One of the most common questions I get from students is “What is the best way to study for (fill-in-the-blank with your current nursing class)?”
Here’s my (not so short) answer!
Step 1: Identify What “Normal” Looks Like
Time to revisit Anatomy and Physiology! If you’ve spent any time around Your Nursing Tutor, you probably already know that I believe Anatomy and Physiology to be the most important topic to understand if you want to be a successful nurse. Even if you “feel like” you already know what normal looks like, this is still a great time to do a quick review and further solidify your A&P knowledge. And if you’re still a little intimidated by A&P, then is is a great way to begin the path towards A&P mastery.
The way it works is you spend about 5-20 minutes reviewing the normal A&P of the system you are studying before every study session. No more than 20 minutes, or else you won’t have enough time to study the disease information that’s actually going to be on the test!! Don’t worry if you don’t have time to review everything, and don’t worry if you don’t understand every detail. Remember, this is a new habit that you’ll be doing before every study session, so you’ll have plenty of time to review some more in future study sessions. Just make sure to jot down any questions that you still have so that you remember to look it up next time.
So if you’re learning about Atelectasis in your Med-Surg class, then you would quickly review the Respiratory System each time you sit down to study. Focus on what the different parts are (i.e. trachea, bronchi, alveoli, etc) and what they actually do. For example, the bronchi are the tubes in the lungs that look like branches that allow the air to pass through. The alveoli are the little “grape-like” sacs located at the end of the respiratory tract, and they exchange oxygen and carbon dioxide with the bloodstream.
It’s tempting to skip this step because you’re stressed out about how much you need to know for the exam…don’t skip it! As you become more of an expert on each area of A&P, you can spend less time on this step (maybe only 1-3 minutes), but even that quick review will keep the knowledge fresh and continue adding to your understanding of nursing.
Step 2: What’s Wrong? What’s Broken?
This step is usually the easiest because the textbook (or the teacher) explains it to you. The problem is that most nursing students try to start with this step before they go through Step One, so they never really understand it as well as they think they do. So I’ll say it again…
***Skipping straight to Step Two without first completing Step One (A&P) will lead to utter confusion and frustration!***
No matter how tempting it is to “save time,” don’t skip it. You’ll end up wasting more time in the long-run. Consider yourself warned…
Okay, so now that we’ve agreed that you will NOT skip Step One, you have my permission to refer to your textbook and read that Atelectasis is a collapsed lung. Specifically, it’s when the alveoli in the lungs deflate, usually as a result of a blockage in the bronchi.
Notice all that A&P terminology I just threw at you? Aren’t you glad you reviewed your Respiratory A&P first?
Since you’ve already done a brief review of the normal structure of the respiratory system and the role it plays in gas exchange, then your brain is all ready to jump to Step Three…
Step 3: Predict the Expected Symptoms/Complications
Now you know what’s normal in the body, and you know what’s gone wrong due to disease process. You have all the puzzle pieces you need to do some critical thinking and guess what happens next. Congratulations, you’re ready to think like a nurse!!
Let’s continue our Atelectasis example. You know that the alveoli are where oxygen and carbon dioxide are exchanged with the blood stream, and you know that Atelectasis is a condition where the alveoli are collapsed so that they are no longer filled with air. The logical conclusion is that the patient will have impaired gas exchange!
(If you’re REALLY paying attention, then you might have noticed that “Impaired Gas Exchange” also happens to be a nursing diagnosis, but that isn’t a requirement for this step…just a happy coincidence in this case)
Let’s take it further. If the patient has impaired gas exchange, then their body is not getting enough oxygen to the cells, and their body can’t get rid of enough carbon dioxide. This could lead to the patient feeling short of breath and fatigued. Plus, with increasing levels of carbon dioxide in the blood, they can develop respiratory acidosis. Then if you think about the lungs, you notice that the empty, unmoving alveoli are a warm, wet environment that is slowly filling up with yucky mucous: which creates the perfect breeding ground for bacteria. And once the bacteria move in, pneumonia may not be far behind.
As you continue to grow your nursing knowledge by practicing this 4-step study method, you’ll find that this step gets easier and easier. It really is all about learning to think like a nurse! But until you get to the point where it becomes second-nature, refer back to your textbook AFTER trying this step on your own to see how many of the expected symptoms/complications you were able to correctly predict. If you missed some, make sure you understand why they occur (based on the A&P, of course).
Step 4: Identify Helpful Nursing and Medical Care
Step Four is a combination of learning new information from your textbook, while also relying on nursing knowledge you’ve already gained. At the beginning of nursing school, you’ll do more “learning of new information;” by the end of nursing school, you should be more “relying on your own nursing knowledge!”
I think it’s best to start by figuring out as much as you can based on your own knowledge before moving on to the textbook, even if you’ve just started nursing school. You really have to in order to learn how to think like a nurse. After all, you can’t always depend on the textbook when you’re taking NCLEX or taking care of a patient! So you might as well start practicing how to use your head NOW during your study time, rather then LATER on an exam. Trust me, it’s safer that way.
Start by looking at the symptoms/complications you identified in Step Three. Then use the following sources to figure out how to best take care of patients with those symptoms:
- Use your common sense. What would you do to make the patient more comfortable? For fatigue, you would do things that encourage them to rest…easy!
- Think back to your Fundamentals class, if you’ve already taken it (or refer to your Fundamentals textbook if you’re currently taking it). What types of nursing care would you provide for certain types of symptoms? If they have difficulty breathing, you know that you should put the patient in high-Fowler’s or semi-Fowler’s position. To help the patient keep their alveoli open, teach deep breathing exercises and controlled coughing.
- Refer to your Med-Surg textbook to identify more disease-specific medical interventions. For example, Positive End-Expiratory Pressure (PEEP) or Continuous Positive Airway Pressure (CPAP) can be used to help keep alveoli open, too, but that might not be something that you already knew.
- Don’t forget to think about possible lab tests, diagnostics, or other medical interventions. A patient with the type of symptoms we’ve been discussing might need to have their ABGs checked for respiratory acidosis, or they could even have a chest x-ray to help determine their diagnosis.
One thing to notice is that this step is not necessarily specific to the disease that you are currently studying! The nursing interventions that you would do for a patient with Atelectasis might overlap a lot with the type of nursing interventions that you provide for a patient with Pneumonia. Both patients will be fatigued, so you’ll need to encourage rest. Both patients will have difficulty breathing, so semi- or high-Fowler’s would be a good position for both.
See, if you’re simply trying to memorize the symptoms and care that go with each disease, then all this overlap is extremely confusing and makes it really easy to make a mistake come test time. But if you study using this 4-Step Study Method, then you’ll always know what symptoms to expect for a disease, and what kind of nursing care to provide.
I go into more detail (with diagrams!) about how to use the 4-Step Study Method with speciality topics like Maternity, Pediatrics, and Psychiatric nursing in the PASS Program. So if you’d like to learn even more about this powerful study technique, then sign-up today!