Nursing School Chronicles

Hi guys! So quite some time, i asked you guys if you were interested in some tips on how i manage to stay concentrated for a long time period and how i prepared for my exam season - writing 4 exams in 1 month when i haven’t written a real hard exam in 2 years. It was not that easy, but i managed to do okay. I passed all of them so far - which is cool for me, because they were exams in business class, and i usually don’t have business classes. Anyway, i’m blabbering, so here’s my tips on how to stay focussed! 

1.  have a look at the material you need to study!

This was actually the first thing i did before studying anything. I checked everything i needed to know, wrote down the chapters on each subject (which was, for me, marketing, cultural philosophy, accounting and leadership), and did a study time planner. I roughly planned the time i needed to study for every subject, then i made a day-by-day-study-plan. I customised it half way through and made sure i sticked to it. Also, be sure that you’re honest with the time you’re planning. If you know that you’re a slow learner, please allow yourself the time you need! It’s not a shame if you’re studying 3 months before your exam. It’s a shame if you don’t study because you wanna be cool and only start studying 2 weeks before your exam. IT WON’T BE ENOUGH TIME, depending on what subject you have! At university, it most likely won’t be. Also, be sure to add other things to your study planner, like birthdays, grocery shopping, eating, work, appointments, showering, etc. These all take time, and only if you note these down, you know how much time you’ll have for your study. 

2. have a regular daily schedule

So this is, in my eyes, the most important advice. For me, it worked best when i studied from 9 am to 12 or 1 pm, depending on my concentration, then have a lunch break, and continue to study from 2 to 6 pm with breaks in between. If i still felt like i could concentrate after that, i did another hour or two in the evening. But i slowly had to make my body and my brain accustomed to this rhythm, which took some time. So, if you know you have a though exam period coming up, be sure to not cram, but to slowly work your way towards studying several hours a day. This is best if you start studying or at least making study guides at least 2 months before the exam. 

3. Don’t study the same thing the whole day

So this is actually how i manage to do such long study periods during exam time. In the morning, i usually study some theory - learn things by heart, learn definitions and these things that require your memory. I read them a few times, then first try to recall them by talking, then i need to write the definitions down. So this actually works best when i’m home. I’m running around in my dorm room and need to be comfortable with that. The Library’s not my favourite place for this kind of study session. However, sometimes i have to go to the library, especially if i can’t concentrate at home, which happens too often. Then, in the afternoon, when my concentration isn’t too good and i feel sleepy, i did some calculating and exercises. Since i studied for marketing and accounting, there was a lot of maths involved, which i always had to practice a lot in order to fully understand stuff. It is not as demanding as learning stuff by heart, but it is still important to do exercises for some subjects. If you don’t have to practice stuff, try to do other stuff. There’s mostly the possibility to play around with your study methods, and i totally recommend you to do so! It’ll boost your creativity and also your brain action so you’ll feel more productive! 

4. take breaks

This is really important. In the mornings, i often managed to study 90 minutes to 2 hours in one session, but then i need a break of at least 15 minutes. In the afternoon, my breaks are often much more frequently. I got quite comfortable with studying 50 minutes and having a 10 minutes break. So it’s like the Pomodoro technique, but the double of it. And after 2 or 3 study session, i’ll have a longer break, for like 30 minutes to 1 hour. Also, in the evening, i’ll take time to do other stuff, for like 1 or 2 hours. For example, i like to practice the piano, do some sports, read a book that doesn’t require much concentration, make yoga, cook something nice, etc. I’m sure you’ll find a creative way on how to spend your breaks. Also, it’s very nice to talk to friends during breaks, or have a walk around the campus, if the weather’s okay. 

5. allow your body the right food

Food is a really important thing. I love cooking, and during exam period, it is even more important for me to stay well nourished. Also, i drink lots of coffee and water during my study sessions. And, which is very important, i also allow my body to have sugar in the afternoon. Yep. It is totally okay to have a muffin, or some other sweets if you feel like your brain is a bit down. It’ll help you to stay concentrated for another hour. At least that’s with me. And yes, i also gain weight during exam periods, but for me, that doesn’t really matter. I can always lose that weight afterwards. 

6. stay away from your phone

Seriously. Lock your phone so you can’t see it. Even shut it down. And it’s best if you’re doing the same thing with your laptop, if you don’t need it to study. I printed all of my material, so i didn’t have to be on my laptop all the time. I now that when my phone is lying right next to me, i’m gonna feel the need to check tumblr, twitter or instagram every half an hour. Or respond to unimportant messages right away. Believe me. Your friends can wait until the evening. Tell them that you need to concentrate on your studying, and they’ll understand. If not, ask yourself if they’re worth it. They should be supportive about your education, and if you decide to only reply to them in the evening, they’ll be okay. you’ll be okay. You won’t miss anything important in a day. Trust me. 

7. make sure you know WHY you’re doing this

This is really important if you feel like it’s all useless anyways. I had a clear focus, because i absolutely wanted to pass these exams. It was a totally different subject from what i study (Cultural management/Cultural studies), but i know that i had to get through these subjects because they’re useful tools if you want to be a top manager, even for a cultural organisation like a theatre or an opera. It is always good if you know about financial stuff, even though there may be someone else responsible for that. So, what i wanna say is: find your goal. Find your motivation, know, why you need to do this, and if it’s only just to prove yourself and anyone else wrong. YOU. CAN. DO. IT. 

(When you’re really stuck)

1. Visualize yourself at the bedside; What would you do first for the patient? Draw upon a previous patient in clinicals - what were your interventions? Recall the priority.

2. Write out the question on scrap paper (if) your school consents you to have it; Write out what you know about the issue that the question presents; it may be lab values, signs and symptoms, adverse/side effects, key words

3. Go with your intuition. A great deal of nursing practice includes following gut instinct when something seems amiss. Apply it to the questions.

4. Change your perspective. Place yourself in the position of the patient. Are your interventions reflective of how you, or a loved one would like to be cared for?

5 Consider mistakes you have made in clinical with skills/meds. Sometimes we learn best by the errors we have made. Recall what you would do differently to ensure patient safety.

6. Never assume math questions are easy. It’s an assumption that throws away points. Check over your answer. Does it make sense, practically speaking? Eg. 900 drops a minute is not practical (unless bolussing a patient)

7. What is the safest answer for your patient? Read over the question, and answers, once again. Visualize what you would do to advocate/protect your patient.

8. Your instructors are actually rooting for you to do well. If it is a practical exam, it’s completely understandable if you’re nervous - but remember, the instructor testing you wants you to be a nurse. They aren’t looking to fail people. They remember what it’s like to be a student. They recall the nervous feeling. They are just as hopeful that you will pass, as you are.

9. Remember the basics. Understanding and application of the foundations is often overlooked in the search for complexities, and tricks.

10. Changing answers at the last minute historically leads to selecting the wrong answer But consider this; sometimes you’re reading a question, and it’s prompted the correct answer from a previous question. If you’re conflicted, recall safety, recall priority and always visualize - is this what I would really do for the patient?

STOP COMPARING

Don’t do it. Don’t compare yourself to other students. That kind of mindset will set yourself up for failure - during nursing school, in your career as an RN and simply in life. No matter how smart or how awesome someone else may seem as a nursing student - that is just how they SEEM. Don’t forget that envy is one of the deadly sins. Just do not do it. Worry about YOU and only you. Also, don’t think you are any better than anyone else. This leads me to my next point.

DONT JUDGE

You are not better than anyone else. Everyone has their own personality, their own learning habits, their own faults and simply their own nursing school style.  Don’t start of your nursing career as a judging jerk. Quite frankly, if you are, you will only bring that into your career as a caddy, stuck up nurse. Most of us are female in this field - instead of following suit with what most people think about us, let’s empower each other as women in the field of nursing and build one another up no matter what.

HAVE CONFIDENCE

Hi friend! Thats so exciting. Here are a few helpful tips for your clinical:

1. Prepare the night before. Make your lunch, make sure you have clean scrubs, check the syllabus to ensure that you have everything, and pack your bag. Clinicals start EARLY so you want to feel ready to go in the morning.

2. Don’t skip breakfast. Find something that’s quick and filling to eat in the morning because you may not have a break for a while (especially if you’re shadowing a nurse and you’re on her/his schedule). 

3. Be on time. Sounds intuitive but the nurses and your instructor will notice if you are late. Give yourself lots of time to get where you are going. Figure out the buses/parking and how to get to the unit the beforehand so you don’t have to stress in the morning.

4. Be nice to the nurses. Most nurses like students and are really helpful but some are not so nice. Don’t take it personally; they don’t know you from the next student. Ask what you can do to help. Introduce yourself and tell them what your scope of practice is and offer to do those things for them (e.g. “I can take vitals and do physical assessments for you but I don’t give meds yet”). If you do anything for the nurse BE SURE to tell her/him what you did and what you found. They shouldn’t have to chase you for vitals that you collected or have to guess what you did.

5. Ask informed questions. If you don’t know how to do something, ask! You are there to learn, and you are in a teaching hospital, so the staff expect questions. 

6. Learn people’s names and be respectful. This includes ward clerks, housekeeping staff, and dietary staff. They will be the ones to tell you where to get the catheters and what to do with used bedpans. They are important to the team and therefore should be treated as such.

7. Have fun and be enthusiastic. It’s easy to get caught up in the “complaining about everything” mindset (i.e., it’s early, you’re tired, you’re nervous, the nurses are mean…) but with this mindset you will cut yourself off from opportunities. Be proactive and tell your nurse/clinical instructor what you want to get out of this experience and tell them what you want more practice in. Most nurses will support your learning and because you’re cheerful and prepared will want to help you! 

Things to bring/wear to clinical:

- clean scrubs, without wrinkles, and minimal dog hair – you are there to represent your school so look the part

- your badge/id/whatever your school requires

- extra hair tie if you have long hair – your hair should be out of your face and you shouldn’t have to keep fixing it (plus you don’t want to touch your hair while doing patient care, gross.)

- a stethoscope 

- watch with a second hard, preferably one that pins on your shirt

- comfortable shoes

- a lunch and many snacks, more than you think you will need

- water bottle

- money for coffee (don’t drink too much though…one or two and then stick to water; you don’t want to be jittery when giving injections lol)

- your drug manual

- black pen and small notebook

- notecards with normal vitals, “cheat sheet” for physical assessments, other skills you will have to preform

- change of scrubs – this may not be needed but you never know, and it would be better to be over prepared than walk around with dirty scrubs all day 

- hand sanitizer ‘cause you never know

some of these i’ve learned on my own, or from family/friends, or reddit/tumblr/pintrest/facebook. but i’ve compiled a list that has helped me remain focused, organized, and not having my mind go all over the place. some of them are just good to know.

1. don’t put it down, put it away (helps immensely with clutter)

2. use a planner for everything, not just school (i use an actual planner because writing it down actually helps me remember it better, but an app can work too)

3. color code class materials, use a different color for each subject (i’m a nursing student and i’m always running around like crazy, my binders, folders, and notebooks for each class each have their own color. ex: bio=green, chem=blue, psych=pink. that way if i’m in a rush, i never grab the wrong stuff.)

4. rewriting class notes, memos, important dates, & anything else worth remembering helps to engrain it in your mind 

5. meal prepping twice every week helps to save time & money & also helps to keep your meals nice and healthy (it also helps me remember to eat because sometimes i have a hard time doing so since my vyvanse suppresses my appetite. it also helps to eat before i take my meds because then i have a more normal appetite and i’m not cranky. i’m also someone who would rather just not eat because i get stressed if i have to cook something, so having something all set and ready to go for each meal is such a huge stress relief)

6. do some sort of exercise for 30 minutes at least 4 times a week because it gets rid of excess energy, helps you to focus, & look & feel great (i do 45 minutes of cardio every other day on the stair-stepper & i’ve just gotten really into weight lifting. cardio definitely helps me A LOT to not be so cranky or all over the place)

7. pick out and get your outfit for the next day, every single night (i pick out EVERYTHING from the actual clothes, to the underwear, socks, bra, shoes, & accessories. this helps because i also have a weird thing about how clothes fit over undergarments & i also have a weird thing about matching clothes with undergarments, socks, & shoes)

8. pack your backpack and whatever else you need the night before (i put all my class materials, snacks & drinks, chargers, gym clothes, etc in my bag every night before i go to bed so i don’t rush or forget anything in the morning)

9. have a bag full of essentials that you take everywhere (i have a purse that i keep my wallet, keys, a protein bar, a water, my iPad, a back up charger, pen, small notebook, planner, gum, & hand sanitizer that i take with me everywhere. everything has it’s own special pocket & i never lose track of the things i need)

10. make lists of “to’s” (to do, to remember, to buy)

11. go from room to room whenever you leave someplace to make sure you haven’t left anything behind 

12. use post-it notes in visible places as reminders

13. set aside one day per week to do stuff you need to get done (cleaning, schoolwork, chores, grocery shopping, etc)

14. have a “time out” for yourself every other day to relax and recharge (i set aside an hour or two every single day to read or watch a tv show or do something that doesn’t require too much thought or energy. i don’t answer calls or texts, and i try not to browse social media. this helps me relax and not feel overwhelmed throughout the day or the week)

A lot of us have difficulty when it comes to learning all types of new information. Especially when we’ve got other priorities to worry about. After much experimentation, I’ve found that the following tips helped me make the most of my time and also helped me plan much more fruitful study sessions!

- Designated Study Area.

A coffee shop, the library, a desk, or even your bed. Figure out where you are most comfortable studying - The right location provides comfort, no distractions and is quiet. Another factor to consider is timing. Are you a morning person, an evening person or a night person? Combine the time with the location and there’s your study area!

- The Key to Success is Time Management.

Plan your time using a simple schedule template, or make a simple to-do-list. The trick is to complete short tasks in a reasonable amount of time; like going over 5 pages of a textbook in approimately 15 minutes. Keeping a written schedule keeps you in line, and this way you won’t forget the tasks you need to complete for the day!

- Note Taking.

Personally, I like to keep a hardcopy of the days lecture and just scribble down any information that I think is important. BUT, there are some pretty cool note-taking strategies out there that you can utilise. Check out The Cornell Method, Mind Mapping, and the Split Page Method. Active learning produces more results than passive learning - so write down those notes and stay active!

- Meet the Syllabus.

The syllabus outlines the most important learning outcomes/ learning goals, and thats pretty much all you need to plan a productive studying session. 

Bid farewell to all that extra, unnecessary information. 

- What is your learning style?

Are you a visual, auditory, verbal or kinesthetic learner? Experiment with all 3 and find out which one works best for you. You don’t necessarily need to stick with one! Do you study better alone or do you prefer group study?  

- Bite-sized Learning.

Do not try to cram in a huge amount of information all at once. Instead, try breaking information down into learnable, manageable chunks. Combining this method with tip #2 will help you make the most of your time.

- Review, Review, Review!

It’s scientifically proven that the more you review material, the easier it’ll be for you to recall it when needed. So, take another look at your notes a couple of days after you make them, then again a week later, and so on.

25 years old, in jail for god knows what, cops bring him in with a lac to his forehead from banging it on the wall repeatedly. He is already handcuffed so we put him in an isolation room, with sliding glass doors. Because he is in custody we take everything but the bed out of the room. 

Patient is screaming the whole time he doesn’t want to be there (same bro) with blood everywhere from the head lac. 

5min later, I hear this sickening crash, I’m pretty sure someone has just run head first into the glass doors, because mate I’ve done that before those curtains are assholes, so rounding the corner I see blood all over the glass door, patient still screaming he wants out but is now banging his head on the glass. 

It takes 4 security guards to hold this guy down, he is absolutely losing his shit, screaming and flailing and has no idea whats going on. Calling out for his mom, for Neil (???), for a sandwich, doesn’t know what day it is or just refuses to answer we can’t tell, pupils 4mm and sluggish but thats how it was when they brought him in, so security cuffs him to the bed so he can’t hit the wall. 

Fastforward 10 minutes and he has dislocated/broken his wrist trying to get out of the bed and to the door, he has puke and stool everywhere, refused to take the ativan so we gave midaz, but that didn’t touch him. 

This guy screamed from 2-7, we maxed out what we could give him for benzos and he was extraordinarily agitated and wouldn’t settle and was only in the beginning stages of withdrawals. It was terrifying, but the thing that got me was after screaming about how we took the 20′s (from his underwear??) he was quiet for a minute, I thought ‘shit the midaz finally caught up with him and now were gonna need to intubate’ but he then screams

“I don’t want to do this anymore, I don’t want to be on drugs anymore, I want this to stop, I want to be clean, please someone help me”

And thats what got me. This guy was 25, had his whole life ahead of him, but got caught up in drugs and it was going to kill him, and he wanted out, but withdrawals were so bad that it was easier to keep using. 

Fuck telling kids don’t do drugs. Show them what its like to try to stop, how all your friends die from OD, how you are one phonecall-not-made away from death yourself, how you get to be tied to a bed in the ER and your nurses need to apologize to other patients because you can’t stop screaming and just shit yourself and puked the cookie I gave you and your body is on fire. 

Don’t just tell them not to do it, because that doesn’t work, show them what its like to try to stop, because sometimes fear works better than facts. 

My current job has me working with children, which is kind of a weird shock after years in environments where a “young” patient is 40 years old.  Here’s my impressions so far:

Birth - 1 year: Essentially a small cute animal.  Handle accordingly; gently and affectionately, but relying heavily on the caregivers and with no real expectation of cooperation.

Age 1 - 2: Hates you.  Hates you so much.  You can smile, you can coo, you can attempt to soothe; they hate you anyway, because you’re a stranger and you’re scary and you’re touching them.  There’s no winning this so just get it over with as quickly and non-traumatically as possible.

Age 3 - 5: Nervous around medical things, but possible to soothe.  Easily upset, but also easily distracted from the thing that upset them.  Smartphone cartoons and “who wants a sticker?!!?!?” are key management techniques.

Age 6 - 10: Really cool, actually.  I did not realize kids were this cool.  Around this age they tend to be fairly outgoing, and super curious and eager to learn.  Absolutely do not babytalk; instead, flatter them with how grown-up they are, teach them some Fun Gross Medical Facts, and introduce potentially frightening experiences with “hey, you want to see something really cool?”

Age 11 - 14: Extremely variable.  Can be very childish or very mature, or rapidly switch from one mode to the other.  At this point you can almost treat them as an adult, just… a really sensitive and unpredictable adult.  Do not, under any circumstances, offer stickers.  (But they might grab one out of the bin anyway.)