I also wanted to work on a general floor and get the most out of my experience at bedside so I decided to apply only for medical-surgical positions.

So how about you? Ask yourself the following questions and find what specialty you want to get into.


Questions to ask yourself?

  • Why did you get into nursing?

Some people naturally wanted to get into nursing because they want to work with kids or the elderly. Only you would know what your 'calling' is and you should go towards that direction.

  • Which facility did you like working in, hospital, long-term, dialysis, rehab, school, etc?

I have eyed the hospital setting since I was in nursing school. I knew that I needed to get into the hospital as soon as I became a licensed practical nurse.

  • What population did you like working with? Geriatrics? Pediatrics? Newborns?

I have a soft-spot for the geriatric and adult population. Though I love babies and children, I do not have the patience to work with them (just being honest here), therefore I knew I would not be able to work in a pediatric or mother-baby unit.

  • What specialty did you find the most interesting during nursing school? Did you do well in that course?

I loved medical-surgical. It was the most interesting and I did the best in that course because I understood the disease processes very well. It’s one thing to find something interesting, but it also matters if you did well in it. Once you’re on the field, its better to get a good understanding of what you’re dealing with.

  • Do you find yourself going for an ED and/or ICU position?

This can be controversial but heck, I’ll say it anyway. It is harder for ‘fresh’ new grads to thrive at an ED and ICU position if they have never had any clinical experience in the past.

I know that people will read my post and try to argue my statement, but let me state the reality. Any specialty has its own ‘specialized' workload and their own specialized stress. An oncology nurse’s stress, for instance, could be different from a stroke nurse’s stress. However, a lot of units have a medical-surgical foundation, in which a medical-surgical nurse can float to an Orthopedic or Stroke unit. 

With that being said, ED and ICU requires a little bit more. As a medical-surgical nurse, I will not be able to float to either of those units because it’ll be unsafe. ED and ICU units not only require a strong medical-surgical background, but they also require knowledge of what to do during emergency cases, ventilation machines, high-risk medications, and so much more. You will be exposed to situations that could be traumatizing to a fresh mind. The amount of work stress in intense care units could lead to nursing burnout and in turn, could cause compassion fatigue and career changes. Be mindful of your workloads and patient ratios: A medical-surgical nurse’s patient ratio could be 5-6:1 versus an ICU nurse’s ratio could be 2:1, which is said to be an equal workload. (I believe that a medical-surgical nurse’s workload should be 4:1, but I’ll save the for an opinionated article… LOL!)

So now let us all be realistic. For those who are new grads with no experience, do not be surprised if an ICU or ED unit turns you down! Apply for a medical-surgical unit, build your foundation, and apply for any position.

HOWEVER, I know that some ED and ICU units have hired new grads with BSN degrees. But even with that being said, I have spoken to many ICU nurses within my hospital that state how unsafe this may be, not only for the unit but also for the actual new grad.

  • Where do you see yourself in the next 5 years?

Try to find a deep answer for this. I see myself with my master’s in leadership and management and help run operations within a hospital. Now what that may entail… I have no idea. There are so many positions available within management, but regardless, building nursing experience is the most important.

Finding the answer for this question could help guide how you drive your career path when you’re out on the field.

  • Which one is more important: high pay or experience?

There are so many factors that could affect pay. Long-term care facilities pay higher than hospitals. Advancement (which comes with higher pay) could also vary depending on how small or big a company/facility is. Pay could also depend on location, in which hospitals within major cities pay higher. 

Nursing is known for its high pay and good benefits, but I hope you are not in nursing just for the pay…

Depending on your end career goal, nursing experience is so important for a lot of job opportunities. Job opportunities could care less about what you’ve been paid with in the past. In this field, the more experience you have, the more opportunities you have.


How many specialties are there?

Too many to count! I came across a list from discovernursing.com that shows the characteristics and the education required for each nursing specialty. If you click a specific specialty, it provides a brief preview of what to expect when you're in the field. 

CLICK HERE FOR THE DIFFERENT SPECIALTIES

provided by Johnson&Johnson and their campaign for nursing

 

Hope you guys found this article useful! Please comment below what specialties you decided to go into!

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How to Succeed In Your Nursing Clinicals

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Going to your clinical site can be quite overwhelming.  For those of you who are just beginning your nursing school years, each institution has a requirement amount of clinical hours, where each student will have to attend a specific facility to follow a staff member (either a Registered Nurse [RN] or a Certified Nursing Assistant [CNA]) and learn under them. 

 Pic from pinterest.com

Pic from pinterest.com

A clinical site can vary according to your lecture or theory class. This means that if your lecture is about the Medical-Surgical specialty, your clinical site will probably be at a hospital setting at a medical-surgical unit. The amount of hours for each clinical specialty can vary according to your institution. For instance, our psychiatric clinical rotation required us to complete much less hours than our medical-surgical rotation.

Here is a breakdown of what my clinical rotations looked like:

  • Fundamentals: Nursing Home (Long-Term Care)
    • Head-to-toe physical assessments, bed baths, medication pass, bed-making, wound care, care plans.
  • Medical Surgical: Hospital
    • Head-to-toe physical assessments, understand diagnoses, understand medications and their use, pass medications, write care plans, start nursing skills (IV insertion, NG tube insertion, etc.), documentation, Operation Room (OR) rotation, Cardiac Rehab rotation, Intensive Critical Care Rotation.
  • Community: Projects
    • Group project included research on the community (focused on spreading the word on the community's efforts that go against drunk driving), interview community officials and their thoughts, present and publish our efforts.
  • Psychiatric: Acute and Outpatient Facility
    • Interview residents using effective communication techniques, determine which techniques were effective and non-effective, explore psych diagnoses and differentiate accordingly
  • Pediatric: Acute and Elementary School
    • Complete head-to-toe assessments, same duties under medical-surgical except there were no rotations.
  • Obstetric: Acute and Doctor's Office
    • Complete OB assessment, interview a patient, same duties under medical-surgical except rotations included different specialties (NICU, Labor and Deliver, post-partum)

Now let's get started with some tips on how to succeed and get the most of our your clinical experience.

1. Be on time! 

If not on time, be there early! I can't stress this enough. Sometimes it takes more than a minute to get setup and get ready for your day. Get all your assessment papers ready, have your stethoscope around your neck, and get ready to start your day!

2. Get your assessment done early!

The earlier you finish your paper work (assessments and care plans), the more you can observe and learn from the nurse that you are following.

3. Look up your medications!

Before you give any medication with your clinical instructor, look up your medications. This is very important. Knowing your medications off hand will let you know what to expect after you give it. Your patients could ask you questions about the medication and educating them properly is a part of medication safety.

Your clinical instructor is constantly observing you during this process. Sticking to the 5 patient rights of medication safety is so important. You can get in a lot of trouble if you don't adhere to those rights. This is basic nursing fundamentals, don't ever forget them!

4. Have pocket clinical books!

It's nice to have references for everything, but carrying a big book to clinical is difficult and not functional. There are usually pocket versions for everything. For clinical, it would be best for you to have these pocket books on the go.

5. Have all your supplies ready!

Click here for the Must Haves for Clinicals! This article provides all the supplies that you'll probably need for clinical. Don't ever forget your stethoscope! Some instructors will send you home if your forget it.

Some include:

  • Extra pens and pencils
  • Watch
  • Stethoscope
  • Penlight
  • Scissors
  • Pocket books
  • Clipboard
  • Study notes/cards from lecture/theory

To make the best of your clinical experience, not only from a 'trying-to-pass' standpoint, but for your own personal gain, always study your pathophysiology in order to understand your patient's case. It serves no purpose to go to clinical, to come across a medical diagnosis, and have no clue on what it is and how to nurse through it.

Your clinical instructor will be asking you questions throughout your day and it is so important for you to be answer those questions with great confidence. Your clinical instructor will be looking at how you can apply your knowledge into a clinical setting and this is the time to prove that your capable of being a nurse!

Hope you all enjoyed short and sweet article! Please feel free to comment below and if you have questions at all, don't hesitate to ask!

My Nursing Journal: Why You Should Start One

My nursing journey is so full of experiences that at times, it is difficult for me to remember every single aspect of it. Everyday, I learn something new and in order for me to reinforce it, I write it down. I've been journaling about nursing and my experiences about 1 year into nursing school and I am so happy that I started such a habit. Not only do you get to keep track of your experiences, but you also monitor your progress. You can read back and see how you've bloomed into what you've become now.

I started journaling with a great company called Midori Traveler's Notebook and up to today, I still continue to journal in it. My first booklet consisted of learning content from my nursing school's lecture class, but once school finished, I found myself journaling more of what I learned during work and my experiences. I continue to use my nursing journal for noting completed tasks, my emotions, and everything else that I've learned that is new. Journaling is such a great way to relieve stress, manage progress, and plan out how to get better at what you do. I stand behind journaling and how it plays a part in our health. 

As of right now, my midori contains 3 booklets (I use Field Notes):

1. Training/Assessment booklet:

This booklet contains everything I learned during my computer/system training for work. I use this as a reference to remind myself of daily shift requirements for assessments, admissions, discharges, and other computer necessities.

2. Nursing Reference booklet:

This booklet contains references for protocols, medications, procedure checklists, and so much more. Everyday I learn something new from others and at the end of my day, I try to write them down in this booklet.

3. Calendar/Nursing Diary booklet:

This booklet I use as a diary. I used to write down my work schedule, but making calendars are too much work with a busy schedule. I just use this more of a calendar list, where I write down the days I work and write a quick 3-line diary entry beside it. This allows me to look back at how I handled that situation and/or how to make it better the next time.

I hope you guys enjoy this quick article about my nursing journal. Hope this inspired you to start one for yourself. Please feel free to leave a comment below if you have any questions. Love you guys! Happy nursing!

Study Tips for Nursing Students

Nursing school is tough. Nursing students are made responsible to memorize and understand so much material in so little time, but guess what? Before you know, you're mixing up signs/symptoms (s/s) between medical diagnoses. This is when you start making mistakes during exams. Every student usually develops their own study habits after the first or second exam, but I wanted to share how I studied throughout nursing school with the hopes that it may help you as well. Note: Some of the habits that I developed I've acquired from different people. I will give credit to those throughout my article because without them, I would've never passed! :)

1. I never 'just' used the professors lecture material...

Don't get me wrong... Some professors provide the necessary content for you, however, some do not. And those who don't provide the content usually want the students to go home and do they're studying. This is one of the main reasons why I never just rely on given content. It's almost ALWAYS good to go home and study on your own when you go home.

Usually I have the professor's lecture printed out before hand when I go to class. I usually use the printed out material to take my notes down. After lecture, I would go home and re-type everything! (Note: I used to re-write everything, but this was very time-consuming so I decided to re-type instead.) Re-typing was my way of re-inforcing everything. The more you re-inforce, the better it sticks.

2. I always make cheat sheets...

You're probably like.. Cheat sheets? We can't cheat in nursing school! lol! Yes, definitely... there will be NO CHEATING in nursing school at all! But these sheets that I make includes everything in one sheet of paper per diagnosis. And when I say everything, I mean everything (diagnosis, s/s, labs, tests/exams, interventions.) I developed this habit from my cousin, who also graduated from the same nursing school I did. She would make these cheat sheets and took them everywhere she went. 

For an empty cheat sheet template, click here!!!

 I usually just write my cheat sheets, but I decided to type one for you. I use bullet points to make everything much more visible and organized.

I usually just write my cheat sheets, but I decided to type one for you. I use bullet points to make everything much more visible and organized.

3. Join study groups, but make time to study by yourself...

Everybody in my nursing program recommended to make time for study groups. With study groups, you'll be able to see what others know and know what you need to work on. You'll be surprised at what information you can learn from others that you totally missed from studying on your own. However, this doesn't work out all the time.

You can see success with study groups depending on the people who you study with and how much they know. Some study groups can get off track by talking about other things that don't pertain to your study session. Some people come in to the study group knowing the minimum amount of information, therefore can contribute only what they know. And if the content is not fully understood, study group members can confuse each other the wrong information.

Really pay attention to who you study with. While study groups can be helpful, make time to study on your own. Studying on your own keeps you focused on the information and your rationales. If you have questions about something, you can always call someone or ask your professor the next day during lecture time.

4. Practice questions! Practice, practice, practice!

I'm sure you already know that nursing exams are so different than what you're used to. Medical diagnoses can be so similar to each other in terms of s/s that you can confuse them during the exam. So it is sooooooo important for you to practice questions in order to get comfortable with them. Along with practicing, you'll be able to come across rationales and further understand the disease process.

Here are some of the success books I used for Q&As!

By Beth Richardson PhD RN CPNP FAANP
By Kathryn Colgrove, Ray Huttel
By Margot R. De Sevo PhD LCCE IBCLC RNC
By Patricia M. Nugent RN MA MS EdD, Barbara A. Vitale RN MA

5. Take breaks and some time for other hobbies...

Remember to take of yourself and make some time for your hobbies in between studying. I remember learning in my Human Anatomy class that the human brain can only retain 45 minutes of information and be stored into long term memory. Beyond 45 minutes will only be stored as short term, therefore will be useless when you try to reinforce information. (I have no evidence for this fun fact! I learned this years ago!)

For me, I loved to play with my planners and my journals in between studying. Playing with art and crafting as little as 15 minutes allows me to break off from the books and retain information better once I start studying again.

In conclusion, develop your own study habits and conquer your nursing program...

While some of you may find my article helpful, some may not and may still need to develop their own study habits. There is nothing wrong with that all! Find what works better for you and please comment below so that others may incorporate your ideas as well. Most students find a study habit that works for them after the first or second exam per semester.

Hopefully you guys enjoyed this 5 tips I have written up for you today! If you have any questions at all, feel free to leave a comment or email me directly. Otherwise, you guys have a great day today with more happy days to come! Happy Nursing!


Nursing School Graduation Made Easy: Nursing Graduation Checklist

If you're like me, you look through Pinterest to find all the answers for everything. Pinterest has been really good when it comes to providing me with all sorts of ideas and sources to use. When my nursing graduation was right around corner, I looked through Pinterest for some kind of checklist for me to use to keep organized. Surprisingly, there was not a lot of pins regarding nursing graduation. Yes there were a lot of pins that showed different kinds of graduation cap ideas, but I was looking for an actual timeline or checklist when planning a nursing graduation. So I decided to make one for myself with the hopes that you will find it useful for yourself.

Nursing Graduation List:

  1. Apply for graduation/NCLEX (mid-semester)
  2. Purchase cap and gown (mid-late semester)
  3. Make sure you pass! (end of semester)
  4. Buy cap decorations (1 week after finals)
  5. Take grad pics (1 week after finals)
  6. Create & design invites (1 week after finals)
  7. Make an invite list & send invites (1 week after finals)
  8. Party Ideas (can be done whenever)
  9. Purchase dress and shoes (1 week before graduation)
  10. Graduate & Party time! (graduation date)
  • Apply for graduation/NCLEX - Every school usually has their own due date on when to submit an application for graduation. Ours was in the middle of the semester, which was nerve wrecking since we were all still trying to pass this one last class. But make sure to submit yours by their due date and when approved, make sure you get a copy! Some institutions help with the process of applying for the NCLEX. My institution provided us with the Board of Nursing applications, we filled it out and they submitted it for us. This also has a due date before the semester ends. They don't send the applications until after graduation date.
  • Purchase cap and gown - This was also offered early, way before graduation date as well. I'm not sure how early other institutions are, but I know this process can be intimidating to complete. I say that because some people do not want to purchase a cap and gown until they're sure that they passed the class. But during this process, positivity is so important. I would purchase the cap and gown regardless of an unknown outcome, unless you have solid evidence that passing is inevitable. Some institutions may even run out of stock so whenever available, be positive, know you will graduate, and purchase your cap and gown! :)
  • Make sure you pass! - If you don't pass, unfortunately there will be no graduation.
  • Buy cap decorations and decorate - Usually done in the end, when it is definite that you will be graduating. Go on Pinterest for inspiration and start decorating yours!
  • Take grad pics - This is optional. I chose to do it with the help of my brother. It's something fun to do. I used my grad pics for my invitations.
  • Create & design invites - My institution provided cards where we can print our invites with their logo embedded on it. But you can get creative and make your own!
  • Make a list & send invites - start sending!
  • Party ideas - I used Pinterest to help me plan mine. 
  • Purchase dress and shoes
  • Graduate! & Party! - go and walk! Don't forget to party!

You've graduated, so what now?

If you read the first step of the nursing graduation list, you will see that it's NCLEX time. Whether or not you institution helped with the application process, you have to apply to take the NCLEX through the Board of Nursing. You have to fill out the application process and make sure that you have everything you need according to the state that you're applying to. Once submitted, follow up with the Board of Nursing. If your school sent out the applications for you,  follow up with the school and then the Board of Nursing. Once the Board of Nursing has confirmed that they have received it, give them 4-5 days to process the application. Within 1-2 weeks, you will receive your ATT (Authorization To Test) code via e-mail. Once you get this code, follow their directions and schedule your NCLEX date whenever you're ready to take it. Then you're all set! Happy Nursing!

Click here to read my blog: what I did to pass the NCLEX or to read about my NCLEX experience.

What I Did To Pass The NCLEX

Hello everyone! You're probably opening up this post to figure out how to tackle the NCLEX. Before I get started, I do want to say that I'm no NCLEX expert. Some of the things I mention below may work for you and may not work for others. I sure do hope you find this article helpful.

Just a quick background story about myself, my nursing school journey has been up and down. The subject that I found the hardest was Pediatrics and the class I haven't looked over since I passed it was Obstetrics. The easiest class I've had was Medical-Surgical and the class I passed a long time ago was Fundamentals. My overall hated subject matter was, of course, Pharmacology. As far as my work and social life, I worked for 3 days a week, 12 hour night shifts and went out once or twice a week with family and friends.

So now that I have told you a quick story about myself, lets begin!

I did not have my authorization to test (ATT) date just yet, but I evaluated my strengths and weaknesses and arranged my studying according to studying my weaknesses first. This was my order:

  1. Pediatrics (weakness)
  2. Obstetrics
  3. Fundamentals
  4. Pharmacology
  5. Medical Surgical (strength)

I studied lecture and theory first until I got my ATT date. Once I got my ATT, I scheduled my NCLEX date a month out. Some people would like to take it as soon as possible, but because of work purposes, that was not possible for me. So I had my mind set of having a month to study for this exam. Instead of focusing on lectures, I decided to shift my studying to focus on NCLEX style practice questions. I used Kaplan and an app called NCLEX RN Mastery for NCLEX study programs. Both programs contains thousands of practice questions.

In the beginning, I used NCLEX RN Mastery and their study schedule. The first week, I had to do 20 questions every day. The second week, I had to increase it to do 60 questions a day. The third and fourth week, I had to to do 120 questions a day. During the third week, I decided to incorporate Kaplan qbank questions. The minimum amount of questions that Kaplan gives is 75 questions. After I did 75 questions from Kaplan, I switched over to RN NCLEX mastery until I did 120 questions a day. Now that I have done the NCLEX, I can safely say that Kaplan questions is the closest to NCLEX questions, however Kaplan is $350-$400. RN NCLEX mastery is only $29.99, however the questions are more so like the questions we had on exams for lectures. 

Once I finished my questions for the day, I studied 1-2 hours of lecture starting with my weaknesses. If I get tired of reading about one subject, I studied another subject until I am done studying for the day. I did that until it was the day before test day. My only break from studying was the day before the actual NCLEX day. The day before test day I decided to relax and pamper myself. The most important thing was to make sure to get a good night's rest.

In the morning, I made sure to cook a nutritious breakfast. I drank the most delicious coffee I've ever mixed up and decided to look at my quick notes. The only thing I looked at last minute was lab and drug toxicity values. And then it was time to start driving to the test center and take the test. 265 questions later... I passed!

For my nclex experience, click here to read!

Hope you guys found this useful. If you guys have any questions about anything, please feel free to comment below or email me direct me! Remember that you too will pass! Have a great one!

My NCLEX Experience: 265 questions and passed!

 The beginning to everything! 

The beginning to everything! 

Finally.

The day has come. It was test day.

I had a few hours to myself before it was time to take the biggest test of my life. Knowing my test wasn't until 8:00am, I decided to wake up four hours earlier to get beautified for the moment. I made myself some breakfast with a cup of coffee and roamed through Pinterest for a while.

When the time hit 6:00am, it was time to start driving. When I got into the car, I knew that this was it. This was the moment of either making it or breaking it. I was so anxious that I started to feel palpitations. My anxiety was through the roof and all these negative thoughts came through my head. But I started to think and breathe more effectively. I couldn't let my anxiety run me over. I arrived at the testing center and underwent the whole process of signing in. Once they called me to the back room to start my test, I got really nervous. I was so ready to get this test over with. 

The test was going well in the beginning until the harder questions came rolling in. The harder they got, the more nervous I became. I was hoping to stop at question 75, but it kept going to 76, then 77, 78.. and then I found myself at 150. I knew that this test might go all the way to the end. Surely enough, my test cuts off at 265 questions. It took 3.5 hours to finish my test! I left the building in shock and disappointment. Despite my exhaustion, I still had enough energy to stress over it. I'm thinking to myself, "I must've done so terrible that PearsonVue had to give me 265 questions to figure out if I'm passing or not." I knew for sure I failed the exam!

I immediately called my mom and started crying while driving home. I told her that I didn't know if I passed. But with good faith and a lot of prayers, I calmed myself with positivity. I told myself, "Be patient. Quick results will be available 48 hours. You'll know soon enough." I waited a few hours , but I couldn't help myself... I had to do the PearsonVue Trick. I felt some relief when PearsonVue wouldn't take my payment and I got the "good" pop-up message. I did the PearsonVue trick a few more times until I felt better. To add to the relief, I googled the subject matter "265 questions on NCLEX" and I was happy to read about a lot of students who passed at 265 questions. Later on the night, I prayed and read my prayer letters over and over again. The outlook was looking great or at least promising, but I was not going to be satisfied until I got the actual results. So I let the days pass by. 

It was finally Sunday. I knew my 48-hour wait would be done once the clock hit 11:30am. Me and my family went to church and continued to pray. Around 10:30, the test results were available. My heart rate shoot up because I didn't think the quick results would be so early. I paid PearsonVue.. and finally I found out I passed!

A quick sense of happiness and relief came over me. My family is so excited to hear the news and they celebrated this moment with me. I could not believe that I finally conquered the biggest obstacle of my career. After all the stress from nursing school and feeling hopeless, I can finally say that I am officially done with nursing school! I am now Dominique L. Tecson, RN!

If you're reading this article, I'm assuming that you're also trying to find some kind of hope that you passed after taking a 265-question exam. I know you're stressing out and anxious at this moment, but with prayers and good faith, you will pass! I hope that after hearing my NCLEX experience, you will find that sense of relief that even with 265 questions, you can pass too!

 

Don't let 265 questions get to you! Train yourself to taken the whole exam and be confident that you will pass!

Stay positive! You will make it through!

Nursing School: Must-Haves For Clinicals

Nursing programs have different requirements for clinical rotations. Depending on your semester, clinical rotations can differ in specialty and require you to do a various set of nursing skills. Regardless of which unit your clinical semester will be, the necessities are still the same. I have provided you a list of must have books, tools, and so much more to make your day or night at your clinical rotation a lot easier. 

Buy Links to your everyday clinical needs now available to be bought through the links on the right!


Basic everyday needs for clinical:

  • A pen with different colors (BIC)

Instead of carrying several, different colored pens, you can just be carrying one pen. The different colors are useful to make special notes pop out from your assessment sheet, such as allergies, specific events, etc.

  • Extra pens and pencils

You should always carry extra pens and pencils for emergency purposes. It is really easy to lose your stuff at the hospital.

  • Stethoscope [!!!]

This is a deal breaker for most professors. You should always have a stethoscope ready for clinical. If you forget your stethoscope, they can send you home and put you down for a clinical absence.

  • Perfect fit scrubs and comfortable shoes

If your school requires you to wear a uniform, try to wear your scrubs fit, but yet loose, meaning you should be able to breathe and be comfortable in your scrubs. Remember that nursing is not a fashion show and that showing your figure is not professional.

Comfortable shoes are so important. Try to find comfortable shoes because you’ll be on your feet probably the whole time. Most professors don’t like to see their students sitting down so it would be nice to have those shoes that have gel or soft sole cushions inside. Some people recommend using Ted stockings, but this can be a hit or miss. Some of my peers swear that these stockings helps with leg and calf pain, but there are some, including me, who find the stockings uncomfortable. They were cutting of my leg circulation, but they're really cheap so why not give it a try to see if it works for you.

  • A small pocket notebook

This small notebook is just for notes. It’s really good to write down what you learned especially when it’s something new. This is good way to reinforce learning.

  • Nursing blunt scissors

This may not seem important now as you're reading this, but you’ll be surprised. Scissors are used to cut clothes for immediate assessments (usually see this down in ER or new admissions), cut gauze and tape for dressing changes, and so much more.

  • Penlight

This is a requirement for clinical assessments, such as pupils, wounds, etc.

  • Clinical pocket medication book

There are various medication books out there that organizes content differently and vary in size as well. I use a pocket size medication book that has the most commonly used medications. It’s so small that it can fit any pocket I have, however, it does not contain every medication. After using it at the hospital where I work, I came across one or two medications that was not listed in the book.

  • Clinical pocket book according to specialty

You should have a clinical pocket book according to the floor where you work. For instance, if your semester is at a medical surgical unit, you should have the clinical pocket book for that subject. They also have books for the psychiatric and obstetric unit.

For medical surgical unit here’s what I used. 

For obstetric unit, here’s what I used. 

I did not purchase one for the psychiatric floor because my rotation for that unit was more community-based, meaning I visited rehabs and other facilities where acute psychiatric intervention was not necessary. However, I did have my lecture notes handy if I needed it during this rotation.

  • Clipboard with calculator (can separate the two)

I personally just had a clipboard and a small calculator handy. This worked very well for me. However, I did come cross some of my peers who used a big clipboard that opens up to store their papers inside. On the top of the clipboard is a small calculator. I never purchased one because it didn’t really bother me if they were separate but for those who are new to clinicals, this can be very handy to you. I also came across a clipboard that folds in half, and when folded, you can put it in side your pocket. Depending on your scrubs, this may not fit if you wear your scrubs too tight. (Note: I do believe that your scrubs should be tailored to your shape but you should not wear your scrubs so tight that you aren’t able to move. Scrubs should fit nice, but yet loose so that you are comfortable while working.)

  • Blank patient assessment sheets

Your professor may give you one to use or they might be okay with you using your own. For my clinical semesters, I’ve used my own assessment sheet and I usually just transfer the data over to the sheet that the professors wanted. You can even make you own!

  • Nursing Diagnosis Book for care plans

This is very useful to have especially when you have to develop nursing care plans for every patient you have.

  • Study note cards from lecture

If you’re one of those students who uses flash cards or study sheets for lecture, bring them to clinical and put it on your clipboard. When there’s downtime on the floor and you have done everything you could do for your patients, you can study for lecture for a little bit. It’s also good to refer to if you don’t have you clinical pocket book.

Hope you guys find this article useful when starting your clinicals for the semester. Please feel free to leave a comment below if you have any questions or if you have any suggestions for new nursing students as well :). Happy Nursing!!

How To Get Organized For Nursing School

Play the video!

Some things to think about when going into nursing school is how to get yourself organized. Whether this is your first or your last semester in nursing school, you know how crazy our schedules can get so it is really important for you to get organized and stay on top of things. Hey, lets get started!

Let's talk about how get organized for LECTURE and CLINICAL! And then we can discuss how to get organized for both. Please be mindful that anything tips suggested are just advice. People learn in so many different ways and if one suggestion doesn't work for you, don't force yourself to do it. :)

LECTURE:

1. Get a big binder! This binder will hold everything for lecture.

  • I use dividers to divide my binder into how many exams we have in the whole class. For e.g., if our lecture will have 4 exams for the whole lecture, I'll have 4 dividers in the binder. 
  • Within each divider, I will have all the topics in it for each exam and use small sticky notes to divide the topics. For e.g., if the first exam is on fluid and electrolytes, cardiac, and GI issues, then I'll divide each topic with a sticky note.
  • I place a folder inside to hold papers such as case studies and articles only related to the exam that we're studying for. After we're done with that exam, I take out those papers and place those in another folder to use as a reference later. This allows me to store more papers that are relevant to the next exam.
  • I add my lecture schedule to the very first page in order for to constantly be up to date with what's going on with lecture. I usually protect the lecture schedule with a sheet protector.
  • Last but not least, I also add blank sheets of paper in the back of the binder just in case.

2. Get a small composition notebook! This can just be used to jot down quick notes. 

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3. Get pens, highlighters, sticky notes, and page flags!

  • I use all different kinds pen! Make it colorful! You'll actually like to read over your notes when it's more colorful rather than having it all dull and boring.
  • Use highlighters to highlight the important stuff. Some professors will repeat themselves more than once, and if he or she does that.. then more than likely that that's something to remember soooo... highlight it!
  • Use sticky notes to write down side notes.
  • Use page flags to remember to look over that page or topic.

4. Get a bag that's only dedicated to your lecture class. This prevents you from clumping up lecture and clinical into one bag. Combining the two can cause major confusion. :/

5. (Optional) Bring a laptop or iPad. I say this is optional because now a days we can use our phone to access anything anyway. Unless you're the type of person that never forgets to print out your presentation slides or lecture notes, you may want to consider bringing in some type of gadget that will allow you to access your notes just in case you forget to bring it in for lecture. You'll be surprised at how many times you come in to lecture thinking you're all prepared, but then the professor asks you to take out the case study that you were supposed to have printed out before coming in to class and you never printed it. Usually sharing with another person is no problem but sometimes it's best to have your own copy.

CLINICAL:

1. Get a small binder for clinical. This binder will hold everything for clinical. Use a folder to hold blank patient assessment sheets and another folder to store the completed sheets to keep track of what you've done throughout your clinical semester. NOTE: PLEASE BLACK OUT PATIENT NAMES ON ANY ASSESSMENT SHEET! THIS IS A VIOLATION OF HIPAA! YOU CAN GET KICKED OUT OF THE PROGRAM IF YOU GET CAUGHT LEAVING THE FACILITY WITH ANY PATIENT'S NAME ON ANY OF YOUR PAPERS.

  • Depending on the how much you have to to get done for every clinical will determine how many folders you should have in your binder. For eg. If I need to get a patient assessment and a nursing care plan for every clinical day, I'll have two folders: one holding several blank copies of a patient assessment sheet and  another blank nursing care plan sheets. You should always have several copies just in case you mess up, you'll always have one handy.

2. Get a clipboard. Usually I like to prepare my clipboard in the morning and clip a blank patient assessment sheet and everything else that is due for that clinical day. That way you're all ready to go on with clinical.

3. Get a small calculator. Very useful when calculating doses for meds.

4. Have a clinical drug book, nursing diagnosis book, and whatever pocket clinical companion book of whatever specialty you're in. If you're in med-surg, have a clinical book ready for that. If you're OB or Pediatrics, have a clinical book for that. Note: Don't bring your text book...they're too big. Clinical books are smaller with the same context. Some nursing book companies make books and a clinical book so that the context are consistent between the two.

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5. Get a bag just for clinical. Put everything for clinical only in this bag.

 

Both LECTURE and Clinical:

1. Plan your semester. It's good to have a planner that shows everything for both lecture and clinical. This tip really helps with time management. You should know when things are due and exam dates. Not only will this planner have your school plans, but you should also jot down your social life as well. I know with nursing school, you'll feel like you won't have any time for anything, but it'll be nice to still keep track of what's going in your life.

 My Erin Condren Life Planner! 

My Erin Condren Life Planner! 

 2. Always have pens, pencils and a calculator handy! 

Welp! There you go! You're all ready set to go! Hopefully some of you guys found this article to be helpful. If you guys have questions or comments, please feel free to leave comments below. Go out there and be great nurses! 

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What to Expect With Nursing School: A Full Breakdown of Nursing School For First Semester Students

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Let me start off this article telling you a quick story about my journey. Nursing school has been a real struggle for me. I am currently in my last semester of nursing school and I couldn't be any happier to be almost done. My journey has been filled with ups and downs, but it's very rewarding to have gotten to this one last class. Thus far, I have completed Fundamentals, Medical-surgal I and II, Psychiatric, and Obstetric/Pediatrics.

It has been quite a journey for me. Nursing is definitely difficult, but it does have its rewards. Before starting nursing school, there were a lot of things I wish I would've known before the program and during the program. By all means, all nursing programs are different so I will try to base my answers not specific to my school.

Concepts to accept about the nursing program:

  1. Nursing is NO JOKE!   Nursing has a lot of content. Content will vary depending on which specialty you're learning. You will be going over all of the specialties in different semesters depending on your program. These will include: Fundamentals of Nursing, Medical-Surgical Nursing (may require 1 or 2 semesters), Psychiatric Nursing, and Obstetric/Pediatric Nursing. Some programs (I've heard through word-of-mouth) are set-up differently, in which some may require you to take Pharmacology and Pathophysiology. I'll list the quick details about each class below.
  2. Nursing will take up your time.  Since nursing requires you to learn a lot of content, it is possible that nursing may take up majority your time. This may be controversial since some students have that magical ability to juggle work during nursing school and still manage to have a social life. Some students even have families and still manage to complete nursing school. Don't get let down by this fact, but just know that you will need to set aside time for nursing.
  3. Nursing will take up your money.  Nursing classes, books, scrubs, and other necessities can be very costly. Get all the scholarship grants and awards you can get.
  4. Nursing will take up your energy.  Nursing will not only take up energy for your lecture and theory classes, but it will also require you to meet a certain amount of clinical hours per semester. You can look at clinicals just like volunteer work for the facility while learning the Registered Nurse (RN) roles. Depending on the program, you'll be required to pass medications under the supervision of your clinical instructor while also tending to the needs of the patient who is under your care. This is why nursing students drink LOTS of coffee! Starbucks will be your best friend for the rest of your life.
  5. Nursing will require you to have a lot of support.  I think this is one of the most important factors to understand. Every nursing student needs to go into the program with great support from family and friends. Your loved ones should be understanding in the fact that you're currently in this phase in your life that requires you to put all your focus into school. In other words, your family and friends should be more than understanding whenever you pass up a social events for study time. Sometimes this is not the case and your loved ones will find you to be dismissive. But it's important to address this matter ahead of time and explain that you will need a lot of support as you make your future career a priority at this moment.

Things to know before the program:

  1. Nursing exams are different from what you're used to.  Let me just say that I was one of those students who excelled in every class. But I wish I would've known that nursing exams were different. When I say 'different', I mean that nursing exam questions are not designed to be concrete. You're probably used to exam questions to have one answer. Nursing exam questions require you to know your content and know how to apply that information into patient scenarios. For example... a typical Human Anatomy Exam Question will be: "The pituitary gland secretes what kinds of hormones?".. then you pick A, B, C, or D and only one can be right. BUT a Nursing Exam Question may look like this: "The nurse walks into a patient's room to find the patient's trash can on fire and the patient is sitting on the chair across the room. What is the nurse's best action at this time? A. Pull the fire alarm B. Remove the patient from the room C. Pull the fire alarm and get the fire extinguisher. D. Confine the fire by closing all the doors and windows." All of these answers look correct, right? But if you've learned the content about RACE (Remove the patient from the area, Alarm the sound, Confine the fire by closing all the doors and windows, and Extinguish/Evacuate) you would be able to direct to the right answer, which is B. I'll let this whole paragraph sink in for a moment. LOL!
  2. Nursing may require you to buy extra books outside the program.  There are students who are naturally gifted and do very well throughout nursing school. But there are some who need a little bit more help. There are books out there available that are made to make learning the content easier. For example, Nursing Made Incredibly Easy books are available for any specialty. There are also Success books available for questions and answers to practice before exams. Some students find the pocket books for clinical very convenient during clinical hours. I've provided you with pictures below so that you know what they look like if you're interested in buying them.

Helpful Key Points:

  1. Develop a good study habit. This key point deserves a whole article itself. There's a lot of ways for you to develop a good study habit depending on your schedule or program. Make it a habit to study the content before going into lecture so that you're ahead of your theory lectures. Practice nursing questions related to exam content every day if possible. Study with a group if that helps you in any way.
  2. Cutting your work hours. I know this may be hard for some of you, especially for those who are financially paying for school, your family, etc. However, statistics have shown that working full-time during nursing school greatly affects your grade. Most employers are quite supportive of school so cutting your work hours may be a good option for you.
  3. Have two bags: one for school and one for clinical.  This is just a way to get organized.
  4. Take care of yourself. It's hard to stay healthy during the nursing program especially under all the stress with exams and clinical. Remember to stay hydrated and eat the right foods. It's easy to gain weight during this time.

Hope some of you found this article helpful. If you'd like for me to write about specific topics about nursing, please feel free to comment below and I would be happy to do that for you. And please.. if you have any tips and tricks to add for those coming into nursing as well, feel free to comment that below as well. Let us help each other! Have a good one! :)

By Dominique Louise