Differences between Nursing School and the First Year of Nursing
By: @That1Murse

So as we near another graduation year, I decided I would discuss what I learned in nursing school versus the first year of actual nursing. I had several other good ideas given to me and I will get to them within the coming weeks.
Ok, let’s be honest. Nursing school is difficult, time-consuming, frustrating, and a pain in the ass. But
it’s the hoops that you have to jump through to get those letters behind your name. The old adage of
what do they call the person who finished last in his class in medical school… they call him doctor. The same applies to nursing. It doesn’t matter if you finish first or last, you will still be a nurse. My badge does not say, That1Murse, RN (B student).
So why is nursing school so freakin’ hard? Well here’s the honest truth. It’s all about Pass Rates. The
nursing school has to have high NCLEX Pass Rates to not be looked at by the state Board of Nursing. If a schools NCLEX pass rate is low enough, they have to submit a plan of correction to the Board of Nursing. So it’s difficult to make sure you are prepared to take that test. Most of everything in nursing school breaks down to passing the NCLEX. Day 1 of nursing school we stated with 40 eager people. When we graduated in 2 years…. We were down to 17 of those original 40.
Nursing school gives you the picture perfect world where every patient will present with the same signs and will give the exact same complaints and everything is rainbows and buttercups when you practice in the Ivory Tower. I’m not taking away from nursing school because it does give you a nice foundation but you’re learning will take place in the first year after school.
The first year after school is sometimes more difficult than nursing school itself. You will sometimes feel inept and stupid and I guarantee at least once you will say, “What the fuck did I get myself into?” To give you some examples, my first LPN year (went to a bi-level ADN program) I worked at a nursing home. In that year, I had a fire (and had to evacuate the home at 10 p.m.) and had a guy show up with a gun looking for me (apparently, my sarcasm is lost on some people). My first RN year in the ER, I couldn’t get a successful IV stick to save my life. This was also when I worked lots of traumas and codes. Your first year of nursing truly is a trial by fire. The important thing to remember is not to get discouraged and remember why you went to nursing school. If it was for the money, then I’m sorry but in 5 years you probably won’t be nursing any longer.

Other thoughts from your first year of nursing: You will always remember the name of your first death. Lean on the staff you have to work with. Ask questions. This is when you will truly learn to be a nurse. Nothing is like it is in the book. A smile to a patient will sometimes forgive ineptitude. Have fun. Find a support system (prefer medically) to vent on. If you are future murse and you are in a relationship with someone not in the medical field, it’s going to be more difficult than if she was in the medical field (Think about it you go home always talking about what Becky did or Jamie was so funny or Michelle didn’t do this.. all you talk about is women). Know that it takes time to build trust with your docs but once you get that life gets so much easier.
The idea of this blog is to not discourage you or make light of nursing school but you should know that the first year is going to be hard (maybe even harder) than nursing school. But this year is when you will learn nursing and then your life will start getting better.

@That1Murse

Hey, @MurseWisdom here, I wanted to expand on this one a little and talk about career choices.  I bet you get asked this at least twice a day in clinical... "Where do you want to work after graduation?"  I just want to point out that you will more than likely not get to do what you want right out of the gate.  I'm sure that working on a Peds floor or a NICU or being a Flight Nurse is your dream job.  Hardly anyone says, "I want to work in a Nursing Home", or "I want to work for Hospice."  Well, I want to make it clear that this nursing "Shortage" includes Nursing Homes and Hospice.  And you, my friend, will have no experience and you are going to have to take whatever you can get at first. 

I just reread that and realized what a bummer that shit is... Ok, lets not get discouraged.  You need the experience that you get at that first job out of school.  Do you really want to be two days into your RN and be on a helicopter running a code by yourself?  I have performed medical treatment on a helicopter in flight.  You think this shit is hard in the hospital, try it at 200mph in a sardine can.  There I go again, I'm just negative today, I apologize.  You need to spend some time in the trenches of Med-Surg or a similar type of floor.  The most rapidly growing population on the planet right now is the elderly.  The need for nurses in Longterm Care is great and contrary to popular belief it is challenging.  Med-surg you may have 4-1 or 5-1 ratio on a bad day you may have 8 or 10-1.  Everyday at a nursing home is 40-1 or greater and it's you and a squad of  minimum wage CNAs. That is a challenge. 

I don't even remember what point I was trying to make.  Just keep your options open. 

@MurseWisdom