SURVIVING AND THRIVING IN THE NURSING PROGRAM

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1 SURVIVING AND THRIVING IN THE NURSING PROGRAM The JCC nursing faculty has prepared this handbook to help you better understand and meet the expectations of your nursing program. Above all, be persistent. Listen carefully the first day of each new course. Success means understanding the course/clinical expectations and meeting them! Nothing in the world can take the place of persistence. Talent will not; nothing is more common than unsuccessful men with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent. The slogan "Press On" has solved - and always will solve - the problems of the human race. - Calvin Coolidge Study Hints Decide on the best times for you to study and make appointments with yourself. Make your attitude positive. Think, "I choose to study now so I will do well on the test," rather than "I have to go study now." Before coming to class, read the text to learn more about the subject. When reading, your goal should be learning the material, not just finishing the assignment. Get out the syllabus for the course. Look at the headings and read information specified in the headings. Read the chapter summary before reading the chapter itself. Try to answer the objectives as you read. Do not read passively, read in an active way to answer the questions. Recite your answers out loud to help them get into your memory. You learn in many ways. Some people tape record important information and play it back repeatedly until they memorize it. Others use mnemonics to help them memorize. For example, the nursing process is ADPIE: Assessment, Diagnosis, Planning, Intervention, and Evaluation. Still others use visualization and imagery to learn. Imagine yourself with congestive heart failure: sitting up, gasping for breath, legs swelling, neck veins sticking out like cords. Study groups are very helpful and highly encouraged. Whatever methods you choose to help you learn, be sure to fill in all the objectives listed on the course syllabus. Practice generating questions and coming up with the answers. Studying works best when done frequently for short periods of time. Daily study sessions are better than once-a-week crams. Avoid long study sessions the night before a test. You will do better on the test if you study the material as you cover it in class and then review it the night before a test. You also need breaks in study sessions to stretch, go on a brief walk or some other activity to clear your mind.

2 Study groups are highly encouraged. In each course find a group to study with. Stick to the task at hand and use your time wisely in study groups. You instructor will have additional suggestions regarding group study. Write care plans and papers early in the course. It is very helpful to have these assignments finished prior the end of the semester when you will need more time to study for exams. Remember, since each nursing course builds on the information you learn in other courses, it is very important that you learn the material well the first time. You will be studying to learn, understand and apply the information, not just memorize. Retain your syllabi, texts, notes, etc., from each course to have as resources for the future. The color yellow is known to assist people in retaining information. Use yellow legal pads to take notes, yellow index cards to write facts on, yellow or lime green highlighters. Prioritize when you read and study. Always work first on the need to know material and save the want to know as a lesser priority. Underline only single words to assist in retaining information, not long phrases or sentences. PRINT IN CAPS WHEN TAKING NOTES. Success in Your Courses In the nursing program, you must earn a 2.0 in each course to be eligible for progression. As you work, ask yourself: Do I have good study skills? Is my personal life causing too much stress for me to study? Am I working too much? Are my test-taking skills good enough? Do I need help? Resources You Will Find Helpful There are many services available at Jackson Community College for students seeking to improve academic skills and abilities. Talk with your instructor if you HAVE concerns; they will arrange for study or problem solving sessions. Another valuable resource is The Center for Student Success. It is located in Walker Hall, Room 123. You can reach them at or simply drop in. The usual hours are Monday through Friday 9 a.m. to 7 p.m. o There are many services and they are eager to assist you. Some examples of the kinds of assistance available include specific help with math, reading and writing.

3 o o You can also take advantage of a number of study strategy workshops on various topics such as preferred learning styles, reading for meaning, test success and many others. They can analyze the NET test results for you and work to remediate the problem areas. Tutors are available at no cost to students. Students requiring special assistance (including those affected by the Americans with Disabilities Act) should contact the Center for Student Success. This is the first step in seeking to acquire the appropriate accommodations to facilitate your learning. Believe in Yourself. Think, "I will pass this test." Remember the saying: "Anything the mind can conceive and believe, it can achieve." Avoid negative thinking, the "I know I'm going to flunk, I'll blow it for sure" routine. When these thoughts come into your head, say "Stop!" Purposely replace them with positive messages. You went through a very selective process to be admitted to this program; you are an intelligent person. Successful athletes do not go into competition thinking "I know I'm going to flub up." They are positive thinkers! Practice, Practice, Practice. In test taking, this is known as studying. Avoid cramming the night before the test. Instead, study daily for shorter periods; you will retain the information better. In some courses, you will have an opportunity to take practice tests to help prepare yourself. Use them. If the instructor does not offer practice tests, you can make your own. One effective method for group study is to have each member prepare an exam on the material. Swap exams, then score and discuss them. We highly recommend that you establish a study group in each nursing course and study weekly in groups. Prepare Yourself Physically for Test Taking. Get a good night's sleep the night before a test. Often there are analysis questions on the test that require you to have a clear, well-rested mind. Avoid alcohol, hypnotics and stimulants. Instead, use relaxation techniques and keep your sleep cycle regular. Eat a good breakfast before the test, more than sweets and coffee. You need "brain food" - carbohydrates and protein. Learn Techniques to Deal with Tension. Be aware that some anxiety is helpful and will motivate you to do well. High anxiety, on the other hand, will make it difficult for you to think or remember the material you have learned. If you have difficulty concentrating, use these techniques to relax. Practice and you will know them when needed. Some students have severe anxiety while taking tests - called Test Anxiety. Please let your faculty member know about this and you will be referred for help. There is also a tutor available to help students with studying and testing.

4 Muscle relaxation exercises. If your back and shoulders are tense, increase and exaggerate that tension, hold it, then suddenly let go. If your hands shake, exaggerate the shakiness. Shake them as hard as possible for 10 seconds, then let them go limp. Imagine that you are about to have an explosive attack of diarrhea. Tighten your gluteus muscles as hard as you can and stop that attack. Clench your fists as hard as you can and hold them. Then let go. Breathing exercises with meditation. Close your eyes and focus on your breathing. Breathe in slowly through your nose, and slowly out through relaxed lips. Say "re" when you breathe in and "lax" as you breathe out. Do this rhythmically, letting your head move back and forth to increase relaxation. Imagery. Remember a wonderful moment or place in your past. Let a pleasurable experience into your consciousness and go with it. Remember the sounds, smells, and sights with the experience. Put yourself there mentally. The experience may be at the beach in the summer: listen to the waves lapping the shore; smell the air; feel the warm sand and sun shining on your body, relaxing every muscle. Melt into the sunshine. Taking Tests: Game Rules You must learn to successfully answer NCLEX style questions to pass your nursing courses and ultimately the nursing boards. Below are some suggestions towards that goal: Stay in control. Use relaxation techniques to decrease tension whenever you have trouble concentrating. Purchase a nursing test preparation book and work through it systematically. By doing so you will learn many strategies for success on nursing examinations. We recommend Successful Problem-Solving and Test-Taking for Beginning Nursing Students by Patricia Hoefler, or Soar to Success: Do Your Best on Nursing Tests by Paulette Rollant, 1999, Mosby. Read each question stem carefully at least twice. Analyze the stem for key points and underline them. Cover up the answers and try to figure out one of your own. Cross out any obviously incorrect answers. Try to narrow your choices to two answers. Often the correct answer will be the one you thought of while reading the question. If both choices seem correct, choose the one that makes the most sense to you. If you do not know the answer, mark down the number of the question, skip it, and go on with the rest of the test. Sometimes information in another question will help you figure out the answer to an earlier one. Sometimes the answer will just come to you while you are working on another problem. After you have finished the test completely, go back to the question(s) you skipped and look over them again.

5 If you are completely stuck - guess. Never leave an answer blank. There's no penalty for guessing. Budget your time while taking tests. If you have 50 minutes to complete a test, by the time 25 minutes pass, you should have completed half the questions. Plan on being the last person to finish the test! This will lower your anxiety when you notice some people leaving while you are still working away. Forget about everyone else and concentrate on using the time you have to do your best. Remember that Jack Nicklaus does not rush a shot. Believe in yourself! You are one of JCC's finest! THE NATIONAL COUNCIL LICENSURE EXAMINATION It is essential that all nursing graduates of Jackson Community College pass the National Council Licensure Examination (NCLEX) in order to become a nurse. The examination is designed to protect the public from nurses who are not safe to practice nursing because of insufficient knowledge, skills and abilities to think critically. If the graduate does not pass the examination, he or she will not be able to become a nurse. We highly recommend that students go to the National Council of State Boards of Nursing web site each week and take the free practice question of the week. Get into this habit on Mondays of each week. The web site address is: There are four levels of cognition (thinking ability) used on multiple choice tests. Here are examples of the four levels of questions: KNOWLEDGE QUESTIONS - What do you know? A 62-year-old client is admitted with heart failure. The nurse is performing the admission assessment. Which of the following is a symptom of heart failure that the nurse should record? a. Tremor b. Fever c. Diaphoresis d. Dyspnea The student must find the symptom seen with heart failure. This requires accurate recall and can be done with memorization by the student. The correct answer is Dyspnea. COMPREHENSION - What do you understand? A 62-year-old client is admitted with heart failure. The nurse is performing the admission assessment. Which of the following is the most significant symptom of heart failure that the nurse should record?

6 a. Respiratory rate of 18 b. Crackles throughout the lung fields c. 1+ edema of the feet d. Dry cough The student must sort through which is the most significant symptom - this is higher order thinking because the student is making judgments. The correct answer is, Crackles throughout the lung fields. APPLICATION - What can you apply to real life nursing? A 62-year-old client is admitted with heart failure. The nurse is performing an assessment and obtains the following data: crackles throughout both lung fields, neck vein distention, 4+ pedal edema, and slight confusion. Which of the following nursing actions should the nurse take first? a. Restrict fluids to 1000 cc/24 hours. b. Apply oxygen at 2 liters/min. c. Place the call light within the client s reach. d. Have a family member stay with the client. Here the student is taking a nursing situation with specific information and determining the appropriate action to take based on knowledge and ability to make judgments. The correct answer is to apply oxygen at 2 liters/min. ANALYSIS - What can you analyze? Can you break this down into it s specific parts and recognize the assumptions and patterns to determine appropriate care? A 62-year-old client is admitted with an exacerbation of heart failure and Type I diabetes mellitus. Then nurse is performing the admission assessment and obtains the following admission data: crackles in both lung bases, neck vein distention, 2+ pedal edema, diaphoresis, tremor, confusion, agitation and hitting behavior. Which of the following nursing actions should the nurse take first? a. Call the physician for orders. b. Apply soft restraints. c. Do accu-check of the blood sugar. d. Give a glass of orange juice. The student must sort through which symptoms are associated with heart failure, or diabetes, decide on the severity of the symptoms, and make priority judgments about what is the most important thing to do next. The correct answer is to do an accu-check of the blood sugar. The NCLEX examination tests on higher levels of cognition. The NCLEX-RN tests on the application and analysis levels. The NCLEX-PN tests on the comprehension and application levels. You will find that a certain number of your questions are thinking questions and that you will have more of them as

7 you progress through your nursing program. Please recognize that these questions are necessary to prepare you for the NCLEX examination, and that you want to be able to master them. Personal Issues If personal problems arise that are too much for you to deal with alone, your instructor may be able to help. There are many public and private agencies and services that are available in the tri-county area to which they can refer you. The Jackson Community College faculty and student services can assist you in finding the appropriate resource. It is important that you care for yourself to maintain your personal strength so that you have something to give to patients. Employment Many students find it necessary to work part-time while they are enrolled in the nursing program. It is extremely helpful if the employer can be flexible in scheduling. For example, it is best not to work the evening before clinical or before a test. In our experience, working full-time or close to full-time while attending nursing school creates great difficulty for students. Each individual must determine what is best in their situation, however, must students do best when working approximately fifteen to twenty hours a week. Exceeding this number of hours tends to be associated with great difficulty in achieving academic success. While this is a personal decision of yours, please be aware that the time and energy requirements of nursing school are very rigorous. If you must work nights be aware that alterations in your sleep schedule will make studying and course work more difficult. Please realize that you may be scheduled for VARIABLE SHIFTS at some point during the program. Family The support of your family is critical to your success in the nursing program. The demanding nature of a clinical health curriculum means that you and your family will experience the effects of a full schedule of classes, labs and clinicals. It is best if you prepare your family for the changes that can be anticipated and enlist their support ahead of time. Naturally those needs vary from person to person. It might mean enlisting friends and family to assist with child care so you have adequate time to study; giving up some responsibilities with household chores or cutting back on volunteer or recreational activities during the program. Balance While the demands of the program mean inevitable changes in your life and giving up some activities, it is important that you maintain balance while in the program. That means continuing to meet your physical, emotional, social and spiritual needs. Find time to continue your activities such as exercise,

8 prayer or meditation, socializing with friends and family, eating balanced meals and other healthy actions. You will need to make changes in your schedule, but it is important to keep perspective and make time for some fun and leisure time also. Your Instructors Your instructors are here to help you. Without you, they would have no purpose at JCC. Please take advantage of their expertise. If you have problems scholastically, personally or financially, your instructors may be able to help you or refer you to someone else who can help. They cannot help if they do not know your needs. All instructors post office hours on their office doors. If these hours are not convenient, appointments can be set. Seek out your instructors; they want you to be successful and achieve your potential!