Monday, August 23, 2010

What They Didn't Tell You in Nursing School...


I was once asked to speak at an orientation for freshmen Nursing students, and the anxiety in the room (not coming from me for a change) was palpable- these kids were really eager to hear the trade secrets of surviving Nursing school. These tips are learned from my actual experiences, but I sure hoped someone told them to me beforehand so I could have prepared better. So here they are- hope these are useful to future or current Nursing students:

Fact #1: Though you will be swamped right away with 31 academic units on the first semester, but that will be your best chance in getting the highest grades you can get- because in your junior and senior year they will only decrease.

The curriculum may have changed already and I am not sure if the same policies apply, but back in our time there was a grade cut-off every semester or every year in other schools. In our college, we needed to maintain 2.2 (83%) General Weighted Average to be eligible to proceed to junior year. This meant acing the very basic subjects like Organic and Inorganic Chemistry, Physics, Communication Skills, Math, Statistics, Anatomy,etc. The passing grade for quizzes and exams is only 50% (ie.in a 100 item exam, if you get 50 items correct you'll get a 75% rating) so this makes it easier, come third year the passing rate is set at 75%- which now means in a 100 item exam you also need 75 correct answers to pass. This is done to help prepare the students for the board exam. Moreover, the topics in the later years which covers actual nursing theories and practice are a lot more difficult, so if you are aiming for honors, better get those 1.0's (95%) from PE, Basic Computer, and other "giveaway" subjects.

Fact #2: Starting your 2nd year, skills matter.

During the first year, you need little more than a sharp mind to get the best grades since it is almost purely theoretical. Related Learning Experiences- starting with the very basic vital signs, to enviromental sanitation, to physical examination, to giving bedside care and administering medications including giving injections- skills comprise half of the grade. If you are jumpy or tend to forget things when nervous- this could significantly affect your grade even when you get high scores in pretests, post-tests, worksheets, and major exams. Work on your confidence to boost your skills, and the way to do that is to practice constantly.

Fact #3: Junior year will be the most stressful because of your transition to the clinical area, and at the same time tackle the major Nursing subjects like OB Pedia/ Operating room nursing/ and Psychiatric nursing.

The clinical exposure during 2nd year is very minimal, but after the Capping and Badge-pinning ceremonies, students are officially immersed in the hospital setting. Three days a week (plus one day for nursing audit) will be devoted to honing your clinical skills, and of course this will bleed into the lecture hours at school. During audit day, most students do not sleep because they need to finish all the requirements otherwise they will not be allowed to go on duty the following day. Most finish their requirements by 5am, just in time to take a bath and go attend to their patients like a zombie.

The studying gets even more ridiculous, because if in the second year you needed to finish reading four chapters of two different books before going to class, in junior year you finish the three inch Operating Room Nursing references in four days. The only time devoted to this topic is two weeks, including learning instrumentation, and before you know it- you begin a new area for discussion. Another fun fact: you will work will all sorts of temperamental Clinical Preceptors who will rate you according to both knowledge and skill, and get this- attitude!

You need to develop a study habit by this time because unlike the first two years when one can just relax, you will not survive if you have no discipline. Come up with a way to "detox" after having a stressful or toxic exam or duty- like listening to music or taking a walk, because if you won't find a way to cope you'll burn out (and perhaps lose the will to live, I'm kidding).

Fact #4: Sactions are a bitch.

Always have been, always will be. Make-up duties (they usually give three days once you have an unexcused absence) eat up the days between semesters when you should be resting, so try as much as possible to follow rules and regulations and don't piss anyone off.

Fact #5: You need to have a very good foundation of all Nursing areas in promotive, preventive, and curative nursing, including community and psychiatric nursing because in your senior year, you will integrate and synthesize everything for your Compre.

It is a known fact, the subjects which have the greatest mortality are Foundations of Nursing, Promotive and Preventive (NCM 101), and Curative 1 & 2- in fact our batch shrunk from 500+ in the 1st year to 200+ in the 4th year. The most toxic time would be the final semester because you will have in-house review during the weekends and intensive lectures and seminars during the weekdays. In short, for the month of January and February, we only had a grand total of 2 days that were free.

We had 13 areas in Nursing which had 75 item post-tests, 200 item pre-tests from the in-house review, and two major exams. Do the math: that's 3,175 questions answered in the four month semester. It's a miracle our heads didn't explode.

Tip: Photocopy or buy NCLEX reviewers which will prepare you for the exams, especially if reading the actual books on the concepts cannot be accommodated on a single night. Which is why again, you need to have good foundation since your 2nd year. One of the things I did was create a summary (or bullets) of a certain area, for example psychiatric nursing, I made a reviewer using two books as reference in the third year, and kept it so I could use it as a reviewer for the Comprehensive exam in the 4th year.

FINAL WORD:

Relax. It isn't really as bad as it sounds- believe it or not we also had our inuman sessions or gimmick like regular students do. The trick is finding a balance between studying and fun. Join clubs in school or do engage in something athletic. Gather your strength from your friends and groupmates- you guys are in it together to finish your bachelor's degree. Value the time you are in the hospital or community because experience offers better lessons than those learned in the classroom. Most of all,learn to love your work. Being a nurse gives your great opportunities to touch people's lives by taking care of them. When your heart is really set on finishing Nursing, with a little hard work and prayers, support and inspiration from your loved ones, everything else will fall into place and you'll surely be a success.

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