Nursing School Week by Week

The difference between working in a hospital and working home health is night and day. I’m going to be talking about my experience as a home health nurse, what a day in the life looks like. I’m going to touch on some myths about home health nurses, kind of the reputation that they have and if I think that that’s warranted or not. And how it compares to working in the hospital. These are just things to kind of tuck in your back pocket if you’re going through nursing school right now, or if you’re about to go through nursing school. And if you’re anything like me, I had no idea what kind of nursing I wanted to do after I graduated. Some of my friends knew exactly what they wanted to do and I always envied that. But that was not me, and I think in some ways, I’m still looking. You know, but I don’t think there’s any shame in that. I think it’s good to be curious, and I hope I’m forever curious and forever learning. And that’s what I’m doing right now. I’m learning about different specialties within nursing, and that is the beauty of nursing.

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Today we're talking about a basic one but a big one. We’re talking about falls. We're gonna get into what constitutes a fall, because it may not be exactly what you think a fall is but it would still count as a fall. We're gonna get into what makes a person more likely to have a fall; we're gonna get into what we as nurses can do to help prevent falls, and we're also going to touch a little bit on the good and bad of placing so much importance on preventing falls.

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Let's continue talking about the pros and cons of working night shift vs day shift as a new nurse.

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First up, on the day shift, there are more meds to give. So, that can be good if you’re trying to practice your skills, but bad just because it’s more work and it’s going to take longer to do each of your med passes. Especially that first morning med pass. That’s when the patients are getting the bulk of their medications. 
And you can have the full gamut of pills, IV bag meds, IV push meds, plus topical medications, all in one med pass, for one patient in the morning. So if you’re doing that for 5 or 6 patients, for one med pass, that can take up a lot of your time and can be stressful to feel like you have to rush rush rush to get it done. 
And there were times, only on day shift, when I started my shift at 7am and it was 9:30-10am and I was being called away to do something else, and I’m like, “I can’t. I still am not done with my morning med pass. 
You know, my meds are an hour and a half late.” And that’s not ok, but I was just so busy that that’s what the situation was honestly. And that was very stressful to me because I don’t wanna be late on my med pass. I want to give my patients their meds when they’re due because that’s what’s best for my patients. 
So it’s very stressful when you feel like you’re just one person, but you’re being given the workload of three people. Especially when you’re a new nurse. You know, maybe a seasoned nurse would not have been late giving those meds, but as a new nurse, that was just my reality. And that was very stressful. But yeah, on night shift, you typically have a lot less meds to give. 
And if you’re in clinicals, you can look this up in your patient’s orders, if you get a chance, just compare what medications they’re getting during the day (especially that first morning med pass) versus what they’re getting at night. And it’s almost always a lot less at night. 

Today I want to talk about the differences between day shift vs night shift for nurses. Maybe you’re on the fence, you don’t know if you want to work day shift or night shift when you graduate, so I want to go over the pros and cons of each to help you make your decision.

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Now I have worked both day shift and night shift on a med surg unit and in the emergency room, so I feel like I can talk to the pros and cons of both.

Alright, so first up, I definitely have to mention that if you’re in it to make more money, then the night shift is the obvious way to go. Because you’re gonna get that night shift differential, which is usually, some places do it differently. Some places do it like just a set amount per hour more, like 7 dollars more per hour if you’re working on the night shift; then other places will give like 1.25 times your base hourly rate. But either way, you’re gonna make more on the night shift. 

And when I calculated it out, it was basically a car payment every month. So about $600 more per month than what I would have made on the day shift. So that’s pretty significant. And if you’re working night shift on the weekend, then you’re gonna get even more cause you’re gonna get that weekend shift differential in addition to the night shift differential. So that’s what I tried to schedule myself when I was working nights. I would try to make it on Friday, Saturday, and Sunday night so I would get both of those differentials to maximize the pay. Cause if you’re there, putting in the time, you might as well get paid the most you can possibly make.

Alright, another difference between day shift and night shift, is that, and this can be seen as either a pro or a con, depending on how you look at it, but during the day shift there are more doctors around, more physical therapists, more occupational therapists, more social workers around, and more management around. 

So this can be a good thing, because if an emergency situation arises or if you need to change verify an order, then the doctor is just a chat or a phone call away. Or if the patient starts going downhill fast, you can reach out to the doctor easily and you don’t feel like, you know, you have to wait until it’s an absolute emergency because you don’t wanna wake up the doctor in the middle of the night, and what if they get mad at you and yell at you? You’re not as worried about that because the doctors are already there working anyway. So that is a good thing, but it can also be a bad thing; because there’s something nice about it, I mean that’s one reason why the night shift is more quiet and less hectic because there are just a lot fewer people there; a lot less doctors putting in orders, changing orders, wanting procedures done right then and there.

You just graduated from nursing school, and now you're working as a nurse in the emergency department. The EMTs bring in a 26 year old female with generalized weakness of the left lower and upper extremities, and a sudden headache. What do you do? Can you complete all 5 critical actions, or will you carry out a dangerous action? Learn the most important things to do for stroke patients as a nurse.

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 Today we are focusing on Strokes, or Brain attacks. This is one of those conditions that is so important for us nurses to know the signs and symptoms of, because your patient could have a stroke at any point. They could come into the ER with a suspected stroke, or they could be recovering on the med-surg unit, about to be discharged, and then have a stroke. So it can happen at any time, and we want to make sure we know what to look for. We also want to make sure we know what their baseline looks like, so we have something to compare any changes to. This is one reason why, when you’re in nursing school clinicals, your instructors will stress that you do a bedside shift report, or at least that you go into the patient’s room and do the physical assessment within the first hour of your shift starting. Because if you don’t go in there for four hours, and then when you finally do, they have slurred speech and limited arm movement, you’re not going to know if that’s what they were like before your shift, or if those are new changes. 

It’s almost time for a new semester to start and a lot of you will be going to clinicals for the first time, and the rest of you will be going to clinicals again. I am all done with clinicals now, but I know when I was going through it, I packed a lot of things that I really didn’t need at all, and then there were some things that I didn’t pack, that I kept having to bum off my friends. So, we’re gonna go through all the things that you need for nursing school clinicals.

Thinking about going to clinicals, especially if it’s your first time going to clinicals. There’s so many questions about what it’s going to be like. But, I mean really, the main thing that you want to bring to clinicals is, it sounds cliche, but is a good attitude. Just show up, ready to learn, bring your questions. Don’t be scared of looking like an idiot. Cause you’re a nursing student. You’re gonna look like an idiot. You’re not gonna know how to do very much. You’re not gonna have all the answers, and no one expects you to. Because you’re a nursing student. They expect you to come eager to try new things. To get in there and volunteer to do things, even though they know you’re nervous about it. And they know that you haven’t done this before, but that’s how you learn. You get in there and you try it. But they do expect you to have the supplies you need, so take this time to get your clinicals bag ready to go and packed.

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With a new semester just around the corner, and some of you starting nursing school for the very first time, it is so important to make sure your study system is top-notch and ready to go. As James Clear would say, "You do not rise to the level of your goals. You fall to the level of your systems."

In this episode, I'm sharing my insanely effective study system for nursing school, step by step. It is efficient and it works. Take what you like, and leave the rest!

This is a study system that is big on active learning, and NOT passive, time-wasting things. I’m NOT talking about re-reading or re-writing your notes. I’m NOT talking about getting cozy on the couch with your textbook and reading the chapter while highlighting. No. Those are passive learning techniques, and are not the best use of your time. In nursing school, you have precious little time, and you’ve got to make the most of it.

I use 4 resources to study for nursing school, and no, the textbook is NOT one of them. All four are mobile apps and can be used with a laptop or tablet as well.

The 1st is Picmonic.
This app uses pictures and stories to help you remember difficult-to-learn concepts and facts.
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The 2nd is Nursing.com.
This one has videos that are about 10 minutes long on just about every subject you’ll cover in nursing school.

The 3rd is the Anki flashcard app.
This app spaces out your flashcards and shows them to you at the perfect time for your brain to remember the information.

The 4th app is any podcast app. 

There are pros for going straight for your RN, there are pros for doing LPN first, or even just doing LPN. Not everyone who gets their LPN degree is planning on becoming an RN. 

The first obvious pro for going the LPN route is that it’s faster. You can get your LPN in just 12 months, whereas getting your RN takes about 18 months. So you’re gonna save like half a year, which isn’t a huge deal. I mean, once you’re in nursing school, the time goes by so quickly anyway, that 6 months feels like nothing. But it is true that getting your LPN is faster and it’s cheaper. So, if you’re just looking for the quickest way to get a steady, fairly well-paying job in the healthcare field, then LPN is a good way to get your foot in the door. 

But, I will say, the LPNs get paid significantly less. The average pay for an LPN is $23 an hour, whereas an RN gets $37 per hour. So that’s a $14 an hour difference. So that’s pretty significant. Over a 12 hour shift, that’s gonna be, let’s see, let me calculate that… That’s $168 difference over a 12 hour shift. So that’s about a $2,000 a month difference. So you would make about $2,000 less per month as an LPN than you would as an RN. 

But one reason why you might choose to pursue an LPN rather than an RN straight out of the gate is that it’s easier to get into LPN school than RN school. Maybe your GPA isn’t exactly where you want it to be to be competitive, so you could get into an LPN program, complete that, and then, once you have your LPN, it’s much easier to get into the bridge program that will take you from your LPN to an RN. And if you did the LPN program and then the bridge program back to back, that would take you 12 months for the LPN and then another 12 months for the bridge program, so if you’re comparing that to the RN, that would take you about 6 months longer than if you just did the RN straight out of the gate. But, like I said, it’s much easier to get into the LPN program. You don’t have to have the same level of grades that you would need to have to get into most RN programs. And you could even do your LPN program in 12 months and then get a job working in a hospital, and most hospitals do tuition reimbursement, and usually it’s quite a bit for nurses, and they will pay for you to do that bridge program, to go on and get your RN degree. So that would be the most financially responsible way to go about it. 

I patient comes into the emergency room with chest pain. What are you, the nurse, going to do about it? Would you recognize it? Go through this case study with us and see what to do when a patient is having a heart attack, or myocardial infarction. Learn the 5 critical actions you must take as a nurse  to prevent lasting damage from a myocardial infarction.

Are you looking for an easier way to study for your nursing school classes? Check out Picmonic and get 20% off an already super affordable subscription.

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