Embarking on the journey of nursing school can be both exhilarating and overwhelming. As someone who has navigated through the trials and triumphs of nursing education, I've compiled a list of key insights that I wish I had known before beginning this challenging yet rewarding path. The information in this blog post is not to deter anyone from going to nursing school, but just to provide information that I wish I would’ve known prior to accepting my seat in my program based on my own personal experiences.
Another thing to keep in mind is that every program is different. Some nursing programs are more demanding than others, and there are different nursing degrees you can get. Depending on the degree, you may have a better, or worse, experience than I did. Regardless of the program you plan to attend, you should be aware of things that may make it more challenging.
So, what exactly do I wish I would’ve known before I started my nursing school venture? Keep reading to find out!
Before delving into the content of this blog post, it's important to emphasize that the information provided here is for entertainment purposes only and should not be construed as medical advice. While we strive to offer informative and engaging content, it is not intended to replace professional medical guidance or diagnosis. Any questions or concerns regarding your health or specific medical conditions should be discussed with a qualified healthcare provider or medical professional. They can provide personalized advice tailored to your individual needs and circumstances. Remember, your health and well-being are paramount, so always seek the guidance of a medical expert for any medical-related inquiries or issues.
As a little kid, I was a pint-sized nurse in training, armed with my trusty tackle box filled to the brim with bandaids, peroxide, and tweezers. While other kids toted around toys, I proudly carried my makeshift medical kit, ready to spring into action at any moment. From curing imaginary boo-boos to rescuing stuffed animals from "medical emergencies," I was on a mission to nurse my family back to health, one bandaid at a time. With each pretend procedure, my determination to become a real-life nurse only grew stronger. Little did I know, those childhood adventures were just the beginning of my journey toward fulfilling my dream of making a difference in the world of healthcare.
I continued to have this dream throughout my teen years. I obtained my Certified Nursing Assistant (CNA) certification before I graduated high school. I started college that fall and began my pre-requisite courses to prepare me for my future program. To say juggling full-time classes and a full-time job was hard would be an understatement. As it turned out, it was the easier part of my college experience.
The summer before my first semester of nursing school we were brought in for our Nursing Program orientation. We were greeted by several professors and the Dean of Medical Science. As expected, we were informed of all the rules of the program. What was not expected, however, was that our families no longer mattered and that if we had jobs, we would have to quit them. I thought that was a tad dramatic. After all, several of the students in my program had families of their own. They couldn’t just drop them for the program, could they? I soon found out that having a social life and a full-time job just weren’t realistic when I was on the verge of failing my first semester. Reluctantly, I quit my full-time job and instead worked as a nurse extern, which only required two shifts per month. This put a whole new strain on me financially as college was not cheap, and ended up costing me quite a bit in student loans.
It’s understandable to expect to have to work hard in nursing school, but to be told your family and jobs are no longer the most important part of your life is rough. We were told several times that this is real life and that when we started work in the nursing field, we would not be allowed extended time off or be allowed to call in for personal or family matters. This is true to an extent, but most jobs offer PTO, sick leave, and bereavement.
Our program only allowed a total of two missed days for the entire two and a half years of our Bachelor program. This was clearly not realistic, and definitely did not align with the expectations we were given about real-life nursing jobs. Unfortunately, the school knew that if we wanted to become a nurse, we would show up no matter what.
My point is, your program may tell you a lot of things but in my experience I feel that they probably tell you that stuff to scare off the weakest links. They need to make sure that you are willing to work as hard as possible to do the best you can. After all, the overall pass/fail scores of the students affects the program’s accreditations.
If you don’t know what accreditations are, allow me to explain.
Nursing school accreditations are formal recognitions awarded to nursing programs by accrediting bodies. These accreditations signify that the nursing program meets specific quality standards set by accrediting organizations, ensuring that students receive a high-quality education and preparation for their future careers in nursing.
There are two main types of accreditations for nursing programs:
Institutional Accreditation: This accreditation assesses the overall quality and integrity of the institution offering the nursing program. It evaluates factors such as faculty qualifications, resources, student support services, and educational outcomes. Institutional accreditation ensures that the nursing program is part of a reputable and credible academic institution.
Programmatic Accreditation: This accreditation specifically evaluates the quality and effectiveness of the nursing program itself. It focuses on curriculum content, clinical experiences, faculty expertise, student outcomes, and adherence to professional standards and regulations. Programmatic accreditation ensures that the nursing program meets the rigorous standards set by professional organizations and regulatory agencies in the field of nursing.
Accreditation is voluntary but highly desirable for nursing programs, as it demonstrates a commitment to excellence and continuous improvement. Graduating from an accredited nursing program may also be a requirement for licensure or certification in some jurisdictions. Examples of accrediting bodies for nursing programs in the United States include the Accreditation Commission for Education in Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE). Prospective nursing students should always verify the accreditation status of a nursing program before enrolling to ensure that they receive a quality education that meets industry standards.
Sometimes, I catch myself thinking I should have picked a different profession. Nursing is a very stressful, and demanding career. However, I truly believe that if I would have known these 10 things before I started the nursing program, I would have been better prepared for not only the nursing program, but also the real world, after I graduated.
Time Management is Non-Negotiable
Nursing school demands a significant time commitment. From classes and clinical rotations to studying and assignments, effective time management is essential. Establishing a schedule and prioritizing tasks will help you stay on top of your workload and maintain a healthy work-life balance.
Due to the high demands, it is difficult to schedule time for literally anything…appointments, birthday parties, functions, family gatherings, the list goes on. This is something you should explain to your friends and family before starting the program to help them better understand why you will not have additional time while you are in nursing school. I did not have kids when I was in nursing school, but I imagine you would have to make sure that you have plenty of support for the long hours the program requires.
I cannot stress enough how important it is to put your degree before anything else if you are determined to become a nurse, especially if you are in a more difficult program. I recommend getting a planner and writing out everything that’s due on your syllabi and any clinical dates for each semester, then schedule studying around those days along with any papers that are due. Once you get that done, you might be able to schedule a few hours of sleep at the end of the day. But you probably won’t find any free days until your break between semesters.
I wish I would’ve known just how time consuming my particular nursing program was going to be. I believe everything worked out like it was supposed to, but I could’ve taken a different route. Maybe I could’ve gotten my LPN first and possibly worked some while I did my LPN-to-RN bridge? Although it may have been possible, there is a chance I wouldn’t have gone back. Either way, I could’ve saved some on my student loan debt and possibly have known sooner if nursing was the right career choice for me. Not to mention, I could’ve went to more events with family and friends. Do I regret my choice to go straight for my bachelors right out of high school? Absolutely not! But having more options can never hurt.
Self-Care is Vital
Amidst the rigorous curriculum and demanding clinical experiences, it's easy to neglect self-care. However, prioritizing your physical, emotional, and mental well-being is crucial for success in nursing school. Make time for activities that rejuvenate you and seek support when needed. Be sure to get plenty of sleep. This can be especially difficult when trying to balance the full workload of all the classes, clinicals multiple days a week, tests to study for, and papers to write. But your brain does its best work when it’s well rested. Don’t live off of energy drinks! It’s easy to believe you need more caffeine to keep up with your new busy life, but there are so many possible problems that may arise when drinking too many energy drinks. And honestly, it’s not worth it. Take that break you deserve, and stay hydrated by drinking plenty of water. Had I known that breaks are just as important as studying, I would’ve taken a few more of them! Your brain can only learn so much in a period of time and it needs breaks to fully absorb and retain that information. Ever heard of information overload? Well, that’s what happens when you study for extended period of time without breaks and this increases your chances of getting information mixed up.
Some Nurses Really Do Eat Their Young
The phrase "eating their young" in nursing refers to a phenomenon where experienced or senior nurses mistreat, belittle, or undermine new or inexperienced nurses. This behavior can take various forms and has detrimental effects on the nursing profession as a whole. Here's how nurses "eat their young" impacts the nursing profession:
During my nursing school days, I first learned about the concept of nurses "eating their young." However, the reality of how pervasive and extreme this behavior can be exceeded my expectations. Had I known the extent of it, I might have considered either changing majors to avoid such treatment or given more thought to where I wanted to begin my nursing career. The initial months on the job, including any preceptorships required by the school, are crucial for one's mental well-being. A supportive preceptor who fosters learning can set the stage for success. Conversely, being mentored by a seasoned, burnt-out nurse may lead to job dissatisfaction from the outset. While not inevitable, such experiences can certainly have a significant impact.
Intimidation and Bullying: Experienced nurses may intimidate or bully new nurses through verbal abuse, criticism, or derogatory comments. This behavior can create a hostile work environment and contribute to feelings of insecurity and inadequacy among new nurses.
Undermining Confidence and Competence: By undermining the confidence and competence of new nurses, experienced nurses may hinder their professional development and ability to provide safe and effective patient care. This can lead to self-doubt, anxiety, and decreased job satisfaction among new nurses.
Isolation and Exclusion: Experienced nurses may exclude new nurses from social circles, cliques, or professional networks, making them feel isolated and unwelcome in the workplace. This sense of isolation can further exacerbate feelings of alienation and disconnection among new nurses.
Impeding Learning and Growth: When experienced nurses "eat their young," they may discourage new nurses from asking questions, seeking clarification, or advocating for themselves and their patients. This impedes the learning and growth of new nurses and perpetuates a culture of silence and complacency in the workplace.
High Turnover and Staffing Issues: Nursing turnover rates may increase as a result of experienced nurses mistreating new nurses, leading to staffing issues and continuity of care concerns. High turnover can strain healthcare organizations, disrupt team dynamics, and compromise patient care quality.
Flexibility is Key
In nursing, no two days are alike. Similarly, nursing school will present you with unexpected challenges and changes. Cultivating flexibility and adaptability will help you navigate these situations with ease and grace. Nursing is a constantly changing profession. There are always new things to learn, new ways to improve current practices, and new rules and regulations to follow. Being flexible is one of the most important aspects of nursing. If you are considering travel nursing after you get some experience, you must master flexibility. You should be able to make changes to your routine, schedule, and life in a short amount of time. I highly recommend travel nursing if you are interested. Read my blog “Navigating the Globe in Scrubs” if you want to learn more about travel nursing. While I do believe that nurses should be flexible, I thought it would be a more simple type of flexible. Trying to juggle fifteen tasks for five different patients is hard enough without adding on the fact that the physician just placed an order for “transfer to ICU” for your patient with pneumonia who isn’t tolerating a BiPAP and needs to be intubated. Prioritization goes hand-in -hand with flexibility. As things change and new situations come up, you must prioritize the tasks from most severe to least. You will get better with this over time!
Burnout
Burnout among nurses can lead to a variety of negative behaviors and attitudes that can contribute to a toxic work environment. Burnout is a state of emotional, physical, and mental exhaustion caused by prolonged stress and overwhelming work demands. Nursing burnout can have significant repercussions not only for the nurses experiencing it but also for their coworkers and patients. These include, but are not limited to:
When nurses experience burnout, they may exhibit the following toxic behaviors:
Cynicism and Negativity
Lack of Empathy and Compassion
Poor Communication
Decreased Job Performance
Resentment and Blame
Withdrawal and Isolation
The Insane Rivalry Between Dayshift and Nightshift
The rivalry between dayshift and nightshift in healthcare is a longstanding phenomenon fueled by differences in work schedules, workload perceptions, and communication challenges. Nurses working on dayshift and nightshift often find themselves on opposite ends of the spectrum when it comes to their experiences and perspectives.
Certainly, I was already familiar with the lighthearted rivalry before starting nursing school, having worked as a CNA. However, I've found that the dynamics of this rivalry are somewhat different for nurses. At times, it can escalate to the point where doctors or management need to intervene. In extreme cases, one shift may resort to deliberately spreading falsehoods about another, particularly targeting one or two nurses from the opposing shift. Regardless, it's essential to safeguard yourself and uphold professional integrity to protect your license. If you are unsure about any procedure or practice, it's crucial to consult the facility's policies to ensure proper adherence and provide a reliable foundation of support.
It's important to recognize that unless you're actively engaged in someone else's role, it's difficult to fully grasp its challenges and demands. It's unfair to make assumptions like "the lab should be quicker" or "nightshift has it easy with all that downtime." Each department and shift operates under unique circumstances and pressures. Having worked both dayshift and nightshift in a hospital, as well as serving as a field RN and case manager in home health, I've experienced firsthand the diverse demands of each role. While some may perceive certain positions, like case management, as less physically demanding because of desk work, they may overlook the mental and organizational challenges involved in managing a large patient caseload. Every job comes with its own set of physical and mental demands, and it's essential to appreciate the complexity of each role.
The rivalry that has developed can be incredibly draining, to put it mildly. Nurses often find themselves either pushing harder to demonstrate their worth compared to the other shift (though this is less common), or succumbing to tension and resentment, which ultimately hampers productivity (a more common outcome).
Here are some key aspects of the rivalry:
Shift Schedules: Nurses on dayshift typically work during traditional daytime hours, while those on nightshift work overnight, often during non-traditional hours. These differing schedules can lead to a sense of disconnect between dayshift and nightshift nurses, as they may have limited interaction due to their conflicting work hours.
Workload Perceptions: Dayshift and nightshift nurses may perceive their respective shifts as having different levels of workload and complexity. Dayshift nurses may feel that they bear the brunt of patient admissions, discharges, and procedures, while nightshift nurses may argue that they deal with higher acuity patients and emergencies without the same support resources available during the day.
Communication Challenges: Communication between dayshift and nightshift nurses can be challenging due to limited overlap in work hours. Handoffs between shifts may be rushed or incomplete, leading to misunderstandings, errors, and frustration on both sides. Additionally, communication barriers may arise when nightshift nurses need to contact dayshift staff for assistance or clarification during off-hours.
Perceived Favoritism: In some healthcare settings, there may be perceptions of favoritism or unequal treatment between dayshift and nightshift staff. For example, dayshift nurses may feel that they receive preferential treatment in terms of scheduling, resource allocation, or career advancement opportunities compared to nightshift nurses.
Camaraderie and Solidarity: Despite the rivalry, dayshift and nightshift nurses often develop a strong sense of camaraderie and solidarity within their respective shifts. They bond over shared experiences, challenges, and victories, forming tight-knit teams that support each other through the ups and downs of healthcare delivery.
Efforts to Bridge the Gap: Recognizing the importance of collaboration and teamwork across shifts, healthcare organizations may implement initiatives to bridge the gap between dayshift and nightshift staff. This may include scheduling occasional joint meetings or social events, implementing standardized handoff protocols, and fostering a culture of mutual respect and appreciation for each other's contributions.
Embrace Lifelong Learning
The field of healthcare is constantly evolving, and lifelong learning is essential for staying current and providing high-quality care. Cultivate a thirst for knowledge, pursue continuing education opportunities, and remain open to new developments in the field.
If you don’t like learning new things, nursing definitely isn’t the field for you. Like I said earlier, nursing is always evolving. This is something you have to get used to. When you start at a new facility, you have so much education. Most facilities require around 1-2 weeks of class orientation, and then obviously you have orientation on the job with a preceptor. Not to mention you have CEUs that are required for renewing your licenses every 1-2 years depending on what state you live in, and you will have learning modules due throughout the year as well.
I love to learn, but honestly it gets exhausting trying to keep up with everything going on in my personal life, my job, keeping up with being a mom and wife, and trying to keep up with housework, bills, and more of those daunting grown-up things. Then you add a big dollop of education on top of everything else?? It can be a lot.
Something I have heard in the years I’ve been a traveler is that sometimes people get the impression that when you are a traveler, you are exempt from the hospital or facility’s education. This is not the case. You are still required to do their education and the education your agency requires you to do.
Nurses (and CNA’s) Are Undervalued
I don’t mean this to be negative, but it’s true. It is very rare to find a facility that actually puts your opinions and needs first, proving that you are truly valued. I cannot tell you how many facilities I have worked at that “want” our feedback but do absolutely nothing to make a change.
Hospitals go on and on about cutting costs, but by cutting costs, not only are the workers suffering, but so are the patients. Buying the cheapest products at limited supply brings a whole new level of stress to the workplace. How can they expect that we will be able to provide even decent patient care when we don’t have enough supplies?
There’s also the fact that nurses just aren’t paid enough. If I knew that my “big payout” for every huge accomplishment or holiday was pizza, I definitely would’ve been less excited about the money side of nursing. And if you’re night shift, forget anything fresh. You’ll be eating rock hard leftover pizza and cookie crumbles for dinner. My whole life I was told “nurses make so much money”, and while we definitely don’t get paid minimum wage, we aren’t too far from it. I didn’t sign up for nursing for the money. Let me guess.. you’re probably thinking “everyone says that”, am I right? In all seriousness, I did it because I knew I wanted to take care of people, but having a good paying job never hurt anyone, right?
Staffing. Ugh. This one is probably the worst part of being undervalued. I say this because not only does it cause burnout, increased stress, and poor productivity, but it also decreases patient satisfaction (which, by the way, affects HCAHPS scores).
Patient dissatisfaction can have a significant impact on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, which are used to measure patient satisfaction with hospital care. When patients are dissatisfied with their healthcare experience, whether due to long wait times, poor communication, or perceived lack of empathy from staff, they are more likely to provide negative feedback on HCAHPS surveys.
Lower scores on HCAHPS surveys can result in reduced reimbursement for hospitals and negatively affect their reputation and competitiveness. Therefore, healthcare organizations SHOULD strive to address patient concerns and improve the overall patient experience to maintain high HCAHPS scores and ensure quality care delivery.
With that being said, I still just don’t understand why hospitals are so reluctant to put more money into hiring more staff, decreasing nurse to patient ratios, increasing pay for all healthcare workers, providing more meaningful rewards, providing all areas of the hospital with up-to-date and working equipment, and ensuring they are ordering high quality supplies.
You have to spend money to make money! I get that it’s all a game of monopoly… making sure you end up with the most profit. BUT, it’s our license on the line. The happier your staff, the happier your patients. And the happier your patients are, the less likely the hospital is to face lawsuits. Not to mention the fact that the hospital’s reputation would skyrocket, and staff would be in a much better mood.
Prepare for Emotional Challenges
Nursing is a deeply rewarding profession, but it can also be emotionally taxing. Prepare yourself for the emotional demands of caring for patients and witnessing suffering. Seek out support systems, practice self-reflection, and prioritize self-care to cope with these challenges effectively. I was prepared for this to a point with my experience as a CNA. I knew how difficult it could be emotionally, but what I didn’t know is how much more difficult it would be as the nurse. You are the one administering the medications, doing the education for not only the patient but also the family, monitoring for and reporting changes, and sometimes even administering the last medication and, in turn, watching the patient take their last breath. Not only that, but you also have the emotional rollercoaster that you take on internally. Between high expectations of delivering the best patient care, keeping your patients alive, being physically or verbally abused by a patient or family member, constantly worrying if you did everything you were supposed to do during your shift, and being stretched thin due to inadequate staffing, you are completely exhausted by the end of just one shift. And if you suffer from pre- or post-shift anxiety, you never get off the rollercoaster. Another emotional situation is workplace bullying. This happens frequently and most victims turn a blind eye because either they don’t want to cause any issues or maybe because they just don’t have the mental capacity to deal with it at that moment. Workplace bullying in nursing is a serious issue that can have profound effects on both individual nurses and the overall quality of patient care. Nurses, who are dedicated to caring for others, may find themselves subjected to various forms of bullying, including verbal abuse, intimidation, and undermining of their professional competence. This toxic behavior can erode morale, lead to increased stress and burnout, and ultimately compromise patient safety. Moreover, workplace bullying creates a hostile work environment that undermines collaboration, teamwork, and effective communication among healthcare providers. Addressing workplace bullying in nursing requires a collective effort to foster a culture of respect, support, and accountability, where all members of the healthcare team are valued and treated with dignity and professionalism. By recognizing the signs of bullying, promoting open dialogue, and implementing policies and interventions to prevent and address bullying behavior, healthcare organizations can create healthier work environments that prioritize the well-being of nurses and the delivery of safe, compassionate patient care. It is so important to recognize when enough is enough of the emotional challenges. Don’t be afraid to get professional help or even make a change in your environment. Sometimes changing specialties, moving to a different hospital, or climbing the ladder is what you need to make yourself happy.
Trust in Your Abilities
Finally, believe in yourself and your abilities as a future nurse. You have chosen a noble and impactful profession, and though the road may be challenging, remember that every obstacle you overcome brings you one step closer to achieving your dreams. This was hard for me to conquer. For the first few years of my nursing career, I was very skittish. I was constantly second guessing myself and over-analyzing every little thing. With time, I have gotten better about trusting myself and what I do know. There are still times that I jump the gun, but I step back and think about the patient’s symptoms and ask any follow-up questions I can think of, and then take my next steps. Find a good balance between believing in yourself and not being too cocky. Nurses who believe they know it all, usually make the most mistakes. It is okay to not know something, but also listen to your gut as it usually helps guide you through difficult situations. After all, you made it through the program, you got pinned, you received your diploma, and you passed the boards. You must know a little of something, right?
Overall, the journey of nursing is a transformative experience filled with growth, challenges, and moments of profound learning. By embracing these insights and lessons, you can navigate the complexities of nursing with confidence and resilience, ultimately emerging as a skilled and compassionate healthcare professional. Just be sure you are ready to take on the challenges before you begin to give you the greatest chance of success.
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