Nursing OnPoint

Snapshot: This article reviews strategies, both general and specific, for succeeding in nursing school, in academic and clinical settings.

Jump to:

Academics Clinicals
 

Academics

• Practice “active reading.” When you read nursing and science texts, don’t just skim and try to memorize facts. In addition, try to understand why body systems work as they do and why particular nursing policies and priorities are preferred over others. Studying nursing is unique. It requires that you not only recall what you learned, but that you also successfully apply that knowledge in real-world situations. If you understand the underlying reasoning for something you’ve studied, you’re much more likely to both retain it and be able to apply it (not just on a test, but also when you’re working as a nurse).
• Do practice questions (the more the better). Most textbooks and other sources offer end-of-chapter or end-of-book quizzes. Make use of these, and actively re-read areas where you were having trouble. When we read, it’s easy to “zone out” and skim without retaining much. (See the above bullet point). Doing practice questions is a valuable way to see how much you’ve retained, and how good you are at applying what you’ve learned. You’re better off being unpleasantly surprised by your current knowledge level on a practice quiz, when you have time to go back and study more, than on a real test.
• Try studying from different sources. Some textbooks and other study sources are better-written or simply easier to study from than others. If you’re finding your current study source inadequate, try studying from another source, especially one that breaks down or effectively summarizes the information you need to learn. Many NCLEX review books (such as Saunders) offer excellent, highly readable summaries of key nursing concepts. Studying the same material from multiple sources may also help you to examine it from fresh angles, and to therefore better understand it.
• Don’t forget to study the right stuff. It may sound obvious but before you begin studying, carefully review what you need to learn for the test or quiz and make sure that’s where you focus your efforts. If your instructor was kind enough to produce a study guide, read through that first to make sure you aren’t missing something; instructors will sometimes point you toward priority study areas. When you look over the syllabus for the class, be sure you’re covering the right chapters or page numbers. It’s also important to know whether the test you’re studying for is cumulative (whether it tests material from the start of the class) or just material since your last test.


• Don’t “read into the question.” When you’re taking a nursing test, especially when you’re beginning nursing school and have had little practice, it can be tempting to construct “what if” scenarios for any given question and make otherwise implausible answer choices seem plausible – and correct. Avoid doing this. Instead, read the question prompt and interpret the information presented in as straightforward and literal a way as you can; don’t assume or “add in” information to the question that isn’t presented. Doing so can lead you astray and cause you to give incorrect answers to questions you could have answered correctly.
• Find the best answer – given the alternatives. When you’re taking a nursing test, it can sometimes feel like none of the available answers choices is the “right” answer because none of the answer choices available is the “ideal” answer. Remember that your job, however, is simply to select the best answer choice relative to the other choices available. Especially in the beginning of nursing school it can be frustrating to get used to this fact, but that’s how many nursing test questions are often written.
• Pace yourself. Before you take a test, it can be helpful to do a quick calculation to figure out how much time, on average, you can devote to each question. For instance, a 1 hour test with 60 questions on it means you’ve got about 60 seconds (1 minute) to spend on each question; a 1 hour test with 90 questions on it means you’ve got about 40 seconds to spend on each question, and so on. When you’re taking a test, therefore, don’t get too hung up on any one question and waste time on it. If you’ve spent your allotted time on a question you can’t answer, simply make a notation to come back to it and move on. Remember: on most tests you don’t get any more credit for getting a hard question right than an easy one, and you don’t want to miss points because you ran out of time to finish the test.
• Trust yourself. When you’re studying difficult material, or taking a challenging test, it can be tempting to begin doubting your knowledge and abilities. At those times, pause for a moment and remember to trust yourself. As a general rule on tests in particular, don’t second-guess yourself and change your original answer unless you can clearly identify something you misunderstood or overlooked. (See the “don’t ‘read into the question’” bullet above). As long as you study far enough in advance – and study effectively – you have every reason to trust your instincts and abilities.

Clinicals

• Be prepared and on time. Many nursing students get so busy with their academic work that they forget that clinicals require preparation too. It may sound obvious, but at a minimum make sure that your uniform is clean, and that you have proper identification and equipment (stethoscope, notepad, scissors, penlight, etc.) with you at all times. Don’t be late. Not only does it hold everyone else up, you’ll start your clinical feeling rushed and overwhelmed. You’re better off arriving early so that you can start your day feeling relaxed, prepared, and confident.
• Just do it. When you first begin clinical rotations it can be intimidating to interact with patients in a “real world” setting. There’s no perfect way to overcome this anxiety, but plunging into doing the tasks in front of you – with full knowledge that you’re not going to do them very well at first – is probably the best way to overcome it. The more you do, the more skills and confidence you’ll gain, and the better you’ll probably feel. Clinicals are what you make of them. You’re there to learn, and you can’t do that if you shy away from fully participating.
• Listen – but don’t be afraid to ask questions. Clinicals require that you strike a balance between listening attentively and learning for yourself, sometimes by asking questions. It’s a good idea to carry a small notepad with you to write down tasks and patient information; you can use the same notepad to jot down notes while your clinical instructor is speaking if that helps. For some people simply the act of writing helps them to better retain information. Whatever you do, however, don’t worry about asking a “stupid question.” Chances are that if you’re unclear about something others probably are too – and they’ll likely be grateful you asked.
• Actively plan your care. While you won’t be able to know in advance all of your patients’ needs, practice actively anticipating – and planning – for the care you provide. For example, before you walk into a patient’s room, make sure you’ve got all of the equipment and supplies you’ll need to complete your tasks so you don’t have to leave to fetch different items. As you go, practice prioritizing the importance of your assigned tasks, and document and communicate clearly with others so that they what you have and have not done. Your goal is to become a proactive, critical thinker who plans and anticipates care, not someone who merely passively responds to patients’ immediate needs.


• Cooperate. Nursing is a “team sport,” and there’s no better time to practice that skill than in your clinicals. Even if you’re assigned your own patient, pay attention to the needs and requests of others throughout your clinical day, and offer to help when you can. The more patients you can interact with, the more you’ll learn, and the more you offer to help others the more they’ll want to help you when you need it. That experience will be valuable when you begin working as a nurse.
• Reflect. While it’s difficult to assess what you’re doing moment by moment, actively participate in end-of-clinical discussions by sharing your experiences and reflecting on what you and others have learned. While you’ll probably be tired at the end of the day, try to pay attention because this is your chance to review and learn from what you did. Consider, in particular, how your clinical experiences align or don’t align with what you’ve been taught so far in school, and why. Not only will this help you to better understand what you’re studying, it will help you think more critically about your clinical experiences too.
• Let go of perfectionism. Some nursing student approach their clinicals with the false belief that they can or should be “perfect” in how they deliver care, which is bad, or that others should be “perfect” too – which is even worse. This kind of self-criticism is counter-productive, and if you direct it toward others you’ll become disliked (and with good reason) very quickly. Perfection is unattainable even with years of nursing experience, let alone as a student. Be glad that you have the opportunity to practice nursing skills safely and with the help of your instructor, but don’t hold yourself to such an unreasonable standard that you’re unable to relax, try new things, and learn.
• Trust yourself – and have fun. Especially when you’re a student, it can be easy to feel overwhelmed by how much you don’t yet know. While it’s good to have a healthy skepticism about your current knowledge level, it’s equally important to learn to trust your emerging clinical instincts and abilities, which will grow over time. And while patient safety is always your number one priority, do let yourself enjoy the learning process. Clinicals can be a great way to bond with other nursing students, and to remember why you probably were drawn to nursing in the first place – to directly help and interact with patients. So be safe, work hard, and let yourself have fun along the way!