So, you’re getting ready to graduate nursing school and are looking around for some free and paid NCLEX® questionnaires. Let’s be real, everyone would like to try to get as many practice test questions as possible, which typically consists of checking out not one, but multiple free and paid NCLEX® question banks to maximize your dollar and time.
What to look for in NCLEX® Questionnaires
Getting access to NCLEX® questions is helpful, but there’s more to it than that. You don’t just want to know the right answer, you want to know the rationale so you can learn why that’s the right answer. Even better, if they can tell you the level of difficulty and how it stacks up against the rest of their question bank, that’s amazing.
Remember, the NCLEX® isn’t a normal test… it’s a computerized adaptive test (CAT). What does that mean? Here’s a great explanation from the National Council of State Boards of Nursing (the people who write the test!) about what a CAT really means. So, just getting a bank of multiple choice questions isn’t going to cut it. You need to know not only the right answer, but the rationale and how difficult the question is, as well as questions with alternate formats. You also don’t want to get the same questions over and over, so you need a large bank of question (1,500+).
What’s best is if you can find a question bank that also has a content review, so if you got a question wrong and need more information than the rationale supplies, you’ve got resources to dive deeper into. More things to look for are programs actually written by nurses, ones that provide the ability for you to give feedback on a question, as well as the ability to to purchase more. The absolute best if if you can find one that has a money-back guarantee if you end up not passing the NCLEX®.
If you want a comprehensive, quality NCLEX® questions and review, you are looking at dropping at least a few hundred dollars. It’s expensive, but not passing the first time around can cost on average $10K – $20K in lost wages, fees, and study costs.
Look for the following aspects of quality NCLEX® questionnaires:
A large bank of questions
At least over 1,500 but you may want to look for one with substantially more because if you’re diligent in taking practice questions, you’ll go through 1,500 faster than you realize
Questions with alternate formats
All of the possible alternate format question that may appear on the exam include select all that apply, hot spots, fill in the blanks, ordered response, audio options, graphic options
Difficulty level of the question
Nurses actually writing the content/questions
Able to use features on mobile
This would be a bonus, not a requirement – in my opinion
The ability to provide feedback
This would be a bonus, not a requirement
The ability to take a simulation exam
This wouldn’t provide the answers immediately, but attempt to simulate the NCLEX® to assess your level of readiness
Test.com is simply 23 free NCLEX® prep questions with a buy-up option to their course. You don’t have to register to get the correct answers, but it’s just a few. The buy up is to their review with 800 questions, which is written by nurses, contains a money-back guarantee, mobile-enabled, a create-your-own flashcards, as well as simulation exam capabilities. It’s probably one of the cheapest, if not the cheapest programs out there.
I am a big fan of the way Khan Academy teaches. They utilize short videos that are packed with high-value information. Also, they’re free! The NCLEX® prep section has over 600 YouTube videos that are around 10 minutes each. They are mostly taught by physicians, however, because they’re going into the pathophysiology behind things and not actual nursing care. Essentially, you’re missing a massive part of the test content. While they do have some NCLEX® prep questions, it’s only 86 total. You do not have to register to get access to them.
My thoughts – this would be a good resource for reviewing pathophysiological content that is hard to grasp and just to have access to 86 free questions… but it should by no means be your only review. Since their focus is on patho, there are no nursing topics which comprise major aspects of the exam. I’d do the 86 questions, then use a handful of videos if needed.
Nurse Labs is arguably the largest database of free NCLEX® prep questions at over 3,500. You don’t have to give them your email, they’re broken up into different categories, and they have different modes you can take them in (exam, practice, text). They have some free study guides which accompany content. You are told which answers are correct and it seems like (sorry I didn’t take all 3,500+ questions to know for sure!) there’s a rationale most of the time, but not always. The way it is organized isn’t the best, but what can you expect when you’re getting a ton of free questions?
My thoughts – this is a ton of free NCLEX® prep questions. I feel like the way the site is organized, it’s hard to keep yourself organized. As far as I could tell, there were no alternative format questions or an option to purchase a full review. While there is some content review, you do have to look for it. Also, one of my nurse red-flags went up when looking into the site… their “about” page is pretty non-descript. I cannot tell who writes these questions or who owns this company, which is a little concerning to me. The way I would approach this is I would purchase an NCLEX® review and use that as my primary question bank, then I would only use the Nurse Labs one if I went through all of those questions.
If you do all three of these, you’ll have 3,609 free NCLEX® practice questions.
Please note, UWorld, Hurst, Kaplan and NRSNG all offer a free set of sample questions – but they are all discussed in the paid section!
Paid NCLEX® Questionnaires
Kaplan is quite well know. They have different options for reviews like just an adaptive practice test (cheapest), a self-paced online course, a live online course, and an in-person course.
They have a 3,400 question bank which includes alternate format items, content review, workbook, simulation NCLEX®, as well as a money-back guarantee. They teach a “decision tree” which helps you think through each question in a systematic format. Their price points range from $129 – $500. Some schools will include this review within your tuition. You can also simply purchase their question bank.
NRSNG Academyhas an adaptive NCLEX® simulator (“SIMCLEX”), a question bank of 3,500 questions with the ability to provide feedback and see the difficulty rank, 500+ flashcards, image and audio database, a test-taking course, and 10 concise content courses, is entirely available on mobile, a private Facebook group for support, and lifetime access to content after the subscription is complete (9 months). Their pricing structure is a bit different, in that you pay a monthly fee for 9 months. They also have a 200% money-back guarantee, so if you don’t pass the NCLEX® while using their resources, they’ll refund your money and pay you that same amount as well.
What is cool about this is you can get it when you start nursing school, and it will be valuable throughout school, during the NCLEX®, and after. Also, if you only need it for a few months, it’s significantly cheaper than the other NCLEX® review options. They also have the option of simply purchasing their question bank. Right now you can get a 7 day trial for only $1.
Hurst has 3 different options of an in-person review, a live online review, or an online course. They have a question bank of 1,000 questions, a workbook, test simulator, 4 125-question prep tests, an online coach, and a money-back guarantee. If you buy the in-person review, you are able to attend as many in-person events as you’d like.
Board Vitalshas a question bank of 4,100 questions with rationales and alternative formats, an exam blueprint, computer adaptive exams,
Interestingly enough, with each purchase they donate a vaccination to a child in need. Two of their 4 plans have a money-back guarantee. I personally know people who have tried all of the other products mentioned, but don’t know anyone who has used this product.
NCSBN (National Counsel of State Boards of Nursing)
This is an NCLEX® prep program from the same company who actually write the test. Their question bank has 3,100 questions, a content review, quizzes, capable of being used on mobile, and an Ask the Instructor feature. I somewhat stumbled upon this during researching these options, so I’m not very familiar with it or know anyone who has used it. But, given that it comes from the same company that writes the test, I’d say it’s safe to assume it’s quite reputable. They also have study plans, which are nice to have structured for you.
UWorld is another popular choice. While it’s test bank is 1,950 questions, they also have two 75-question self-assessments, are mobile-ready, and I’ve heard that their rationales are superior to some others NCLEX® reviews. I actually did a more comprehensive review of this system on the blog already! Click here to check it out. I think this is a good option or someone who just needs test question practice and not content review, because you will not get that with UWorld. Their pricing structure is different than some of the others as well, since they go by month rather than one large purchase.
Whatever program you pick, it’s important to do what’s best for you, your learning style and needs, and budget. Some people just want a content review, some just want practice questions, some want both. There’s no shame in your NCLEX® prep game, do what you need to do to pass!
Thank you to AORN for partnering with us for this post.
So you’re a nurse or in nursing school, and you think you want to work in the operating room… or endoscopy… or the postanesthesia care unit… or interventional radiology. But, what are the important things to know before getting into this specialized field within nursing? What do perioperative nurses do, exactly?
What do perioperative nurses do?
I had the opportunity to interview Amber Wood, MSN RN CNOR CIC FAPIC, who is a Senior Perioperative Practice Specialist for the Association of PeriOperative Nurses (AORN) and previously an operating room (OR) nurse at Children’s Medical Center in Dallas, TX. She shares what it’s really like to be a perioperative nurse.
Options for a new graduate interested in perioperative nursing
Working as a critical care nurse, I have to admit… I was a bit ignorant to all of the perioperative options. Amber informed me that the options include, not only your typical preoperative (pre-op), intraoperative (operating room, or OR nurse), and postanesthesia care unit (PACU), but also procedural areas like endoscopy, cath lab, and interventional radiology.
Nurses can further specialize in the OR. Amber noted that, “you can specialize in the OR by service line. For instance, things cardiac surgery, neurosurgery, orthopedics are all specialties… all of which are are challenging in their own way.”
Naturally, your options are dictated by the size of the institution. If it’s a large hospital or a teaching facility, you’ll have more options. If you’re in a smaller rural hospital, you won’t have as many.
When thinking about OR subspecialties like cardiac surgery, orthopedics or neurosurgery, there’s more to consider than the type of population you’ll be serving. You really have to also consider the team you’ll be working with and the flow of the day. Maybe you love orthopedics, but you don’t really mesh into that group of people well… or maybe you like lots of volume and patient turnover rather than longer cases with sicker patients.
What’s most rewarding about perioperative nursing?
When I asked Amber about the most rewarding aspect (in her opinion) of the perioperative nursing specialty, she responded by saying, “it’s definitely being able to advocate for patients when they are most vulnerable. Their family isn’t there and they can’t advocate for themselves.”
In the perioperative world, patients are sedated for their procedure. Their family members cannot come back and hold their hand mid-procedure and ask questions. The responsibility to comfort, encourage, and advocate falls upon the nurse.
What’s most challenging about perioperative nursing?
When discussing challenges within this specialty, Amber mentioned how different teamwork looks in the perioperative world.
When I think about teamwork while providing patient care, I connect it to my experience. For me, I’m used to being on a floor or critical care unit in which I call a physician or healthcare team member as needed to discuss issues. However, this is not the case in perioperative nursing.
Teamwork is elbow-to-elbow. Instead of paging a physician with a concern and waiting for a reply, the physician is right there. While that sounds easy and wonderful, some are not used to it.
Amber stated, it’s “different from working in other areas because everyone on the team is working at the same time, rather than coming in and out. This real-time teamwork and collaboration can be challenging for some. You really have to function within that team and play your roles at the time. This means you have to know and understand everyone else’s roles as well. This can be particularly challenging if you enjoy working independently.”
Amber went over a typical day for an OR nurse with me. One of the first things she mentioned was that the way your day will look really depends the shift/time of day and if you’re scrubbing in or circulating.
Amber noted that, “the scrub nurse is more focused on instrumentation, planning, and coordination of that while the circulating nurse would be more focused on positioning, equipment, medications, and ensure any issues with implants, tissues, and/or specimens that are needed is addressed.” Also, depending on your facility, you may or may not be working with surgical technologists.
A typical day as an OR nurse
Receive your assignment for the day
Go over the surgery schedule: the charge nurse will communicate any special needs, requests, or changes to the plan that have arisen
Begin preparing the operating room
You typically have around 30 minutes before you must get a patient in a room
Begin planning the day, getting special equipment ready for surgery
Ensure rooms are cleaned and ready to go
Check important equipment (like suction!)
Ensure you have the appropriate instruments for the day
Head to pre-op holding to get your patient
Receive report from the preoperative nurse, ensure you’ve got consent, and begin building rapport with the patient – they’re about to put their life in your hands
Transport to the operating room
Assist as needed with anesthesia
Begin positioning, skin prep, establishing a sterile field, and monitoring
If everyone else is scrubbed in, you’re grabbing anything that’s needed
If it’s a surgery requiring multiple surgeons, you’re coordinating that
Once surgery is complete, call report to their destination
Get them ready to go and transport
Clean the room and get ready to start all over again!
Amber says it can sound a lot like a traffic controller because so much is going on at once – and lives are at stake!
Recommendations for people interested in perioperative nursing
Perioperative nursing is a highly specialized field, therefore you really want to ensure it is where you want to be.
Amber recommends getting as much clinical experience in perioperative areas as possible during nursing school. Amber, like myself, completed an externship between her junior and senior years of nursing school and spent time in the OR. She said this further solidified her interest in working in a pediatric OR.
But if you must work in another area of the hospital because you can’t get into the perioperative areas, try to stick to surgical areas within the service line you’re interested in.
learn the latest in best practice with over 200 continuing education units available
on-demand streaming service for sessions you couldn’t get to
session in the exhibit hall)
network with perioperative nurses all over the country
take advantage of the largest surgical trade show in the country by visiting the exhibit hall
feel energized from all of the fun events and passionate nurses.
A special opportunity for students
AORN is excited to offer nursing students a complimentary* registration to Global Surgical Conference & Expo 2018!
Students from local nursing programs can come for the entire week, or attend AORN Student Nurses Day on Tuesday, March 27th for a special one-day student program. This conference offers nursing students a unique opportunity to learn more about perioperative nursing and take advantage of superior education developed by leading industry experts.
During AORN Student Nurses Day, AORN will offer special activities. In the morning, students will have the opportunity to practice hands-on activities (like proper hand hygiene, gowning and gloving, surgical prepping, and positioning). In the afternoon, AORN will host an exhibit floor session to explore the complexity of surgical products and equipment. Students will be able to interact with vendors, including multiple nurse recruiter booths.Plus, student nurses who attend will receive a free one-year m
If you are at all interested in becoming a perioperative nurse, you must attend this conference! We’ve partnered with AORN to make that a little easier for you.
AORN has generously donated a 5-night hotel stay to one lucky student to enable them to come to the conference! As mentioned, entry for students is complimentary and with this 5-day hotel stay, you’ll be able to reduce the cost significantly!
Complete the entry form below for a chance to win.
Pharmacology is challenging in nursing school, but it doesn’t have to destroy your life, soul, and all that you hold dear. If you take a few steps in organizing yourself before you tackle this class, it will make it easier to learn and recall later down the line.
Pharmacology tips – just for nursing students
The way nursing school approaches teaching pharmacology varies widely, but the subject matter remains the same. There are different pieces of information to know; some require straight memorization and repetition (dosages, names, antidotes), while others require some deeper understanding (like the mechanism of action, applying it to a clinical situation).
Know that while you’re starting to learn pharmacology, it’s not one method that works for all aspects of this course. One must leverage both memorization and deep thinking to fully comprehend all that encompasses medications. You can’t just take one study tactic and think you can use that to understand each aspect. The information is just different. Also, what further complicates things is that different professors teach this process different ways. Therefore, take some time to develop a routine that works for you and carry this method across different courses.
Whatever it takes, learn the mechanism of action inside and out. If how your professor has explained it doesn’t click, find some good videos, podcasts, or other explanations. Understanding this is helps you to predict side effects, adverse reactions, antidotes, and more. If you understand the mechanism of action, you have a solid understanding of that class of medications, and be able to troubleshoot questions easier.
Here’s an example of a great, free YouTube video of the mechanism of action behind NSAIDs.
Once you think you get it, try to explain it to someone else. If you don’t have someone to explain it to, explain it to yourself on your phone and listen back to it to see if it makes sense.
Memorize with intention
There is no short cut around a few things like prefixes, suffixes, generic and trade names, and dosages. You can create flashcards with pen and index cards, color-coding along the way… or, you can download an app. The wonderful things about apps are that you’re saving paper, can change them easily, organize into categories, and use them on the go.
Some examples of (free and not) apps you can get to create your own and use on the go are:
Whichever method, devote time to memorizing these things and doing flashcard drills. While you’re memorizing, it can be helpful to make up ridiculous things to help jog your memory. For example, beta blockers are funny so they always make me LOL, or ARB’s are what pirates use for their hypertension because they make them go arrrrrr(b)ggg, or lisinopril has a license to always throw an ACE (inhibitor) down in cards … you get the picture! The more ridiculous, the better. I found that if I could connect something to my favorite books/TV shows/movies, I remembered it better.
Check out the MedMaster podcast on NRSNG – it’s a helpful way to reiterate topics on the go.
Don’t just try to cram it all the night before – that’s too much to retain at once. If you know you have a med quiz in 7 days, use today to create your flashcards and your first time going over the mechanism of action. Schedule yourself for one focused hour tomorrow; part of the time diving into the mechanism of action over again, take a 5 minute break, and then spend the rest of the time drilling cards.
During downtime throughout the day (on the bus, in the elevator, waiting for your doctor’s appointment, whatever) go through some more cards. Bonus if they’re on your phone and you don’t have to remember to bring them everywhere.
If you can devote a specific amount of time each day to this, it makes the task much more manageable than trying to understand and remember it all within a day or two.
Save your notes
Medications come up over and over again and may be applicable in multiple courses. You’ll learn about magnesium sulfate in your OB/women’s health course, but see it again in med-surg and/or critical care as well. Keep track of notes, paper or electronic flashcards, and memory devices. Even if they’re ridiculous or inappropriate – if it works for you, it works.
And don’t make the mistake of forgetting the awesome memory device you created – make sure you write it down! That way when you go back to studying for another course, you can pick up where you left off rather than trying to think of another way to remember the information.
NCLEX® tip! Chances are if you get a medication question on the NCLEX, it’ll be the generic name of the medication and not the trade name. Make sure you know these, which can be a bit challenging since they’re typically longer.
Do what works best for you
Pharmacology doesn’t have to suck. Be intentional and organized with your study time. Focus during this time – close your apps, your phone, and focus. Do this for 20-25 minutes at a time, followed by a break. Repeat for a few hours, then take a long break.
Leverage resources that work for you, not your friends, your classmates, or your instructor – you! That may look like listening to the MedMaster Podcast during your commute, a flashcard app while you’re waiting for class to start, and the Khan Academy free YouTube vides to solidify the mechanism of action… or that may look like the textbook for the mechanism of action, paper flashcards, writing things out, and quizzing yourself. Figure out your unique recipe for success and stick to it!
There are quite a few different options here from podcasts to blog posts to courses and even a subscription services.
However, my favorite and one with the most bang for your buck is the NRSNG Academy. Their medication resources built into each course, and it’s pharm course, are incredible. You can use it throughout your entire nursing school journey, not just for pharmacology. Every single module has NCLEX® points, they also have a simulation NCLEX exam, a massive database of NCLEX practice questions in addition to a huge content review in Fundamentals, OB, Peds, Med-Surg, EKG, Cardiac, Pharmacology, Labs, and my favorite… Test Taking.
Epocrates – a really popular medication resource used by many clinicians and hospitals
Micromedix – expensive to purchase yourself, but many hospitals have this available. Check it out, it is incredibly valuable. At my last hospital, there was a Micromedix link within the Medication Administration Record (MAR) of the Electronic Health Record (EHR) and I used this reference everysingleshift.
Preparing for the NCLEX is a daunting task. I took the NCLEX back in 2010 and passed in 75 questions in 1 hr and 20 minutes. I’m not a great test-taker and wasn’t a 4.0 student. I did, however, do what I outline in this post. I wanted to share my thoughts with you in hopes that it’ll help you in preparing for the NCLEX so you don’t feel like you’reguessing at a good approach in both studying and mental preparedness. You don’t have to be an A+ student to pass, but there are some important practical steps to take that can make a big difference in whether you pass or fail. Below are my 4 practical tips for preparing for the NCLEX.
7.5-minute video on preparing for the NCLEX
If you don’t feel like reading, here’s a short video of these tips!
Alright here are the tips I go over in the video, but in more depth!
1. Don’t fixate on 75
A lot of people will get a mental goal of passing in the minimum required (75 questions). However, if you fixate on that and anticipate it shutting off at 75 questions (and therefore consider yourself a failure if it doesn’t) it’ll psych you out unnecessarily. I’ve never had a patient, loved one, colleague, or… well, anyone ask me how many times I’ve taken the NCLEX, let alone how many questions I answered.
Let go of the desire to live or die by 75
Man, that was pretty poetic wasn’t it 🙂
2. Know how it’s structured
The NCLEX is NOT like other exams. It is a computer adaptive test. What’s that, you ask? Basically, the first question you are given is of medium difficulty. If you answer it correctly, you’ll be given a more difficult question. If you answer it wrong, you’ll get an easier question. They will keep asking you questions until they can definitively decide if you are above their predetermined passing standard. The NCLEX does shut off if it determines that you will not be above the passing standard as well.
Here is really informative link on computer adaptive testing from the National Council of State Boards of Nursing (yes, the people who write the NCLEX!). And here is a great 6-minute video explaining computer adaptive testing from the NCSBN as well. Please, please watch this! (I promise it’s not a workout video…)
3. Pick a plan and stick to it
There are a lot of NCLEX review options out there. Whatever you pick, develop a study plan and stick to it. You must be disciplined right now; it is not the time to kick back, do a few practice questions, read a few pages of an old text book, and give it a try. Be active and intentional with your studying. Do not be passive and relaxed. Focus.
I took Kaplan’s in-person review course in 2010, and answered 25 questions each day (6 days/week) up until I tested 1.5 months later.
There are many companies that you can purchase NCLEX reviews from. Which ever company you go with, I recommend sticking to their information and not overwhelming yourself by cross referencing everything with the 400 textbooks you acquired during nursing school. If you get the NRSNG Academy, stick to those resources and only cross-reference when needed, not with every point. If you get the Kaplan course, stick to the book they provide to you.
Let’s dive deeper into NCLEX reviews…
NCLEX review options and considerations
There is quite a bit to consider when you’re picking out which NCLEX review material you’ll focus on. Let’s chat specifically about types, considerations, and the top options out there.
Types of NCLEX reviews
In-person review (you physically go there), online-review (similar to an online course), written materials (a self-guided book), content review (access to online or print reference material in various media formats), apps (reference material provided in a smartphone application), and the most important aspect.. NCLEX-style question banks.
You MUST get a course with a question bank. No questions asked…
Seriously. Don’t buy a course or resource without one. The key to success is answering practice questions on a regular basis until you test. Period.
Things to consider when selecting an NCLEX review course
Below are some good questions to ask yourself as you select a review plan. The questions marked with * are of particular importance!
Do you get your money back if you don’t pass?
*How many questions are in the question bank?
*Do the questions provide rationales?
Can you afford it?
Does their teaching method align with your learning style?
Do they have an option to use their content on mobile?
Pro-tip: answering questions on your phone while you’re waiting on a bus, in line at the store, or whatever, is a great way to sneak questions in
Do the provide you with a simulation NCLEX?
Can I try it out before I buy it?
*Do they also provide test-taking strategies?
Do I know anyone who has used it before? What’d they think?
Kaplan, Hurst, and ATI are the big company ones. They provide similar materials and options, and their prices aren’t terribly different from one another. I took Kaplan as a new graduate in 2010. They provided test-taking skills (essential), a question bank, in person course, textbook, and a pass guarantee.
If you just want the Kaplan content book (which I thought was pretty good), here is an Amazon link:
NCLEX Mastery is a smart phone app. I personally haven’t used it and not sure of others who have, but it’s got a ton of reviews!
NRSNG / NRSNG Academy is a question bank, large content review, simulation NCLEX, audio files, case studies, image database, and more. You can also get a 7 day trial for just $1.
(Full disclosure, I taught the mental health and OB courses, but I love all of our resources and the thought that goes on behind the scenes… and that they all come from nurses, not big companies!)
4. Bring down your anxiety threshold
The NCLEX is a big deal and creates anxiety in even the calmest of individuals. Spoiler alert: we’re all nervous about the NCLEX, some are just better at pretending than others. Even if you don’t struggle with anxiety, this test will make you worry and anxious. The last 2-4 years culminating into one big scary exam is no fun. However, there are some active steps you can take to get control of it.
Know what to expect on NCLEX exam day
The more unknowns you can remove from the day, the better. Check out this great resource from the NCSBN (again, the people who wrote the NCLEX!) about what to expect when you go to take your exam. They go over things like what to bring, what not to bring, acceptable forms of ID, breaks, and more. Click here to check it out.
Naturally, security and identification is a big deal at NCLEX testing sites. Therefore, they have very strict rules that you must follow. You don’t want to get there unprepared and unable to test.
Plan out your NCLEX exam day
Once you know where and when you’ll be testing, start planning. If you test at 8:00 am in a city that’s 2 hours away, consider that travel time. Do you have to worry about driving and traffic? Do you know where you’re going? The more structured you can be and the more predictable the day is, the better. Maybe you’ll want to get a hotel nearby so you don’t have to stress in the morning about the unknowns. I tested at 1:00 pm in a city about 2 hours away. My husband drove me, we went really early and grabbed lunch nearby, and was at the testing center about 45 minutes early. I walked in… and right back out about 1 hr and 20 minutes later!
Figure out where you will go, when, where you’ll park, and any other little details.
Meditate the week before / become a Yogi bear
I know this sounds odd you guys, but it works. If you can meditate for 15-20 minutes twice a day for at least a week before the exam, you can help reduce your anxiety threshold and get yourself in a better frame of mind. Yoga and meditation are a great combo… especially after you sit and stare at a computer for longer periods of time, answering practice test questions.
(If you have medical conditions, please make sure you check with your doc.. however, these are really light exercises and more about mindfulness, so they theoretically should be appropriate for most individuals.)
Here is a great video where you can do this in the privacy of your home, for free.
Trust your plan
Once you’ve read what you need to, planned out your studying and NCLEX exam day schedule – trust in that. Don’t try to over-control it all. Stick to your plan, be active in anxiety prevention and studying, and trust yourself. You’ve got this.
There are a ton of resources out there. Some great, some… not so much. In my personal experience, one of my favorites and most cost-effective options is the NRSNG Academy. Every single module has NCLEX® points, they also have a simulation NCLEX exam, a massive database of NCLEX practice questions in addition to a huge content review in Fundamentals, OB, Peds, Med-Surg, EKG, Cardiac, Pharmacology, Labs, and my favorite… Test Taking.
Click here to try out all of the below courses, question banks, flashcard app, and more for only $1!
And, here are some more to check out that were all written by nurses!
Starting nursing school can be pretty intimidating, let alone surviving nursing school. You don’t know your classmates or their experiences. You just assume everyone else knows more than you and they all know exactly what they’re doing.
Well, I’ve got a secret for you. Lean in a little closer because I need to whisper this – a lot of people don’t want me to let this one slip..
((None of us know what we’re doing. Some of us are just better pretending than others.))
This post is going to provide you with some study tips, life tips, things I liked to use as a nursing student and practicing nurse, as well as explain some of our well known resources and communities. So let’s dive into how to survive nursing school.
The bottom line is that getting into nursing school is tough, nursing school is tough, and so is being a nurse! But remember, you got into nursing school for a reason. Don’t doubt yourself now!
Nursing isn’t one of those majors you can just read up on the information the night before the exam and expect to do okay. It takes a lot of strategy to manage your time appropriately. Each exam is over so much information that you must have a plan of attack!
After your first day, get all of the syllabi together and write out every single due date on a calendar that you actually will look at daily; ideally one that you carry with you (whether this be on your phone or an actual print calendar/planner). After all of those dates are written out, then plan out when you will study for these exams in reasonable blocks of time. This means 2-3 hours here and there, not 6-8 hour chunks of time. No one can pay attention and absorb information in those longer periods of time. It’s an inefficient and ineffective use of your time.
After you plan these study times, then plan when you will write your papers. Schedule short-term goals (I’ll find 2 sources on this date, write my intro this date, edit on this date, etc.) so you’re not sitting down to write an entire paper the night before its due. Schedule yourself to finish this paper 1-2 weeks before the due date, so if you run into any roadblocks (not understanding something, changing a section, clarifying with the professor) you’ve got some wiggle room.
Get a folder and/or notebook for each class. Keep notes together and organize them so they’re easy to find. Have a folder on your desktop for nursing school, with subfolders for each class, then subfolders for each section. I realize this sounds a little organization-crazy but bear with me..
If you have to spend 10 minutes looking for a document on your computer, or 15 minutes looking for a hard copy of something around your dorm room, and you do this a few times a week, you’re losing 30 minutes – 2 hrs roughly just searching for things. That’s an absurd amount of time completely wasted. Think about how much quality studying you could give yourself in 2 hours. Or what if you used that time to nap? Naps are amazing. I would much rather nap than waste my time searching.
Something that is important to remember is YOUR TIME IS VALUABLE. Look to maximize it at every turn. Try to look for and eliminate inefficiencies or wasted time (searching for books, notes or documents because your desk is a mess, taking forever to get your paper formatted because you haven’t taken time to learn how to write in APA, forgetting about a deadline and scrambling to meet it).
Don’t just study hard. Study smart AND hard. Don’t say “I’ll just study the whole day before the test” because that’s not going to work. People can’t focus for that long at a time. We retain information best in 20-ish minute increments. Block out everything for those 20 minutes, then take a 10 minute break. Do this for 2-3 hours and it will be MUCH more effective than a full day of staring at your text half asleep. Turn your phone on silent and put it in a drawer. Close all of your tabs. Put your tablet away. Have a snack and a drink near you so you don’t get up.
Break time? YYYYAAAASSSSSSSS!
Try to understand whole concepts, like try to understand and explain the renin-angiotension system to someone else. Do not make the mistake of just trying to memorize the material. There is way too much to try to memorize for this study technique to be worthwhile.
Learn your professor’s teaching style
Let’s be real here; just like people learn differently, people teach differently as well. Some professors are more relaxed and care more about understanding the big picture, while others want every little thing in an incredibly specific way, and many are somewhere in between.
Learn each professor’s style.
This will take some time. If I had one professor that was a stickler for details, I made sure to pay really close attention to that with assignments. But if I had another that was more big-picture, I wouldn’t stress over minute things they didn’t really care about anyway.
You really won’t learn this until you get back some of your first assignments. You may miss some points here and there. You may have wasted your time worrying about things you thought they’d care about when they actually don’t. It’s okay. There’s a learning curve at the beginning. Put in what you think each class requires, see how some of those first assignments come back, and adjust your time and efforts accordingly.
Learn your learning style
I really didn’t figure out my learning / studying style until nursing school. Up until nursing school, I didn’t have to be as regimented about it because I didn’t have to be. Then nursing school came and smacked me in the face. Some people are auditory, some visual, some more hands-on, or a combo. I figured out that I learned best if I took handwritten notes in class, then typed them and added supplemental info from the books, then went back over them and highlighted. Some classmates taped their lectures and listened in the car or while working out. Figure out what works for you and stick to it.
Learn your resources
The quicker I learned how to use APA formatting for my papers, the better. Again, less wasted time is key. Have your books flagged to frequently used sections. Have them next to your desk for quick reference. Learn how to use your school’s online library and databases. The quicker you can utilize your resources, the better.
Make sure you know where you’re going. If you’re nervous, do a test-drive there the night before. Walk up to the unit. Get your bearings so come game time, you know what to expect.
Have good scrubs (I talk about which ones I use later on). If they’re white scrubs, make sure you have the appropriate eh-hem.. undergarments. Have a back up set in your car in case you get puked/peed/pooped on. (Seriously). Pack your lunch. Have a granola bar or quick snack you can grab if you start to feel woozy.
*Note – I’ve seen so many nursing students pass out that I’ve lost count, make sure you grab a snack
If you got your patient assignment the night before, look up the disease processes and chief complaint of the patient so you’re aware of what they’re experiencing. Get all of your paper work done.
Don’t just arrive on time, be early. If you’re showing up right on time, you’re late.
Clinicals are scary, but don’t be so worried about getting all of the answer correct that you’re not mentally present. Engage with your clinical instructors, nurses on the unit, patients, loved ones, nursing assistants, doctors, nurse managers. Ask questions. Watch procedures. See how you can help. Don’t be that student that stands in the hall, leaning against the wall, waiting to be told to do something.
Make sure you’re also allowing your other classmates to get in on everything too. Find the balance of being helpful and engaged but not so much that you’re taking up all of the instructors time and the other students don’t have a chance to try or see anything.
Also, don’t complain about the patients. Even if someone is rude, or decides they don’t want a nursing student today… please don’t complain about it to the staff. It doens’t look so hot.
Listen during report. Wait to ask any questions until they’re done giving report, as they may end up answering your question later. It’s a nurse pet-peeve when you’re trying to give report and the person receiving report is continually interrupting with questions. They may speak really quickly. If you don’t know an abbreviation or diagnosis, write it down quickly and ask the nurse or your instructor after.
Get a report sheet that you like. Give it a few shifts before switching to a new one. Click here to download 33 nursing brain sheets for free.
Things to write down when getting report (this is incredibly general and will vary if you’re on a specialized unit):
Nobody’s perfect. You’re not going to know everything. No one expects you to know the answer to every question or handle every situation perfectly. You’re there to learn how to do things, not show everyone how much you already know at every turn. So take a breath, and relax. It’s okay if you don’t know something.
If you don’t know something, just say you don’t know it. If a patient asks you a question and you don’t know the answer, say, “You know, I don’t know the answer to that but I will find out.”
I do understand that need to try to avoid saying you don’t know something because you don’t want to be ostracized in front of your classmates. Some instructors will take this opportunity to make you feel bad for not knowing something, but most will just be glad when you say you don’t know something because it lets them know what they still need to explain.
The sooner you get used to being honest about what you don’t know, the better. This will continue to benefit you throughout your career.
Also, if you screwed something up, own up to it. We can usually tell if you’ve messed something up and are trying to make it seem like you didn’t. Once I saw a student go to hang an IV antibiotic on a secondary line. Normal saline was the primary line. She had forgotten to do something (it was so long ago I can’t remember what) and the antibiotic (which was green) backed up into the bag of normal saline. The instructor came in and saw it and asked what happened. She said that the saline bag came like that.
If normal saline came to you green, that’s a problem and it shouldn’t have been hung in the first place.
However, she held firm to it coming from pharmacy like that. We were all pretty sure she was lying, but no one had physically seen it so we couldn’t refute her.
So we had to do the appropriate incident report, call pharmacy, etc. etc. Basically, we had to do a lot of things that we really shouldn’t have had to if she had just owned up the mistake. And honestly, the mistake wasn’t a big deal. We could have easily taken time to educate about what should have happened, grabbed a new bag of saline and antibiotic and that would have been that.
It’s not just about your patients
Not only are you learning about disease processes and how to care for people, you’re also learning time management. Watch the time management styles of the various nurses you’re following. Once you get to your first real nursing job, you’ll have to figure out how to manage your time and it will be helpful to see how various nurses do things. You can learn how you would like to do things and also how you would not like to do things. I’ve observed how people have done things and learned ways to avoid managing my time because I noted they were always behind or flustered. There’s no perfect, textbook way to do this. You’ll develop your own style.
Pay attention to not only the tasks they choose to delegate, but how they delegate them. How do they work with nursing assistants? The NCLEX® will teach you which tasks to delegate, but that’s the easy part! The hard part is delegating tasks to nursing assistants that have worked on the unit for decades. Developing rapport with your team is another piece of the learning how to be a nurse puzzle and you can learn a lot from watching how everyone interacts. Every does this a little differently, so if you hear verbiage or talking points that you like (“Hey I really like how she asked that CNA to take that patient to the bathroom.. I don’t want to forget that”) write it in a small notebook that you keep in your scrub pocket (I’ve got a link in a later section for said notebooks). Or talking points / responses to nurses dealing with tough situations.
Once I heard a nurse firmly respond with a, “I know you’re frustrated but I am your nurse and you will not curse at me,” and I was like..
DANG – RESPECT.
**quickly ran to the nursing station to scribble it down on a piece of paper so I wouldn’t forget it**
(That patient immediately apologized and connected with her about what was really bothering him and requested her for subsequent shifts.)
It’s really important to treat everyone you encounter with respect. From the housekeeper to the physician to the case manager to the physical therapist to the nursing assistant. Even if you never want to work in that particular unit, you need to treat the people that have chosen to work there with respect. So if you know you want to be a NICU nurse but you’re starting your med-surg clinicals, make sure you treat all of those nurses, nursing assistants, etc. with respect even though you know you’ll most likely not need to know that information for your potential job. Just because it’s not important to you does not mean it’s not important.
Let me say that again.
Just because it’s not important to you at this particular point in your life, does not mean it is not important.
Nothing frustrates clinical instructors, nurses, and nursing assistants more than that “I never need to know this so it’s not important” attitude. I’m actually getting hypertensive thinking about it. Even though it’s not information that will be practically important to you in the long run, it is still important to someone.
Student nurse-life tips
Being a nursing student and nurse is not just a major and a profession, it’s a lifestyle. There are certain things you can do to prevent burn-out, minimize stress and maximize your personal and professional life satisfaction. Let’s discuss…
Take control of your environment
It’s hard to study and retain information in chaos. A desk in the living room, family room, dining room or in the common area of your dorm is not ideal. Try your best to secure a consistent and quiet place to complete focused study. Keep the area clean and organized with your resources nearby. Every semester, I wrote down all assignments on a piece of paper and taped it above my desk. As I completed things, I would cross them off. That provided a sense of accomplishment that boosted my mentality.
I like to diffuse essential oils while I work / study. I’ve got a diffuser on my desk and will use lemon, wild orange, or peppermint. I mainly use the Doterra brand, but there are others. I also bought this diffuser from Amazon for about $23 and I keep it on my desk.
I also like to classical listen to music. Piano Guys radio on Pandora (does anyone still use Pandora? Just me? Ok, great…) is an go-to of myself and my husband.
Figure out what puts you in that game-time, get it done mentality. That eye of the tiger, coming down the tunnel for the Super Bowl mentality.
And just do it.
(Ugh.. sorry for the lame Nike reference but it really would have been a missed opportunity if I didn’t.)
Communicate with your loved ones
Nursing school takes up a ton of time. Unless you’re in it, it’s hard to understand the magnitude of things to do and learn. Therefore, be proactive about communicating your needs to your loved ones. Doing things last minute or the night before an exam won’t be the best thing for you during your nursing school journey. You may have to say no to some things you really want to take part in. The, “hey I want you to know that nursing school is my priority right now and I’ll probably not be able to do as much but it’s not a permanent thing” conversation is better to be had before school starts, not mid-heated argument about why you can’t go to another night out, dinner with friends, family event, etc.
Also, make sure to communicate about your needs while studying. If you need to be interruption-free, focused and alone, communicate that. “Ok so if I can be interruption-free for the next 2 hours to really focus, I’ll be able to go to dinner… or hang out with the kids.. or go to that work out class”. I have a feeling there will be some miscommunications and hiccups. Even the best communicators don’t do this perfectly. Be slow to anger and quick to forgive
Prioritize your sleep
I read a quote recently (and please forgive me, I do not remember who said it)… but this person said:
Being tired is not a badge of honor.
I love that. Sleep deprivation is NOT a badge of honor. I feel like whenever I would get to work or class that it was a competition about who got the least amount of sleep. I started to feel like it was another way of saying, “I’m really tired so expect less of me today.” But if we’re chronically exhausted, when can those around us actually have normal expectations of us and not have being tired as an excuse?
We must prioritize our sleep – even if that means going to bed embarrassingly early because you know you think better early in the morning. Or working late into the night because we know we can get the sleep we need the next day. Or taking a power nap in the afternoon.
Do what you can to get the best sleep possible. For instance, I like to get into a made bed, so I make my bed after I get up. I like to shower at the end of the day to relax before bed. I occasionally diffuse lavender or put a drop or two on my pillow. I get ready for bed about an hour before I actually want to fall asleep. I like to take my time getting ready for bed. I’ve got a memory foam pillow, Sleep Number bed, black out curtains, and nice sheets. I read a few chapters of Sherlock Holmes, Harry Potter, or some other fiction book before bed.
I recently readthe 4 hour Work Week by Tim Ferris and he recommended reading fiction before bed and its made a big difference. I used to read non-fiction, but for some reason reading about a story or situation that didn’t really happen.. that takes you to another world, really relaxes me and gets my mind ready to rest. (Update: I’ve been doing this for months and it’s really working to help me get to sleep faster)
Class. Study. Eat. Sleep. Repeat.
Class. Study. Eat. Sleep. Repeat.
Class. Study. Eat. Sleep. Repeat.
You can start to feel like a zombie. Make sure you’re making time to exercise. You’ll sleep better. You’ll feel better. You’ll be healthier.
At the least, look up some You Tube yoga videos do some good stretches. This is my favorite YouTube yogi bear. This stuff really helps so much, especially when you spend so much time sitting at a desk / computer. You can do it in the privacy of your home in as little as 10-20 minutes. Straighten out your neck and back, do some back hyperextension, work your core, do some deep breathing and meditation.
It’s also nice to have something to completely focus on that is not related to nursing. Get your favorite work out music and just escape. I enjoy doing some cardio and lift weights.
Try your best to eat well. If you’re eating a lot of take-out, quick meals, sugary drinks, etc. it can leave you not feeling as full, then to more snacking. You also aren’t putting the best nutrition in your body either. Plan your meals. Occasionally indulge. Eat naturally.
I also reviewed Butter Soft Scrubs from Uniform Advantage, Greys Anatomy, and Infinity by Cherokee in this blog post.
I use the Littmann Master Cardiology stethoscope, but I really like MDF scopes as well. MDF is definitely more affordable, yet still high quality. They’re just a lot heavier but I think for the price difference and quality, it’s not that big of a deal. When I was in nursing school, I purchased a $20 cheap scope and it was not worth it. I ended up getting a more expensive one after a semester because I just could barely hear anything.
Nurse tip! Get your name engraved on your scope so no one steals it!
I’ve heard rave reviews about WhiteCoat clipboards. I know many nurses, physicians, medical students, and nursing students who love these. It folds in half so you can stick it in your pocket, has bunch of nurse-related info printed on it, and folds out to a full-sized piece of paper. Click here to check it out on Amazon.
NRSNG also has some great clipboards and nursing school packs available on Amazon that are awesome.
I always, always get asked about nursing shoes. I’ve tried a lot. My current favorite are Work Wonders® by Dansko. I used to wear the regular ones but these are lighter, tighter and cheaper. I did a review on my blog of these as well. Here’s the link!
I also get asked about compression socks a lot. FIGS compression socks offer 20-30 mmHg compression, are long enough and sturdy enough to stay put for 12-hours, and I’ve washed them quite a few times since I got them a few months ago and they’ve withstood the washings and have not faded. They come in the pictured cranium pink, grey pills, or a slick black and grey.
My previous top compression socks were Cherokee True Support, and I wore them with each shift, but since switched them out for FIGS.
Planners and notebooks
I love planner and notebooks. Papersource has some AMAZING notebooks and planners and I want all of them. We live near one and I just like to go in and look at them all and pretend they’re mine. Here’s a link to their planners. And there are some that are more feminine and some that are more masculine – options for all! They also have a great selection of mini-notebooks, which I love. They fit in your scrub pockets so you can use them to take notes in if you clinical instructor doesn’t want you using your phone. Here’s a link to their notebooks.
After a few years in the field I’ve learned a lot of different resources. Here we go!
The big companies are Hurst, ATI, and Kaplan. You purchase these when you finish nursing school. They are all comparable in price and performance. Some nursing schools will host a review post graduation on-site, which is convenient. The main downside is that they come into play at the end and they’re quite pricey.
You can use a question bank only as well. This would be for people who don’t want/need a content review and simply want to take practice questions. Options include:
My nursing school NCLEX prep long-term recommendation and plan
My ultimate nursing school resource is by far the NRSNG Academy. It’s an NCLEX prep course, 10 additional content course reviews, a question database of 3500+ questions, cheatsheets, a private Facebook group for support, a Flashcard app, simulation NCLEX, and more.
Some of these are nurse-related, some are life-related, some are medicine-related.. basically this is a list of books that I believe are helpful in the practical and emotional work it takes to become a successful nurse. I went to Twitter and asked people which books they think that nursing students should read and here is the list! All links are for Amazon.
** Prices may have changed – please click on the links for the most up to date price
I again asked my Twitter buds which apps they recommended for students. Please touch base with a clinical instructor before pulling out your phone and using it during clinical time. When I asked online if clinical instructors were okay with using phones as a resource, I got a bunch of different responses. They ranged from “absolutely not” to “yes” to “only if we were looking at apps for clinical and patients/family could see” (so in a break room, bathroom, med room, etc.). The take home message: don’t use your phone in clinicals unless told that it’s okay.
Here is a list! They are free unless otherwise noted.
ScrubCheats App – a free app by the NRSNG team designed specifically to be used at nursing school clinicals containing relevant quick reference material
Medscape – a free medical app with tons of information about varying disease processes, drugs, etc.
Figure 1 – a free app of medical cases for health care professionals. This one is fun to flip through randomly to see interesting cases and read physicians, nurses, and students chatting about what they think is going on and potential treatment courses.
Micromedex – there is a free version and a $2.99 version. I love this one. My hospital actually has it within our electronic medical record so I can access it within their med list, so I rarely use the app. The information is awesome though. I use this most frequently to quickly look up indications or IV compatibility.
Nursing Central – a free app with drugs, definitions, diagnoses, and test info.
Nurse Grid – a free calendar app that helps you schedule your shifts. (You’ll quickly learn that regular calendars aren’t ideal for shift work.. especially night shift)
RN Crush – a free NCLEX® review app from the NRSNG team
David Drug Guide – multiple options from free – $39.99 of a comprehensive drug guid
Epocrates – a free medical app that has a ton of great information
LabGear – a $2.99 app that describes various labs in depth (OMG YESSSSS)
MedPulse – a free app that is the news portion of Medscape
SmartFOAM – a free app that is Free Open Access to Medical Education
iTriage – a free symptom checker
iStethoscope Expert – a free app that allows you to hear heart, bowel, and lung sounds
As someone working their way to becoming a nurse, I just want to say WELCOME to the nursing community. I want to encourage you to connect with others walking through the same journey and find people who are where you want to be and connect with them as well. It can be incredibly encouraging when you’re having a rough time. It can also be really educating as well! You can do this in so many ways. Twitter, Facebook, Tumblr, Instagram, professional nursing organizations, student nursing organizations, volunteering, etc.
I want to conclude by saying welcome to the team. Getting into nursing school is no easy task, so congratulations! Nursing school is going to challenge you mentally, physically, and emotionally but in the end, it will be worth it. Something I want you to remember is that while in school you’re learning about disease processes, care plans, procedures, delegation, prioritization… but at the end of the day, you’re taking care of people. When you are so focused on learning that other stuff it can be easy to get distracted and forget that those are mothers, fathers, brothers, sisters, wives, husbands, daughters, sons, grandmas, grandpas, aunts, and uncles all sitting in those hospital beds.
They’re sad, scared, nervous, in pain, nauseated, frustrated, fed up, exhausted, and ready to go home yesterday. Don’t forget to also learn how to feel with patients.
How to be present.
How to empathize with whatever they’re feeling.
At the end of the day, they may forget your name. They may never know you caught that med that should never have been ordered or that lab value that was out of range. They won’t know you skipped lunch to help them get their bed bath done. They may forget that you brought their pain pill right on time.
But they will remember that you made them feel safe. Their loved ones will remember that out of all of the other nurses, they trusted you. They felt so comfortable with you that they finally went home to do a load of laundry and take a shower.
Years later, when recalling the day their dad died.. they won’t be able to picture your face, but they’ll remember how comforted they felt when you gently lifted up his head and turned over his pillow so he’d feel the cool side – even though you knew he was brain dead. They’ll remember how they felt when you grabbed them some of the good tissues from the nurses station, stood next to them over looking their now deceased father and gave them a slow, reassuring “I’m really sorry” pat on their back.
Because that’s what being a nurse is. Throughout school, you’ll learn about ventilators, arterial lines, contractility, renal failure, and deep venous thrombosis prevention.
But that’s only half of it.
The other half is learning how to talk to someone who just found out their mom is going to die… how to motivate a patient who has all but given up after fighting breast cancer for 10 years who just found out she has a brain tumor… how to educate a patient with heart failure that doesn’t know how to read.. … how to empower a patient to communicate with his family that he doesn’t want another surgery, he just wants to die..
Because we do both.
In nursing school, don’t forget to also learn about the people behind the diseases because they will teach you more than you ever thought you could learn.
I will look to update this post every so often to make sure it remains current. If there is a resource you find valuable for nursing students, please comment below!
This week I am featuring an interview with my sister in-law, Elizabeth Fields. She recently went to Bora, Ethiopia with the medical mission group Health Gives Hope. Last week, I interviewed their founders, one of whom is actually a Nurse Practitioner! Click here to check out the previous post.
To give you a little background about Bruce and Elizabeth Fields, they are quite the athletes and world travelers. Bruce played professional basketball in Europe for 9 years and now works at State Farm in the Chicagoland area. Elizabeth played volleyball at Parkland College (where I played basketball for a short time!) in Champaign, IL and then completed her BSN at Indiana Wesleyan University while continuing to play volleyball. She has worked at Northwestern Memorial Hospital for the last ten years as a registered nurse, working the last two years as a Nurse Practitioner. She obtained her FNP from Walden University.
These two crazy kids. They met in Austria some odd years ago and have traveled to the following countries either together or separately: Turkey, Switzerland, Austria, Thailand, Ethiopia, France, Italy, Belgium, Norway, Spain, England, Philippines, South Korea, China, Russia, Ukraine, Poland, Germany, Mexico, Japan, Denmark, Canary Islands, Romania, and Canada. Oh, and Bruce has lived in a handful of them as well! Clearly they know a bit about traveling! Me, I’m more of anxious traveler (think Monica Gellar going to London).
I decided to interview them to give people a look into the practical side of what going on a medical mission looks like. As you read, Bruce is not medical. However, what he lacks in nurse-ness, he makes up with hard work and height. (He’s 6’5″.)
Please note, answers given below are from Elizabeth, unless otherwise indicated.
Why did you decide to go on a mission?
I went to Bora, Ethiopia because they don’t have access to health care, and this was something I could not only make a difference doing, but I knew it would grow my knowledge and stretch me professionally. I also went on a mission trip to live out something I was taught and believe in deeply: you should use any talent you are given to bless others. Nursing is a talent that was given to me and I am passionate about sharing it.
What was the travel there like?
This is from the HGH website: The team flies from the US to Addis Ababa, and then drives south through the lower rift valley into the Guge Mountains of southern Ethiopia. The team will then hike 6 miles, ascending nearly 2,000 feet, from where the road ends in Chencha to the village of Bora.
Travel in Africa is entertaining and challenging. We were on planes, boats, buses, and on foot – our baggage traveled up the mountain by donkeys and our road was often congested with cattle, camels, and people.
Tell me what was going through your mind the first time you saw their set up for medical care?
The clinic set-up is smart, efficient, and well planned – their resources are growing – but the first thing you think is – “WOW – they have access to SO LITTLE compared to what we are used to; how am I going to make it work?”. But then, you make it work, and realize how MUCH we have in the States and how profound your assessment skills are!
What are some of the biggest differences between the care you provided there versus in the USA?
We had no access to running water, internet, or specialty consults. We had no diagnostic testing. I had to be excellent in my history and physical taking, and in my assessments so that I could determine differentials and treat appropriately. The creativity needed to get medications into infants, translate reasons, times, importance and information to patients was profound. The translators were amazing, but I have to hand it to the nurses – they had so many amazing ideas to help make these challenges ones we could overcome.
What were your meals like?
AWESOME and different! It was a mix of American food and authentic Ethiopian foods. The people there are extremely hospitable and loved cooking for us. We got to observe and help them cook in a “cooking hut”, and experienced what is like to cook without any modern conveniences. Some of the meals they made for us I have tried to recreate here, and have been moderately successful in accuracy.
What were the sleeping conditions?
We slept in mud huts, on straw, in our own sleeping bags. At first I struggled with the conditions – it is exactly like you would see it in the National Geographic! But looking back, I wouldn’t have wanted to sleep anywhere else; I lived and experience it in the most authentic way possible.
Tell me the bathroom situation, STAT.
Bathroom? You mean tell you what it was like to squat on a gorgeous mountain side and hope no animals or humans saw my southern regions? Two words: wet. wipes.
Tell me about some practical cultural differences.
One of the things that hit us hardest was the reverence and respect for elders that everyone had. Here in the states the elderly population is often viewed as a burden, while in Ethiopia they are cherished and consulted for their wisdom. Another shocking difference was how hard the women worked. The Ethiopian people often refer to women as “provider”. You will see in our pictures that women do the heavy lifting there.
Elizabeth, walk me through one day as an NP there.
I had two interpreters assigned to me. Each patient would come in my exam room, tell me their complaints/history, and symptoms. I would do an examination, diagnose their problem, and prescribe medications (pending availability). When I had a patient that “stumped” me, I called upon the other practitioners and nurses for their expertise. Because we had no diagnostic testing available (labs, X-ray machines) collaborating was our lifeline; we all needed each other to make each day in clinic work and it was an incredible experience!
Bruce, walk me through one of your days there.
Every morning we wake up and walk from our hut down the mountain to a place we called “the cliff”. It was an incredible time to enjoy a beautiful view and reflect on our days there. We then returned to our compound to have breakfast that was made for us by the locals. It consisted of grains, potatoes, sauces, and amazing Ethiopian coffee (FYI, Ethiopia is the birthplace of coffee). We hiked up the mountain a mile to the clinic every morning, with the village children holding our hands the entire way — this experience melted my heart.
My time in the clinic consisted of building shelves, setting up a privacy tent for the bathroom over a hole dug by a previous team, working in the pharmacy dispensing the medication prescribed by the practitioners, and helping teach patients how and when to use them. I often made lunches for the entire team with another group member and did what was necessary to ensure a good flow at the clinic. I was concerned that because I’m not medical I wouldn’t be very useful, but when I got there I found the opposite to be true. We each had a role and without each other it would’ve been impossible for the clinic to be successful.
How much did it cost?
About $2500 a person, and this included flight, ground transportation, lodgings, food/water, two days of sight-seeing. It was the cheapest 2 weeks abroad!
How do you feel this impacted your marriage? Do you recommend married couples going together?
YES! GO TOGETHER! My husband isn’t medical, but the need is so great and watching him use his gifts in service by building shelves, working in the pharmacy, making team lunches, setting up privacy tents, and playing with the kids was – well, SWOON. I can’t exactly bring him to work with me to see patients here in the States; watching each other in our own elements was amazing. It gave us greater respect for one another, and made me want to encourage him more in what he excels in.
I know these experiences are hard to predict how they will affect you. What did you anticipate versus what did you experience?
I didn’t expect to want to stay there longer – but I was so sad to leave. There are days at work when I find myself in the grind of the day, burnt out and discouraged; to feel so needed and impactful in Bora, Ethiopia was priceless, and it took me off guard. I didn’t know I would fall in love with medicine again – I didn’t know that I needed to be there for my own benefit, just as they needed me there.
What did you learn that has changed your practice as an NP in the US?
Because I had to rely so heavily on my assessment skills and collaboration with the team when I was faced with a questionable diagnosis, I have worked much harder to perfect those areas since I’ve been back. Those areas include knowledge and differentiation of various heart and lung sounds, alternative treatments, and preventative medicine. My desire to be a better provider has substantially increased since going to Ethiopia.
Would you do it again?
We would go back tomorrow. Without blinking. It was professionally and personally something that humbled us, empowered us, and revitalized my passion for medicine and nursing.
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