Cover image of Nursing Podcast by NRSNG (NCLEX® Prep for Nurses and Nursing Students)

Rank #98 in Health & Fitness category

Health & Fitness

Nursing Podcast by NRSNG (NCLEX® Prep for Nurses and Nursing Students)

Updated 5 days ago

Rank #98 in Health & Fitness category

Health & Fitness
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Nursing podcast for nursing students and nurses or new nurse. NCLEX® prep, pharmacology, ICU, critical care, and CCRN.

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Nursing podcast for nursing students and nurses or new nurse. NCLEX® prep, pharmacology, ICU, critical care, and CCRN.

iTunes Ratings

295 Ratings
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By LorraineEC - Aug 03 2019
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This is so helpful! Thank you so much!


By Luqman Gunt - Jul 20 2019
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Wow, all of the episodes are all useful. Thank you for making my nursing school easy.

iTunes Ratings

295 Ratings
Average Ratings


By LorraineEC - Aug 03 2019
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This is so helpful! Thank you so much!


By Luqman Gunt - Jul 20 2019
Read more
Wow, all of the episodes are all useful. Thank you for making my nursing school easy.

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Cover image of Nursing Podcast by NRSNG (NCLEX® Prep for Nurses and Nursing Students)

Nursing Podcast by NRSNG (NCLEX® Prep for Nurses and Nursing Students)

Updated 5 days ago

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Nursing podcast for nursing students and nurses or new nurse. NCLEX® prep, pharmacology, ICU, critical care, and CCRN.

Rank #1: Ep181: A&P: 9 Common Cardiac Medication Classes

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Today I want to talk about nine common classes of cardiac meds, that you’re going to need to understand, and you’re going to need to know at a very high level.

We’re going to talk about these meds at a very upper level, what’s going on, why we give these meds, and really what you need to know about them. Again, we’re going to cover nine common classes of cardiac medications.

A lot of times with our heart attack we have that mnemonic, MONA, which is immediate treatment for heart attack.

One of that’s going to be the “N” in MONA is nitrates. What it’s going to do is it’s really going to try to massively dilate the vessel to allow blood to flow. That’s when we would give it, we could give it for that.

Also, if someone has a hypertensive crisis we can give them hydralzine. There’s a lot of things that we can do, and what these, the primary primary purpose of these is to relax the vessels.

The post Ep181: A&P: 9 Common Cardiac Medication Classes appeared first on NRSNG.

Feb 23 2016



Rank #2: Hierarchy of O2 Delivery (ventilation, nasal cannula, cpap, bipap and more)

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Hey everybody. This is Jon with Today I just want to talk about a couple of the different methods of oxygen delivery systems that we have available for our patients.

There will be a chart available for this at So basically when a patient comes in and is in need of oxygen delivery, we have a choice about how invasive we want to be with that delivery and how much oxygen a patient is going to need.

Delivery needs and everything is going to depend on the patient condition, how acidotic they may be, if they’re COPD and various other things that could determine the amount of oxygen that that patient might need. But today we’re just going to talk about the different kinds of oxygen delivery systems and just kind of the basics behind that.

So patient comes in, is in need of oxygen. The least invasive method of oxygen delivery is going to be the basic nasal cannula. Now, the nasal cannula is going to deliver just a very minimal amount more of FiO2 than basic atmospheric air. So we know that FiO2 in the basic atmospheric air, if you go outside today, the FiO2 is going to be about 23 percent.

Now if you give a patient a nasal cannula at one liter per minute, they’re going to get about 24 percent oxygen. Give them the two liters and they’re going to get about 28 percent.

Now with the nasal cannula, you can go all the way up to about six liters per minute and you wouldn’t want to go much above that just for damage to the nasal airways and everything. At six liters per minute, they’re going to get about 44 percent FiO2.

So really at one liter per minute, they’re starting at 24 percent and it goes up kind of four percent per liter and the most you want to give a patient on nasal cannula is six liters per minute.

After nasal cannula, the next option for a patient would be a simple face mask and all the simple face mask does, it really kind of just covers the nose and the mouth and you can start – if you have a patient who needs five liters per minute, that would be a good time to start the simple face mask.

You can go up to eight liters per minute with the simple face mask. With that, at eight liters per minute, they’re going to get about 60 percent FiO2. So the patient really just isn’t cutting it on a simple face mask.

There are kind of two options here. You’ve got a non-rebreather mask or a venturi mask. With a non-rebreather mask, it’s a face mask that is the one that has the bag at the end as well. What the non-rebreather does differently from the simple face mask is it prevents the patient from breathing in some of that expired CO2. So this would help the patient who’s really just not setting [0:03:15] [Phonetic] well despite being on a simple face mask.

So if they’re really just not setting [Phonetic] well even though they’re on a simple face mask, you would – you could throw them a non-rebreather, prevent them from taking any of that expired CO2 and you would start that at about six liters per minute. That would be 60percent FiO2. You can go all the way up to 10 liters per minute and at 10 liters per minute they’re going to be getting close to 100 percent.

So from there, you can do a venturi mask and the venturi mask is a simple face mask but it also has – on the oxygen delivery port, you also have a dial that allows you to provide a set rate of FiO2. So you can definitely get very precise FiO2 using the venturi mask.

So it’s kind of just a simple face mask and coming off on oxygen delivery portion. You can dial in a very precise set rate of FiO2.

Now there are a couple of non-invasive – from there, so the patient still just isn’t doing well. You’re most likely going to need some positive pressure ventilation.

The patient is awake and doing decently well. You have a couple of options for non-invasive positive pressure ventilation. So what positive pressure does is if they’re just really not able to get that air into the lungs and to oxygenate themselves, you can add pressure to the ventilation.

What this is going to do is it’s going to kind of force those alveoli open and in some ways keep the alveoli open on expiration as well. So if you are not wanting to intubate or trache the patient, then you have a couple of options for non-invasive pressure, positive pressure ventilation.

There are two options with that. There’s CPAP and BIPAP. So what CPAP does is it provides positive pressure during spontaneous press. So as the patient takes spontaneous press on their own, it’s going to provide just a small amount of positive pressure to make sure that they’re getting the alveoli open.

So with BIPAP, it’s biphasic, positive pressure. So on inspiration and expiration, it’s going to provide them with a positive pressure. So it’s going to provide that little bit of peep to make sure that they keep those alveoli open.

Now if neither of these are working, there are non-invasive methods. You can go to invasive methods for mechanical – to ventilate the patient. You have a couple of different options with that. There are many options. The two that we’re going to discus are basically SIMV and assist-control.

So if your patient just really – despite all these other efforts or the patient – so really the number one criteria for if your patient needs to be mechanically ventilated is if the physician and if you as the nurse assess that the patient needs to be mechanically ventilated.

If they’re not protecting their airway, if they’re somnolent, if they have a drastic acid-base imbalance, then these are all reasons to mechanically ventilate the patient.

So you have a couple of different settings. So mechanical ventilation just means that you are providing airway assistance inside the airway and there are many different modes for that. We’re going to discuss SIMV and assist-control.

So with SIMV ventilation, you have a preset title volume and rate. But between the ventilator and the patient, there’s a circuit that either allows the patient to take their own breaths and expire – or prevents them from kind of taking their own breaths.

With SIMV, the circuit remains open between mandatory breaths, so the patient can take additional breaths on their own. When the patient takes spontaneous breaths, it triggers the ventilator to not deliver one of its required – one of its [0:07:32] [Indiscernible]. So the patient’s tidal volume varies with those. So, basically anytime the patient takes a spontaneous breath, the ventilator is not going to deliver a breath and the patient can – and due to that, the ventilator is not going to deliver its tidal volume.

So this is usually recommended for patients who – as a weaning method for patients who are maybe trying to get off the ventilator or for patients who are doing a little bit better respiratory-wise, because it allows patients to kind of take their own breath.

So a lot of times what we do on our floor for example is we will start patients on a rate of about 12 on SIMV and as we see that they’re breathing over the vent or that they’re taking more breaths than the required breaths, then we will start to decrease the rate and it kind of allows the patient to take breaths on their own and manage their own tidal volumes, which is the amount of volume that they’re bringing in, the amount of volume that they’re bringing out.

If the patient is doing well with that, then we assume that we can start thinking about weaning from the ventilator. So above that, kind of is the assist control method.

So there’s – with the assist control, you have a preset tidal volume and rate and inspiratory effort is required to assist with spontaneous breaths. So if the patient does take a spontaneous breath, it’s going to deliver a set tidal volume no matter what.

So rather than allowing them to kind of determine their own tidal volumes, we’re pushing a specific amount of air in every time. It’s going to be at that set rate. So it’s not going to say, “OK, well, you’re breathing on your own. I’m not going to deliver a breath.” It’s going to set that rate no matter what.

So whether they’re taking breaths on their own or not, we’re going to push our set amount of tidal volume. We don’t want to keep our patients on a ventilator for too long. This kind of depends by the physician. Some physicians don’t want to keep the patient on for more than a couple of days. Others will go to two weeks, sometimes more.

From mechanical ventilation, from being intubated, what can happen next is that a patient can get trached.

The post Hierarchy of O2 Delivery (ventilation, nasal cannula, cpap, bipap and more) appeared first on NRSNG.

Feb 11 2019



Rank #3: Ep165: A&P: Hemodynamic Parameters (CVP, PAWP, CO, and more awesome acronyms) (cardiac)

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Hemodynamics can be tough. . . simply because there are so many interdependent factors that a nurse needs to know.

In this episode I share some of the KEY parameters the nurse should know as well as provide a free download of a hemodynamics cheat sheet.

Free Download:

Hemodynamics Cheat Sheet

Must Know Values:

  • Cardiac Output (CO): 4-8 L/min
  • Stroke Volume (SV): 60-120 mL/beat
  • Central Venous Pressure (CVP): 2-6 mmHg
  • PAOP: 8-12 mmHg
  • Systemic Vascular Resistance (SVR): 800-1400

More discussed in episode . . . we also talk about how to manipulate each of these values and what conditions might alter a specific value.

The post Ep165: A&P: Hemodynamic Parameters (CVP, PAWP, CO, and more awesome acronyms) (cardiac) appeared first on NRSNG.

Jan 12 2016



Rank #4: Ep169: 12 Tips to Answering Any Pharmacology Question

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Pharmacology is one of the subjects that more students struggle with than anything else.  To conquer pharmacology it is important to have a plan.  This episode provides 12 easy to implement tips to answering any pharmacology question.

These strategies come from our online Pharmacology Course 

  1. Patient Safety
    • The NCLEX® is concerned about if you will be a SAFE nurse. Always think about what option will lead to your patient being safe. You can automatically exclude options that will put your patient in harm.
  2. Focus on Side Effects
    • Learn the top 3 side effects with major medication classes. If you know the class and the major side effects associated with that class you greatly increase your chances of answering correctly.
  3. ABCs
    • Airway, Breathing, Circulation. The ABCs will never go away. Focus on the nursing process and the ABCs with each and every question including side effects.
  4. Prefixes and Suffixes
    • Learn the most common prefixes and suffixes. This will cut down your total study time tremendously.
  5. Look for Patient Clues
    • Does the question provide information about the patients original diagnosis? Use general clues in the question about the patient, their history, and their condition. These clues will guide you to the medications they will be taking.
  6. General Patient Reaction
    • Look for clues in the patients reaction. For example if the patient reports dizziness, this is a clue that you should assess blood pressure. Use your assessment skills to answer pharmacology questions.
  7. Generic
    • Only generic names will be used on the actual NCLEX®. Although these names can be a bit harder to pronounce, they will provide clues (prefix/suffix) into the type of medication it is which will guide you in choosing the correct answer.
  8. Random, Random, Random
    • Regardless of how much you study . . . you will get that insanely random medication that no one has ever heard of. In this case just take a deep breath, relax, and use your nursing judgment, critical thinking, and think Patient Safety.
  9. Medical Diagnosis
    • Does the question identify a medical diagnosis? If you have a working medical diagnosis, use your knowledge to determine what signs and symptoms the patient will have, what medications they will require to manage those symptoms, and what are the main side effects of those medications.
  10. Freebies
    • If you are already familiar with the medication . . . simply use your knowledge, the nursing process, and critical thinking to answer the question.
  11. Med Classes
    • Learn to recognize common side effects with major medication classes and the appropriate nursing intervention for each of these side effects.
  12. Why is the Medication Given?
    • Why is the medication being given. Try to identify a relationship between the medication and the patients diagnosis. If you have the underlying diagnosis you can generally identify what medication will be given for that condition.

The post Ep169: 12 Tips to Answering Any Pharmacology Question appeared first on NRSNG.

Jan 20 2016



Rank #5: 39 Things Every Nursing Student Needs before Starting School [the ultimate list of “must-have” nursing school supplies]

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Getting ready to start nursing school?

Chances are you are feeling a dash of excitement, a pinch of overwhelm, and a whole lot of scared to death. That’s normal. Nursing school is a big step.

Unfortunately, if you walk into nursing school unprepared, you’re already behind the curve. . .  So, what do you need? Here is our list of must haves for nursing students . . . all the nursing school supplies you need.

The Ultimate Guide to the “Must Have” Nursing School Supplies


You can’t do nursing school without the right clothes . . . that’s just crazy talk.

1. The Right Scrubs

Now, this one is tricky. Your nursing school may have guidelines on the types of scrubs you can wear, so you need to check on this first. Find out if you have to wear certain types, colors, or brands so that you don’t buy scrubs you can’t use. But, if you have some freedom, here’s what you should consider.

You need pockets. You are going to be carrying around quite a few small items – pens, pieces of paper, notebooks, guide books, etc. You need to have a place to put all of those things, and, if you are allowed to, think about scrub pants that are painter or cargo style.

Read through ALL the annoying papers your school sends to you to make sure you are buying the right scrubs.

One brand that we love is Benefit Medical.  They create athletic style scrubs . . . if you have some freedom . . . check them out (see the above picture).

Seriously, what list of nursing school supplies would be complete without the RIGHT pair of scrubs?

2. Flesh Toned Underwear

Yep . . . you read that right. . . (see above).  Many nursing schools require that you wear white scrub pants. Once you get past groaning over this, keep in mind that you will want to invest in some flesh-toned underwear…and you might prefer that they are designed to avoid panty lines too.

Check out our Nursing Supplies Checklist!

3. Awesome Shoes

Ask any nurse anywhere and they will tell you how important awesome shoes are. In nursing school, you will be on your feet all the time. And, without the right shoes, you are going to be in pain. There may be guidelines on what shoes you can wear, so check with your school on this.

When you go shopping, you can try different options, but some of the most preferred brands include:

Pick shoes that are comfortable for your feet, though, by taking the time to shop around.  I have never personally used “nursing shoes” . . . when I started in nursing my favorite shoes were Nike Free . . . they don’t provide much support, but it feels like you are walking on marshmallows.

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4. A Wheeled Backpack

Okay . . . despite being made fun of . . . this is a handy little tool to have during nursing school.

To be honest, I used an over the shoulder bag all throughout school . . . and now I have scoliosis (not really).

Do you want back pain or long-term back injuries? If you do, then by all means, carry around a normal backpack. However, if you enjoy walking without pain, then you need a wheeled backpack.

Why, yes Willy . . . I do actually!

The textbooks you need for nursing school are very heavy and unwieldy. Getting something you can drag behind you is just a very good idea. . . .

I have hung on to a good portion of the books I used during nursing school and they take up an ENTIRE bookshelf . . . my MedSurg book alone is 4 inches think.  No, I’m not joking!

You can find a pretty big selection of decently priced wheeled backpacks on Amazon. If you can’t get yourself to do it. . . I also wrote another post on nursing bags here.

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RELATED ARTICLE: 7 Best Nursing Bags For Nurses

5. Nursing Watch

I have a confession . . . I don’t, nor have I ever used a “nursing watch”.  So why have I included it on here?  Because most schools will require you to purchase one and bring it to clinicals.

Instead of a watch with a second hand I either used my phone or the clock in the patients room.  Most hospitals have clocks in the rooms with second hands or a timer on my phone worked well.

The reason you need SOMETHING to measure time precisely is that many meds must be administered according to a set amount of time.  Like over 2 minutes, over 5 minutes, within 10 seconds . . . these watches make that possible.

Here is one that seems popular on Amazon if you choose to purchase one.

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6. Badge Clips

Displaying your name for people to know who to write their comment card out to is not the only convenience of having a badge clip. You can keep some pretty important information on here that will make your job easier. I personally keep an EKG box measurement tool on my badge along with all the important numbers I need to call.

The only thing about badge clips you should know about is that you MUST have a solid, sturdy device. Spend the extra $2 or however much for the good kind. I have broken the string, broken the plastic part that loops through your badge, I have had the entire casing pop off to find a curly piece of metal that flew out and hit me in the face. Just trust me and get the good kind.

Check out our Nursing Supplies Checklist!

7. Lanyards

The alternative to the badge clip is the lanyard. This may seem like a sensible solution to the badge clip drauma until you are turning a patient and suddenly your neck is now held captive. Or you lean over all the things nurses have to lean over and well you get the picture.
Despite my obvious bias, there are plenty of people who prefer the lanyard to the badge clip, leaving you with the conclusion that you should dabble with both before you pledge to one way or the other.


Organization and time management are two of the most difficult things to adjust to and manage as a new nurse.  Here are a few things that can help with that

8. A Student Planner

You are going to have a great deal going on in your life during nursing school. You don’t want to forget anything and you don’t want to get so frantic trying to remember everything that you pull your hair out. Larger stores usually have student planners. This way, you can write your schedule, make notes, and keep up with important phone numbers.

We have done a few podcast episodes about this before:

Here and Here

What it really comes down to is finding a method that works for you and STICKING WITH IT . . . every time you change up your organization method you waste a ton of time re-learning a new system.  Find something you are comfortable with and stick with it.

While I was in school the thing that worked best for me was a simple excel spreadsheet . . . now I mostly use Google Calendar.

Ashley Adkins RN has a great video about nursing school planners on her YouTube channel:

RELATED ARTICLE: What Nurses Really Do All Day? (12 Hour Shift in 12 Pics)

9. Notecards or Quizlet

You are going to be taking a TON of notes during nursing school.  Having a way to condense those notes and make them usable is important.  If you are old fashioned (like me) you will want to buy a lot of large note cards, not the 3X5 ones but the bigger ones.

Also, check out Quizlet . . . this is a digital/crowd sourced flashcard site.  It can be really helpful when you connect it with the app . . . allowing you to view your flashcards anywhere.

The only caveat is that anyone can create any flashcard . . . the down side to this is that you can’t be 100% certain the information is correct on public flashcard decks.

10. A Voice Recorder

Have you ever tried to remember a whole lecture? Or, have you ever scribbled down notes in a hurry and then found it impossible to decipher them when you got home? There’s an easy solution to this problem. Get a tape recorder and actually record lectures so you can listen later.

Sony makes a great voice recorder with 4G of internal memory . . . sounds like alot?  Just wait!

View on Amazon

Talk with your administration and see if they can start recording lectures and making them available school wide. . . many campuses are doing this and it provides students with a lot of great content to ease the journey.

11. Study Guides

Like I mentioned above, my MedSurg book alone was 1,800 pages and over 4 inches thick.

While I appreciate having the information AVAILABLE, it becomes very hard to determine what information is necessary and what you actually NEED to know.

To help with this we’ve created a few online study guides that you can access at any time for free.

Our two biggest study guides are:

On those pages there are links to save to your Pinterest board.  I’d recommend starting a “Nursing” Pinterest board where you can store and save awesome nursing resources . . . make those two pages your first pins. (in fact, maybe save this post too).

Check out our Nursing Supplies Checklist!

12. Facebook Account

I know most people already have a Facebook account, but within Facebook you can create private groups.  Once school starts you should create a Private Group for your cohort or for your study group.

My cohort used the FB group like crazy!

Within the group you can clarify assignments, vent, and share funny stories etc. . . We were able to get a tremendous amount of work done and save our sanity with this simple tool.

Added Bonus:::: since school has ended the private group has been a way for us to stay in touch and share what we are doing since graduating.


I am a little on the obsessive side when it comes to matching and organization, so when I learned of this color system I thought it was the best thing ever!
Now you can change the colors around, but know that I chose the colors I did based on what the colors usually represent or mean.  Red is a color that is associated with intensity.  I use red here to call out due dates.  These are important and you want to keep a close eye on red!

Use over the text:

  • Pink: Vocabulary and important definitions.  This is not for highlighting every word you don’t know this is for easily pulling out definitions later on for study purpose.
  • Blue: Values.  Keep track of the many important numbers you need to know by marking in blue.
  • Green: Examples.  Any time you find a good example or explanation of something highlight it in green.  Keep track of difficult concepts and where they are explained.

Use in the margins:

  • Yellow:  Use this color to highlight or mark anything that you are sure is going to be on a test.
  • Orange:  This color will be used to highlight anything in notes or texts that you need more help with to understand.
  • Red: use this color for noting due dates.  If you are in class taking notes or writing in your planner use red to write down what and when something is due.

Now in practice Here is how you want to use this system.  Lets say you need to do a quick review before a test.  First you want to start with Orange.  If there was anything that you need more time to learn make sure you find these sections and get some help!

Second review all your yellow highlighting.  While you took notes, or sat in class you spent the time to pick out things that you knew were important, or item the instructor specifically mentioned would be on a test.  Now go back and make sure you really understand and have those areas committed to memory!

13. Highlighters

While you are reading material or creating your own notes this is when you will use your pink, blue, and green highlighters.

  • Take the time to highlight any important values in blue.  You will want to find these values later while you are studying.
  • Find any important definitions and highlight in pink.
  • Then you will use the green highlighter for any examples or explanations.  For example if you are reading a section on the kidneys and there is a section on how urine is produced you could highlight that in green.

While you are in class or reviewing notes use your orange and yellow highlighters.

  • If your teacher ever says this will be on the test or if you notice that a topic has come up in several different areas highlight those things yellow.  If you do this well you will be able to browser through all the material before test days and re-read all notes and text books as if they were a study guide.  Just follow the yellow.
  • When there is a topic that is not clicking for you or you have more questions on how it works get out your orange highlighter.  Now when you go to office hours with your teacher you can pull out your notes immediately and ask to go over anything highlighted in orange.  Need a little help with this? We have an amazing guide on how to talk to nursing professors!

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14. Sticky Arrows

Use matching sticky arrows to mark the page for specific things you need.  The orange and yellow sticky arrows will be the most useful in this case.  You can use them to mark the pages that have yellow or orange highlighter sections.  This will make your test reviews very efficient and productive!  This will also allow you to quickly access everything you want to discuss in a meeting with your professor.  Once it has been cleared up you can remove the sticky arrow and know that you have addressed it!

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15. Post-it Notes

Post-it notes can be used in so many ways.  They can help mark specific pages.  They can be used to write your notes on.  Then you can go back later and pull out all those sticky notes and arrange by color.  If you created a yellow note for every thing you expect will be on the test you could then collect all the notes stick up on a wall and review daily for a week before the exam.

You can also use them to insert information you want to add to your notes or text when there isn’t enough room to do so on the page.  I used to like to pull out my text book during lecture to the section we were reviewing.  Instead of taking notes on a separate sheet of paper I would create sticky notes and add to the area in the text book.  I only took notes on things that weren’t already right there in the text so it saved time and also put ALL of the material in one place.

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Here are a handful of tools that I either used on the clinical floor or wish I had as a student nurse on the clinical floor.

16. Clicky Pens

There are two kinds of people in the world:

  • Those that use ONLY clicky pens.
  • And all the crazy people.

It sounds strange, but it really is that important. Try to spend one day in nursing school with a pen with a cap, and see how that goes. You will lose that cap. You will likely lose the pen because you can’t attach it to yourself. And, you are definitely likely to end up with ink stains and marks because you don’t have the pen’s lid.

Clicky pens are much easier to use. You can connect them to your scrubs and you can stow them away without worrying about ink.

To say that nurses are slightly anal about their pens is a MASSIVE understatement . . . we are INSANELY possessive, anal, and obsessive about our pens.  Do yourself a favor and buy clicky pens!

Check out our Nursing Supplies Checklist!

17. Sharpies

Yep, just basic Sharpie markers . . . these are useful during clinical when you need to write on medication stickers that will go on IV fluids etc . . . .  You can also get the fine point ones that help in note taking etc . . .

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To be honest, I generally had two Sharpies . . . one fine point and one larger one.  The larger ones are great for writing on IV bags.

18. Pocket Nursing Guide (Scrubcheats)

Imagine for a moment being able to have the most critical information right at your finger tips . . .

Things like EKG interpretation, IV fluid uses, medication math, medical Spanish and so much more.

Knowing what you NEED to know is such a huge challenge in nursing.  We are bombarded with mountains of information and are expected to extract the most important.  This is no easy task.

To address this concern we created a 50 page pocket sized laminated guide with the most essential clinical information.  Now you can take exactly what you need with you and have quick reference guides right at your fingertips.

View on The Nurse Shop

19. Nursing Cheat Sheets

Every Friday we email out a brand new PDF document with condensed clinical information on it . . . we call them our Friday Freebies.

Along with the cheat sheet (or reference sheet if the word cheat offends you) I tell a clinical story from my experience on how the information provided applies in the “real world”.

We literally cover EVERYTHING (I think): labs, OB/Peds, Pharm, Cardiac, Mental Health . . . you get the picture.

Join over 100,000 nursing students, nurses, nursing educators, and other health professionals and get on board with the Friday Freebies.  Sign up at

Get the Friday Freebies

20. Nursing Report/Brain Sheets

Learning how to take and give report as well as organize your time well in clinicals is something that nursing students, new nurses, and experienced nurses all struggle with.

In fact, as a new nurse my preceptor would make me practice giving her report over and over AND over again until she felt like I was correctly drawing out the information that was most important.

I always though she was being crazy until one day I realized . . . I was giving a damn good report.

And you know what else . . . I can only think of ONE shift where I got out late.  And that was because a patient came in coding right at shift change.

What’s my secret? 

A report and brain sheet that works!

To help you with time management we created an enormous database of nursing report and brain sheets by polling thousands of working nurses and asking for the report sheet that worked for them.  The key here is that no two nurses are created equal. . . what worked for me might not work for you and vice versa.  So we compiled the best brain sheets into a huge FREE resource.

I would suggest downloading this 46 page PDF and trying a few of the sheets out. . . this will be a tremendous tool for you during nursing school and I wouldn’t start without it.

The first two are mine so I am a bit partial.  They are the ones I used in nursing school and as a newbie nurse.

Download the Brainsheets

21. A Good Stethoscope

3M Littmann Cardiology III Stethoscope

View on Amazon

You don’t have to get all of those other medical supplies you might one day need, but a good stethoscope is integral to nursing school. You may want to do your research or even ask other nurses you know what they recommend so that you can choose a stethoscope that will serve you well.

Be careful with this one because a lot of times those crappy ones they sell in scrub stores just aren’t gonna cut it.  The best ones you can buy are going to be a Littman Cardiac  stethoscope . . . they aren’t cheap, and can run over $300.  If you are on a budget consider spending at least $70 or so for a decent one that will allow you to actually hear what you need to hear on the clinical floor.

I know that money is tight while in nursing school (I’ve talked about that here) but do yourself a favor and purchase a quality stethoscope before you start school . . . if you don’t you will just end up spending more money once you graduate and that first one will just be a waste of money.

I can’t tell you the number of times we would finish intubating a patient and ask for a stethoscope only to find that it was too weak to even hear lung sounds.

Check out our Nursing Supplies Checklist!

22. Hemostat

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Whoever invented these are brilliant and I owe them at least a round of beers for all the sticky jams they have prevented for me. To define the use of a hemostat would be to limit the capabilities. Although they were created in the sense of helping in surgeries, they can be used for so many things:

  • clamp IV lines
  • clamp foley’s when changing tubing
  • holding a needle for suturing
  • clamping a bleeding artery
  • unscrew IV tubing
  • clamp chest tubing

The list goes on and sometimes it is just so creative and useful it’s absurd. Can you be a nurse without this item? Yes. But you cannot be an awesome nurse without them, so just grab a pair and save yourself from potential trouble.

23. Trauma Shears

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These handy buggers are a must. You will need them in both non-emergent as well as emergent situations. But most importantly, when you need them, whether you have them on hand or not will make or break your time management.

They can be used for the child adult-proof medication packets you are trying to open for your patients medication pass. That painful weeping wound on your patient’s leg that is wrapped in gauze, you can cut off the gauze to minimize movement of the leg. A patient comes rolling into the ER after a major car accident, well you will be cutting off their lululemon leggings and their eco-friendly organic cotton ‘save the whales’ tee, no matter how expensive because a full visual of any hemorrhage could mean the difference between life or death.

Be prepared with these. Do not be the person who doesn’t have a pair. They are important and can mean life or death for a patient.

24. Foam Hand Sanitizer

This one doesn’t need an explanation. Just choose a small bottle that will fit easily in your pocket.  Yes, hospitals will have it everywhere, but you can get a nice cheap bottle that isn’t so sticky and gooey. . .

Purell makes this really cool one that you can put in your pocket or locker and comes out as a foam.  The first time I saw this was when my son was a patient in the NICU.  I thought it was so cool and much better on your hands.

View on Amazon

25. Pen Light

Like we said above . . . you don’t need to buy one of those “fancy” all-in-one nursing school supply kits . . . I bought one . . . and NEVER USED it.

However, a pen light is a MUST HAVE . . . this helps in neuro assessments and oral assessments.

Sadly, it can be hard to find a great pen light (a problem we are looking to solve).  I have seen physicians use the flashlight on the iPhone before and it actually works really well.

Here is a simple but in-depth video that shows how to assess pupil reaction . . . again . . . a complete must have.

View on The Nurse Shop

26. Good Nursing Clipboard

Nursing clinicals are crazy . . . you will be carrying a ton of paperwork and taking a ton of notes.  Having a nice clipboard where you can store all of that is important.  Check out this clipboard we designed here for nurses.

This clipboard is created JUST for nurses . . . with storage, reference sheets, and durable . . . it will last a lifetime.

View on The Nurse Shop

27.NRSNG Nursing School Starter Pack

We have put together all our best products at NRSNG and created our Nursing School Starter Pack.  Buy it all in one and you will save a ton!!

For the nurse or student who wants to take all the thinking out of what to buy this premium option includes educational and clinical materials.

Includes: Littman Classic II SE stethoscope, storage nursing clipboard, nursing report sheet (25 pack), nurse penlight with neuro badge card, trauma sheers, and hemostat.

PLUS: 4 books (140 Must Know Meds, 63 Lab Values for Nurses, 108 Nursing Mnemonics, N is for Nurse), Scrubcheats, and NRSNG lapel pin.

View Starter Pack Here


Here are some great books, podcasts, and courses to help you learn ALL that material you need to know to make a great nurse!!

28. Test Success

This is the MOST undervalued book in nursing education.

My entire nursing school experience changed when I discovered this book.  I read the entire thing in one night.

Me with my copy of Test Success: Patricia Nugent

You can pick up the older versions of the book on Amazon for less than $5 HERE and the new edition is less than $30 HERE.

The book really dives into NCLEX® style questions and the WAY you need to look at, read, and interpret the questions.  If you have time, I would suggest buying the book before you start nursing school and glancing over it . . . then use it as a reference DURING school.

View on Amazon

29. Nursing Podcasts

If you haven’t joined the podcast train yet don’t feel bad, I just started listening like 2 years ago.

I love podcasts for a couple of reasons:

  • It’s easier than reading.
  • I can learn while I drive or run.

Did you know you don’t need an iPhone or iPod to listen to podcasts?  In fact we have a ton of shows and you can listen on any phone or even on our website . . . how cool is that?

Some of our shows are just a couple minutes long while others are up to an hour long. Oh . . . and they are all free.

Here is a list of some of our shows:

  • NRSNG Podcast for Nurses
  • Nursing Mnemonics Podcast
  • Lab Values Podcast
  • NCLEX Question Podcast
  • MedMaster Pharmacology Podcast
  • Nursing School Struggles Podcast

View all Podcasts

30. NRSNG Academy

Almost more than anything else, we get nursing students emailing us daily saying they struggle with the way they are being taught material.  Either material isn’t explained or professors are just reading powerpoints . . . we saw a problem . . . and we decided to fix it.

We have created courses covering the most complex portions of nursing.  Each course includes cheatsheets, quizzes, case studies, and multiple methods of instruction.

On top of that we’ve created powerful study tools like flashcards, image and audio databases, and massive NCLEX test question databases.

All of our instructors are nationally certified in their field (meaning that beyond RN they have certified in their specialty field).

We packaged all these courses and tools together into what we call the NRSNG Academy

The purpose of the NRSNG Academy is to bridge that gap of what you’ve read and been taught to making it finally “CLICK” and make sense.  You know that feeling you get when the light bulb finally turns on?  You will have a lot of those with our courses.

In fact, we call those moments “LINCHPINS” and our entire cirriculum is built around providing you with those moments.

You can get started with NRSNG Academy now.

Try NRSNG AcademyTry the NRSNG Academy

31. Nurse Drug Reference Guide

I have yet to meet anyone who knows everything about every drug: nurse, physician, pharmacist, etc.  There is too much to know and too much change to know it all.  However, you will need access to as much information as possible and a good drug reference guide will likely be a part of your required texts.  If, by chance, it is not you should consider getting one anyway.

Check out our Nursing Supplies Checklist!


32. Medscape

Medscape is a free mobile app that has a TON of information.  What I use it most for is the pharmacology portion.  You can check drugs, interactions, and even view images of meds.

There isn’t a shift that I don’t pull this out and refer to it.

33. Practice NCLEX Questions

Access to a solid bank of NCLEX® questions can take you a long way.  This way you can take questions as you work your way through your program so that on test day . . . you know what to expect.

Here is a list of a couple places to get practice questions:

I took so many practice questions while in nursing school.  After a while you start knowing exactly what the questions are going to ask before you even finish reading it.

To help you, we’ve create Nursing Practice Questions (NPQ), which is our bank of over 3,500 NCLEX style questions.  Within NPQ you can sort the questions by category so you can take questions specifically on what you are studying in school at any given time.


34. Scrubcheats App

All the quick reference info you will need for clinicals, all at the touch of a button!

Try ScrubCheats App

EXTRAS (the fun stuff)

35. A Sense of Humor

Most people think of the medical field as only serious, but it can be very stressful and if you don’t have a sense of humor, you won’t find it easy to survive. Be willing to laugh at yourself and at awkward situations. It will help.

36. Travel

Hmm . . . yes, it’s true “travel” isn’t really something you can HAVE before nursing school but it is something you should do before you start your program.  Even if you don’t have the budget or the time to do a big fancy vacation before school starts you should take some time to be with good friends and family before your first day.

Create some memories . . . because once school starts you will be so busy that your “free time” will be greatly reduced and you won’t be able to spend time with loved ones.

If you have these things when you enter nursing school, then you will walk through those doors prepared for anything. And, you will definitely feel better than if you just had a pencil and notebook!

The site that my wife and I use for travel is . . . we’ve found some awesome places in some incredible towns for a fraction of the cost that other booking sites charge!

Visit Airbnb

37. A Good Coffee Maker

This is kinda a no brainer . . . coffee is kinda like a major food group to nurses.

Investing in a good coffee maker with a timer is a good way to make sure your daily caffeine ratio is ready before you leave the house and it’s a lot cheaper than buying a cup each morning.

Here is a link to the Keurig coffee maker.

38. Meal Prep Containers

Yeah, yeah, yeah . . . not really NEEDED for nursing school, but trust me, you will run out of time as a nursing student and not having to think about lunch while still being able to eat healthy will go a long way.

Taking a few minutes at the beginning of the week to prep all your meals ahead of time will save an enormous amount of stress and time later on in the week when “stuff” hits the fan.

View on Amazon

39. N is for Nurse

Staying motivated and inspired is important when you JUST don’t want to keep going.  N is for Nurse by best selling nurse-author Jon Haws RN CCRN is a is a full-color ABC book for grown-up nurses, with a powerful message about what is means to “be a nurse”. N is for Nurse looks and feels like a classic picture book. But it’s not for kids, it’s for nurses and nursing students who are proud of being RN.

View Book

What are your MUST HAVEs?  Share below. . .

What nursing school supplies do you think are essential? This obviously isn’t a complete list of all the gear and equipment you will need as a nursing student but this will get you started. . . and keep you ahead of the curve. Let us know below in the comments.

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The post 39 Things Every Nursing Student Needs before Starting School [the ultimate list of “must-have” nursing school supplies] appeared first on NRSNG.

Mar 13 2015



Rank #6: Just 5 Minutes for an Accurate Head to Toe Nursing Assessment

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Nursing assessments are a vital part of learning how to be a great nurse. It’s a skill that can be very difficult to learn because as you learn all these different assessments you realize that as you start to put them all together an assessment could take 40 or more minutes!

There’s no time in a real nurse situation to do a 40 minute assessment. You may have 4 – 5 patients and you certainly won’t have the time for long assessments of each.

Know what sort of issues your patient has so that you know what areas to focus in on and save you time. You CAN do a full assessment in just 5 minutes.

This will allow you to not miss a thing in your nursing assessment but while staying speedy in the way you complete it.

The post Just 5 Minutes for an Accurate Head to Toe Nursing Assessment appeared first on NRSNG.

May 09 2019



Rank #7: 4 Steps to Master Critical Thinking in Nursing School

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What is critical thinking?

Chances are you’ve heard about critical thinking over and over from your nursing instructors, read about it in text books and seen it on tests.

Has anyone actually shown you how to use critical thinking in a nursing setting? I break it down in 4 simple steps how you can master critical thinking.

This will not only serve you well in nursing school but also in your career as a nurse. We can all fall into ruts of assuming things prior to taking in all the available information even as practicing nurses.

If you apply these 4 steps to master critical thinking without prior judgement it will make you a better nurse and keep your patients safe.

The post 4 Steps to Master Critical Thinking in Nursing School appeared first on NRSNG.

Jul 03 2019



Rank #8: Ep216: Critical Thinking in the ED (real life examples from the emergency room)

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Positive troponins

    1. (NRSNG=0.035… check your institutions ranges)
    2. What is a troponin?
      1. Troponins are proteins that initiate contraction of muscle fibers. Troponin I is specific to heart muscle.
    3. Get an EKG
    4. Do we need a third?
      1. Use your judgement.
    5. Is there a cardiac history?
    6. Has the focus of the plan of care changed?
      1. A couple hours in the patient realizes that they forgot to tell you they did a heavy upper arm workout or they have had a cough for a week and it hurts after they cough…
      2. People get things in their mind and think that might be what is pertinent to tell you “I have chest pain, that means heart” but YOUR job is to look at the other factors, ask the questions that could seem not related from the patients understanding of the situation.
    7. First EKG is neg why get a second?
      1. Comparison, has there been a change since the trops were drawn
      2. How long has it been since that lab value was drawn?
    8. Make sure the 2 hour troponin is ON TIME.
    9. Because trops aren’t always released right away
    10. Can be up to 3 hours before release.
    11. Can stay elevated for up to a week before returning to normal
    12. EBR: out of the weeds after 3 negative trops.
    13. Some institutions draw them in 3 hour intervals, Best practice based on evidence is 2 hour intervals.
      1. Why are we drawing serial trops?
    14. What if they have 2 neg trops and the chest pain resolves?

Shortness of breath:

    1. Thinking beyond the lungs- OR- thinking about what deficient lung function does within the body!
    2. Get an EKG- WHY think about the heart?
      1. Hypoxemia causing stress on the heart
      2. But what if their pulse ox is wnl?
      1. Helps to eliminate the heart which is in the same area
      2. Think about connections: if breathing is an issue how does this affect the heart? Breath fast or hold your breath and then check your heart rate.
        1. Brady or tachy
        1. Think about what the pulse oximeter is reading:
          1. How many RBCs have oxygen attached to them?
          2. IE their hemoglobin
        2. But what else attaches to an RBC that can take place of oxygen? :::::CO
        3. 93% Oxygen is good if it is all oxygen.
        4. 83% is not.
          1. Carbon monoxide molecules, even in a small amount, can attach to the patient’s hemoglobin replacing oxygen molecules. A pulse oximeter cannot distinguish the differences and the reading will show the total saturation level of oxygen and carbon monoxide. If 20% of hemoglobin has carbon monoxide and 73% has oxygen, the reading would be 93%.
          2. This can be dangerous. A pulse oximeter should not be used on people with smoke inhalation, carbon monoxide poisoning, and heavy cigarette smoking.
    3. Causes of SOB: Don’t just think lungs. Go beyond the lungs too.
    4. Heart disease or heart attack (in this case, shortness of breath may be accompanied by swelling of the feet/ankles).
    5. Lung disease.
    6. Emphysema.
    7. Pneumonia (breathlessness often accompanied by high fever, cough and mucus).
    8. Asthma or allergies.
    9. Anemia (other symptoms characterized by fatigue and pale skin color).
    10. Panic attacks.
    11. Airway obstructions, exposure to cigarette smoke or extreme exposure to dust or fumes.
    12. Obesity or lack of exercise.
    13. High altitudes.
    14. Blood flow disruption in getting oxygen to the brain.
    15. Intense emotional anxiety or stress.
    16. Some chest pain can feel like pressure, causing breathing issues

MVA with back pain

  1. Check a urine
    1. To make sure that the kidneys weren’t injured and have blood in the urine
  2. It could be related to the MVA it could be coincidence, perhaps a UTI or kidney stone that started to be pesky and pain full OH and the patient got into a car accident…
  3. Immobilizing spine, we are concerned about bones, but don’t stop there, if we are concerned about the spine, think spinal cord, think neuro.

Don’t get caught focusing on just the story, make the connections, that is the idea behind critical thinking.

Abnormal vital sign

  1. Look at patient first
  2. Check equipment
  3. Do manual checks

The post Ep216: Critical Thinking in the ED (real life examples from the emergency room) appeared first on NRSNG.

Oct 24 2016



Rank #9: Ep14: 5 Nursing School Study Tips to Ace Your Way Through

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Nursing school is a beast all its own. Learning how to study so that you can ace your classes can be a challenge.  In this episode I offer 5 study tips that I used to graduate with a 3.8 and secure Summa Cum Laude honors.

The 5 tips I discuss are:

  • Find someone smarter than you
  • Create chapter outlines
  • Create questions for yourself
  • Meet your nursing school instructors
  • Take as many practice tests as you can

Yes, nursing school is hard, but once you figure out the system and learn how to play the game you can make the entire journey much easier and insure that you pass the NCLEX® with ease.

The post Ep14: 5 Nursing School Study Tips to Ace Your Way Through appeared first on NRSNG.

Nov 12 2014



Rank #10: The S.O.C.K. Method for Mastering Nursing Pharmacology (our 4 step method)

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Mastering Pharmacology is one of the most complicated, overlooked, yet ESSENTIAL components of being a well-rounded, safe nurse.

One of our primary foci at NRSNG is teaching Pharmacology.  While many nursing programs around the country are cutting Nursing Pharmacology from their curriculum or integrating it with other courses . . . we are doubling down on our focus on Pharmacology.

In fact, within NRSNG Academy we have several courses on pharmacology.

In this post, we are going to cover a method (system) for learning Pharmacology.  After reading this post, I am confident that if you follow this system, you will become a master of Nursing Pharmacology.  So sit back, grab a note pad and let’s dive in.

**FOR EDUCATORS: feel free to use the resources in this post.  If your nursing program would like assistance in implementing our MedMaster Course into your curriculum please reach out to us via email.

One of the most common questions we get from the NRNSG Family is:

How should I study Pharmacology?  How can I learn all of this!?

You know . . . most of the time, it feels like learning pharmacology is learning a new language.

At NRSNG, we’ve already developed many pharmacology resources (listed below), the purpose of this article is to empower you with a framework for teaching and learning pharmacology.  Educators are encouraged to implement this method into the classroom setting.

NRSNG Pharmacology Resources:

Learn More About NRSNG Academy

The S.O.C.K. Method for Mastering Nursing Pharmacology

When I was 19 I took a job in Los Angeles working with immigrants from Latin America.  The majority of our clients spoke no English, and my Spanish was limited to the Taco Bell menu.

This was very frustrating because I wanted to help our clients so bad, but all I could do for the first 3-6 months was smile and nod . . . in reality I had no idea what was being said.  I became intensely focused on learning Spanish. I wanted to speak as comfortably as I could speak in English.

Doing this required that I did something more than I was doing. . . . I had to engage in META LEARNING.  Meta learning is defined as “being aware of and taking control of one’s own learning“.

Once I became engaged to this level, my learning exploded and people kept asking where I was from because I looked as “Gringo” as they come, but my accent was spot on.

Let’s apply this to learning Nursing Pharmacology.  When you are a brand new nurse or a nurse with limited knowledge of medications, how helpful can you be to your patients?

  • My concern is that limited medication knowledge is less helpful and more dangerous than anything else.
  • Medication administration is one of the paramount tasks of the nurse.
  • In an ICU or MedSurg setting, your patient might be taking 50+ medications.
  • It’s vitally important that you understand those medications, how they interact, why they are being given, and how they should be given.
  • Without that knowledge, you are like 19 year old Jon, just smiling and nodding while people talk to you.

So, rather than give you a “fix” or a couple tips for learning every medication or telling you to not worry because it is a hard task, I’m going to give you a 4 (actually 6) step process for learning Pharmacology that I like to call the SOCK Method for Mastering Nursing Pharmacology.

  • For aesthetic reasons, I’ve called it the SOCK Method, but in reality it should be called the O.K.C.S. Method as that is the proper order of the steps.
  • The order doesn’t matter as much as knowing the framework as it will guide all future learning.  In other words, this isn’t as much a checklist of steps for learning as it is a framework for learning Pharmacology as a whole.

So here is what each letter means . . . we’ll dive in deeper below.

Download the SOCK Method

S: Side Effects

O: Organs

C: Classes/Considerations/Cards

K: Know (Must Know)

Let’s dive in a bit more and uncover what each letter actually means and how you can apply this method to master nursing pharmacology.

S: Side Effects

I am a bit of a “Side Effect Nazi” (ask anyone I’ve precepted!).  In my mind, if you don’t know the side effects of a medication you are giving, how do you know if the medication is working or if the patient is experiencing a severe side effect?

One key to learning side effects is to understand very well what the intention of the medication is in the first place . . . some of your side effects are going to be the opposite effect you were trying to achieve (a patient hypothyroidism might experience a “thyroid storm” while receiving thyroid replacement therapy.

As you are learning medications you should:

  • Focus on side effects that are life threatening
  • Focus on side effects of major organs
  • Focus on side effects that are the opposite of intended therapy

It is possible to get stuck trying to remember 4,348 side effects of Tylenol . . . however, that is not a realistic goal!  Instead focus on the handful of KEY side effects.

In our book “140 Must Know Meds” and in the MedMaster Course, we sifted through the myriad side effects to provide you with a boiled down version that you should remember.

On the clinical floor, I will not let new nurses pass medications if they are not aware of the top/most concerning side effects they should be watching out for.

The best way to think about this is to once again go back to the ABCs.  Those pesky ABCs will come back to haunt you often in your nursing career . . . you must always think of them first.

O: Organs

When learning pharm, it’s important to have a macro understanding of the body, the organs, and how they interact with each other.  This knowledge should come from A&P and MedSurg.  Ideally, a nursing student wouldn’t take Pharm until they have taken and understand Anatomy and Physiology well.

As you study medications, you should also focus on the major organs when it comes to side effects and considerations.  This all goes back to the ABCs that we learn from day one of nursing school.  For example, giving a CNS depressant for pain is fine, but you MUST understand how that will impact the heart and respiratory drive . . . cause we kinda need those to live.  Other side effects, while important, take a back seat to the ABCs.

In general, I recommend learning medications, side effects, and considerations following this order of organs:

  • Cardiac
  • Respiratory
  • Neuro
  • Renal
  • GI/GU
  • Integumentary
  • Musculoskeletal

This keeps you focused on the ABCs.  If you forget that steroids cause “soggy bones” (osteoporosis) that is far less detrimental to your patient than forgetting it will raise blood sugars or depress the immune system.

You should also have a deep basic understanding of what each system will do and why meds would be given to that system.

C: Classes/Considerations/Cards


In Pharmacology we classify HOW a medication works, either how it WORKS or how it HELPS.  These are the pharmacologic and therapeutic classes respectively.

  • Pharmacologic Class: how the medication WORKS
  • Therapeutic Class: how the medication HELPS

For example:

  • Cimetidine (Tagamet)
    • Pharmacological Class: Histamine H2 Antagonist
    • Therapeutic Class: Antiulcer

I recommend learning Pharmacological Classes when learning pharm for a few reasons.

  • This goes hand in hand with learning A&P and focusing on the organs.  If you understand the A&P and then focus on the Pharmacological Class, everything starts coming together.
  • As you understand how the body works and how the medications work within the body to alter physiology things start to click much faster.
  • Most importantly, generic medication names are based on Pharmacological Classes.  If you know that H2 antagoists end in -idine, as soon as you see an -idine medication on a test, MAR, or elsewhere, you know exactly what it does . . . on the other hand not all antiulcer (therapeutic class) meds end in -idine.


When learning a new medication, it is important to look at and remember the nursing considerations . . . these include:

  • Administration concerns
  • Patient education
  • Vital information

Some things that might be included in here are: how slow to administer Zofran, how fast to administer Adenosine, pregnancy categories, telling a patient not to eat grapefruit . . . you get it.

Again, you are looking for considerations that could be detrimental to the patient, will allow them to self administer, or interfere with intended results.

As the nurse, you are the one RIGHT there with the patient administering or teaching the patient how to administer the medication.

A prescription or order does not mean you MUST give the medication.  Be a clinician!!!!!!!

By this I mean you MUST use nursing judgement.  You are the eyes and ears of the medical team . . . you are the one at the bedside!  The physician and pharmacist are NOT AT THE BEDSIDE.

You must know your considerations and know the current state of the patients condition and make a sound clinical decision. BE A CLINICIAN!!!! #beaclinician

Don’t be a blind monkey just carrying out orders.  Knowing the considerations and assessing are paramount to this.


Repetition is king when it comes to learning new information.  Learning nursing pharmacology is no exception.  If you were to ask me, “what is the one thing I can do to learn nursing pharmacology?” . . . my two word answer would be “DRUG CARDS” . . . make them, throw them away, and make them again . . . REPEAT.

Working through the SOCK Method, you’ve identified:

  • The drugs you need to know
  • The things you need to know about those drugs

Now it’s time to start reviewing those medications over and over and over (you get the point).

Many students ask me to create drug cards for them, I’m not gonna do that!!  Creating your own drug cards is the best way to learn this stuff.

Here’s the problem though, most “drug card templates” are a goddamn mess.  Seriously, they are so unorganized that it’s no wonder students struggle with retaining the information.

So here is what I HAVE done for you . . .

I’ve created a drug card template that is developed with the S.O.C.K Method in mind:

Download the Drug Card Template

Here’s what you need to do . . . 

  • Armed with your list of Must Know Drugs, start working through this template for EACH and EVERY drug on your list.
  • Print out as many copies as you need.
  • Create a binder with as many templates as you have drugs on your list.
  • Organize them by generic name.
  • Once you’ve created a drug card for each drug, start redoing cards for the ones you are using most often.

I know what you’re thinking.

“Jon, you’re insane! I already don’t have enough time to study let alone create 6,435,689 drug cards!”

Spending time studying what REALLY matters saves you time in the end.  Your knowledge of the important information grows and you become a more focused nurse.

K: Know (Must Know)

Early on in my career as a nursing student I began to notice some patterns.  Some meds are given and tested on far more than others.  Why is that?  Is it that we just don’t give a damn about patients who take abaloparatide injections?

Of course not!

When it comes down to it, some medications are far more common, taken by more patients, in more situations, and therefore more “important” to know and be aware of.  The FDA had approved 1,453 drugs as of 2014, if it were possible to know each of those drugs intimately, you would be the most amazing pharmacist in the world.

This just isn’t possible.

So here is what we have done here at NRSNG:

  • Outlined the most commonly tested medications.
  • Cross-referenced that with the most commonly prescribed medications.

Once you get a job in a specialty area, you should add this to the list:

  • Add the most common/unique medications prescribed on your unit. 

You should begin making the same lists.  When you are on the clinical floor, keep a note of all the medications you are giving.  As you begin to notice, week after week, that you keep giving Heparin, Insulin, Protonix and others . . . make note of those.  These are the medications (and pharmacological classes) that you need to know well.

This method is known as the 80/20 principal.  You will give 20% of the medications 80% of the time.  And of those 20% that you give, you will administer just 20% of those 80% of the time . . . you see how it works.  It’s about focusing your priorities on those things that are most important.

While you COULD try to learn every medication . . . it’s just not possible.  Focus your attention on learning those that you must know as deeply as possible.

To make this a bit easier, we’ve already done the leg work on a piecing together the most common and must know medications.  However, as stated above, this will vary by unit, by hospital, and by physician so you should also compile your own list.

Download the complete list of the 50 most commonly prescribed medications for free here:

Grab the Free Cheatsheet

We’ve also compiled a list of the 140 must know meds into a book format that also spells out some of the critical, must know information.  You can view that book here: 

View 140 Must Know Meds

The Correct Order:

Okay, now that we are clear on what each letter in our SOCK acronym means, I want to cover the correct order for actually working through this method so that you can become a master of nursing pharm.

  • O: Organs
  • K: Know (Must Know)
  • C: Classes/Considerations/Cards
  • S: Side Effects

To get the most from this system you should actually start with ORGANS and a solid top level understanding of A&P and ABCs.  This will help to keep you focused as you move through the system.

You should then use that base knowledge to help you uncover the MUST KNOW meds using the method outlined above.

From there, you should move onto CLASSES . . . it is so important that you become comfortable with Pharmacological Classes, how they are named, and how they work in the body.  If you take the time at this stage to do this . . . you will be light years ahead of your peers.

CONSIDERATIONS comes next.  Become a master of nursing considerations for the drugs you give most often.

You are ready to make DRUG CARDS.  Use the template offered above and take a focused study session to create a nice pharm binder that includes a drug card for each of you must know medications.

Phew . . . you’re finally ready to dive deep into the SIDE EFFECTS this is the last step in the SOCK Method for learning Nursing Pharmacology and must not be ignored.  When you are learning side effects it is important to focus on the method outlined above.  If you do this you will be a safe nurse who has a deep knowledge of pharm.


More and more we are seeing nursing programs integrating Pharmacology into much larger courses or cut pharmacology all together.  This is a very sad and concerning trend.  In order to function as a true member of the health care team, nurses must be equipped to make clinical decision.  Much of our time as nurses is spent providing medications.  We must understand what it is that we are actually doing.

We have developed the SOCK Method for learning pharmacology to help provide a framework that nurses and nursing students can use in learning pharm . . . ok now dive in!

The post The S.O.C.K. Method for Mastering Nursing Pharmacology (our 4 step method) appeared first on NRSNG.

Nov 16 2017



Rank #11: Your Journey Through Nursing with Nurse Mo

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We all have unique journeys into nursing.  Today I am excited to introduce you to Nurse Mo of as she shares her journey and experiences in the field of nursing.

The post Your Journey Through Nursing with Nurse Mo appeared first on NRSNG.

Feb 12 2018



Rank #12: So You Want to Be a Nurse? (How Hard is Nursing School . . . Really) [plus free download]

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Are you cut out to be a nurse?  Wondering how hard is nursing school? What are the nursing school prerequisites and do they matter?

If you are asking yourself these questions, we can help!  NRSNG is a team of nurses that have been there and know the pain.

How Hard is Nursing School . . . REALLY?

Being a nursing major is a little different than other majors.  Now, I’m not saying the other majors are a walk in the park but.. nursing school is more like having a baby.  Nine months of nausea, vomiting, and sleepless nights culminate into one stressful event and then in end you wonder why the hell you did it in the first place.

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Many college courses consist of exams and papers and maybe a lab or two is thrown into the mix.  Nursing school consists of many different deadlines and exams to keep straight for each course.  Managing your time is essential to being successful in nursing school.  You must be very purposeful with your time – including your time off.  

Things nursing students have to juggle include:

  • Math exams
  • Med quizzes
  • Large and small exams
  • Clinicals
  • Clinical paperwork
  • Care plans
  • Simulation labs
  • Skills check off
  • Certifications
  • Very large reading assignments
  • Learning how to take nursing school exams (the dreaded select all that apply questions and multiple choice questions with all right answers but you have to select the most correct answer)
  • Pharmacology
  • Learning about nursing research and understanding evidence based practice
  • Learning how to write in APA format
  • Learning medical terminology all while trying to understand the flow and culture of various health care facilities

To help with this confusing process, we actually made a webinar that discusses the process of applying to nursing school.  Sign up for it below.

Watch the Free Webinar

As you can see, there’s a lot to try to keep straight.  This is easier for some than others.  Some people are going into nursing as a second career and have many other life commitments in addition to the aforementioned items.  

Others are solely focused on school.  Others have some life commitments but are able to focus mainly on nursing.  Dealing with all of the demands of nursing school will look different for everyone.  

RELATED ARTICLE: Dear Loved Ones of Nursing Students: What it Feels Like Going Through Nursing School

NRSNG Resources for all Learning Styles

To fill the gap in learning styles we have created free resources that address nearly every learning style.  While nursing school may still be hard, we are on the mission to make it easier to learn by creating resources that match your needs:

Here are a few of our resources (click to learn more):

Nursing School FAQs

Here is a list of some of the most common questions we get about nursing school.  Just click the drop down arrow next to any question you might have!

How to choose which nursing school

Which nursing school you attend is a personal choice for everyone. There are things to consider that will direct your decision. 

Some examples of things to consider:

Money. Not all nursing schools cost the same. You need to look at trending tuition increases and credits per hour.

LPN vs RN and ADN vs BSN: This is a personal preference. Sometimes people choose one over the other for money purposes. Taking the LPN to RN route can cost you less up front but more over time, same with ADN to BSN route. It just depends on what you can do now.

Accreditation: Is this school accredited. A school can lose their accreditation too so you want to know if a school has ever lost their accreditation. 

One of the biggest things to consider however is NCLEX pass rates! Each school tracks this information and they have a pass rate. This is very important. I wouldn’t even consider a nursing school with low pass rates.

There is actually quite a bit of things to consider, check out this post for more detail:

Which nursing school is right for me

See if this post helps:

Which stethoscope for nursing school

Nursing students do not need to have the best of the best stethoscope. However, this could be looked at as an investment. A stethoscope is something you will likely use for the rest of your nursing career, so if you can afford it, get a better stethoscope.

Check out more on types of stethoscopes at The Nerdy Nurse:

Which semester of nursing school is the hardest

The first semester by far is that hardest. This is because you are learning all the nuances of nursing school and how to study as well as take nursing style tests.

It is different than any other type of schooling you have done so far. Each semester is going to give new challenges but the first semester is the most shocking to endure.

The sheer amount of reading alone is overwhelming every semester, but like any good nursing student, the first semester you don’t know what is important and what is not, so you attempt to read everything, and either you end up successful but can’t remember everything or you are unsuccessful and only know some of it.

Who accredits nursing school

The Accreditation Commission for Education in Nursing (ACEN) will review multiple factors to determine if a school should be accredited. Check out their mission, purpose and goals page here:

Also, check out any school to find out if they are accredited here:

Why is nursing school stressful

Here’s the thing about nursing school, it is unnecessarily stressful. Having that said, the stress comes from a few things:

  1. Too much information. You are given thousands of pages to read for assignment before you are to come into lecture. Then they test you on about 10-20% of what you hopefully were able to read plus the lecture.  Everyday assignments are basically to find the needle in the haystack.
  2. This is hands on learning in addition to lecture learning. Clinicals are a major part of nursing school. It can be stressful to be assigned a patient where you need to make sure you accomplish your assignment to-do list all while balancing a pleasing act between your clinical instructor and the nurse who actually has the patient. There was often disagreement between the two in my experience.
  3. Nurses eat their young. It is catty and unnecessary but very much so a part of nursing school culture.
  4. OPINIONS. The reality is that many of the ways that nursing is practiced is a preference. I’m not saying all things, but I am saying that many, many, many of the things are. Instructors/professors believe staunchly that their opinion is the only way. You could take an exam question to all of your professors and ask them to answer it, chances are you will get multiple answers with different rationales as to why they are choosing that answer for the same question… Now you have to take an exam and think “What would this professor do or think about this?”…See the dilemma? It’s real, and it’s real stressful.

Those are just a few reasons, but millions of nursing students don’t think this way for a few reasons, check out our post that elaborates on how hard nursing school is and the stressors that can get in the way: .

Why is nursing school so difficult

Nursing school is HARD. You are about to be responsible for people’s lives, you better be prepared! However, it can be too hard for no reason at all. It is almost a strange school of thought where you have to work hard for answers and in the end, you learn the answer the same way you would have if you didn’t have to sludge through piles of mud to get it.

I want to be very clear here: I am not advocating that we do everything the easy way, I am advocating for a reason to do it the hard way. For example: Little Suzy asks, “ What is the name of the wrap you put on a patient’s broken arm that isn’t a cast yet?” and the teacher tells you to “look it up.” (eye roll hardddddd) Really? Yes I have been told this with a rationale that I would be able to find things quicker and more efficiently on my own if I practice looking it up… OR we could try an alternative ending: The teacher replies, “Oh, yes, in chapter 20 we discussed splints that we place on extremities with broken bones to allow for swelling before placing a cast. Anyone have an idea what we would be worried about if a cast were placed first and major swelling occurred?” Boom. Answer plus a resource to look up the answer if you would like as well as an exercise in critical thinking.

Another reason nursing school is hard is because you are being molded and shaped for taking one big, huge test that is very hard itself… And it is a test written by the people cut from the same cloth as your professors.

Check out more information on the teams thoughts on how hard nursing school is: .

Why is nursing school so expensive

Because you need to have equipment to practice nursing such as a stethoscope and you need to have books written by people who would also like to get paid for their time writing the millions billions of pages in their books. You should belong to the student nurses association and have to pay for a prep course, because the schooling itself wasn’t satisfactory enough to boost the school’s pass rates.

It is expensive because it takes a lot of your time. In my opinion time is money, so taking a lot of my time is costly to me.

And lastly it is expensive because of many of the surprise fees that they throw at you.. Like “Surprise! You will need the simulation package in order to participate in class tomorrow, it is only $40, please have purchased this and signed in as well as taken the 20 intro quizzes by tomorrow. Thank you.” You go home, it is indeed $40… if you are a member, non-member fee is $60, Oh and they didn’t tell you about it before signing up for nursing school, it was added last night and needs to be purchased by tomorrow or you get a zero for points in class… and trust me, you need every point because A’s are now a thing of the past. You are now a proud passing 75% student who will be at 73% (AKA not passing) without those class participation points.

You can try to avoid surprise expenses by checking out our ultimate list of things you must have for nursing school: .

Why is nursing school hard to get into

This is a loaded question, on one hand, it helps to weed out people who are less serious or not cut out for the academic aspect of nursing; on the other hand, it makes very little sense having people who are supposed to be strong suited in passion/caring AND intelligence to learn disease pathways and pharmacology be only judged on their ability to perform as an academic.

I don’t personally know what is the right way to go about the selection process. I just feel like the measurements didn’t really equate to good nursing abilities…

Anyway, the reality of having an academically strong nurse has proven to provide safer patient care with less negative outcomes (as evidenced by some of the following articles: Here and here). This means that having more education is correlated with nursing care and makes a difference. So I, for one, am thankful for having nursing school be tough to get into.

If you are reading this because you did not get into nursing school, check out our post here: .

Why is nursing school so competitive

Nursing school is not only hard to complete, but it is also hard to get into. With the level of difficulty to get into nursing school, this allows for nursing schools to pick from the top applicants. You need to both be great academically AND be unique enough to draw attention to your application.

Once you are in nursing school, the bar is set higher. Some classes are curved so even if you did well, you have to do better than enough people to pass. This isn’t always the case.

The other thing that you have to keep in mind is that people who have worked their tail off to get into nursing school are likely high performing, competitive, type A personalities anyway so to cluster a bunch of these people together makes for a very competitive environment.

This can be hard, especially if you are not a competitive person. And even if you are a competitive person, burning the candle at both ends is hard on anyone so if you are getting frazzled, read our post on making it through: .

Why nursing school is worth it

Pride, a sense of accomplishment, the ability to make a difference, you touch people’s lives on a whole new level… I could go on. Really. I LOVE what I do for a living.

Let’s be real with each other, you can make a solid income with benefits and vacation days and it is something you can count on. I lived in a touristy area where I was given 4-5 months out of the year to make enough income to last me the rest of the year. I also love being able to not live paycheck to paycheck. You will not get rich being a nurse, but you will be able to support yourself and to me, that is all I need..

How long does nursing school take

Depends on the program you are doing, the time frame you have selected and what type of obstacles present along the way. Most people don’t realize that you need to do prerequisites before you even get into nursing school. So that 3 year nursing program just became 5 years when you count the 2 years of prerequisites you need to take. This all depends on the path you choose. Deciding which path to take can be difficult. Check out our post on how to choose the right path for you to get a more specific answer on how long it will take you to complete nursing school: .

How do nursing school clinicals work

This is school dependant. But mostly, it is scheduled just like a course in your school classes with the location TBA. They usually aren’t able to provide a placement until the first week of school.

Once you have received your placement you go will meet with your clinical instructor and other classmates in that clinical (usually 6-8 total classmates). The instructor will go over the type of floor and patients you will be having, the syllabus, and get any special paperwork filled out that the hospital is requesting or badges that they need you to have. Check out this post on things you must bring to clinical:

Each day you go to clinical, you will be assigned a patient load, usually starting with one and moving to two later on in nursing school. As you learn things in your skills labs you are given more to do with the patients. It usually starts as bed baths and vital signs, progressing to passing medications and inserting foley’s. The level of paperwork progresses too… which brings me to care plans.

The ever dreaded care plans. You will write many of these. More than you care to ever write. You will hate them more than burning the roof of your mouth on pizza cheese and painfully eating for the following 3 days. But guess what? We got you covered. Check out our post that is similar to us checking the temperature of your pizza before you tragically burn your mouth:

How nursing school changes you

It isn’t just nursing school that changes you, it’s being a nurse too. Seriously, the world is not the same afterwards. I will click on someones facebook article they have posted that is supposed to sway my opinion on something very intense and look at the author of the article before I read it. I want to know what qualifications they have, what resources they used, and if I would consider placing it in my APA paper…

Everyone is different. If you want me to be completely honest, I was fired up about the nonsense that nursing school brought. I looked at other nursing students with compassion and sympathy afterwards. I wanted to change nursing education to practice what they preach. If you preach compassion, teach it through example.

The largest component that I think changes is your ability to study. Nursing school is a completely different animal than any other school, I truly believe that the nature of surviving nursing school is something that gives you the ability to excel in other areas of study..

How to survive nursing school without a job

Making nursing school your number one priority is a great way to get through nursing school… However, I challenge you to consider working as a patient care tech or nurses aid because the stuff you learn in school is easier when you are experiencing it in real life. Having that said, I didn’t have a job for most of my nursing school experience and made it through just fine.

Loans are going to be a bit heavier and your budget will be a bit tighter (unless money isn’t a problem, if so, send some my way!). I had a girl in my cohort who did odd jobs to make money while in school. She did a lot of research projects, especially for people who are trying to get their PhD, they can have a budget to pay people to participate in their research. She also picked up jobs such as babysitting and walking dogs. There are plenty of ways to make a small amount to keep your head above water while you devote your life to nursing school.

You will still need to keep a schedule to accomplish everything and you will still need to have relaxation time. So don’t think because you are able to focus solely on school that you should just study all day.

Paying for nursing school without loans/How can I get nursing school paid for

This can be done!

You can work for a hospital with tuition reimbursement. Most hospitals require you to put in a year before they give you access to the reimbursement programs. You also may have to sign a contract that you will work for them for a period of time. Make sure you look into the rules of these reimbursement programs.

You can save money and pay for it that way. Duh. Sounds easy, right? I think this is the hardest option, because something ALWAYS comes up. You total your car, a tree falls on your house, you break your leg. Life happens all the time and saving money can be hard. Get a financial advisor who can look at your finances and make a plan for you. You may be able to invest some of the money in a government bond or if you are good at investing there are lots of options.  

You can stretch out the schooling over a period of time to make it less money up front. This can be painful because the end goal becomes really, really, far away. But it can be helpful because you are less stressed, say maybe you take 2 classes a semester rather than 5, you could work during the school year to pay for it as you go.

You can apply for scholarships (I personally found these hard to obtain, but it is possible!). The reality is that there are so many scholarships out there it is hard to NOT find one you are eligible for… But this can sometimes take a lot of dedication. You may need to write papers or participate in certain activities to obtain these scholarships. One of the girls in my cohort paid for most of her school this way so I know it can be done..

Nursing school without algebra

This is not a thing. Like you will use algebra in your nursing practice everyday. If you can’t do algebra then what makes you want to give a medication without making sure it is the right dosage? I double check my dosages on every.single.patient. Because this is the safest thing to do. I personally don’t like respiratory secretions but I have to deal with it, learn about it, and treat them every day. Get comfortable with math. Hire a tutor, make games out of it. Just don’t shut down and say you can’t do math. You can. Check out our posts of medication math to see how similar med math and algebra are: MedMath or our MedMaster Course.

Nursing school without a car

This can be difficult because you will likely need to travel to get to the clinicals. Carpooling is one option. Uber, Lyft, or Zipcar could also be an option. Depending on where you live, a bicycle could be an option.

Nursing school need to know

Nursing school is overwhelming. I’m not saying most people feel that way, I am say all people feel that way. So you can take the edge off a little by preparing for nursing school. Check out this post on prepping for nursing school:

But if you have already started nursing school and you are thinking that the information is too much, you will never know all of this and you need to know the absolute must know stuff… check out our academy, it is legit the no fluff, to the point information. I’m not biased or anything 😉 but I think it is the most efficient way to supplement your education and make sure you are getting what you need to know..

How to survive nursing school

Dory says it best when she sings, “Just keep swimming, just keep swimming.” Because this is what you need to do to survive. Plan ahead as much as you can and let some things go. By this I mean, you studied 8/10 topics for your exam and can either stay up all night trying to study the other 2 topics or you can sleep… The answer is to sleep and let the other 2 topics go. I do not mean to say to plan only to study 8/10 topics, I mean to say that if you only get 8/10 studied, respect your boundaries and give yourself some room to be human.

Check out this post to help you stay sane and get all 10 of those topics in:

How to study in nursing school

Plan your study times. Play to your strengths, for example if you are better learning in a group, get a group of people together for studying. Make the best of your time, for example carry flash cards to the DMV, load podcasts to play when driving, type your notes and use color coding to keep topics separate.

Reading for nursing school is a large undertaking. Sometimes the best thing to do for this is to read by heading and stop to summarize what you just read, and highlight as little as possible. If possible, create a typed outline of what you are reading and put bare bones information in it, then when you go to lecture you can add to it.

Here is our compilation of blog posts on study hacks: .

Nursing school entrance exams

Depending on the school that you are going to, you may have to take TEAS or you may have to take HESI. Find out which one is required for the school you are going to apply for. Each test has study guides out there. I highly recommend this as you are going to be tested on things that you forgot you knew and need to brush up on.

Many nursing schools require you to pass with a certain percentage and you may have to wait a certain time period to retake the test if you didn’t do so well plus that will be another expense.

ATI is the company that administers the TEAS test. Here is their website:

The HESI is another test, here is information about their test:

We’ve also created a large database of answers to some of your nursing school entrance exams HERE.

Nursing school requirements

This is variable and depends on the school, but there are a few things that are universal.

  1. Prerequisite courses
  2. Admission Criteria
  3. No felonies!
  4. Good grades
  5. Entrance exams such as TEAS or HESI.

Check what your school is requiring beforehand and see if you are able to meet these requirements.

We cover the things you need to do to get into nursing school in this post: .

Nursing school essay topics

The first thing I want to point out is you will always write better, more compelling essays if you write about things you know about. The second part of writing better essays is to be passionate about what you are writing about. Some topics include:

  1. Why I want to become a nurse
  2. A time I experienced being in a hospital and the impact nurses had
  3. A family member being cared for by nursing and how the nurse made a difference
  4. I come from a family of health care providers, here is my personal experience
  5. I love the human body
  6. How I decided to go to nursing school
  7. What nursing means to me
  8. Personal growth and development
  9. Career goals
  10. Educational goals

How to write a nursing school personal statement

Nursing school personal statements are similar to an entrance essay however, it needs to include more direct information in a shorter amount of words. It needs to include why you want to become a nurse, what has influenced you, what about you is unique, and your experience.

With any writing, create an outline first, fill in areas of the outline with stuff you want to say, work on the transitions of each area, then edit it down to the meat and bones. Also, a major resource for writing is Purdue OWL. I love this site and use it every time I write.

B or C student in nursing school

As long as you pass your classes, the grade you receive doesn’t matter. It doesn’t matter how many questions you get on the NCLEX either. Passing is passing and as Vin Diesel says, “It doesn’t matter if you win by and inch or a mile, winning is winning.”

Once you pass the NCLEX and have those two letters after your name, nothing else matters. The school you attended, the grades you received, the class you had to retake… Does not matter. It will not affect the type of job you can get, it will not change the positions you can apply for or work in. It legitimately does not matter.

Can a misdemeanor affect nursing school


The reason is that the state you live in may not register you as a nurse with a criminal charge, thus the nursing school would be doing you a great disservice if they let you spend your money on a degree that is useless.

The first thing to do it to read up on your state’s nurse practice act. Then check with the school you are applying to. And most importantly, stay out of trouble!

Can I get kicked out of nursing school for being pregnant

No. I actually started with a girl who got pregnant and she went to school right up till her delivery then took a year off starting back where she left off in school. It is possible, but it depends on your school and their rules as well as personal preference. Another girl I was in school with who was also pregnant, gave birth to her baby right after she took an exam and was back at clinical the following week.

Make sure that you plan ahead and talk to the school of nursing administration. They need to know your plans for giving birth and return to school as well as potential other situations such as the baby comes early or you are put on bed rest.

Being pregnant in nursing school is not ideal, but it is not the end of the world and it is possible to get through it..

Can nursing school cause depression

This is a deep question. First, I would like to take the time to say that depression is caused by changes in the brain chemistry and is usually not a result of one particular event. Depression is an illness and needs to be treated medically, both physically and mentally.

Events that happen in nursing school can lead to one feeling depressed. There is a lot of lateral violence, bullying, and a general feeling of inadequacy that occurs during nursing school. It is hard to not let it get you down. If you are prone to depression, you should keep your family and friends on the lookout and keep your counselor in the loop. If you do not have a counselor you need to get one. Mental health is super important and can cause you bigger issues, especially when you are trying to make it through nursing school.

If you don’t keep your mind healthy, you won’t have the capacity to run it ragged learning everything you need to for nursing school.

Can you get into nursing school with a c in Anatomy

It is a possibility, it just depends on the rules of the school you are attending and their admission process.

I do caution this though. If you have a hard time with anatomy and physiology, you will have a hard time with nursing school. They expect you to already know the anatomy and physiology so if you don’t you will struggle.

This doesn’t mean that you can’t do it. Maybe you get A&P, but the teacher was a nutty professor… I get it, there are lots of reasons why you could have a C, just be sure that you are ready for the topics in nursing where they don’t review the basics, they jump into the next leve.

Can you sue your nursing school

I’m sure you can sue anyone for anything. According to this pubmed statement, Nursing Students often win, which I found shocking.

Make sure you have a solid case and a good lawyer. NRSNG does not provide legal counseling, but does support change in nursing education.

Does it matter what nursing school I go to

No. It really doesn’t. In some professions it matters, but in nursing it does not matter when it comes to getting a job. Now it might matter when considering the quality of education you would like to receive. But the main thing to consider when choosing a nursing school is their pass rate for the NCLEX. If they have a poor pass rate, that doesn’t do you much good to have a degree in nursing without a license to practice it.

Check out this blog post on how to choose your nursing school: .

Does nursing school make you gain weight

It doesn’t have to. But many people do gain weight. I gained 45 pounds. I will repeat the because it sounds fabricated… I gained FORTY-FIVE pounds. Yup. Don’t do what I did.

It is important to focus on mental and physical health while in nursing school. You can take the time to walk on the treadmill while doing flashcards. You can study with a partner while lifting weights. You can listen to podcasts, lectures or a recorded reading of your textbook while taking a jog.

Pack healthy meals, meal prep, be conscious of your calorie intake. Get a friend to do this with.

Make it a priority because gaining weight is too easy and you will be fighting to lose the weight afterwards for a while (unless you are a dude in his early 20’s).

Why Be a Nurse?

There are many reasons you may want to become a nurse, whether you have a family member who is a nurse or you like the pay, it is safe to say that all walks of life congregate in the nursing field.

Not surprisingly, these questions will become a theme throughout your nursing school experience and career. Answers can vary and there really isn’t a “wrong” answer. The most common reason why someone wants to become a nurse usually results from an encounter with another nurse who has touched their lives. (link to a nurse is there)

But no matter if you like the medical field or you want to feel like you made a difference, the reason is only part of your decision. Considering the nursing school, the prerequisites, the lifestyle, etc. can become overwhelming. NRSNG is here to help break this down for you.

What is Your Path to Nursing?

Which path is for me?

You might think that after deciding that you want to become a nurse, it’s as easy as just picking a school.  However, there are quite a few different paths to actually becoming a nurse.   How hard is nursing school?  That will depend on many different things. There are different degrees you can obtain to get those two beautiful RN letters after your name.

Licensed Practical Nurse (LPN/LVN):  An LPN is not a registered nurse but is similar.  As an LPN, you provide more basic care to patients (bathing, vitals, administering meds, and so forth).  You can obtain this degree is as little as 12 months and must pass the NCLEX-PN exam to obtain your license.  LPN’s report to RN’s and physicians.  Many LPN’s work in the outpatient or nursing home setting as most hospitals do not routinely employ LPN’s to provide the majority of direct patient care.

Associates Degree in Nursing/Associates of Science in Nursing (ADN/ASN):  This is a 2-year degree in nursing, obtained at a community college.  After completing this vigorous course work, you must pass the NCLEX examination to practice.  After graduating with your ADN/ASN and passing the NCLEX, you are a registered nurse (RN).  If done full time, this takes approximately 2 full years.  This is the fastest and cheapest way to become an RN.

In October 2010, the Institute of Medicine released a report recommending that 80% of the profession of nursing be bachelor’s prepared.  Read the full report here.  Research shows that hospitals that employ more BSN-prepared nurses have better outcomes.  Read the studies that support that here.  Therefore, if you’re an ADN/ASN-prepared nurse, it’s going to be harder to get a job than if you were a BSN-prepared nurse as many hospitals and health care systems are trying to comply with these recommendations.

Bachelor’s of Science in Nursing (BSN):  This is a 4-year degree, obtained at a college or university.  You still take the same NCLEX board examination that the ADN/ASN graduate takes, but you would have BSN, RN after your name instead of ADN/ASN, RN.  The BSN degree will enable you to go on to graduate school immediately and be more marketable, as many hospitals are looking at hiring mostly BSN-prepared nurses.

RN to BSN bridge programs:  These programs are offered to people that have their ADN/ASN and want to obtain their BSN.  Some of these programs are offered completely online, some in class, some are both online and in class.  The length of these program can vary.  You can obtain your ADN/ASN, start working as an RN, then complete an RN to BSN program while working.  Some employers may offer tuition reimbursement, so if you plan appropriately, this can be the most cost effective avenue to obtaining a BSN.

Accelerated Bachelor’s of Science in Nursing (ABSN):  This is an option for someone who already has a bachelor’s degree in any field, you just need to have the appropriate nursing prerequisite courses. They are roughly 18 months long and incredibly intense. The only courses in this program are the nursing core courses.

Direct-Entry Master’s of Science in Nursing (MSN) or Accelerated MSN:  This degree is for someone who already has a bachelor’s degree in another field and upon completion of the program they will have both their RN licensure and their Master’s of Science in Nursing (MSN).  It is a long and rigorous course schedule and many programs require you to choose a specialty upon application, which can be difficult to do if you’re not sure which area of nursing you’d like to go into.

What is YOUR path?Download our free worksheet

What is the NCLEX?

The NCLEX is your nursing board exam.  It is a comprehensive computerized exam.  It’s anywhere from 75-265 questions and you have up to 6 hours to take the exam.  

You take the test and a few days later will find out if you passed or not.  Once you pass this exam, you are officially a registered nurse!  If you do not pass, you must wait 45 days before you can test again and test no more than 8 times a year (unless your specific state indicates otherwise).  

To sit for this exam, you must graduate from a nursing school, register with the appropriate state board of nursing (wherever you plan to practice as a nurse), and register for the exam. (Link to: keeping up your licensure article?)

Which school is for me?  Many factors come into play when trying to decide which nursing school is best for you.  These factors include cost, location, timing of schedule, degree, current educational level, first-time NCLEX pass rates, and accreditation.

What do you mean by first-time NCLEX pass rate?  

The NCLEX pass rate is the percent of program graduates that pass boards on the first try.  This is important to know!  You want to know what percent of each graduating class is passing boards the first time around because if their graduates pass boards on the first try, that means they were adequately prepared.  (ADD PASS RATES BLOG POST) You can find this information on the state board of nursing website (just Google ______ board of nursing to find their websites).  

For example, here’s a screenshot of the North Carolina Board of Nursing’s report of NCLEX pass rates for a handful of NC nursing schools.

What do you mean by accreditation?  Basically, your nursing school must be accredited by the appropriate accrediting body to say “Yes, this school provides education under a nationwide standard for nursing”.  

If you ever want to go to graduate school, you must graduate from an accredited nursing school.  Many employers will only hire nurses that have graduated from an accredited program.  

The two accrediting bodies for ADN/BSN programs in the United States are the Accreditation Commission for Education in Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE).

When choosing a program, it’s important to know if the school is accredited and when their accreditation expires.  (Will the accreditation expire / will they be going through the renewal process during your time there?)  You never know what the future may hold, so it’s a good idea to go to a school that already is accredited so you don’t have to worry about it in the future.

Nursing School Prerequisites

At NRSNG our goal is to develop an army of nurses that is capable and knowledgeable enough to care for the most complex patients in any setting.

There are a handful of nursing school prerequisites that nearly every nursing program in the country is going to require you to take.  These include:

  • Microbiology (1 semester with lab)
  • Anatomy(1 semester with lab)
  • Physiology (1 semester with lab)
  • Chemistry (1 or 2 semesters with lab)
  • Life Span Development (Developmental Psychology) (1 semester)
  • Statistics (1 semester)

Many schools will also require TEAS and HESI exams as a requirement to entrance.

While different schools will have minor differences in other prerequisites, these are the ones that are generally common across all programs and the ones that you should focus your energy on and insure that you perform well in.

Recently, a nursing professor told us that her program will not even consider students that have a C in any of the above classes.

Do Nursing Prerequisites Matter?

A common question we are often asked by pre nursing students is . . . “Why do I have to take all these classes . . . what do they have to do with nursing?”

Prior to becoming a nurse I asked myself the same question . . . “Why should I care about Chemistry to be a nurse?”

Let me give you two reason why you should focus on your nursing school prerequisites . . . and strive to learn all you can from them.

  1. Your acceptance into nursing school depends on it
  2. They are the foundation of everything you do as a nurse

First of all . . . you will have a hard time getting into ANY nursing school if you don’t do well in the above classes.

One of my pet peeves is hearing nurses tell pre nursing students that they don’t REALLY need to know anything from their prereq courses . . . or that they just need to pass them and forget them . . . or worse yet . . . C’s get degrees.

So let’s discuss WHY each of these classes is vital to your career as a nurse.

(I am going to list each course and discuss how it applies to nursing.)


Did you know that some antibiotics only work on gram negative bacteria?

Do you know what a gram negative bacteria is?

Did you know that the phospholipid bilayer of the cell plays a critical role in cellular structure?

Does the word “Kreb’s Cycle” make you Kreb your pants a little bit?  Just a little?

I will be the first to admit that I did NOT enjoy taking Microbiology as a prerequisite to nursing school . . . either time (yes, I had to take it twice after getting a D the first time).

However, understanding the cell, its structure, and its vital role in the body is central to understanding how the human body works.

Now that I have been a nurse for several years I honestly wish I could rewind the clock and take Micro one more time . . . in fact, I am currently reading a book on Cellular Biology . . . for FUN!

Please take this class seriously.  It will pay enormous dividends in the long run.

Anatomy and Physiology

Seriously . . . this is possibly one of the most important courses you will take during your nursing education.

Once you take A&P in your nursing prereqs you will never cover human anatomy again in as much depth.  Most nursing schools require pathophysiology and it’s hard to understand the abnormal human anatomy and physiology if you don’t understand normal human anatomy and physiology.

By the time you take MedSurg in nursing school you will be expected to know what an osteoclast is and why it matters to a patient with osteoporosis.

Understanding the functions of the liver well before you learn how to care for a cirrhosis patient or learn to interpret a BUN (yes BUN on a liver patient) will pay massive dividends in the long run.


Chem plays a key role in pharm and general physiology within the body.

Did you know that Acid Base Balance is driven largely by hydrogen?

If you understand the properties of hydrogen and how it functions with the body your ability to understand what is really happening with your patient multiplies exponentially.

This applies to general chem principles . . .in the end, the human body is just a heap of atoms.

Make Chemistry a major focus in your nursing school prerequisites.


This course can be an easy one to gloss over.

It seems irrelevant when you look at what a nurse does all day.

However, if a manager suggests that every nurse needs to start wearing polkadot scrubs because she saw an article about it . . . how would you respond?

This is a ridiculous example, but understanding Statistics helps you learn how to analytically look at data and draw APPROPRIATE conclusions.

Not only does this play a key role in looking at and analyzing nursing research but it helps you on the path to critical thinking . . . which is so important in nursing.

Are you able to draw relevant conclusions when looking at mounds of data?

What I want to point out to you is that nursing schools nationwide haven’t just tossed a bunch of difficult classes at the wall and said . . . “everybody take these”  . . .

The prerequisites required for nursing school are carefully selected and each one plays an important part in your knowledge base as a nurse.

Don’t brush these courses off . . . focus on gaining all the information you can from each one and draw the connections you can to real life nursing.

Nursing school is hard and these courses will help you in preparing for the gauntlet.

Set Yourself Apart

The truth is that you and EVERYONE else will be vying for an acceptance letter to nursing school. So what can you do to stand out?

Filling prerequisites is the basic part of getting into nursing school. People who go above and beyond not only stand out, but they also are more prepared for nursing school and transition better into working as a nurse.

Start with getting your Basic Life Support (BLS) certification. Anyone can get this and it is such a key part in getting to the next step.

So what is the next step?

Getting a medically based certification.

For example, you can get certified as a nurse assistant (CNA), patient care technician (PCT), or emergency medical technician (EMT). Many EMT’s end up getting their paramedic’s license as well, which is a great way to get more comfortable with autonomy.

Have you already applied for nursing school?

This is where you need to get involved and start to network. Start with the student nurses association (SNA) at your prospective school. E-mail the president of the SNA and ask for any opportunities to volunteer or participate in community service.

Introduce yourself to the people who make the acceptance decisions. Including…

  • The dean of nursing
  • The director of the school of nursing
  • The associate directors of the school of nursing

You can do this through social media such as LinkedIn, e-mailing them or by just going to their offices and saying, “Hi, my name is…”

Are you still in high school?

Take college courses (like the prerequisites listed above), or get AP credit through your high school. AP credits show that you are a motivated individual and can handle learning at a higher level, because let’s face it, nursing school is HARD.

Our Stories

Alrighty . . . so really, how hard is nursing school? Each of us at NRSNG had different things going on in our lives when we went through nursing school.


Nursing NEVER crossed my mind until I was 26 years old.  At the time I was debating between Medical School and Physician Assistant School when a buddy of mine (who was in Medical School) introduced me to CRNA.

After some research I was intrigued by the schedule and salary of CRNA.  After being accepted into an ADN program I decided not to pursue nursing after all and completed a degree in Business Management instead.

One week into my first job in the “business world” I discovered that I was NOT cut out for it.

I later applied and was accepted into a private Accelerated BSN program for people with a previous bachelor’s degree.

When the 18 month BSN program started my wife was 7 months pregnant, I was 29 years old, we had moved 1,300 miles away from family to attend, we knew no one in town, and I was sure I would fail out!

Nursing school was very hard and stressful at the time.  We had no money and I kept seeing the student loans climbing higher and higher.  

When I wasn’t home with our newborn child, I was at the school studying my butt off to reach my goal. Classes were crammed into short semesters, I kept seeing members of my classes dropping or failing out, and we had several professors who didn’t seem to care about teaching us.

By the time I finished school we were over $60,000 in debt and I had no job.  Yes, nursing school is hard and was a very stressful time, but I am glad I did it.


I had my associates degree in applied art and science from a community college which gave me the ability to skip most of the prerequisites. I still had to take microbiology, organic chemistry, A&P, and other classes but I could get general education out of the way.

I was married without children while going through nursing school and honestly, my husband was my rock for so much of what I needed. Most times, nursing school advice says that you will be non-existent to your family and even though that is true, I still had someone to pick me up, cheer me on, and push me to the finish line.

At first I was able to do school full time and not work during school. I am thankful that while I learned how to be a nursing student, I wasn’t working. However, I was strongly encouraged to get a job as a patient care technician (PCT) and I did in the pediatric emergency department at the local hospital. This made a difference for me. I learned more than the books or professors could ever teach me and things started to make more sense.

Despite not having children, a job, or financial concerns, I found nursing school hard. I struggled with concepts and I was constantly overwhelmed. What made me really mad is that it did not need to be this way. I felt like the nursing instructors made concepts confusing and tried to scare you. They would assign unbelievable amounts of reading and paperwork and then be smug if you got a question wrong that was hidden in the pile of information they gave you.


I was 19 when I started my pre-nursing courses.  I was in a relationship with my now-husband (John), but outside of college athletics, I didn’t have any other major life commitments.   I took the pre-nursing coursework at community college while I played basketball there at the same time.  I obtained my Associates in Applied Science and then transferred to a BSN program about 3.5 hours away from home.  I attempted to do my nursing coursework and play basketball at my BSN program at the same time.  That only lasted a semester.  I was totally overwhelmed with the constant work outs and traveling to games hours away with early clinicals the next morning.  I quit basketball to focus on nursing.  John and I broke up around that time as well.  I obtained my CNA license and got a part-time job at a local nursing home and worked for a semester doing both that and nursing school.  That ended up being just as stressful as playing basketball and nursing school, and I only did that for a semester.  The last two years of nursing school, I focused on my coursework and volunteered as a tutor for pre-nursing students and at the local middle school.  By the time I got around to my senior year nursing school commitments, John had proposed and we were planning a wedding and a marriage, maintaining our long-distance relationship, and trying to finish up nursing school and land a job.  I interviewed for jobs in April, graduated school in May, tested in June, got married in July, and started my first nursing job in August.  

It was quite the whirlwind.  

While I didn’t have kids, a mortgage, or a marriage to try to balance during school, I still had quite a few commitments/stressors going on in my life.  I was your traditional college-aged student in my nursing class.  About half of us were traditional students and the other half were not.  I felt like the professors, clinical instructors, and patients took the non-traditional students more seriously because they were older and experienced life a bit more than myself and some of my classmates.  I tried not to take on more than I could handle, but made some mistakes along the way.  Nursing school was very stressful itself and it was hard to learn the balance of what was manageable to take on in addition to school.  Looking back, I would have made some different decisions to try to alleviate as much life stress as possible during school because nursing school itself was very overwhelming without all of the other distractions.

Tips to Make Nursing School Less Hard

Is nursing school hard?  . . . yes . . . but is it worth it . . . hell yes.

The fact that the journey to RN is so hard should not deter you. In fact, it should motivate you to accomplish your goal.

At NRSNG, we are here to help you on the path.  

Here are 6 tips to help you succeed in nursing school.  We even created A WORKSHEET to help you.  To download the worksheet CLICK HERE.

    1. Self Confidence – on the first day of nursing school (or maybe before the program even starts) all the students that will be attending with you (your “COHORTS”) will gather in a room.  Nursing professors and possibly the Dean of the program will stand up and tell you horror stories about how hard the program is, how many people will fail out, and how you will have to give up your entire life.  While this may all be true I want you to do one thing for me . . . look around the room and realize that you were accepted into the program.  It is NOT an accident that you are sitting in that seat.  As humans we often times like to think poorly of ourselves . . . that somehow everyone else in the room is more prepared for nursing school.  Don’t do this!
    2. How Do You Learn – everybody learns differently?  Are you a visual or an auditory learner? Understanding HOW you learn is just as or possibly MORE important than studying material.   You can begin to focus your energy on studying via your optimal learning method.  To help you uncover how you learn take the VARK Questionnaire HERE.

Time Management

  1. – It’s never too early to start learning how to be a master of your time.  One of my pet peeves is hearing people say “I didn’t have time to get to it”.  You ALWAYS have enough time to do what is important to you.  Learning how to identify where you should be focusing your time will make your life as a nurse easy peezy lemon squeezy.  Here is what the process looks like for me. . . .  I have a notebook where I write out EVERYTHING that I want to get done . . . and I mean EVERYTHING no matter how big or small.  From there I go into Google Calendar and start to plug those tasks into actual time slots.  This insures that rather than just having a general list of things to do, that I have them plugged into a space where I know I will have the time to take care of the task.  Separating your tasks out into “NOW”, “SOON”, and “SOMEDAY” tasks will also help you to keep your priorities focused.  Also, understand that some assignments are just not as important as others . . . they just aren’t.  Anatomy and Physiology homework is more important that your assignment for your Underwater Basket Weaving course . . . one course will put you closer to becoming a nurse . . . and the other won’t!
  2. Chill Out – One of the biggest strengths to a strong nurse is learning when to freak out . . . and most situations don’t require a freak out.  Those nurses that learn how to put everything into perspective are able to calm an entire unit during a long and stressful 12 hour shift.  This applies to nursing school too . . . I like to tell nurses that although it doesn’t feel like it, nursing school does eventually end and you will become a nurse.  Learning how to take a step back and look at the bigger picture will take you a long way in nursing.
  3. One Point Isn’t Gonna Matter – There is something about nursing school that brings the grade grubber out of all of us.  It is a highly competitive environment full of superior students and it’s hard not to want that 1 extra point on a test or assignment.   It’s important to learn how to pick your battles.  In the end what matters the most in nursing school is that you learn how to care for the patient . . . not whether or not you agree with a professor’s rationale in every instance.  This may seem ridiculous right now, but trust me . . . when the time comes your are going to have to bite your tongue to avoid fighting with a professor over semantics.
  4. Turn Off – One of my favorite sayings is . . . . “A bow strung too tight will eventually break” . . . by this I mean that if you do not allow yourself to relax and take your mind off nursing school . . . you will eventually snap.  You need to find ways, friends, hobbies, etc . . . that allow you to completely forget about nursing at times.  I was NOT good at this while in nursing school.  In fact, I became so consumed by one professor that I eventually withdrew from my nursing program, you can read my story here.

Conclusion (plus free worksheet)

Our entire mission with is to provide you with the confidence and tools that you need to succeed in nursing school, on the NCLEX®, and in your life as a nurse.

Nursing school is hard . . . no doubt about it, but you can do it.  To help you on this path we have created a worksheet that will guide you on how to discover:

  • Your “why” for being a nurse
  • Your end goal in nursing
  • How to select the right school
  • How to use your strengths to study in nursing school

We want you to have this worksheet for free . . . to download the worksheet CLICK HERE.

The post So You Want to Be a Nurse? (How Hard is Nursing School . . . Really) [plus free download] appeared first on NRSNG.

Aug 01 2016



Rank #13: Spironolactone (Aldactone)

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The post Spironolactone (Aldactone) appeared first on NRSNG.

Sep 14 2015



Rank #14: EP5: Rapid EKG Interpretation | Identify Arrhythmias in 10 Seconds

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Finally, identify any EKG rhythm in 10 seconds of less.  This podcast covers a SIMPLE 5 step method for rapid EKG interpretation and outlines the steps to help you quickly spot arrhythmias with confidence.  There are many more factors involved in fully understanding EKGs but this simple 5 step method will help you know exactly where to start.  If you work through the 5 steps in order you will be able to look at any strip any quickly notice abnormalities. You can view a PDF chart with essential heart rhythms and their criteria here.

  • Rate
  • P Wave
  • QRS Complex
  • P:QRS
  • PR – Interval

To get a FREE EKG Chart click HERE.


With any strip you should start with the rate which can be determined (on a 6 second strip) by counting the P waves or the R waves and multiplying by 10.  You can also count the number of large boxes between R waves and divide 300 by that number.  For example, if you count 5 large boxes between each R wave than your rate would be approximately 60 bpm.  Identifying the rate is a good way to determine where the impulse is initiating and can quickly rule out sinus rhythm.

P Wave

The P wave is representative of atrial depolarization and the wave should have an upward direction, it should be visible, and smooth.  If you do not see P waves or they are misshapen you are not dealing with sinus rhythm.

QRS Complex

The QRS complex represents ventricular depolarization and should be present.  The complex should have a length of 0.06 – 0..12 seconds (1.5 – 3 small squares).  Anything out of this range is abnormal.


Every P wave should be followed directly by a QRS.  The ratio between P and QRS should be 1:1.  This represents the appropriate route of impulse travel.  Deviation or alteration from the impulse traveling from SA node through Purkenji fibers in the right direction may be identified with the P:QRS.

PR Interval

The PR interval represents the onset of atrial depolarization and the onset of ventricular depolarization and is a factor in determining how long the impulse is held in the AV node.  PR interval analysis is helpful in identifying AV heart blocks.  The PR interval should be between 0.12 – 0.20 seconds (3 – 5 small squares).

This is intended as a brief introdution into the basics of EKG interpretation and will help you identify arrythmias in 10 seconds of less.  For a FREE PDF EKG Chart Click HERE.


This is Jon. Welcome back again to another podcast episode with the Podcast. Today, we’re going to be talking about the five-step interpretation of EKGs and how you can quickly identify and analyze these rhythms to identify the rhythm that you are seeing on a monitor or on the EKG strip.

Now, we will be giving away a free EKG chart, PDF chart that will help you have a quick reference sheet to all the different rhythms that you need to know and the different criteria for each of these five steps.

If you want that chart, go to,, and you can get that chart for free.

All right. So let’s go ahead and start. First, to be able to quickly identify rhythms, you need to understand very briefly how electrical impulses travel through the heart. Every electrical impulse should start from the SA node, that’s the sinoatrial node which is located in the top of the right atrium. And that should initiate an impulse that will then travel down to the AV node, the atrioventricular node which sits in between the atrium and the ventricles. That’s going to hold the impulse for a minute before it then travels down the bundle of His and into the Purkinje fibers which will then depolarize the ventricles.

So starting at the SA node, go to AV node, travel down to bundle of His and the Purkinje fibers to depolarize the ventricles. OK? So that’s the normal mode of transportation.

Within the heart, we have three different pacemakers that will set the rate for the heart. The first one is the SA node as we talked about, the sinoatrial node. It sits in the right atrium. That’s going to initiate an impulse every – about 60 to 100 times per minute. That’s why our normal heart rate is going to be 60 to 100.

Next, if the SA node isn’t able to fire, the AV node can actually initiate impulses 40 to 60 times per minute. If that ultimately fails, then you have the Purkinje fibers that can also initiate their own impulse at 20 to 40 beats per minute. So that’s why it’s really important that we understand that normal heart rate as 60 to 100 and analyze anything that is below that. We want to know if the person is bradycardic for reasons other than just being athletic or in extreme resting state. If they are not initiating impulse in the SA node, we need to know where that impulse maybe coming from and further analyze that.

  1. So there are a couple of complexes and waves that we are going to identify on a rhythm strip. First, we have our P wave. We have our Q wave, R wave, S wave, and T wave. There are few more waves but these are the ones that we’re going to identify, so P, Q, R, S, and T.

Then we have our PR interval which goes from the beginning of the P wave to the beginning of the QRS complex. And then we also have our QRS complex. QRS complex makes up the QRS waves and that’s going to identify ventricular and depolarization.

So really, for our needs in identifying our rhythms quickly, we are going to look at our rate, our P wave, our QRS complex, our PR interval, and the P to QRS ratio. OK. So P wave is going to identify atrial depolarization. QRS complex represents ventricular depolarization. PR interval represents the onset of atrial depolarization to the onset of ventricular depolarization.

  1. Now, to have sort of five things again that we’re going to identify to interpret our rhythm is going to be our rate, is going to be our P waves, our P wave to QRS complex ratio, our QRS complexes and our PR interval.

Now, a normal rate is going to be 60 to 100 beats minute. And there’s a couple of ways to identify what your rate is if you’re looking at 6-second EKG strip then you can just take the amount of beats in those 6 seconds, multiply it by 10. If you don’t have a 6-second strip or you want to maybe get a little bit more accurate, then you can identify your R waves or your P waves, count how many large boxes are between those and divide 300 by that number.

So for example, if you identify your R waves and you know that there are six large boxes between those two R waves then your rate is going to 5 beats per minute. OK?

The next thing after rate that we’re going to look at is our P waves. We want to notice that there are P waves present and that they are upright and that they are smooth, that they aren’t jagged or sharp. So we want P waves to be present. We want them to be upright and we want them to be smooth.

Next, we’re going to notice if we have QRS complexes. We want to notice if our QRS complexes are present. And we want to count the number of small boxes between our Q and RS. We want there to be 1.5 to 3 small boxes between our QRS – our Q and RS wave. So we want present QRS complexes and we want 1.5 to 3 small boxes between the Q and the S.

Next, we want to notice the P to QRS ratio and we want there to be a P wave before every QRS and we want there to be one P wave for each QRS. So there needs to be a P wave for every QRS and the P wave needs to come before the QRS complex.

The last thing we’re going to identify in our five-step method is going to be our PR interval. Now, the PR interval starts at the beginning of the P wave, the beginning of the QRS, and we want there to be 3 to 5 small boxes.

  1. So you have to count the number of small boxes between those two and you want there to be 3 to 5 small boxes. OK? So first rate, then P waves then QRS then P to QRS ratio and then PR interval. So that’s how we’re going to identify our rhythms. OK?

So one more time, we’ll go through it. We want to identify our rate. We want our rate to be between 60 to 100 beats per minute. We want to then look at our P waves. We want there to be present P waves. We want them to be upright and we want them to be smooth.

Next, we’re going to look at our P to QRS. We’re going to look at – make sure that our QRS complexes that they are 1.5 to 3 small boxes, between the Q and S. And then we’re going to notice our P to QRS ratio. We want that to be a one to one ratio, for every P there is a QRS and the P comes before the QRS.

And then we’re going to look at our PR interval. We want that PR interval between beat to beat, about 3 to 5 small boxes. So as you go through these checklists, as you look at the rhythm, you can quickly start identifying what the rhythm is and you can start eliminating specific rhythms based on each of these criteria. So I mean first of all, if you look at your rhythm and your rate is 150, you can already eliminate sinus rhythm because it’s greater than 100.

If you’re on there and you look at your PR interval is greater than the five boxes, you’re going to start looking at some of your heart blocks. But that impulse is being held in the AV node too long. If you start seeing that the P waves are either absent or going downward rather than upward and smooth, you might start looking at junctional rhythms.

So to really understand this, I really recommend that you go and you just download that free chart. That will really help you look through the criteria for each of the different rhythms that you’re looking at and give you some kind of practice in identifying rhythms and working through these five criteria.

But if you look – work through these five criteria to be able to identify any rhythm and quickly be able to rule out specific arrhythmias and determine if it’s sinus rhythm or if it maybe more of a lethal rhythm or if it might just be a little nuance that you may not have seen if you hadn’t worked through these five steps.

So that’s going to be my suggestion. This was just a quick podcast on what you’re looking at. We didn’t really go into the different arrhythmias here …

The post EP5: Rapid EKG Interpretation | Identify Arrhythmias in 10 Seconds appeared first on NRSNG.

Oct 28 2014



Rank #15: Lions Don’t Give a ****

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One of my favorite quotes is:

Lions don’t concern themselves with the opinion of sheep.

We want you to be a LION.  Be humble, work your hardest, do everything that you can . . . and then . . . rest easy at night and don’t concern yourself with the opinion of sheep.

The post Lions Don’t Give a **** appeared first on NRSNG.

Dec 18 2017



Rank #16: Ep190: You Are Stronger Than Your Struggles (having a baby in nursing school, passing the NCLEX® in Canada, accelerated BSN, and brand new program)

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As nurses and nursing students, we only fail when we stop trying.

My guest today reached out via email about a month ago and shared her journey to RN.  Her name is JoAnn . . . well, JoAnn RN

In short, she was faced with many challenges . . . but never gave in.  Some of the struggles she faced:

  • Having a baby during nursing school
  • Taking the NCLEX® in Canada
  • Attending an accelerated program
  • Going to a new nursing program

"Be easy on yourself and don't stress out a lot when you're starting."

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Each of these struggles on their own is tough . . . but JoAnn dealt with all of them at once and is now an RN with a job on a Post-op floor.

In order to pass the NCLEX® on her first attempt in a province with a 66% pass rate, JoAnn used the following resources:

The post Ep190: You Are Stronger Than Your Struggles (having a baby in nursing school, passing the NCLEX® in Canada, accelerated BSN, and brand new program) appeared first on NRSNG.

Apr 17 2016



Rank #17: How I Made Over $70,000 My First Year as a Nurse (how I learned to game the system)

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One question I remember Googling all the time while I was in nursing school was: “what nurses make the most money? ” . . . or “how much do nurses make?”

I never went into nursing FOR the money, but, long story short, my salary doubled my first year as a new grad nurse.  I didn’t work in any special field . . . I just learned how to game the system to max my pay.

My Salary Used to Suck

My journey into nursing was a long one . . .

To spare you the lengthy (boring) details, I will simply say that I debated entering the field for nearly 5 years.  I was accepted twice into different schools only to back out at the last minute for various reasons.

Eventually I took a job as a buyer with a large sporting goods store.  It sounded like the PERFECT job for me.  After my first day on the job I came home and told my wife I had made the wrong decision. It was simply mind numbing, soul crushing work!  To top it off the job only paid about $38,000/year.  We were hoping to eventually have children and we knew that wasn’t enough money to support a growing family.

Back to Nursing School

I was lucky to gain admittance to an accelerated BSN program and in 2013 I finally completed my BSN.  Prior to entering school I spent a lot of time investigating salaries and pay in the DFW area (that’s where we lived).  If my calculations were right I figured I would make about about $10,000 – $15,000 more as a nurse and have a couple more days off a week to maybe mow yards or something to make ends meet.

RELATED ARTICLE: 4 No Fail Tips to Get a Spot in the ICU as a New Grad RN

My First Job

I was lucky out of school to get a job in a Level I Trauma ICU right out of school (how I did that is a discussion for another time). The starting pay for the job was $23/hour base salary.  Not a ton of money (about $41,000 base) so I knew I would have to find ways to make a bit more money.

Working the System

Most hospitals pay a premium for working nights and weekends.  Mine did . . . so I took advantage of this.  Here are how the differentials worked out at my hospital:

  • Base Pay: $23/hr
  • Nights: $4/hr
  • Weekends: $6/hr (Friday – Sunday)

So even as a new grad I was able to make up to $33/hour if I worked nights and weekends.  Well, that’s what I did.

During my entire first year I only worked nights.  This immediately brought my base pay up to $27/hr.  Since I am married and have two kids I don’t usually go out and do anything crazy on the weekends so working Friday and Saturday nights was not a huge sacrifice for me.  For the most part during the entire first year I worked 2 weekend nights a month.  Doing this brought my average pay for the 3 – 12 hour shifts to about $31/hour.

So, if you have done the math:

$31/hr * 36 hours/week * 50 work weeks/yr = $55,800

That’s obviously not more than $70,000 . . . how did I make the extra $15,000?

Like most hospitals, my hospital has a retention program for all nurses as well as a clinical ladder.  By simply staying at my job I continue to make more money.

Here’s how it works:

After six months I was given an additional $1/hr raise.

After 1 year I was given another $1/hr raise.

I worked hard to learn all that I could and to be a “good nurse”.  Doing this lead to preceptor opportunities.  Every time I was a preceptor I made an additional $1/hr.

Check out our FREE EKG Cheat Sheet Here

Overtime Pays Big $$$

It is not uncommon for you to hear nurses complain about overtime in movies and TV shows.  It is a VERY common issue within hospitals for them to have a hard time finding qualified nursing staff.  Once you have your foot in the door and simply do your job, show up on time, and basically know your crap, there is opportunity to work as many hours as you want.

My hospital is no exception to this . . .

With very little exception . . . not a week has passed that overtime or BONUS shifts has not been offered to the nursing staff.   Pay for extra shifts starts at $7/hr on top of ALL other differentials, and all hours worked over 40 are paid at time and a half.  If there were critical needs within the hospital the bonus pay would go up to $10/hr extra.

That means that during a bonus shift I could make as much as: $600 – $700 (about $50/hr)

For a brand new grad nurse that is great pay.

I found that by clumping a few extra shifts together I could pound out the long weeks and then have time off as well.  I think I did like two months of bonus shifts out of the 12 months in the year.

Check out our FREE EKG Cheat Sheet Here

Time Off

“It sounds like you were just working all the time!” . . . here’s the deal.  I am actually in the middle of an 18 day off stent from work!

18 days off!

This isn’t the first time that I have taken an extended amount of time off either.  When you only have to work 3 days per week you can manipulate you schedule to work the first three days of one week and the last 3 days of the next week . . . BOOM. . . right there you have 8 days off between shifts.   If you take just three days off you can have over two week off.

With very simple planning you can workout to have VERY long vacations!  Even after taking a FEW extended vacations I still have extra PTO saved up that I will be able to cash out (at my base rate) at the end of the year.

$70,000/yr So What??

First of all . . . I KNOW.  $70,000 is peanuts in places like CA, WA, NY etc but keep in mind, Texas is about 1/3 cheaper to live in than these other places. So, $70,000 in Texas is more like $100,000 in a more expensive state/city.

$70,000 won’t make me a millionaire any time soon. But check this out.  According to the National Association of Colleges and Employers the average starting pay for new college grads (Class of 2013) was $44,259 . . . that means my starting pay as a new grad was about 1.6 times  higher.  (the argument can be made about advancement for nurses).  I am guaranteed 3 raises this coming year too. These raises will take my base pay up an additional about $5,000/year.  Not a ton, but there are SO many ways that nurses can make more (education, position change, certification, career ladder).  I am not worried about being able to make more.

According to the NACE website, they list the highest starting salary was for Engineers at ~$62,000 . . . as a new nurse I made more than that.

Wikipedia lists the median household income in the US at about $52,000.  With those holding advanced degrees averaging $72,000.

A recent study by NPR listed that 80% of ALL individuals in the United States make LESS than $70,000 (image posted below . . . see the article here).

RELATED ARTICLE: 10 Jobs for Nurses Outside of the Hospital (can I have #6 please?!)

CONCLUSION: Why do I share all these numbers. . . . ?

I disagree with the notion that nursing is a LOW paying job.  Is it a HARD job . . . Hell yes!!!  But there are ways to make a GREAT living as a nurse.  You simply need to play the system a bit and find the ways to make the highest wages at your hospital or employer.

Is it ALL about the money . . . NO!

But listen, I have a wife and two kids . . . I don’t really have a choice but to MAKE money.  I actually have to feed my kids and provide them with a place to live.  So, while I work as a nurse changing the world (and bedpans) I also want to make a good living for my family.

While I would never suggest nursing to someone just for the money, if you wonder what kind of nurse makes the most money it really comes down to playing the differentials and system more than anything else.

I think that nurses can make good money and should make good money.  It is HELL staying up all night answering strange call lights and trying to learn everything you can to not kill a patient.  This is a VERY hard job, but at the end of the day you can feel good about the work that you do and sometimes you REALLY do make a difference and in the end you can even make a good living doing it.

Share your thoughts below!

The post How I Made Over $70,000 My First Year as a Nurse (how I learned to game the system) appeared first on NRSNG.

Jan 09 2017



Rank #18: Vancomycin (Vancocin )

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Sep 23 2015



Rank #19: Understanding the Difference Between Hypotonic and Hypertonic

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Today we have Nicole Weaver our Director of Curriculum breaking down IV Solutions and more specifically the difference between Hypotonic Solutions and Hypertonic Solutions.

This is sometimes a difficult topic to grasp and even practicing nurses struggle with this concept. After listening to this podcast episode we’re confident that you will fully grasp the basic differences between Hypotonic and Hypertonic solutions and be ready to impress all your coworkers or classmates.

One main thing to consider is that when discussing IV Solutions we are mostly talking about osmosis and the passing of fluids as well as how the body’s cells react to each type of solution.

A quick easy way to remember the difference between Hypotonic and Hypertonic is to think of HYPERtonic as someone who is hyper and works out a lot so they get skinny so the cells will shrink but with HYPOtonic think of a hippo and it wants to eat everything and get really big so the cells will swell.

If you want a more in depth understanding of IV Solutions you can head on over to our Fluid and Electrolytes course for a full review.

The post Understanding the Difference Between Hypotonic and Hypertonic appeared first on NRSNG.

Jun 27 2019



Rank #20: Ep53: Renal Failure Pt Care

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Today I answer a question from another NRSNG reader!

I’m a new nurse and am unsure about things I should be doing for renal failure pts.  How much concern should I be about urine output in stage 4/5 CKD pts?  What should my expectation be for output- when should I call the doc about decreased output?  What preparations should be done prior to and after dialysis- meds: what to hold/give, wt, VS?

So we go into detail about these specific questions we caring for renal failure patients.  Caveat . . . I’m not a dialysis nurse but I do care for many renal failure patients.

For an indepth discussion on renal failure and current trends check out the “Renal Failure in the ICU” podcast episode from Medicine Grand Rounds by University of Arizona.

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Apr 21 2015