Entering Nursing Later in Life

A reader recently requested that I cover some tips on how to manage family and course-work for the student who is coming to nursing school later in life. Since this page is all for you, readers, I am happy to oblige!

Keep a Calendar

You will have tons of reading, homework assignments, clinical days, and meetings. On top of this, you will have appointments, family affairs, errands, etc., etc., etc. Begin with a calendar, preferably a small one you can keep with you. Many people choose an electronic calendar, such as one on a smart phone. However, a paper calendar can give you a quick glance of the entire month, rather than switching from day-to-day. On the other hand, your phone can alert you to important engagements. Whichever one you choose, start out by putting in the most important appointments, the ones you cannot or should not change. This will include class days, clinicals, and assignments for school. Additionally, you want to make sure you put in any doctor's appointments, dental appointments, etc. For the time being, nursing school will have to come first many times. You won't always have to sacrifice, but I recommend putting it high on your priority list. Which brings me to my next topic...


Family is Always Important, But...

...you want to succeed, so don't push nursing school to the side. I know this sounds terrible, so let me explain. I'm not asking you to forget about family and friends at all. However, I AM asking you to let your friends and family know how important nursing school is to you so that they won't push you to spend unrealistic amounts of time away from your studies. Nursing is intense (you will have lives in your hands upon graduation), so you have to know your stuff. This leads to my next point.

Create Study Time

Some people do well just by asking their family members to give them some time to study. However, this doesn't always work. Just ask my old classmate. She had 5 children, and when mom wasn't around (she was in her bedroom studying), they missed her so terribly that they would knock on her door until she let them in. Talk about distraction. Yes, love your children, and please don't ignore them. Spend good quality time with them. Actually build that time into your schedule. Write it on your calendar. But also schedule in study time. My old classmate put a sign on her door that let her children know that it was study time and that they were not to disturb her unless (insert emergencies here). This was difficult for her husband, however. He ended up having to deal with all of the "smaller" catastrophes.

Let Your Spouse (or Significant Other) Deal With It

That is....if you have a significant other (SO). If you do have someone living with you, nothing says your husband, wife, or SO can't handle some problems without your input. Many of you have handled "it" often enough that your spouse can take the wheel for the moment. My advice? Talk to your spouse or SO. Let him or her know that you have to have so much time of uninterrupted studying, and ask if he or she would please handle things until study time is over. Yes, you will still contribute to the household, but don't let your spouse or SO think he or she can't handle some things alone. Let your family know specifically what you need, and it will cut down on a LOT of frustration and irritation. I cannot stress how important it is to have support from your SO. If you do not have the support of your SO while going back to school, there is an underlying problem that must be dealt with, and that is beyond the scope of this blog. Professional help is likely in order. If you do not have a husband, wife, or significant other, your situation will be a little different, and is not really the focus of this post.

Use Study Time for Studying

This should go without saying, but I had to say it anyway. Why? Because some people have taken advantage of their alone time. If you want your family to respect your alone time, you must respect them by showing them that you are doing just what you said you would do with that time. If you have set aside time for studying, then study. If you set time aside for writing a paper, then write the paper. Another reason why this is so important is that if you use your study time for something else, will end up needing more time to do your actual studying. This means you will be taking time away from your family that is NOT study time, so you can study or write your paper. That isn't fair to your family. Everyone around you will have to make sacrifices, so please don't make it harder on them than you have to.

Study Tips

Find a nice, quiet, comfortable place to study. If possible, make your study environment away from the rest of the family. Nothing is worse than trying to study in the kitchen surrounded by bored kids. Make your study spot your own by finding a comfortable chair, a desk or table, and study supplies (e.g., pens, pencils, highlighters, sticky notes, markers, tape, stapler, paper clips, etc.). Make sure you have adequate lighting. You don't want to get a headache from trying to read in dim lighting.

Schedule your study dates and times. Actually put them on your schedule, and stick to it. Make studying a priority and do not deviate from your plan unless it is an emergency.

Take breaks often while studying. If you're feeling "antsy", get up and walk around, go get something to drink, or just relax for 15 minutes. But then go back to your studies. You will have to have a lot of willpower, but you can do this!


Eat healthy foods and don't neglect your body. Your brain works much better on healthy foods and when your body is in good shape. So many people give up everything while they are in nursing school, but it just makes things harder. You may have to cut down on the time you exercise if you used to work out for hours at a time, but 30 minutes a day is adequate to help you stay in shape.

Get plenty of rest. Don't stay up until 4 am every morning. It will start to wear you down, and you will be irritable and forgetful. Those are two things you don't want to happen to you in nursing school.

Think about what is important for the nurse to know. Is it really important that you know what is happening on the cellular level? Probably not. Get a good general understanding of the disease process and what signs and symptoms to look for. Then know the usual meds given, nursing interventions, and what will tell you if the things you are doing are working to help the patient. That's all the nursing process is. Study by the nursing process and you have it!!

In Summary

The best thing you can do is sit down with your family and friends and tell them what is expected of you and what you need from them. DON'T neglect them, but make sure you take time for yourself as well. It take a lot of willpower, organization, time management, and inner strength, but with your family and friends behind you, you can make it through with support, caring, and understanding. Best wishes.

Have a Question About Nursing or Nursing School?

Have a question about nursing or nursing school? Leave your question in a comment. Is there a topic you would like to see on this page? Leave your suggestion in a comment. This page is all about you!

Nursing 101: Introduction to Nursing

"Intro to Nursing", "Essential Nursing Skills", "Fundamentals of Nursing". These are all common names for the very first nursing course you will take as a nursing student. During this course, you will begin to learn nursing skills, learn some health care lingo, begin working with simple medication calculations, and gain some invaluable insight into nursing.





The Check-Offs

Oh...the dreaded check-offs! While some schools do not hold these student return demonstrations (boy, those students are missing out!), many schools continue to torture students by forcing them to demonstrate their ability to perform simple psychomotor skills safely. That was a bit of satire, by the way! In all truthfulness, students do believe we professors love the thrill of torturing students, intimidating students, or whatever the current complaint is these days.

The whole point of skills checks? To make sure you can perform them before you go into clinical. The intimidation factor? We try not to be intimidating, but you DO have to ensure us that you're not going to fall to pieces in front of a client, or perform something in such a way that it is unsafe to a patient. Is that unreasonable? I don't think so, but I might be biased because I may be a patient some day! You will be in clinical before you know it, and you will have to perform these tasks on a real-live person. Can you handle that? Will you run away screaming? Some of the things we have to do are things you wouldn't normally do in day-to-day life. Think about it. How often do you insert a catheter into someone's bladder? My guess is never. We want you to be able to do it quickly, efficiently, painlessly, and without humiliating the patient. That is all we ask. Yes, it is intimidating to have someone watching over your every move, scrutinizing every move you make with a fine-toothed comb. We have to be sure you're maintaining the basic principles for patient safety, so that when you DO insert that catheter, you won't increase the patient's risk for infection more than the usual risk.

I've found that most of the intimidation comes from the students themselves. YES, you read that correctly. Students have the amazing ability to place so much pressure on themselves that they become anxious, scattered, and sometimes utterly dysfunctional. I have had students make one small mistake and begin sobbing, totally unable to complete the task. Here's a little factoid you might enjoy: Most instructors will give you multiple chances to make up for your mistakes by just saying what you did incorrectly and then stating what you would have done to prevent or correct the mistake OR have you perform that step one more time. So lighten up on yourself. Relax before you come into the room. If you've practiced the skill correctly 100 times, then you know what you're doing. Prove yourself. Walk in with confidence and pretend the professor isn't right there. It will do you good.

The Lingo

Students love the lingo, for the most part. It is amazing to see and hear the transition happening! The first week, students are asking questions about some of the most common lingo. After about 4 weeks, the students have absorbed a lot of lingo and even work it into their own conversations. I love going around while students are sitting in groups, just to hear how they are using medical terminology without even flinching. Students don't even realize how much they have learned in those 4 weeks until you point it out. Four weeks ago, you didn't know what HOB, ROM, BP, BPM, BR with BRP, or PRN meant. Now you use it in everyday conversation. WHOA!

The Math

Medication calculation. Those are two dreaded words for many nursing students. Some nursing students are determined to make it harder than it has to be. I think it has to do with the fact that many people have had difficulty with some or all types of math in the past, and they have become afraid of it all. I am telling you right now that I had trouble with math in school. Algebra, geometry, trig...they all intimidated me and I had to study so much just to learn the basics. But, med math is very simple for the most part (it does get more difficult later). We also give you specific formulas. The key is plugging the information into the formulas correctly. Once you get that down pat, you're good as gold.

The Insight

Your instructors often will tell you stories about their own experiences in certain situations. Often, these stories will lighten the mood, hit home a serious point, or serve as a lifetime reminder to you. I still remember many of the stories my instructors told while I was in nursing school. I gained insight into nursing through those stories. (Hey...my instructors are real people who really worked as nurses, and they figured out how to do things better because of this situation right here. I think I will remember that for future use!) One story I tell my students (when we start talking about medication administration) is about the time I made a medication error because I took for granted that the pills in the box were what the label on the outside of the box said they were. I neglected to look at the actual package of the single pill. I tell this story for several reasons. One, I am human and I make mistakes. Two, it was my mistake because I didn't look at the individual package to ensure I had the right medications. Three, I wrote myself up because I made the mistake and no one was around to write me up for it. Four, I helped to create a safer work environment BECAUSE I wrote myself up. The pharmacy had labeled the box as 0.5 mg, but had stocked the box with 1 mg tablets. The sign-out sheet still had 0.5 mg written on it. In the past, when the change was made to 1 mg, the pharmacy and all the nurses knew about the change, and the sign-out sheet had been blacked out and 1 mg was written in. However, on this particular night, someone forgot to mark out 0.5 mg and replace it with 1 mg. I was new and didn't realize that someone usually did this, and I knew nothing about how the box was previously stocked. So, in haste, I grabbed a pill, didn't look at the package, didn't think twice about it, and gave it. Oops. It could have been a BAD mistake, and although the box wasn't labeled correctly, it was MY duty to read that package before administering. Nurses are the LAST LINE OF DEFENSE prior to medication administration. Go back and read that line one more time. Yes, I mean every word.

When I wrote myself up, the form asked what occurred, why I thought it occurred, and what my suggestions were to help prevent it from happening again. Of course, my first sentence was, "I was very busy, and in my haste, I neglected to read the package." After that, "The box and sign-out sheet were both labeled with 0.5 mg, though I should have read the individual pill package." Note what I wrote there. I took responsibility for my own actions. I wrote it exactly as it occurred. No blame on anyone else. I did write about the mislabeled box and sheet, but those things, even though they played a small part in my mistake, didn't change the fact that I didn't read that individual package. I then wrote, "In the future, to prevent this from happening again, I will be SURE to read individual packages to ensure I administer the correct medications and dosages. Also, all boxes and sign-out sheets should be updated immediately so that the labels correspond to the respective medication. So, the committee that reviews those things took my write-up and investigated. The result? I was lauded because I wrote myself up (showed integrity) and the box and sheet labels were replaced with the correct labels. They use those write-ups to help improve patient safety, NOT to get someone in trouble. Turns out, even if I HADN'T actually given the wrong dose, but ALMOST gave it, I should have written that up, too. Because if I nearly gave something or performed something incorrectly, others would do the same thing. Patient safety is our #1 priority, so you can never be too cautious.

So...that is a story I tell every single one of my students. You can see all of the different reasons I do this. Also, it's shocking to students to hear that I made a mistake when giving medications, and for such a stupid reason as not reading a medication label. Of course, we pounded it into their heads, "ALWAYS READ THE MED LABEL!!!!!!" about a million times. But when you get out there in the real world, you DO get busy. You get swamped. You get tired. You have so many patients with so many medications. It's actually easy to make a mistake. However, if you do the right thing the right way everyday, you're good as gold.

My point to this long, drawn out story? Listen to your instructors. Learn from their mistakes. Learn from their triumphs. Remember those helpful tips and hints. I promise you, when you are faced with a similar situation, you will be able to think back and remember those stories. It may even make you a better nurse.

5 Common Misconceptions Held by Nursing Student Hopefuls (and the Reality)

These days, it seems as though everyone wants to get into the medical field. I've hypothesized that it's more about a stable job environment than the desire to help others, but I have done no real research on the matter. Everything you read below is based solely on my observations and real-life encounters.

5. "I've never had to study before, so I won't have to study in nursing school."

 Whoa, Nelly! I'm definitely not knocking any other courses out there, but many courses taken before nursing school are considered 'core' courses. These courses are meant to provide you with a base of knowledge that you will build on in nursing school. Many times, these courses involve a lot of memorization and a moderate amount of application. Nursing school involves a lot of memorization and a lot of application. If you read 200 pages and think you're only going to have to memorize everything, I hate to break it to you (honestly), but you're wrong. Much of what nursing is depends on how well you can prioritize, manage time, delegate, and critically think. For example, not only must you know what you can and cannot delegate, you also have to know to whom you can delegate specific tasks, what information the person you are delegating to must know, and what outcomes you want. You have to pull information from many different sources and put them all together to come up with solutions. Studying and test-taking skills are a huge asset in nursing school.

4. "Everything I need to know, I have already learned from [insert TV medical show or movie here]."

I don't hear these exact words come out of student mouths, but I do often hear, "Well, I saw this on [insert medical show here] and this is what they did." That is wonderful that you can recall specific episodes and details, but you must remember that television shows and movies are not real life. They are made for entertainment purposes only. For every real life situation depicted in a show or movie, there are 5 more situations that are very unrealistic.


3. "I don't need to know this. The doctor will tell me everything I need to do."

I can definitely relate to this one. I had this same misconception when I began nursing school. (Boy, was I wrong!!!) Some of you are shaking your head, thinking, "How could anyone ever think that?" while the rest of you are thinking, "Yeah! I don't need to know this!! The doctor tells nurses what to do!" Things couldn't be as far from the truth as this.

Yes, physicians and advanced practice nurses do give orders for nurses to follow. However, there are so many facets to nursing that are not outlined by the physician's orders that a nurse without critical thinking skills will not be able to keep his or her head above water. Nurses are the eyes, ears, and hands of the nursing profession. In hospitals, nurses provide patient care 24/7. When a problem arises, it is up to the nurse to assess the situation, figure out what is going on, implement certain nursing interventions, or actions, reassess the situation, call the physician when needed, and even provide suggestions on what should or could be done to solve the problem. There are also many times the nurse doesn't even call the doc. The nurse intervenes and gets things done so that the patient recovers faster. Go nurses!

2. "I work in a [hospital, clinical, nursing home, outpatient center, etc.] as a [CNA, scrub tech, secretary, housekeeper, etc.] so I already know most of this stuff."

I hear this one a lot, especially from new students. Don't get me wrong. The things you learned (and are still learning) from your workplace can be invaluable. But please don't underestimate what nursing is. Nursing involves so much more than people often think, some of which I've already covered in previous paragraphs. In order to learn something from nursing school, you have to open yourself up to learning. 

1. "I need to perfect my nursing skills while in school."

You are probably thinking, "Well, YEAH!" The reality is that this isn't 100% true. Nursing school provides you with a foundation of knowledge. You then build upon that knowledge with your experience. It is next to impossible to become an expert at all the skills you will need while in nursing school. However, you do learn the correct procedure in school, so that you can perfect it once you do it a million times at work. So, take a deep breath and relax. Get the basics down, and you'll get better with time and practice. I promise.

It's Been Awhile...

It's been really hectic at work lately! I had hoped to update more often, but I just couldn't get around to it. In the meantime, I have been thinking about what I should write about. Since I haven't gotten any feedback or special requests, I thought I would try to answer some frequently asked questions (by nursing students). I hope this will help out any current or future nursing students out there.

Q: Do I really have to know this?

A: YES. We wouldn't teach it to you if we didn't think it would be valuable to you for one reason or another. I often get asked this question about medications. Medications are so important to what nurses do that they are ingrained into the curriculum. We choose only the most common medications, so there is a big chance that you will see that medication repeatedly in clinical (or on tests).

Q: Do I really have to practice my skills? Can't I just get better at the ones I'm going to use in practice?

A: Yes and No. You do have to practice all the skills you are assigned because you are very likely going to need them in clinical. Nothing is more disappointing that finding a skill opportunity at a hospital and then finding out that the student cannot remember one bit about how to perform that skill. Additionally, learning one skill can help you to become better at other skills. For instance, you might not have to insert a Foley catheter much in your OB clinic position, but you may have to obtain multiple in-and-out caths. The same principles apply - sterile technique. We teach the major concepts so that you can carry them with you throughout your career. There were many skills I thought I would never have to use because I was going to work in a certain area. However, I have worked in many different places and I have used every single skill I learned in school. One example is checking dilatation. I NEVER thought I would work in labor and delivery. However, one part of my job as an ER nurse was checking dilatation on anyone coming in who thought they were in labor. Thankfully, I had paid attention in class!

Q: Why do I have to wear this uniform? Can't I just choose my own scrubs to wear?

A: Your nursing school uniform is how everyone identifies who you are in the clinical setting. Health care professionals can tell at one glance what school you are with. Also, it looks very professional.

Q: Why can't I wear more jewelry during clinical?

A: Jewelry can spread microorganisms as well as tear fragile skin during care. I recommend wearing only a plain wedding band (this means no jewels in it at all) and SMALL stud earrings. I have seen students wear large studs, and they have lost them when taking the stethoscope out of their ears. They could fall into a patient's bed, which could cause injury to the patient, or they could fall on the floor, causing someone to slip on them. Necklaces can get broken so easily, so I do not recommend them at all in the clinical environment. Remember, the priority is the patient; it's not a fashion show. You can wear your jewelry to class all you like.

Q: Will I survive this?

A: Yes...but only if you really want to survive. Nursing school is tough. I've probably said that more times than I can count, but it's so true! The school you go to for initial licensure is going to be the toughest thing. Any higher nursing degrees obtained after that will be tough, but nothing like that initial school. The reason for this is that when you come in, you must learn everything from scratch. You have to build a foundation upon which to learn. Higher degrees simply build upon what you already know. Don't get me wrong...grad school is tough, but a different kind of tough.

Q: Should I try to get a higher nursing degree?

A: YES! While there is a nursing shortage all around, the largest shortage is of nurses with higher degrees. You can still become an RN with a diploma or Associate degree, but many hospitals are looking for nurses with a Bachelor's degree or higher, especially those hospitals seeking magnet status. I fully support getting a diploma or Associate's degree first, but I really urge students to seek a higher degree. It opens up so many more job opportunities and possibilities.


If you would like a particular topic covered, please comment below.

My Bones are Weary

It's been one of those days (or nights). You hit the floor running and even had to stay late to catch up on charting. You never once had time for a lunch break, much less a bathroom break. You had three total-care patients with extensive dressing changes, two patients in severe pain, and one patient who could not stop vomiting, regardless of how many antiemetics you gave her. You finally made it home and all you want to do is use the bathroom and go to bed. But the kids and husband (or wife) are wanting to spend time with you. Do you, A) tell them you are too tired and fall over into your luxurious bed, or B) push yourself to spend some much-needed time with the family?

This is a question that many nurses (and nursing students) are having to ask themselves. With the onslaught of higher acuity patients, nurses are becoming more and more tired at work. One recent study found that more and more med-surg nurses are not as happy with their jobs as they were 10 years ago. Why is that?

Sicker Patients

The patients we are seeing in the hospitals are much sicker than in the past. People are waiting until they are deathly ill before they see a doctor due to the rising health care costs. Also, they are being discharged earlier, so there is an increased need for patient teaching in a short period of time.

Money is Tight

Money is tighter, so hospitals are forced to slack off on the amount of nurses on each unit. Even having one less nurse per shift can cause the amount of work to be done to increase for those left behind. I remember some years ago, when I worked on a med-surg floor. We were all scurrying around, trying to get everything done. We were all sweating, turning patients, cleaning patients, giving meds, giving patients cold washcloths, cleaning bed pans. We all finally got to sit down to chart and the CNO came around. She said that since we weren't doing anything, one of us would have to go home. We tried to tell her that we couldn't manage, but all she saw was us sitting down. One nurse had to go home and we would have to take up the slack. None of us sat down for the rest of the shift, which caused us all to stay late to finish up charting...which caused us all to have overtime. Was that overtime less than what the other nurse would have been paid, had she been able to stay? I don't know the answer to that, but I can tell you that our morale was zapped. We were unhappy campers.

More Demanding Patients?

Patients are becoming more and more savvy. That is a good thing. They know more about their health issues than ever before. However, some of these patients feel as though they should be treated like they are guests in a hotel. Is that so wrong? Maybe...maybe not. Patients do deserve to be treated well, with kindness and respect. So when you follow a nurse who hasn't been all that respectful and kind, the patients can already be in an uproar when you come onto your shift. It seems like an endless cycle. When I come across an angry patient, I try not to become discouraged. I see it as a challenge. Can I get this patient settled and happy before the end of my shift? If I can do that, I will have done my job.

All of these things, and more, all lead up to some very tired nurses. So what is the solution? Nurses should start thinking about the upcoming shift more. When you use the last of an item, replace it immediately. If you write on the last line of the nurse's notes, put in a new sheet. Keep your patients happy so the next nurse isn't land-blasted.

Another thing you can do is work in teams. Teamwork is so helpful on a med-surg floor because you can all share the work. When it is time to go bathe patients, get a cart ready with everything you will need and park it outside of the patient's room. Everyone can get in there, clean up the patient and the room, including placing new linens on the bed, in less than 10 minutes. Move on to the next patient, and before you know it, everything will be done.

When you work in teams, you begin to read each others' minds. I have had some great teams in the past, and I keep reinforcing teamwork with all of my students. Don't ever say you won't help someone, because you may be the one needing help someday. It MUST be a give-take relationship. If everyone gives, then no one has to feel guilty about taking from time to time. Just don't be the one who is always taking and never giving. Anger can grow quickly!

Start out your shift with a smile on your face. This may sometimes feel impossible, but studies have shown that if you force yourself to smile, your brain is tricked into thinking you're happy. In recent years, I have never seen more scowls as I have when I walked onto a med-surg floor. However, I smile at everyone, and before I know it, others are smiling back at me. Are smiles contagious? I don't know the answer to that, but I do know that one can certainly affect the moods of others...so why not have a positive effect?

Don't forget about your family or yourself. You give yourself over to your patients every day you are at work. But don't forget that you have a loving family at home. Make just a small effort to spend time with them. It doesn't have to be anything big. Come home, take some ibuprofen, and allow yourself to relax. Having a supportive family is crucial, but they won't be supportive if you always come home in a negative mood. Leave your work woes at work, and turn that smile on again when you walk through your door. You never know...you just might brighten your family's day as well.

Friends for Life, and Life as a Nurse

I've given out some tips in my previous posts, so I thought it was time to add something a little fun. This time, I thought I would talk a little bit about the friends you can make while in nursing school and some thoughts I have about being a nurse.

Friends for Life

Nursing school is a rough time. You are always under a ton of stress, you have very little spare time, and it seems like there is ALWAYS a test. However, your classmates know exactly what you're going through. You probably spend more time with them than you do your family at times. You start to have those "inside" jokes...jokes only you and your classmates know about and think are funny. One little note here...nursing students and nurses have to laugh about some things, even if they don't seem funny to anyone else. This is because if they didn't laugh, they would cry, and they would probably fall apart at the seams. But I digress. It is because of the close proximity to others in these stressful situations that many students find themselves in new friendships. Friendships that can be closer than any other friendship previously. That isn't always the case, but I have two very close friends that I met during college. One I met in my pre-req classes for nursing school. We still see each other every day - we work together at the university. She left to go to another nursing school, but we still went to nursing school "together". We are best friends, and she was my maid of honor at my wedding. Another friend has moved to another state, but I still think of her as one of my very best friends. So cherish those moments with your nursing school buddies. You may just get a lifetime friend ( or many) out of it!

Life as a Nurse

When I graduated, I was scared to death. I felt like I was on a tightrope without a net...and I have NO grace! I just knew that I would fall to my death. But I didn't. I had a wonderful preceptor, and she took me under her wing. She understood what it was like to be brand new and string-free (no instructor there to save me). I was doubtful of my skills. But I had the book-smarts, so I began working on honing my skills. Before long, I was the one everyone was calling to start those difficult IVs. Now, IVs, NG tubes, and Foleys are my favorite things to insert. I know that may sound weird, but I see them as a challenge. I absolutely LOVE using sterile technique to dress a CVL. I don't get to do these things much anymore since I don't work outside of education, but now I get to help my students hone THEIR skills.

One of the things I was most afraid of was taking care of a patient who had something I knew little or nothing about. Yes, we covered so many topics in nursing school that I thought my brain would explode, but what about those disease processes we didn't cover? So, I brought my books with me to work, namely my Taber's Medical Cyclopedia and my med-surg book, so that I could look things up if I needed to. It turned out that I used them very frequently. Later, I didn't need my med-surg book as much anymore, but I used that Taber's nearly every time I was at work. I was always running across new terminology, or I saw something that I had never seen before. Now, with smartphones so popular, one can look up almost anything. There are even applications specific to nursing. One of my favorites is the Taber's app. Another is the RNotes app. I also have a drug guide on my phone. It's much easier to carry a phone than a ton of books. I just have to be careful not to whip my phone out in front of everyone, because looking up something looks suspiciously like I'm texting, and that just doesn't look very professional.

One of my most memorable moments was when I was still very new to nursing. I was working on a med-surg floor, but the ER nurse wanted to turn me into a savvy ER nurse. So I bit. She would call me if she needed extra help in the ER, and I would come running after I made sure my patients were okay and someone could watch them for me. One night, the ER nurse called me and said she needed me right away. I ran to the ER to find the nurse and the paramedic from the local ambulance company in with a small girl who was actively seizing. The ER nurse said, "Hurry, I need an IV in this girl so we can give her some meds. They weren't able to get one on the ambulance because she hasn't quit seizing and she's so strong one person can't hold her arm still." I panicked. How was I going to do it if the paramedic couldn't do it? The nurse and the medic patiently and gently held the girl's arm steady for me (well, as steady as they could). I hesitated. The ER nurse said, "Don't think, just DO IT!" I took a deep breath, steadied my own shaking hand, and stuck the IV in. Blood return! YES! I threaded the IV, taped it down quickly, and we pushed her meds. I nearly passed out. I was so relieved that I hadn't hurt the little girl, and that I had gotten the IV on the first stick! The adrenaline rush was amazing. That was when I knew for sure I wanted to work the ER, and I knew I was meant for nursing.

Another story comes to mind. Again, I was working a med-surg floor, different hospital. I was caring for an elderly woman who had just had open heart surgery a few weeks previously. She was very demanding, and I could never please her. I kept doing whatever I could to appease her, but it just didn't seem like enough. I would listen to her complaints patiently, and then basically bend over backwards just so she would stop scowling. I had her for a few nights in a row, so I was worn out! I got to know her family, and the woman had quit complaining quite so much, but she still kept me on my toes. One night, she told me she was dying. Her vitals had been stable, her cardiac strips had been normal. There was nothing I could see that would make me believe this woman was dying! I tried to comfort her the best I could by listening to her and holding her hand. She told me that she was going to try to get some sleep. As soon as I walked out of her room, the telemetry room, which was right around the corner, went crazy with alarms. I didn't even look to see whose monitor it was. I ran right back into my patient's room. She was coding. We worked on her for about an hour, desperately trying to revive her, without results. The family was called in, and the doctor and I went out to see them. The family was heartbroken. The daughter asked me if she could speak to me privately. Oh no! Was she angry about the way her mother had been treated? Had I not done enough? I was sure I had ransacked every closet for extra pillows, but maybe....

The daughter and I sat down. She said, "I just wanted to tell you that mother thought the world of you." Heart...in my throat. "She told me over and over again how much you cared for her and how much you did. I know she can be a little difficult sometimes, and I just wanted to thank you for taking such good care of her. You were her angel, and I know she was in caring hands because you were her nurse." Okay. At this point, you would have thought that Ol' Faithful had started up. I began crying and I couldn't stop. Usually I have pretty good control until I am away from the family. But at this point, I had invested so much of myself in this one patient, and I had felt like I had been a huge disappointment. Now I was finding out otherwise. I tried to pull myself together. I thanked the daughter profusely for telling me that, and I told her how much that meant to me. That moment sealed the deal for me. I knew I was put on this Earth to comfort people, no matter what. When I went to work from then on, I told myself that if I just made one person's day a little brighter, then I had done my job. I went on to make a lot of people's lives brighter by living by that credo. Now I try to instill that into my students.

You're probably thinking, "But why don't you still work in the hospital instead of teaching? You can't comfort patients if you're teaching." Well, now I can comfort my students...and I can teach them how to comfort others. I can affect so many more lives this way! And...when a student has a patient who needs that extra TLC, I warm my hands up, go in the room with the student, and we comfort our patient.

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Being a Nursing Student

When I am advising a potential nursing student, I often get the question, "So what can I expect when I am a nursing student?" This is a difficult question to answer. Many times, it is only after a student has been accepted into the program and in the thick of it, that the realization of what nursing school entails hits the student like a brick...or a ton of bricks! While I am sure that talking about what it is like to be a nursing student isn't just like "being there", I feel like I need to shed some light on the subject...even if it's for the sake of the nursing student's family members (I told you!!!).

Nursing School is HARD!

Nursing school was the hardest thing I ever had to do...and I've been to graduate school! Grad school was a piece of cake compared to my undergraduate studies. In grad school, I made a 4.0. In my undergrad...well, I was lucky that I made B's and C's. It takes dedication, time, effort, loyalty, ingenuity, strength, courage, love, and patience. It takes all of that and then even more. Nursing school requires that students give more than and work harder than they have ever given before. I have had students who have fought in a WAR say that nursing school was harder than being in Iraq or Afghanistan. One student was even shot during war, and he felt that the skills check off during the first semester was tougher than that. Now THAT'S saying something. I mean...really let that sink in for a moment...wow.

Nursing School Requires Family Support

Being a nursing student means having minimal luxury time. That being said, family members really have to pitch in if the student is to be successful. Sometimes family members do not understand this. If you are a family member of a nursing student reading this, please....I beg of you...support the nursing student as much as humanly possible. The nursing student is working on little sleep, probably a ton of sugar and caffeine, and has the lives of his or her patients in hand. Only once you're in nursing school can you understand the depth and brevity of this. A nurse has the weight of the world on his or her shoulders. So much responsibility, so little time...

Nursing School Requires Time

Time is an issue for nursing students. That is probably the understatement of the decade...or millennium, for that matter. Nursing students have to figure out how to read 100+ pages each week, do homework, get prepared for clinicals, take care of family, cook, clean, etc. It is tough, but manageable with a plan. It is wise to get the entire family in on the plan, so that everyone has a duty. The nursing student shouldn't have to worry about every single house matter that arises. A little (or a lot) of sacrifice (on the part of the nursing student and the support system) is needed for nursing student success.

Nursing School Requires Patience

Nursing students often feel overwhelmed. When I've asked students the exact reasons they feel overwhelmed, I've been told, "I feel like I need to know everything right at the beginning." While this isn't 100% accurate, it has a certain truth to it. If we haven't gone over congestive heart failure (CHF) in class, but you are taking care of a CHF patient, you are expected to know about that disease process in order to care for that patient. However, your instructors do not expect you to be an expert. They are well aware of when you will learn that information. So be patient. Don't freak out because you haven't yet learned about diabetes. If you had to know everything the first week of school, we would NEVER have any nursing students. Everyone would run away screaming and crying. Yes, do your very best...and even better. But don't stress over not knowing everything. You have years and years and years to learn...and you still won't learn it all. So don't get worked up about it.

Nursing School Requires Determination

I have told many nursing students that if they want it bad enough, they will sacrifice until they have it. I don't mean sacrificing a marriage or kids. I mean sacrificing fun times. I didn't have a life when I was in nursing school, and neither will you, most likely. I don't know of many people who do have a life during nursing school! The "nursing school no social life" memes are some of my favorites because they invoke *fond* memories of my own time in school.

If you do have a life, you may not do so well in nursing school, or you may not pass boards. Nursing school requires more than just being smart. You have to memorize and then apply what you know. Most students are used to memorizing...but the application is what's so difficult. How will this information help you to take care of your patient? THAT is the question.

Nursing School Requires Passion

If a student doesn't have a passion for learning, or a passion for helping people, nursing school will be even harder. Some people get into nursing for the money. Yes, while there is money in nursing, remember that RN does NOT stand for "rich nurse". One has to really love caring for people in order to make a life-long career out of nursing. Otherwise, burnout is always right around the corner.

My advice? If nursing is worth it to you, do the best you can. Make those sacrifices for two years (plus or minus). If it is not worth it, don't waste your time and effort. Best wishes to all of you!

You are Not Alone

I often get questions from students who wonder if they are the only ones who feel like they "don't know enough". You are not alone! Even nurses who have been at it for a long time will run across situations in which they do not know what to do. This is when you rely on your book knowledge, your experience, and your gut instinct. True, when you're new, you don't have much experience or instinct to rely on. However, listening to other nurses and to your nursing instructors when they are telling you stories can add to your "experience." Additionally, if you make good friends with nurses who have experience, you will have a valuable team when in times of trouble.

Recently, I had a student tell me that while she enjoyed hearing my stories in class, she felt that the time I used telling stories in class would be much more valuable if I stuck to content only. I didn't tell her (though I probably should have) that I've chosen my stories for good reason. Thinking back to my own school days (daze?) I can still distinctly remember many of the stories my instructors told us instead of the bland lectures I sat through. Don't get me wrong, I learned a lot through lecture and I hung onto every word. However, I still remember the story that one of my instructors told us of running through a swinging door that didn't have a window in it. She knocked over a patient, the patient was injured, and the hospital was sued. Ever since that day, I have NEVER ran through a door that didn't have a window in it. I always open doors with caution. While I never actually had the experience of knocking over a patient, I learned from my instructor's mistake, and it became a part of my own experience. Over the years, I have thought of many of my instructors' stories, and based some of my decisions on them.

One of my best pieces of advice I can give is, "Don't panic." This is from my favorite sci-fi book, but it can also pertain to nursing and emergent situations. If you panic, you won't help the situation at all. Take just a second or two to take a deep breath and gather your thoughts. Before long, it will all come naturally.

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Social Networking and Nursing

With recent news-breaking stories about social networking and nursing, I felt like I could provide some guidance for nurses and nursing students alike.

One of the best bits of advice I can give is to reserve social networking sites for what they were intended - being social. What you do at work should remain at work. I know it is tempting to tell everyone that you took care of a woman who was in a car wreck and had to have her leg amputated, or to tell your family that you took care of long-lost cousin Bill. However, these are all HIPAA violations. Even if you do not state someone's name, people can infer who you are talking about, and that can lead to serious legal ramifications.

Something else to think about: even if a nurse or nursing student wins a lawsuit regarding a possible HIPAA violation, that person may be thought of negatively for a long time after the dust has settled. Why even risk the possibility of losing your job or losing your spot in nursing school, only to have it overturned in court? Don't put yourself in that position, because it can follow you for many years to come. You don't want any problems in your background keeping you from getting a new job.

Don't tweet or post to Facebook while you're at work. Even if you aren't giving out patient information, your boss could inadvertently see your posts, or someone could tell your boss (or clinical instructor) that you've been posting during working hours. While it may not affect your productivity, it does not look good for your reputation, especially if you're writing that you are bored! Any time you post to a social networking site, do so thinking that your boss is reading it. Furthermore, using a cell phone or getting on the internet may be violating hospital or school policy. This could lead to termination or severe problems for you.

Don't post pictures of yourself that will put you in a negative light. Also, don't write posts or tweets that would make others question your ethics, integrity, or honesty as a nurse. Public opinion can be very fickle, and if you're posting pictures of yourself in compromising situations, or if you're posting about playing hooky from work, that opinion of nurses could start circling the drain. The Gallup Poll has consistently shown that the public trusts nurses more than any other profession. Don't do anything that would harm that reputation that so many nurses have worked hard to attain.

In conclusion, always think about the ramifications and possible side effects of what you post online. The results may not be what you bargained for.

The Infamous Nursing Exam

If you're in nursing school, you know why I call the nursing exam 'infamous'. Nursing exams are infamous for being tricky and tough. But that's the point. Your patients will be tricky and tough! Nursing exams are there so your instructors can get you prepared for critical thinking on the job, when you're in a tight spot, and you have no supplies. So how do you tackle a nursing exam and come out alive? I have a few tips that may save you a few heart attacks, mental breakdowns, and depression.

Don't Fall Down on Your Reading and Studying

Don't ever let yourself get behind on reading and studying. The instructor will give you the MOST important information in class, but you can (and will) be tested over material that was in your reading assignment. Why? Because there is absolutely no way your instructor can cover every single detail in class. If she were expected to, classes would last forever, and you'd be in nursing school for years and years and years.  So block some time into your calendar just for reading and studying. Make sure you spend 3 hours x the credit hours for that course in reading and studying each week. So if you are taking a course that is worth 5 credit hours, multiply 5 x 3 hours, and you get 15 hours you need to study for that one course.

Study Your Notes Immediately

Take good notes during class. Make spelling errors, make them sloppy, make up abbreviations that you will understand. But...if you don't read those notes again until a week later, you won't know what you were writing about! Once you are done with class, go home or to a study area immediately. Pull out your notes and your textbooks. Rewrite your notes legibly and so you can read them and understand what they mean. Use your textbook to fill in information that your instructor didn't talk about in class. So, you covered hanging IV fluids in class, but the book says you have to check Y-site compatibility before you hang any medications with the primary fluids. Write that down in your notes. You will come away having already studied AND you have a more thorough idea of the concepts covered during class.

Take Care of Yourself

The night before the exam, DON'T CRAM. That is almost everyone's first instinct. Yes, read over material but don't cram so much info into your mind that you lose most of it. Your brain takes time to convert short term memory into long term memory. If you don't know something the night before the exam, chances are you won't know it for the test. Allow yourself time for plenty of rest. Eat well. Relax. Wake up early so that you can eat a good breakfast. Don't overdo it on the caffeine. One cup of coffee or soda - MAX. Don't try the energy drinks. Too much caffeine will make you nervous, jittery, less alert, and even nauseated. You wouldn't want a surgeon coming to do your surgery in that condition...so don't take a test in that condition. Lay everything out the night before that you will need. You might need a pencil, an ID badge, or other supplies. Put everything next to your keys and bag. Even get your clothes ready the night before. This will cut down on the rushing around. Rushing around the morning of a test will only make you more nervous. Give yourself time and you will be much more relaxed. Make sure to arrive early enough that you won't be breathing hard when you get to your seat.

Stay Away From Negative Nancy

Nursing students are always nervous about tests. A career is on the line! But don't get sucked into a situation that will only cause you to freak out and send your B/P skyrocketing. I often see students huddled out in the hallway prior to a test, chewing their lips, saying, "I'm going to flunk this test! I should have studied that more. I didn't know about that! Were we supposed to study that???" These students only get others around them more worked up. If you are nervous and worked up, you won't concentrate as well. Let your friends know that you love them, but that you have to have quiet time before an exam. Then go find a quiet place away from everyone else until the test room doors open.

Take a Minute

Before you start your exam, listen to any instructions the teacher has for you. Listen carefully! Then, before you even look at the first question, put down your pencil, close your eyes, and take a slow, deep breath, in through your mouth. Then let it out slowly through your mouth. Tense up every single muscle in your body. Then relax your body from bottom to top, relaxing each muscle group in turn as you move up your body. When everything is relaxed, take in a few more deep, cleansing breaths. Open your eyes, pick up your pencil, and begin.

READ THE INSTRUCTIONS!

I have seen more students get questions wrong from not reading directions than anything. Follow the directions to the finest detail.

Read Each Question and Answer Thoroughly

Cover up all answers for the question you are reading. Read the question thoroughly. If you are allowed to write on your test, underline all the important words, such as BEST, MOST, FIRST, etc. Then read the question again to be sure you understand what it is asking. Is it really asking about the patient's breathing, or is it asking about the sputum? Cancer or therapeutic communication? Once you understand what the question is asking, formulate an answer in your head. Then uncover the first answer. If you think it could possibly be right, put a checkmark by it. If you know it's wrong, without a shadow of a doubt, but an X beside that answer. Do this for each answer, reading each one thoroughly. When you are done, look at what you have left. Do any answers match the answer you formulated without looking at the answers? If so, that is most likely the answer. If not, what would your second guess be for the answer? Is it listed below? If you can knock the correct answers down to two to choose from, which one is the MOST correct? Don't infer anything...EVER. Use ONLY the information supplied to you in the question. If you start developing 'what-if' scenarios, you will think much too deeply and end up getting the question wrong.

Trust Yourself

Most students go back over the exam and their answers if they have time (if it's a paper and pencil test...more on computerized testing later). The thing that kills me is that many times, a student may have had a correct answer the first time, but then erased it and changed it to the wrong answer. This happens because the student begins to panic and starts second-guessing him- or herself. Yes. Look over your answers. HOWEVER...DO NOT CHANGE YOUR ANSWER IF YOU UNDERSTOOD THE QUESTION THE FIRST TIME AROUND. If you read back over the question and realize it's asking something different from what you thought the first time you read it, THEN change your answer.

Make Pretty Dark Bubbles

If you use a ScanTron, make sure you bubble in your answers thoroughly. ScanTrons are graded by running them through a machine, and if a bubble isn't dark enough, or doesn't cover the circle all the way, the machine may overlook it and count it wrong. Don't make any stray marks on the ScanTron as that could also affect your grade. If you are using computerized testing, make sure you selected the answer you meant to select. Some electronic exams allow you to save each individual answer before moving on. If so, save your answers. If a glitch occurs and your exams goes away before you are finished, you do not want to have to work on questions you have already answered again.

Breathe a Sigh of Relief

Before you turn in your test (or hit the submit button), take some more deep breaths. Turn it in and either return to your seat or leave...whichever your teacher has instructed you to do. Don't worry about it any more. There's no going back once you have turned in your test. Worrying will not do one thing. So many people want to worry and worry and then worry some more. But honestly, what does that do? NOTHING! If you have to go back to your desk and wait, put your head down on your desk if that's permitted. Or get in a relaxed position. Don't look around at what others are doing. It will only heighten your anxiety. Meditate, do breathing exercises, relaxation exercises, or fix your stare on a dot on the wall. Whatever you do, just keep your mind off of the test until needed (if your school does test review, etc.).

Have Fun

If you have to wait on grades to be posted, don't sit around and think only about what your grade might be. Go have a little bit of fun. Go down to the lake or take a scenic route home. If you have to go to work that will also serve to keep your mind off of the test. Don't sit at home hitting refresh on your browser until grades are posted. Anxiety = elevated B/P. And there's  no use worrying about it at this point. What is done is done. At least enjoy the moments in your life that you are not using to take a test.

Future postings will discuss computerized testing and different learning styles. Knowing your learning style will help you tremendously when studying, so make sure you check back soon! And quit worrying about that test after you have taken it!

How to Get Accepted into Nursing School

So many people have asked me how to get into nursing school. While every nursing school has different requirements, there are some standards things that all schools look at. So, if you're interested in getting into that nursing school of your dreams so you can get started on your career, you've got some work to do!

Don't Slack in Your Pre-Reqs

This is a mistake that I see very often. There are times in college when we all just want to relax and have a good time. But college is also a serious time. It is meant to prepare us for our careers - what we will be doing for the rest of our lives! Check out the pre-reqs that the nursing program requires, and make sure you do top-notch work in those classes. The other classes are important as well, but a 'C' in Interpretive Dance probably won't hurt you as much as a 'C' in A&P I and II.

Another thing I am seeing more frequently are multiple repeats of prerequisite courses. While the last grade you receive is the one used in calculating your GPA, repeats of courses can be an ominous sign. Nursing school slots are very limited, so applicants who are the cream of the crop will be chosen. Usually, those who have most or all of their prerequisite courses with a high GPA will be chosen.

Send in Your Application on Time...Or EARLY!

Nothing makes someone look less professional than being late. The same thing goes with the application. There are deadlines for applications for a reason. Those on the Admissions Committee must sift through literally hundreds (maybe even thousands) of applications each year. Nothing makes you stand out in a bad light than turning in the application after the deadline. The application is marked as having been turned in late, and those who submitted prior to the deadline will be chosen first. While some schools allow late application submissions, the chance of being accepted will be even greater if the app is turned in early.

Do Well on the Admission Exam

Admission Exam?!?! Who said anything about THAT? Not all nursing schools have an admission exam. However, they are proving to be more and more predictive of student success. Schools are looking for students who will be successful in their programs. Why, you ask? Many people think that colleges and universities only want students' money. That is far from the case. While colleges and universities definitely need money to stay afloat, student success is in everyone's sight. That being said, some basic knowledge is needed in order to do well in nursing school. If a nursing program requires an admission exam, it usually contains English, Math, Science, and Critical Thinking components. If the exam has a study book available, it is advisable to get it. You may be able to borrow it from your local library or even the library at the college. Or, if you are applying with a lot of your friends, you might all chip in together to buy one book. This will save you some much-needed money - nursing school is expensive!

Complete Your Application Completely, Legibly, and Professionally

You may not believe this, but I have seen some applications that looked as though a 3rd grader wrote them. There were misspelled words, missing information, and the handwriting was barely legible. Not only does this cast you in a bad light, it might be a part of the nursing program's admissions policy to place those applications on the wait list. Make sure to put your best foot forward. Your application is usually your first impression with the nursing school. Sometimes, the only thing the admissions committee sees is your application, if there is no interview process.

Attend an Advising Session

If the nursing school requires it, you must attend an advising session. The program may have you come to meet with an advisor one-on-one, or it may have you come in for a group session to learn about the program. During this session, dress comfortably but professionally. Arrive early. Call ahead for directions, parking tips, and walking distance. I say this from experience. I have had several students come in late for an advising session because they arrived to campus on time but didn't realize they had to walk a mile in from the parking lot. They came in, didn't have any time to prepare, and appeared distressed. Take your time. If you arrive too early, go to the restroom and make sure you still look presentable. You are likely meeting with a future faculty member if you make it in!

Make a Good Impression in your Interview

Some schools require you to participate in an interview. It is important to present your best, professional self during this process. Dress appropriately (ask if you are not told what the dress should be; if all else fails, dress in business attire), and work in front of a mirror prior to the interview to ensure you maintain composure. If you were asked to bring any documents with you to the interview, make sure the documents are crisp and clean. Carry them in a manila folder or envelope - do not fold them. You may elect to carry them folder or envelope in a business case or bag. This shows your organization. Arrive several minutes early (but do not show up too early). If the school has a secretary, introduce yourself and tell him or her you there for an interview with (name). When you enter the interviewer's office, introduce yourself with a firm handshake, stating your first and last name. Speak loudly enough to be heard, but not so loud that it is uncomfortable for you or the interviewer. Respond to questions with thoughtful answers and make eye contact with your interviewer when you are talking. Do not be afraid of letting a little silence fall between the question and your answer. Many interviewers appreciate interviewees taking a little bit of time to think about their answers. This shows thoughtful contemplation. Have a few questions handy you would like to ask about the program, but make sure it shows you have done your research. Once the interview is over, thank the interviewer for his or her time, and give another firm handshake. Tell the secretary goodbye and thank him or her for helping you. Exit the building with efficiency (don't run out, but don't dawdle around, either). Some people opt to send a thank you note to the interviewer (either a paper note or email). If you do decide to do this, make sure the thank you is succinct and professional. Do not repeatedly call, write, or email asking for a decision. You will only slow the process down and you will show an unprofessional side to the admissions committee.

Good luck to all of you out there who are desperately trying to get into nursing school. I have one more bit of advice: try to get as many pre-reqs out of the way as possible before starting nursing school. Once you are in nursing school, your life is pretty much consumed. So many students who are taking outside courses struggle because the weight of nursing school is so heavy. Compound that with a job, a spouse, kids, and other duties, and you are a ticking time bomb. So do yourself a favor and get those pre-reqs out of the way. I promise you'll thank me!

Dealing with the Stress of Nursing and/or Nursing School

Stress. It's everywhere these days. Our lives have become so busy that we often do not realize how stressed we are until health problems arise. There are ways to de-stress your life, even if you are a nurse or nursing student. While the following tips are mainly for nursing students, nurses can also use the advice.

Manage Your Time

One of the best ways to prevent or reduce stress is to manage your time wisely. Get a calendar or use the calendar app on your phone or home computer. First, put in appointments and meetings that you cannot miss, such as doctor appointments. For nursing students, put in your class dates and times. Next, if you're a nursing student, put in your study time. Studying should not be done in huge chunks...rather, divide your study time into small chunks of time and spread it out. Lastly, put in social engagements, time with family, etc. You may think it is silly to put time with your family into your schedule. However, if you do not put it in, you will find that you are overwhelming yourself with school or work.

Find a Release

"All work and no play makes Jack a dull boy" - The Shining. If you've watched The Shining, you know how that ends! If you haven't watched The Shining, then just know that doing nothing but work and not having any time for yourself can make you extremely stressed. So many nursing students spend every waking hour studying or thinking about nursing. You should not let it overpower your life. Yes, you are learning about the career that (hopefully) you will have for the rest of your life, but if you never balance it with other things that you love, you are setting yourself up for loads of stress. Some people choose to exercise, take a hot bath, hike, perform yoga or meditation, or punch a punching bag to release stress. Others try their hands at photography, playing an instrument, or cooking. Whatever makes you happy, make sure to make time for it (and put it on your schedule!).

Take a Few Minutes to Compose Yourself

The way my day goes depends on my mornings. If I oversleep, I rush around, forget important things at home, and it seems like I am rushed the entire day. However, if I wake up with plenty of time to get ready, drink a cup of coffee, and think about my day for five minutes, my day goes much more smoothly. One morning I overslept, and I had forgotten that I had set up appointments with students all day. I ended up getting to work late, and a student was already waiting on me. I had to rush through that meeting, and still went over time, causing my next appointment to run behind. I felt rushed the entire day, and my mind was always distracted by wondering how much time I had left in each meeting. I wasn't doing myself or my students a favor at all.

This works in the hospital as well. Take just a few minutes to think about your plan for the day. When I worked in the hospital, I would take time in the morning before I left for work, and then I would take another five minutes after receiving report to 'plan' my day. When I did that, my day went so much more smoothly, even if I had to deviate from my original plan.

Calm Down

There are times when we are just overloaded and there's nothing we can do about it. There are deadlines we cannot miss, bosses looking over our shoulders, patients yelling at us. No matter what the source of stress, take time to calm down. Someone who is anxious or stressed will do no good in any situation. Go to the bathroom if you need to. Close your eyes and take deep breaths, breathing in through your nose and out through your mouth. Before tests, I always try to calm my students down by guiding them through a relaxation technique. It takes about one minute, and the students can calm down enough so that stress and anxiety isn't plaguing their thoughts. I have the students close their eyes and tense every muscle in their bodies. I guide them through breathing in through their noses, and out through their mouths. I then have them release the muscles in their bodies, slowly, from the ground up, starting with the toes and feet, moving up to the calves and thighs, and so on. At the end, when all muscles are loosened, I then have them breathe in and out again, just as before, twice. I then have them open their eyes. Try this at home. When you open your eyes, it is almost as if you see things in a different light.

Don't Sweat the Small Stuff

I have found that nurses and nursing students who are the most stressed out are the ones who are perfectionists. These are the ones who will write and rewrite a paper until it is absolutely perfect, align corners until they match exactly, arrange objects on a desk 'just so'. They do not necessarily have Obsessive Compulsive Disorder (OCD), but you get the picture. I used to be one of these people. I was only a perfectionist when it came to school work or something I had to present for work. Okay, I'll admit that I am still somewhat a perfectionist, but I have learned when to let go. I enjoy my sanity, and I want to keep it. Sometimes I have to give examples to students about what they can stop obsessing over. Yes, while instructors and bosses want you to have legible handwriting, that does not mean that your hand has to cramp with perfection. Just write legibly, and that is enough. If you have naturally neat handwriting, that is wonderful, but don't spend hours trying to make something look perfect.

Spend Time with Yourself

People often forget to take care of themselves. That is very easy for a nurse or nursing student to do. We take care of others by nature. That is often why people choose nursing as a career. However, take the time to take that hot bath, get your hair done, or read. Whatever it is that you like to do by yourself, take a few minutes every now and then to do it. Your body will thank you for it.

What is Nursing All About?

First of all, I would like to thank you for stopping by to view my page. By coming here, you are most likely a nurse, a nursing student, or someone who is interested in the health care field. Since I meet so many people on a daily basis who are interested in nursing, but do not really know what nursing entails, I would like to shed a little bit of light on the subject here. In future blogs, I will go into more detail, answer questions, and hit on some of the more specific topics.

So...what does a nurse do? When I first began nursing school, I wore rose-colored glasses (not literally, because I would have looked silly). I thought that the doctor would tell me what to do, and I would do it. Boy, was I wrong! Yes, nurses do carry out physicians' orders, but they do so much more. I should state right now that nursing differs depending on the facility and setting in which one works.

Nurses think critically and with a certain amount of autonomy. For instance, if a patient comes into the hospital with an infected wound, and the physician has ordered antibiotics, the nurse must first determine if a certain test, called a wound culture, has been done prior to starting the antibiotics. Without going into too much detail, a wound culture is a test that can tell us what germs are in the wound, causing the infection. Why is this important, and why is it important to know before starting the antibiotics? Antibiotics kill all bad germs, right? Wrong! It is important to know if the culture has been done before starting antibiotics, because the doctor will order an antibiotic based on what he or she thinks is causing the infection, usually based on the appearance of the wound among other factors. So, the physician will start the patient on antibiotics right away to get the germ-killing underway. However, in order to make sure the patient is taking the most appropriate antibiotics, we have to know what we're up against. So, the nurse will take a wound culture, send it to the lab, and in just a few days, we will know exactly what bugs are in the wound...and what antibiotics are most effective at killing them. If the nurse inadvertently starts the antibiotic BEFORE getting the wound culture, it could affect the results, which could mean that the patient doesn't get the most appropriate antibiotic with the most efficient and specific germ-zapping capabilities.

Nurses staff hospitals 24 hours a day, 7 days a week. Nurses generally work 8-, 12-, or 16-hour shifts. These days, you are more likely to see a hospital nurse who works 12-hour shifts. Nurses in outpatient clinics may only work 8- or 10-hour shifts, and may only do so during the weekdays. However, nursing care is provided in the hospital around the clock. Nurses become the eyes, ears, and hands of the physicians. Registered nurses (RNs) perform shift assessments. This means that at the beginning of each shift, an RN will do assessments on all inpatients. If you have been a patient in a hospital, you may have noticed that the RN assessed for things that you thought were irrelevant to the reason you were in the hospital. However, this is for good reason. Our bodies can tell us things in such strange ways that the entire body must be assessed, from head-to-toe. Did you know that if your liver is failing, the white part of your eyes becomes yellow? Did you know that certain medications can lead to severe neurological damage, and can be detected early by looking into the eyes, or by having you hold out your hands? Every little thing that the nurse does during the assessment has a purpose.

Nurses document...and then document some more. Nurses generally live by the credo, "If you didn't document it, you didn't do it!" While that may seem a little strange (kind of like the philosophical question, "If a tree falls in the woods, and there is no one around to hear it, does it make a sound?"), there is truth to it. Yes, you may have started an IV, drawn blood, assisted a patient to walk in the hallway, and changed a dressing, but if you did not chart that it was done, you can't prove in a court of law that it was done. So, nurses document everything they do. They may even document some of the things their patients say, if it lends something to the documentation. For example, the nurse may chart, "Complains of abdominal pain." This is an accurate statement. However, take a look at the following piece of documentation. "Complains of abdominal pain. States, 'It's very sharp and it hurts worse than anything I've ever experienced before.' Facial grimacing present when patient changes positions in bed." The person who is reading this can tell much more about the patient than if he or she read the first piece of documentation. Nurses must learn to write succinctly, which means - give a lot of information and meaning with as few words as possible. So, nurses cut out extraneous words, but then choose the words that will have the most impact, and the most accurate meaning.

I could go on for days, but I have included some of the most basic nursing duties here. Keep looking back for more topics, musings, and must-knows!