Despite today’s nurse shortage, college nursing programs can be difficult to get into. So, if you’ve been accepted into nursing school, congratulate yourself now! Whether you are entering an LVN/LPN, ADN or BSN program, you have undoubtedly worked hard to make it this far, and you will put in much more time, money, and effort before it’s over. Protect your investment by studying hard and following this guide.

Overcoming a Daunting Workload

Like nurses in the workplace, nursing students may find themselves assigned more tasks than they can possibly accomplish during an allotted period of time. Maybe you have more pages assigned than you can possibly read in one night. Or perhaps you have several tests in the same week. Just like a working nurse, you have to learn to prioritize, spending the most time on the most important tasks.

Ideally, you would arrive in class each day with the assigned pages read and your own notes on the material perfectly outlined, in compliance with the recommendations of your professor. Indeed, all the study hints in the world cannot compete with hard work. But in real life, you may very well arrive in class not having read the material. I did not always read before coming to class, and I did not always study every day, but instead did a lot of late-night cram sessions. Nonetheless, I graduated valedictorian of both my high school class and my college nursing class. Your success depends on not only hard work, but your ability to maximize your time by sorting the important stuff from the fluff.

Going to Class is “Important Stuff”

During my entire high school and college careers, I almost never missed a class. Unless you are moaning and vomiting, you probably have enough energy to sit and take notes, even if you feel a bit under the weather. (Though coming to clinical ill is not recommended.) Never miss a class to catch up on your reading. Reading the book is no substitute for finding out what your teacher thinks are the chapter’s most important points, which is most likely what will be on your test.

If you cannot read the chapters before class, at least try to skim through the pages to see what is being covered. Looking at the section headings, pictures, and diagrams will give you an idea of what you are about to learn, and how best to structure your notes. A good set of notes is the most important thing you can gain from class time.

In note-taking, your goal is not to write down every word the teacher says. Some nursing school students bring cassette recorders to try to catch every word the teacher says during a one or two hour lecture. Then they take the tape home and may not even get around to listening to the whole thing again before test time. While tape recorders have a time and place, they cannot learn the material for you. Other students try to write the teacher’s exact words, but find they cannot keep up and end up missing important information. You must learn to take the important parts of what the teacher is saying and put them on paper. In order to keep up, you may have to use abbreviations and subtract adjectives, small words, and unimportant statements. Use your psychology skills to get into the lecturer’s head and judge what points she deems most important. Concentrate on writing notes about those points.

You should always try to write down everything written on the board, overhead projector, or PowerPoint presentation. This material comes from your teacher’s own notes and is therefore golden.

Ask questions as needed to understand the material further, but be aware that in most cases, when the professor is answering another student’s “sidebar” questions (other than clarifying presented material), you can put down your pen. Listen to the question and answer, or continue to catch up on writing down what is on the board. Especially if the teacher and a student begin arguing, the student has probably taken the subject in a direction the teacher finds irrelevant.

Even if you find classroom lectures useless because the professor teaches or tests straight from the book, you should still attend class, in case she mentions an important study tip or decides to somehow penalize those not in attendance. You can use class time to catch up on your reading or studying, unless of course you are likely to get called on for not paying attention! In addition, try to go to every evening study session your professor may schedule. If she is discussing something you already understand, tune her out and study your own materials. You will be there in case she mentions something you didn’t know, or gives hints about the test.

Studying for Exams

There are many ways of studying for exams, but the following is an especially effective one. First and most importantly, listen closely to what the instructor says. She may tell you which sections to concentrate on, which to leave out, and which topics are sure to be tested. These should receive your foremost attention.

Ideally, you have been studying for the exam daily during the presentation of the course material. Realistically, though, you should at least begin preparing for the exam about a week before. Buy some index cards, or just cut up pieces of notebook or typing paper in small squares. Begin with your class notes, and write everything on them in the form of a question, with the answer on the back. If you have important reading notes, do the same with these. You may learn the material by writing it a second time. You should try to read all the assigned chapters, or at least the sections your teacher emphasized during lecture.

At least two or three days before the test, you should start going through your question cards. If you know the answer to the card, set it in one pile. If you don’t, set the card in a pile to go through again and again until you know it. When you get down to a few facts that your brain stubbornly refuses to learn, write them down on a page of “Things I Didn’t Know,” and think about them carefully. Find a way to remember them. One helpful trick is to draw a silly picture (like a characterization of a hormone performing its function). The sillier it is, the more likely you will remember it and be able to picture it on exam day. Also helpful are creating mnemonic devices (like “On Old Olympus’ Towering Tops” for memorizing cranial nerves I-V), and writing your facts again and again as simply as possible to increase retention.

You should, at the very least, make sure you know everything on your question cards before the exam. Next, reread your class notes, and you will start to understand how everything fits together. If you have more time, you can go through the cards again, study your page of “Things I Didn’t Know,” and reread the pages in the book. Sometimes it helps to go through all the diagrams and pictures in the chapters right before the exam, to cement your knowledge, and to be prepared for questions that might come from these sources. (If you note after the exam that your teacher likes to make questions from the book’s pictures and diagrams, be sure to include these in your study for every subsequent exam from the same professor!)

Taking Written Exams

Since the state nursing exam you will take later is multiple choice, nursing programs will often try to model their exams the same way. Your success depends not only on your knowledge, but also your test-taking skills. Channel exam stress into positive energy. Remember, if you are well-prepared, the exam should be an exciting challenge! Go into the test with a pumped-up ego, knowing you have studied your hardest and are sure to do well. The test is the reward for all your studying.

Read all of your multiple choice options carefully, even if you think the first answer you read is correct. (There may be an “all of these” option.) Don’t panic if you don’t immediately know the answer. You may find you can at least eliminate two choices you’re certain are not correct. Afterward, you have a 50/50 chance of getting the answer right. Rely on your intuition and choose the option you feel is best the first time you read it. Usually, your subconscious will lead you to the right choice. If you try to read too much into the question, you may select the wrong option. You should almost never change your answer, except if you go back and discover you misread it the first time (or if another test question triggers your memory, and you realize your first response was absolutely wrong).

For electronically scored tests, mark the answer clearly with no smudges. If you erase, erase thoroughly, since the machine is sensitive and may score an incomplete erasure.

After you have finished the test, go back and check it again. Make sure that you marked all the answers as you intended to, without getting off on your numbering and shading, which could be disastrous. If you have time, reread the questions to be certain you read them correctly the first time.

When you turn in the test, allow yourself a sigh of relief, then get ready for the next step, which will give you an edge over the competition at final exam time. (This step applies only if you will not have a copy of the exam you just took to study for the final.) If the test is taken up and kept secret, the reason is probably that the same types of questions are likely to recur on the final examination! Help prepare yourself for the final now by sitting down with your notes again, going through each item and remembering as many exam questions as you can. Write them all down. If you remember that a certain topic was tested but don’t remember the question, just note the topic. Then, keep this list and use it as a study guide for your final exam!

Math for Medications

Some students have more difficulty with math than any other part of nursing school. Math obviously cannot be studied the same way as most nursing topics. The way to learn math is to start small and build gradually on your knowledge, with plenty of practice along the way. You began the process in elementary school and continued it in high school and college. If you have kept up with every step along the way, you are probably good at math. If you got stuck at some point between then and now, you may be having difficulties.

Nursing math problems are based on real life, so they are word problems. Some purposely provide unnecessary numbers and data that are not needed in your calculations, so beware. Read the questions carefully to pick out what information is needed and what is not. Some might not even require a calculation. (For example, if the doctor’s order says to infuse a solution at 60 cc/hr, there are 100 cc in the bag, and you are to give it every 6 hours, how fast should you set the pump? The answer is 60 cc/hr, and no calculation was required! But the extra facts will throw some students off.)

The first step you can take toward successfully performing nursing math is to memorize all the conversion factors your instructors give you. If you don’t know how many milliliters are in an ounce or a liter, you may not get the problem right no matter how good a mathematician you are!

If you have trouble with math, your nursing program may hold tutoring sessions to help you. Attend them, and don’t forget to practice at home! The more problems you do, the better you will get. There is no easy substitute for practice where math is concerned. With each problem, write down exactly what the question is asking for and what data is given. Cross out any extraneous information. When you work several problems of a certain kind, patterns will begin to emerge.

Should your math troubles persist, ask your instructor for more practice problems. You can also get help online or seek a personal tutor. You may feel somewhat reassured to know that a nurse is rarely called upon to do all her own complicated calculations while working at a hospital. (Calculations are usually provided by the pharmacy or checked with another nurse.) However, you are the person who ultimately administers the medicine, and giving the appropriate dosage is a critical and serious responsibility.

Skills Test Success

In nursing you will encounter tests of a different kind than elsewhere in academia: skills tests! I admit that I failed my first skills test. I came into nursing school pompously, considering myself quite the academic, and I thought that testing my ability to make a bed was frivolous and stupid. My attitude was reflected in my performance. So learn from my mistake: Skills tests are just as important as regular tests, if not more so! As far as your instructor knows, the care you take in making a bed now may be equivalent to the care you will later taking starting an intravenous line (IV) or inserting a urinary catheter.

Though in real life nursing practice your hands may not be sterile before touching clean bed linens, and a dirty sheet may fall to the floor or brush your uniform, skills tests in nursing school are where you must prove that you know how to perform tasks the right way. You will be graded strictly, because if you don’t get it right in school, you will probably never get it right in practice. Since your state boards do not have a physical component, nursing school is your proving ground.

But do not dismay. With the right attitude and study you can excel at skills tests too! You will need to study for skills tests in a different way. Sitting at home and memorizing a list of steps for task accomplishment won’t help much. The way to learn a physical skill is to physically practice it again and again. Make use of all available nursing lab hours to practice your skills on the dummies and equipment until you feel comfortable executing them. The more similar your practice environment to your test environment, the more comfortable you will feel, and the more successful you will be. If possible, perform the task in practice for the instructor who will be grading you in testing. Sometimes two instructors will have slightly different techniques, so learning your scorer’s technique is beneficial. Go to the learning lab and watch other students practicing. Keep performing the skill over and over until you feel confident in your ability to pass the skills test.

Clinical Conduct: Careful and Competent

Nursing school provides you with the opportunity to practice your skills in actual health care facilities. You will be supervised and graded, both by your clinical instructor and by hospital employees helping to orient you, called preceptors. Just as your first goal as a nurse in practice is to do no harm, your first goal as a clinical student is not to scare your instructor. Perhaps you feel especially confident in a clinical setting because you have worked in a hospital before as a nurse aide, or maybe you have EMT (emergency medical technician) training and have started IVs in the field. No matter how confident you feel, it is important not to overstep your boundaries as a student! If you begin performing unassigned, unsupervised tasks beyond your level of nursing school training, complicated liability issues come into play. Instead of being impressed, your instructor may reprimand you (or worse, depending on the insult).

Come to clinicals prepared! If the facility allows you to come in the night before to select patients and read their charts, do so, and study them well. Write down the names of any medications you might be giving and research them thoroughly the night before. Arrive well-rested and early on the clinical day, dressed in approved attire and neatly groomed. Be prepared to listen and observe preceptors carefully. If you are checking off on a skill you have learned in the skills lab, try to review it again in the lab before performing it on a person. (You will discover that performing a skill on a person is much different than using a dummy, and you want to make certain you know exactly what you’re doing to counteract any unexpected distractions!)

Even if this is your first time performing a skill on a patient, it is not necessary to tell him/her that it is your first time. The patient already knows you are a student, so he/she has probably guessed you have little experience. It is okay to feel nervous on the inside, but try to project an outer image of confidence. You are being supervised by an experienced nurse whom you can look to for guidance.

The best clinical students lie somewhere on the scale between the overly nervous and the overconfident. If nervousness is your problem, channel it into an inner caution that prevents you from overstepping boundaries or risking patient injury. Tame overconfidence down to an external projection of your competence. Together, caution and competence will ensure your success as a clinical student, and later as a practicing nurse.