Nursing School – A Reflection

Nursing school takes a whole lot of blood, sweat, and tears to get through. Quite literally. Not only were there a lot of blood, sweat, and tears, you can also chuck in a whole lot of faeces, vomit, needles, stress, anxiety, fear, confusion, and a whole lot of time spent caring for Pat, our dummy patient. Pat went through a lot.   

At the end of 2019 I was able to sit and pass state final. The last hurdle towards officially becoming a registered nurse. Three years of study had finally come to an end. As a result, I’m rewarded with a degree, the privilege of joining the nursing workforce, and memories of nursing school which will remain with me for the rest of my life.

Nurses are encouraged to routinely reflect on our own practice and experiences. It serves as a way to solidify our learning and acknowledge which areas of practice we could improve on. As my time as a student nurse comes to a close I thought it would be appropriate to write a reflection on my own experience of nursing school as a whole. I see this as an opportunity to share my individual perspective of the journey. Maybe this piece could encourage someone to pursue a career in this profession, or maybe it could help someone decide that nursing definitely isn’t their cup of tea.

I will be breaking down my experience year by year to give you an overall picture of how I experienced nursing school. Please note that it would take more than one blog post to fit everything in. These are also my own experiences which may differ to others.

YEAR ONE

The first year of nursing school was all about learning WHAT a nurse is and what they do. What is sphygmomanometer? What is atherosclerosis? What are the stages of Erikson’s Stages of Development? We learnt about basic nursing theories alongside some anatomy and physiology, psychology, sociology, and pharmacology. This year was largely theory based. Personally, I didn’t find it too challenging as my year at university beforehand had set me up well with appropriate studying skills and strategies. Having this year of tertiary study beforehand definitely gave me an advantage. In between classes we had clinical lab sessions where we learnt the fundamental skills of nursing such as taking a blood pressure, recording vital signs, and providing basic cares. My first few attempts at these skills were disastrous, but with practice I was able to gain confidence in eventually using these skills in real-life practice settings.

My first major struggle I encountered in nursing school occurred when I had my very first placement at a hospital level aged care facility. Prior to this placement I had never set foot in such a place. I had no experience in basic cares at all. I struggled with this placement and had huge doubts over whether nursing was something I really wanted to do (I felt this many times throughout nursing school). Although I know I didn’t enjoy that placement and would be quite happy to avoid such a place again, I can say that I appreciate the lessons it taught me in providing basic cares for another human. It was a real lesson in humility and compassion which will stick with me throughout my career.

My second placement was on a surgical ward. I enjoyed this one a lot more as it had more of what I first envisioned nursing to be. I was able to administer medications, take vital signs, and I even gave my first injection. I spent these four days in awe of the incredible work that my preceptors were doing each day. A lot of it went over my head and I felt very out of my depth, but I could fall back on the excuse that I was only a first-year nursing student. An excuse I wasn’t going to be able to use as freely next year.

YEAR TWO

Second year definitely felt like a huge step up. The focus of this year was learning about the HOW of nursing. Less time was spent in class and more out on placement putting the theory we had learnt into practice. The book work also started to increase in difficulty as we started learning about pathophysiology and the various diseases and conditions which can wreak havoc on the human body. We learnt about research and ethical principles within the nursing profession, and we had a look at the health of the Maori population of New Zealand and how past events have caused the outcomes we observe today.

We had three placements this year. A medical/surgical placement, a mental health placement, and a primary health placement. Each three weeks long. My favourite placement was probably my day surgery placement. This involved admitting patients, getting them ready for surgery, then caring for them upon return from the operating theater. It was an insightful experience into the realm of perioperative nursing. The highlight of this placement was being invited to watch a total knee replacement. Lowlight? Well, that had to be fainting after cutting my finger on an ampoule.

Simulations were introduced in second year. As a year two student who still felt like I knew nothing, these were really intimidating. Practicing a scenario under the watchful eye of a lecturer and colleagues wasn’t a comfortable situation to be in. But what I soon came to realise was that simulation sessions were actually an incredible opportunity to practice nursing skills in a risk-free environment. No one was going to die in these simulations. Maybe you forgot to give oxygen to the patient who just had an opiate overdose, but in the simulation scenario it doesn’t matter because although you’ve screwed up, no one is actually hurt or dead at the expense of your mistake. The worst outcome is that you’ve learnt something really important, and that’s still pretty good. Pat will live to survive another day no matter how badly you screw up.

One thing I’m grateful for in this second year was the range of placements I experienced. It was an opportunity to dip your toes into an area of nursing you may have never considered before. At the end of the year I still hadn’t found an area which hugely appealed to me. However, my eyes were opened to the huge variety of environments which nurses work in. They don’t just work in hospital wards! What I had experienced was only the tip of the iceberg.

As the year came to a close I was beginning to gain confidence in the practical setting. It’s strange though. Sometimes it feels like you’re nailing it and know exactly what to do for whatever comes your way, then other days you feel like you know absolutely nothing. It’s like a confidence rollercoaster. As soon as you build up knowledge and confidence in your mental health setting, your thrown into an ENT clinic and have to start learning about nasal cavities and tympanic membranes. However, some skills are transferrable, such as communicating with patients. Coming into nursing school I had a very quiet personality. I still have that, but as I had more and more experience interacting with patients I learnt how I could bring my unique self to these therapeutic relationships. I didn’t have to pretend to be someone I’m not to establish rapport with a patient.

As the end of the year approached, I had to think about which options I wanted to put down for next years placements.

YEAR THREE

My final year of nursing school consisted of just five weeks in class. The rest was spent out on placement in the real world. This is where the real learning happens. After our first week back in class we were quickly thrown straight into our first placement for the year. I was placed on another surgical ward. I struggled here. It wasn’t that I couldn’t do what was expected of me, it was a lack of confidence and uncertainty which wore me down. I wasn’t a fan of ward nursing, and because of this I felt like something was wrong with me. Why was I even in nursing if I found no joy in working on the ward? This is what real nursing is right? I seemed to have forgotten that the scope of a registered nurse was not just limited to working on a ward. I still really wanted to care for and help people, but in a different way, in a different setting. Fortunately this emotional rut was only temporary, and I was able to enjoy my next placement at a youth mental health facility.

In replacement of a primary health placement we were assigned group projects to complete. We were allocated a small town to travel to where we had to talk with the locals, identify a health issue within the area, and come up with some sort of solution to it. I really enjoyed this project. I learnt a bit more about the different way’s nurses could make an impact on the health of not just an individual but also a whole population. I think this project is what spurred me in the direction of pursuing a nursing career in primary health.

We had another block of simulations which this time felt far less stressful. They were more challenging, but I was able to approach them with the mindset that it was a useful learning opportunity. My advice to anyone doing sims is to take any opportunity you can to be involved. The only thing that could go wrong is that you look like a bit of an idiot. But that’s ok because you’re out there taking those opportunities and learning! Taking these chances shows your determination and willingness to learn and is a good opportunity to get into the habit of challenging yourself and pushing outside of your comfort zone. Remember, no-one is going to get hurt!

Soon enough it was time for transition to practice. Our final placement of nursing school. A ten-week stint in an area of our preference. When entering my preferences I was still at a loss as to where I really wanted to work. I knew I didn’t enjoy ward work; mental health wasn’t growing on me, emergency and trauma was something I was considering, but what I did know was that I had a gut feeling that primary health was the area for me. After discussing options with lecturers I settled on public health. I spent my final 10 weeks of nursing school working as a public health nurse.

Before starting this placement I thought I had a decent idea of what a public health nurse did. I was wrong. They do so much more. Public health nurses work with children and adolescents out in the community. They visit schools, work with families, vaccinate, advise, advocate, educate, and much more. I thoroughly enjoyed this placement and felt like I had finally found an area of nursing which I could thrive in.

While accumulating the hours on placement I also had to focus on job interviews and the state final exam. There is a nationwide process for allocating new graduate nurse’s jobs after completing nursing school. Personally I’m not a fan of this process but here isn’t the place to express those frustrations. I was lucky enough to land a job doing public health nursing where I had spent my last ten weeks of placement.

New Zealand is one of the few remaining countries to have a state final exam in order to become a registered nurse. Studying for this exam was difficult as there weren’t really any guidelines as to what would be in it or how the questions would be structured. It felt really intimidating knowing that if we didn’t pass this we couldn’t gain our registration which we had put in so much work for. Revising three years’ worth of notes felt impossible. Instead, I went hard on the practice multichoice questions. Any I got wrong, I would note down and look into further. Looking back I now realise that a lot of the study I did was actually a complete waste of time. I remember revising my notes on measles over and over only to not find a single question on measles in the entire exam. I believe the main reason I passed the exam was not because of the study I did in the weeks building up to it, but because of the learning I had done over all three years of nursing school. The questions aren’t ones you can really study for, they’re just ones you happen to know the answer too through experience. As daunting as it seems, have confidence that you’ll pass as my year had a 100% pass rate.

CONCLUSION

At the end of all this I was lucky enough to secure a job doing public health nursing. Will I do this for the rest of my career? Probably not. Will I stay in primary health my whole career? Who knows? Will I progress to advanced nursing positions? Maybe. I don’t know where this career will take me, but I’m excited to see where I will end up. I may not even be in the nursing profession in my working life. The future is a big unknown, and I’m ok with that.

I’ve enjoyed reflecting back over my three years in nursing school. It’s brought up a whole lot of memories. Some I will cherish forever, others I would rather forget. It’s been a life changing experience and I can confidently say that I am a better person now than I am when I first walked in. I’ve developed a new sense of self confidence and learnt many life lessons in the space of these three years.

What has really made nursing school so memorable though? The people. Lecturers, colleagues, patients, preceptors, friends, and family. They have provided the laughs, the motivation, the shoulder to cry on throughout this degree. Nurses are incredible people and it’s been an absolute privilege to work alongside them and join this respected workforce which is having such a positive impact on the world.

I’ve done my best to provide a brief overview of my time in nursing school and share with you the main things I took from this experience. Nursing school is hard, but it’s definitely worth it. Please contact me at benjamin.rowley2112@gmail.com if you have any further questions!