Want to know 12 of the most important things they don’t teach you in nursing school?
These are a must-know once you graduate!
I like to think of nursing school as the “NCLEX world” and working as a nurse as the “real world”.
Although we all need to go through nursing school in order to learn the basic skills of becoming a nurse – nursing school prepares us for the NCLEX, but not necessarily how to be a nurse in the outside world.
In your nursing school exams and in the NCLEX, questions will be worded in a “perfect world scenario” where you will have ample time, all the available resources, and everyone is willing to help.
In real life, however, this won’t always be the case.
After working as a nurse for a few years, there are still many things I wish nursing school prepared us for – but I understand it is nearly impossible to do so.
So here are 12 things I’ve learned throughout my career as a nurse that nursing school did not teach me, but I wish it did!
This post is all about what they don’t teach you in nursing school.
12 Things They Don’t Teach You in Nursing School:
1. It does not matter what school you went to or if you had a 4.0 GPA
You may have been told that the nursing school you attend will make a huge difference.
I’m here to tell you, that it actually doesn’t.
Going to the top school in the country will not guarantee a job, and going to the most affordable nursing school does not mean you will be job hunting for a year.
As long as you go to an accredited nursing school, you do your best to get good grades, actually learn how to apply concepts, and pass your NCLEX – that is all employers will be looking at!
Also – it does not matter if you did not have a 4.0 GPA!
Nursing school is hard and in order to stay in school, you do need to keep up with your grades and GPA.
But this does not mean that if you are not in the top 5% of your class, or if you are not valedictorian, you won’t be a well-respected nurse.
Of course – study, aim for good grades, and always do your best, but do not beat yourself up if you are not getting straight A’s.
Just remember, if you did not go to the “Harvard” of nursing school, if you didn’t get a 4.0 GPA, or you didn’t pass your NCLEX in 70 questions –
This does NOT make you any less of a nurse!
2. Nursing diagnosis and care plans are not a real-life thing
You know those long dreaded care plans with multiple nursing diagnoses that clinical professors love to assign?
In the real world, no such thing exists.
When I tell you that you will never see a nursing care plan outside of clinicals, believe me.
And having to come up with a nursing diagnosis for any of your patients? Never has happened before!
So don’t worry about having to make a huge care plan when you are at work, because that is just for nursing school clinicals!
3. How to talk to doctors
One thing I always like to remember is – residents/fellows/doctors are our coworkers, not our superiors.
Sure, they’re the ones to diagnose and write the orders – but you are the one who double-checks and makes sure that everything is correct.
You are your patient’s eyes and ears – you are with them for 12 hours and are the first to notice if anything is off – so do not be afraid to advocate for them!
Everyone is human and anyone can make mistakes – even doctors!
One way to calm your nerves before you make the call is to know exactly what you’re going to say before you say it.
We all heard of SBAR in school, but I like to use more of a mini version that has always worked for me.
What you can say is:
- Who you are
- What unit you are calling from
- Patient’s name/room number
- Current issue
- What can be done/recommended?
If you have any suggestions say them! But I promise 99% of doctors won’t just sit there and wait for you to come up with a solution – they’ll tell you what orders they’re going to put in or if it’s a resident, they will consult with their attending and call you back!
So don’t be afraid, doctors don’t bite!
4. There’s more to nursing than just bedside
Nursing does not start and end at the bedside.
You do not need to work at a hospital fresh out of nursing school if that is not what you want to do, and you do not need to be a bedside nurse for the entirety of your career.
There are different nursing specialties such as OR nursing, PACU, clinics, aesthetics, case management, utilization management, and so much more!
Nowadays more and more new grad nurses are being accepted into these specialties, when before it was unheard of – the only thing you need to do is apply!
The beauty of having a nursing degree is that you can so much with it!
5. How to handle death
Death is a tough subject for most, and being in a career where you are exposed to it so much can get to you.
Even if it was mentioned during nursing school, and you were taught about post-mortem care, dealing with the grief and the emotions it comes with is something that cannot be put into words.
Although you most likely will get used to it, it does not necessarily mean it will get any easier.
Your first patient’s death will be rough and you will remember it for life, but you will get better at managing the grief.
If you find yourself having a tough time dealing with a death at work, talk to your charge nurse or manager – see if you can possibly get your shift covered so you could go home and take some needed time off.
6. Nursing judgment/critical thinking
I know – all you learned in nursing school was how to critical think.
But the thing is – using your critical thinking skills during an exam/NCLEX and using them at work are two completely different things.
As I mentioned before, nursing school will give you perfect world scenarios, but in real life, you will have to use your critical thinking abilities while in the middle of a fire.
Nursing judgment will be hard to grasp at first, but with time and experience, it will become second nature.
There will be one day when you will look at your patient and you will just know something is wrong!
7. Giving and getting “report”
“Report” is the information you give the oncoming nurse about the patients you had during your shift.
This can be tricky and hard to learn at first – since most units are completely different from each other.
My best advice is to analyze how your preceptor takes and gives report during your first and second day of orientation, as well as the other nurses in the unit.
For the most part, this will let you know what you should and shouldn’t include when you do start giving report yourself.
I would also recommend making your own report sheet, or getting some ideas online!
This way you can stay organized, and you have a system that works for you!
8. Time management skills
Learning how to manage your time wisely is a huge learning curve!
As nurses, we are constantly juggling a million things at once, while still trying to provide the highest quality of care to our patients.
Being able to multitask, while still being detail oriented, is key.
Don’t worry if it feels overwhelming at first, this is a skill that will come with time and experience.
I would highly suggest keeping a report/brain sheet at all times and using different color pens to coordinate care and differentiate between what needs to be done and what you already completed!
Being organized and on top of your tasks is what truly helps with your time management skills!
9. Stress management
In nursing school, you were probably told how stressful nursing could be but it is not something they teach you how to manage, and you probably wouldn’t understand it until you have been in the field for some time.
While working, especially as a bedside nurse, it is vital to take care of yourself and keep a life outside of work!
I wrote a whole blog post about stress management techniques that I believe will truly help!
You can read all about it here!
10. Nursing is physically demanding
Nursing is mentally draining, and your body will be feeling it too!
Ever seen that meme that says “Who says nursing is stressful? I’m 39 and I feel great!” and it is actually a picture of an old lady? LOL, that’s exactly how it feels.
Especially if you work with adults, the constant moving, turning, and helping the patient get up and back to bed, can put a huge strain on your back.
Remember always to use proper body mechanics and never change a patient alone! You can always ask the PCA or another coworker for help.
And you should also offer help – we all need to take care of ourselves.
But don’t be discouraged! Just keep moving outside of work, try some yoga poses – even if at home, and don’t ever feel bad asking for help.
11. Your work environment is more important than you think
We spend more than half our lives at work, and whom you work with can truly make or break your experience.
You may have landed a job at your dream specialty, but quickly realized it is a toxic work environment.
Or you could have gotten a job at a unit you’re not too fond of, but your coworkers are the most helpful people and you are constantly laughing and happy to go to work.
If you begin to feel stressed, overwhelmed, and on the verge of quitting – it may not be nursing, it might just be the current unit you are in.
Take a deeper look at your environment, and do what is best for your mental health!
12. Nursing is not the end all, be all
Everyone has a different story as to why they became a nurse.
You could have wanted to be a nurse your whole life, or maybe it’s a career you picked when you were younger and just kept on with it.
No matter the reason, remember you are not stuck.
In the past 2 years, there have been more and more nurses either leaving the bedside or leaving nursing altogether – and with how things have been lately, I do not blame them.
You could have started nursing school with the purest intentions, wanting to help people, but a year in feel so burned out that your compassion has decreased.
If this is you, I’m sorry. I know the feeling.
Just know that just because you chose to become a nurse, it does not mean you need to be a nurse for the rest of your life.
This post was all about what they don’t teach you in nursing school.
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