Summer is almost over, and with the end of one season comes the start of another—nursing school. For first-year nursing students, the first semester can seem daunting and overwhelming. New classes mean new changes, workloads, and a new beginning for an exciting career.
Some examples of responsibilities nursing students will have within their first year include classes on anatomy and physiology, pharmacology, and other fundamentals of nursing. Your classes can also include hands-on activities and a mix of labs and lectures. Clinicals will test your lab skills and will be the start of nursing basics like administering vitals, giving shots, and conducting full-body assessments.
Some nurses say that their first year of nursing school is the hardest. This isn’t necessarily because of the coursework but the transition into nursing while learning the ins and outs of properly taking care of a patient.
So, take care of yourself as you face this transition in your life. You’re on your way to becoming an actual nurse! As exciting as that sounds, it’s also scary because you never know what’s on the other side of all of the work you’re about to do.
Remember that learning nursing skills can take practice, and it’s easier for you to take time to learn the expertise needed on the job instead of expecting yourself to have it all figured out the first semester.
You’d be surprised at how many resources you have when looking around. Read the materials given to you on orientation day, or stop by your school’s student services to find more (free!) opportunities available to you as a student. You never know what you might find.
Taking the extra 10 minutes to read assignment instructions, the syllabus, or any other material you have can save you from asking additional questions at the end of the day.
Ask questions that feel “dumb.”
Yes, you’ve probably been told that there are no “dumb questions,” but when it comes to a patient’s well-being, it’s worth asking a question someone else might have, too.
If you feel anxious about doing this, practice asking questions to an advisor first, and then build confidence in larger rooms with multiple students.
Your instructors and advisors are there to help you succeed. Even if you think you might have asked a question that doesn’t make sense and embarrassed yourself, at least you know you’ve done it to avoid potentially hurting a future patient.
Strategies to help you stay organized and avoid missing deadlines include getting a calendar you can see daily and writing down upcoming deadlines. Another tip is to fill out a planner with all future assignments’ due dates and exams.
Find what self-care routines work for you.
Carving out time for self-care is as important as time spent learning. We all need breaks now and then, including nursing students who may think that time spent not studying is “wasting” time.
Good grades are essential, but they’re not everything. Designate space to refill your tank with activities away from school that make you feel good. This looks different for everyone, but some examples are exercising, getting enough sleep, or even something small like eating lunch with a friend.
Even though you’ll probably have strong emotions starting the new semester, know that this moment won’t last forever. The struggle of long nights studying will likely include making new connections with aspiring nurses who understand what you’re going through. Hang in there, and remember to be kind to yourself throughout your nursing journey.
In the world of nursing, consistent rates of students graduating from nursing programs, becoming licensed, and successfully entering the workforce are critical to the long-term viability of the nursing profession and the healthcare system itself. As the true lifeblood of healthcare delivery, nurses are central to patient care, from long-term and public health to acute care and home health. In that regard, nursing education is a pipeline to the future.
Nursing School Capacity
In May 2023, the American Association of Colleges of Nursing (AACN) released data showing that student enrollment in entry-level baccalaureate nursing programs
decreased by 1.4% in 2022, the first decrease in 20 years. Overall, 844 colleges and universities offer a BSN education, and many turned away thousands of qualified candidates due to a lack of clinical training sites and faculty. In 2022, 66,261 candidates were rejected, and in 2021 applications by 76,140 candidates were turned down.
Alongside these disappointing numbers in the entry-level BSN category, the AACN identified other factors:
Enrollment in RN to BSN bridge programs has been declining over the last 4 years.
Master’s programs have seen a 9.4% decrease since 2021.
Nursing PhD program enrollment shrank 4.1% from 2021 to 2022.
DNP program enrollment is at a virtual standstill.
When it comes to nursing school capacity, there’s plenty of evidence that something isn’t right. This statement from an October 2021 article by National Public Radio says a great deal about one major hurdle: “One of the biggest bottlenecks in the system is long-standing: There are not enough people who teach nursing. Educators in the field must have advanced degrees yet typically earn about half that of a nurse working the hospital floor.”
Becker’s Hospital Review reported in August 2023 that the California Hospital Association and the Service Employees International Union (SEIU) have teamed up to introduce a bill that would hold community colleges accountable for reserving 15% of enrollment slots for healthcare workers looking to advance their education and move into higher-paying career tracks like nursing. Whether this bill can make it through Congress and become law is unknown.
The U.S. Department of Labor has issued $78 million in grants to expand nursing school enrollment in 17 states. The state of Maryland has awarded its nursing program grants to boost schools and address the long-standing and worrisome nursing shortage. New Mexico is also expanding its nursing school capacity through support for increased enrollment.
While legislation, grants, and expanding nursing school capacity are all valuable strategies to increase the nursing workforce, we can also keep more grassroots efforts in our sights.
In families from many different backgrounds, a multigenerational tradition of service in the nursing profession is often the norm. Aunts, mothers, fathers, siblings, and others can profoundly influence younger generations’ career choices. When the value of being a nurse is communicated from generation to generation, a familial line of nurses can extend over many decades as additional family members join the profession.
As nurses, speaking proudly of the profession and our work can generate interest in those considering their options. While twenty-first-century nursing and healthcare have enormous challenges, we can also tell the story of how nursing provides endless opportunities and flexibility. Of course, there is the potential to travel and see other parts of the country and see one’s education through to a terminal degree such as a PhD or DNP.
In communicating about the possibilities to be found in nursing, we can point out that, contrary to what the public and the media might think, not all nurses work in the hospital. There are expanding opportunities in the pharmaceutical, biotech, and medical device industries; public health; informatics; nurse entrepreneurship; medical writing; legal nurse consulting; nurse coaching; research; and many other fascinating areas. In the interest of our profession’s growth, we paint an expansive picture for those who think of nursing as solely hospital based.
Pipeline to the Future
Whether a new graduate nurse eventually becomes an operating room nurse, a biotech research nurse, or a self-employed legal nurse consultant, the nursing school remains the pipeline through which that individual must pass to realize their dream. No matter how one person’s professional journey unfolds, it all begins with admission to an accredited nursing program, successfully graduating and passing the NCLEX®, and then receiving a license to practice. The nursing school is the funnel for future nurses of every stripe and interest.
When nursing school capacity is hobbled, our profession and society suffer. Decreased graduation rates translate to a shrinking nursing workforce, staffing shortages, nurses working under stress, and the potential for compromised patient safety and outcomes. Burned-out nurses are more likely to leave the profession and less likely to encourage younger generations to pursue the same career path.
Addressing decreased nursing school capacity is paramount, and we can use our collective genius to find solutions, whether through grants, legislation, and public relations or the direct recruitment of faculty through the offer of increased salaries and improved work conditions.
We must use every available means to secure the flow of fresh talent through the pipeline to the future. Our society and the lives of those within it depend on the quality and quantity of the nursing workforce, and it’s our responsibility to see that the pipeline remains filled with the talented nurses of tomorrow.
The National Council Licensure Examination is a prerequisite for becoming a nurse, and with increased nursing school applicants, we thought it would be worthwhile to offer tips on how best to pass the NCLEX. We each tried our techniques and utilized similar options to help us pass the exam in May of this year. With some guidance from our parents, we also have plenty of tips to help others pass this challenging exam with much more confidence than you otherwise might have exhibited.
Watch Tips and Tutorials on YouTube
YouTube has tons of great material on every subject, including the NCLEX. We recommend finding some tutorials and tips to help you pass. Shannon, in particular, used this study method for subjects she didn’t fully understand. It enables you to gain knowledge in areas where you’re lacking and is just a fun, easy way to gain more information and help you feel more confident with that material.
Allot Yourself So Many NCLEX Questions Per Day
Don’t try to push yourself to get through hundreds of practice questions when you don’t have the mental capacity. Instead, give yourself a few months to take your time and practice until you feel comfortable. It’s best to allot yourself so many questions daily and only focus on getting through one set at a time. Shannon stuck with the 75 questions per day rule, and it helped.
You can also go with Kristyn’s technique and allot yourself so many daily topics. Then, pick two or three and work on the material until you feel like you’ve nailed it. She spent one month working this way until she felt confident she could pass the test.
Study and Correct Your Incorrect Answers
By only focusing on so many questions each day, you have time to go back over the answers. You can correct anything you got wrong and take the time to understand why it was wrong. Then, use your results to help you study better and refocus on the problems you’re having trouble tackling.
Let Your Family Help
You don’t have to do this alone. Sure, you’ll be the only one taking the test, but that doesn’t mean you can’t get help practicing and preparing in the meantime. Let your family help you in any way they can—we both did. Kristyn’s mom helped her by being a pretend patient. Her aunt and uncle let her stay with them while in college to help save on costs. Shannon’s dad tried to help keep their dog occupied, so he wasn’t in her way or disturbing her studies.
Be Sure to Eat Healthily
Speaking of Shannon’s dad, Mark stresses the importance of eating well. It’s important to eat something healthy and keep your body full and your brain working to the best of its ability while studying and before you have a big exam. So, eat something healthy and keep your body full and your brain working to the best of its ability. That will go a long way toward ensuring you can pass your NCLEX without the pangs of hunger interrupting your thought process.
Also, Enjoy a Snack
You don’t have to eat all the time healthily, however. Sometimes, it’s good to get your favorite snack and reward yourself a little for the hard work you’ve been doing. So, grab your favorite candy bar and savor every bite before you get back to the work at hand. That little bit of goodness in your day can be a huge motivator and help when feeling down.
Add Vitamin D to Your Day
It’s also essential to make sure you’re staying healthy overall. Adding Vitamin D to your day, especially by soaking it up outside, is beneficial for how you feel mentally. Don’t just sit and study for the entire day. Get outside. Enjoy the fresh air. Take the break you need and deserve. It will help give you mental clarity so you can return to your study routine afterward.
Utilize UWorld
One of the best things you can do for yourself (or a family member) is to purchase a pretest system that allows you to see how well you would do on your NCLEX. It’s excellent practice and shows you the areas where you need additional guidance before you take the actual test. We used UWorld, and it offers options for both RNs and PNs. It helped us gain the information and experience necessary to help us feel genuinely prepared for the exam in real life. In addition, the UWorld NCLEX-RNⓇ provides more than 2,000 questions to help prepare for your impending. If you want easy-to-understand information, this program is for you.
Take Your Time During the NCLEX
Our final piece of advice is to take your time. It isn’t necessary to feel rushed during the NCLEX because you get five total hours for the entirety of it. Don’t rush through any questions. Please read it thoroughly so that you’re entirely comprehending what it’s asking. Some questions can be tricky, and you’ll misinterpret what it’s asking for if you don’t read them all the way through and give yourself time to sort through the possible answers.
Why Preparing to Be a Nurse Is So Important
It takes a village to support nursing students and current nurses, particularly given the added stress of the pandemic. In addition, as current nurses are exiting the profession due to burnout or attrition in large numbers, student nurses must find the resources they need to support their academic and career goals. A family and friends support network can also help make all the difference in reaching your goal of being a nurse with a healthy work-life balance.
This article written by Shannon Rosen and Kristyn Smith was published in the September 2022 issue of Minority Nurse.
About the authors
Shannon Rosen graduated from Nova Southeastern University, passed the NCLEX in May 2022, and is an Operating Room Nurse at Naples Community Hospital in Naples, Florida.
Kristyn Smith graduated from Chamberlain University, passed the NCLEX in May 2022, and is a Pediatric ER Nurse at a hospital in Houston, Texas.
When he is not treating kids as a pediatric Transitional Care Unit (TCU) nurse at VCU Health in Richmond, VA, Ren Capucao, MSN traces the rich heritage of Filipino nurses in the US.
As a nurse historian (Capucao’s first article was published in 2019 in the Nursing History Review), he focuses on studying the fascinating story of Filipino American nurses. Capucao is working toward a PhD at the University of Virginia School of Nursing, and his scholarship has shown so much promise that he has been named a Fulbright Scholar for 2022-23 and will be a Fellow at the University of the Philippines, Manila.
“Seeing through my mother’s lens as a nurse,” Capucao says, brought home to him “the sacrifices she made to care for her loved ones. For all the trailblazing nurses that immigrated to the U.S., I can only imagine the struggles they faced on top of caring for patients often culturally dissimilar, so I am humbled to have these nurses invite me into their homes and openly share their memories.”
Capucao will use the Fulbright grant to travel to the Philippines during the 2022-23 academic year to continue his investigations into Filipino nurses’ histories, conducting interviews, collecting oral histories, and diving into historical archives. He is also an editor for the nursing and medical history blog Nursing Clio, and his dissertation study “Pressed into Starched Whites: Nursing Identity in Filipino American History” has already earned him grants and accolades from the Virginia Humanities, the Philippine Nurses Association of America, the Bjoring Center for Nursing Historical Inquiry and the Barbara Bates Center for the Studying of the History of Nursing.
In this video, “A Culture to Care,” Ren shares some background on the history of Filipino nurses in the US and his own very personal links to nursing and the tradition of nursing among Filipinos.
For most nursing students, passing the NCLEX is their top post-graduation task. Once they have that exam under their belts, they become a registered nurse and can move forward on their career path. Many students study on their own using various methods and approaches, but this study shows clear benefits between more HESI exams taken and a better outcome on the HESI Exit Exam and on the final NCLEX-RN exam.
According to Christine Gouveia, PhD, vice president of Applied Learning Sciences at Elsevier and visiting professor at the University of Pennsylvania, the findings help educators and students prepare more efficiently and effectively for the NCLEX. “HESI exams span a nursing program and curriculum and are an excellent indicator of student progress on their academic journey,” she says.
Preparation with HESI exams offer multilayered benefits as nursing students gain knowledge and confidence from the testing, preparation, and remediation tools offered with HESI specialty exams and results. As students progress through different exams, they answer questions that are designed to closely resemble the questions on the NCLEX, so they can apply their knowledge in a practical way and demonstrate their critical thinking skills, says Gouveia. Those tools are helpful as they finish school and begin their careers. “Clinical judgment is critically important,” says Gouveia. “Critical thinking is necessary for nurses to practice safe effective care.”
The HESI specialty exams are an important tool for educators as well. Educators analyze the individual and cohort results to help students identify weak areas where they can use some additional work. They are able to work on remediation quickly using quizzes and case studies to synthesize their knowledge effectively. The scores also reveal students’ strengths and give them an indication of where they are excelling in their studies and can help them stay focused and motivated. Coaching support is also available to students to help them navigate challenges and to reflect on what and how they are learning and how to gain the most from their nursing education.
The results of the latest study mirror previous findings from a smaller sample size. Student success is more easily predicted when students score a 900 or greater on the HESI Exit Exam, says Gouveia. Those students are 96.4% to 99.2% likely to pass the NCLEX-RN. The study found, for example, that a student who took six specialty exams scored on average 29 points higher than those that did not take any. Completing 12 HESI Specialty Exams translated into an average gain of 160 points.
Gouveia says the study results have been translated into effective evidence-based tools using data to create predictive algorithms and interpret the results on the HESI® Readiness for NCLEX®Dashboard. The data allows educators and teams to monitor results and trends throughout a program and make real-time adjustments to benefit students as much as possible.
