7 Challenges That Student Nurses Face

 7 Challenges That Student Nurses Face

 7 Challenges That Student Nurses Face

One of the best days in your life is going to college. Here, you will meet a lot of people from different backgrounds and ethnicity. If you choose to become a nurse, nursing school can be one of the most memorable times of your life. There are many challenges that student nurses face during their time in college, and here are seven of them.

Bring on the Challenges

Congratulations on making it through high school and into college! Consider this as one of the best days of your life but also the most challenging. Choosing a nursing school is a good decision, but you must first learn from the beginning to truly become a nurse. So what can you expect on your time in nursing school? 

1. The long lecture hours.

If you think sitting in your high school chemistry class was hard for an hour, expect that nursing school can double that! I am not threatening you, but lecture hours in nursing school can last for hours. It is the lectures that set nursing apart from other college programs. Most lectures revolve around complicated concepts and theories. It also introduces you to pre-nursing subjects like Biology, Anatomy, Chemistry, and many others.  

Not only will you attend regular classes, but you also have to attend long lectures and retain what you have learned from other lessons as well. On top of that, thick nursing textbooks are your best friend. These usually come in two volumes (Medical and Surgical Nursing textbooks especially), are weighty, and are not very easy to grasp in one reading. 

2. Grueling homework and projects.

Besides going to long lecture hours, student nurses face one of the challenges is the projects and homework. These usually include tons of research and reading. Some come in case studies, nursing care plans, and reports. By the end of your school year, you will be presenting a thesis that you need to defend. That said, you need to brace yourself for intensive research and learn how to manage your time effectively.

3. Unexpected clinical rotations.

As a student nurse, clinical rotations are part of your routine. Your shifts can change during your clinical, and so will your patient assignments. To survive your nursing school, you must learn to be adaptive and quick learners to pass. 

4. Stressful and limited time in college.

Nursing school is, no doubt, stressful. Most of your time is spent studying, researching, and reading. Clinical rotations also limit your time to do other things like going to places or parties. However, as you adjust, you will learn to balance your school life and personal life like a pro. So don’t worry about this too much!

5. Nerve-racking exams and tests.

As a student, exams, and tests are part of your life. But if you are a nursing student, these exams usually test your knowledge and nursing skills. However, these exams are for a good reason too. It is because your nursing school is training you to become future professionals handling the life and health of other people. If you do well in these exams, you are a few steps to becoming the nurse you have always wanted to be. 

6. Training after graduation.

One of the challenges that student nurses face after graduation is the training. If you think you are done with nursing school, think again! Your graduation only leads you to more mandatory training you need to earn certifications to increase the chances of securing a job. In some countries, passing the nursing licensure exams is essential for a registered nurse [1]

Meanwhile, nurses in the U.S. require you to train for basic life support, IV therapy training, and cardiac life support before hiring a staff nurse. The challenge here is that the competition is brutal, so you might consider working through your Master’s degree to stand out among all applicants. 

7. Pressure from other people.

Many student nurses are expected to do well in school, especially during emergencies. People will expect you to know what to do when you face an emergency or if someone is sick. Most of the time, you will feel that they are uncalled for, but it does happen. Just don’t give in to the pressure. 

In Closing

Yes, being a student nurse is challenging, but in a good way! Be sure to find time to balance life and school work; you will be alright. Your time in nursing school can be your best days or worse days. It can be overwhelming at times but make sure that these experiences taught you lessons that you can apply as a future nurse. 

 

What’s in a Nurse’s Bag? 6 Must-have Items

What’s in a Nurse’s Bag? 6 Must-have Items

What’s in a Nurse’s Bag? 6 Must-have Items

What’s in a nurse’s bag you ask? Ever wonder why nurses always carry a big bag with them? Whether you are a nurse or a nursing student, having a bag full of essentials is part of your everyday life.  

The Must-Haves

Having these items ready in our bags is more of a need than a want! Of course, we do love accessories but along with it comes practical use. You’ll never know when an emergency arises, so it’s best to be ready than sorry! Here are the six items we love to keep in our nursing bag. 

Trusty stethoscope and blunt-tip scissors

Nurses cannot go without their stethoscopes [1]. Although sometimes they get mistaken to be “the doctor,” – this tool is just part of our daily routine. Besides, it is always good to have your stethoscope to use on patients, especially when checking vital signs. The blunt-tip scissors come in handy in cases of emergencies when a wound dressing is needed. It helps cut medications or clothes during emergencies. 

Medical kit for personal use

What’s in a nurse’s bag that you should not leave without? A medical kit. When studying as a nurse, a headache, tummy ache, or colds can occur anytime. The same goes when you are a nurse on duty. Long shifts can cause fatigue and a few aches and pains in between. Having a personal pharmacy kit is essential. This kit usually contains vitamins, meds for headache, toothache, some balms for aches and pains, meds for allergies, or anything needed for your survival. You may also find some lotion, mouthwash, toothpaste, toothbrush, and other hygienic products that you use. 

PENS, LOTS OF PENS!

As a student nurse, I was an avid collector of colored pens for my notes [2]. I always had highlighters, pencils, erasers, liquid markers, etc. My pencil case is always full of them, and it looked like I had a stash of school supplies with me! I’ve always thought that it was just a thing I did, but I found out that my nurse friends did too. So, it is a nurse thing. Besides, these pens come in handy when taking notes or rewriting them in a way that you will understand. Dry-erase markers are essential when it comes to correcting your patient’s information on whiteboards. 

An extra set of scrubs

Your shifts are unpredictable. One minute it’s boring, and the next thing you know, you’re dealing with an emergency! Things could get messy in a second, and if you are not careful, you might have bodily fluids smeared on your scrubs. That said, it’s always best to keep an extra pair in your bag or car just in case you need to change. Pretty practical, yeah? 

Hand sanitizers or disinfectant alcohol

When I was a student nurse, I developed the habit of carrying a hand sanitizer with me wherever I go. I always prefer cleaning my hands with it even after I have washed them (to be extra clean). So, even until now, I still make sure that I have that in my bag. It is always a must to clean your hands before and after dealing with patients to minimize the contact of germs, bacteria, or viruses. 

Water bottle, candies, or snacks 

As a nurse, we are always on the go. Sometimes we forget to eat on time. Having snacks or candies in your bag can help spike your sugar levels when you are feeling low. Of course, don’t forget your water bottle. It is essential to hydrate at all times! The job we have needs our whole force, so we must also take care of ourselves. Having these in your bag will come in handy! 

Miscellaneous items

These could be your wallet, phone, car keys, extra socks (if you need them), cologne, wet wipes, facial tissues, an iPad for your study notes, and many others. 

Now You Know What’s in a Nurse’s Bag! 

You see, we are prepared for anything! Our patient’s lives and the people around us matter. Having all these essentials with us helps deliver quality care to those in need. Whether we are in a hospital setting or not, our hearts are ready to serve! 

 

EP 140: Pulmonary Hypertension 101

EP 140: Pulmonary Hypertension 101

Pulmonary Hypertension

Pulmonary hypertension is a type of high blood pressure that affects the arteries in the lungs and the right side of the heart resulting in increased pulmonary vascular resistance and pulmonary arterial pressures [1].

Diagnosis

Pulmonary arterial hypertension is diagnosed with a right heart catheterization or Swan–Ganz catheter showing pulmonary arterial mean pressure greater than 25 mm Hg and not by echocardiogram.

  • Normal pulmonary artery pressure is 15-25/8-15
  • A normal mean pulmonary artery pressure: 10-20
  • Normal pulmonary artery wedge pressure: 6-12
  • A normal CVP: 2-6 
  • Normal CO: 4-8
  • A normal SVR: 700-1500

Causes

The typical heart has two upper chambers (atria) and two lower chambers (ventricles). Each time blood passes through the heart, the lower right chamber (right ventricle). It then pumps blood to the lungs through a large blood vessel (pulmonary artery).
 
In the lungs, the blood releases carbon dioxide and picks up oxygen. The blood flows through vessels in the lungs (pulmonary arteries, capillaries, and veins). It then goes to the left side of the heart.
 
Changes in the cells that line the pulmonary arteries affect the wall of the arteries. They become stiff, swollen, and thick. These changes may slow down or block blood flow. It blocks the flow of blood through the lungs, causing pulmonary hypertension.
 
The right ventricle spends little time in isovolumic contraction or relaxation. As a result, is able to generate cardiac output with only a fifth of the energy demanded by the left ventricle (LV).
  • Left-sided heart failure can cause pulmonary hypertension.
  • Pulmonary hypertension can cause right-sided heart failure. 

Groups of Pulmonary Hypertension

This condition is divided into 5 groups by the World Health Organization

WHO group Etiology of pulmonary hypertension Mean pulmonary arterial wedge pressure Example causes
1 Pulmonary arterial hypertension Normal Idiopathic, hereditary, drug or toxin-induced, shunts related to congenital heart disease, connective tissue disease, portal hypertension, chronic hemolytic anemia, Collagen Vascular Diseases 
2 Pulmonary hypertension secondary to left heart disease Increased Valvular heart disease, systolic dysfunction, diastolic dysfunction, pericardial disease, congenital/acquired left heart inflow/outflow tract obstruction, congenital cardiomyopathies
3 Pulmonary hypertension secondary to lung disease Normal Chronic obstructive pulmonary disease, severe asthma, interstitial lung disease, sleep apnea, long term exposure to high altitude, congenital lung abnormalities
4 Chronic thromboembolic pulmonary hypertension (CTEPH) Normal Chronic pulmonary embolism
5 Pulmonary hypertension with unclear and/or multifactorial mechanisms Normal or increased Systemic diseases, sarcoidosis, vasculitis, hematological malignancies, chronic renal failure, metabolic disorders, lung tumors

 

Group 1: Pulmonary arterial hypertension (PAH)

Causes include:

  • Unknown cause (idiopathic pulmonary arterial hypertension)
  • Changes in a gene passed down through families (heritable pulmonary arterial hypertension)
  • Use of some prescription diet drugs or illegal drugs, such as meth
  • Heart problems present at birth (congenital heart disease)
  • Other conditions such as HIV infection, chronic liver disease (cirrhosis)
  • Collagen Vascular Diseases – Diseases such as R.A & Lupus. Inflammation is probably an important contributor to the development of pulmonary hypertension. Clustering of macrophages and T‐lymphocytes around vascular lesions has been reported in PPH and associated with this condition and has been linked to vascular remodeling [1].

Potential causes of PAH based on pathophysiology: Endothelial dysfunction, impaired vascular dilatation, alterations in the expression of NO, ET1 and serotonin, increased expression of inflammatory cytokines and chemokines, loss of endothelial caveolin-1, and disordered proteolysis of extracellular matrix contribute to the pathogenesis of PAH. 

Definition of Proteolysis – The breakdown of proteins or peptides into amino acids by the action of enzymes.

Group 2: Pulmonary hypertension caused by left-sided heart disease

Causes include:

  • Left-sided heart valve diseases such as a mitral valve or aortic valve disease
  • Failure of the lower left heart chamber (left ventricle)
    • In response to a massive increase in left-sided filling pressures, more specifically left atrial pressure

Group 3: Caused by lung disease

Causes include:

  • Chronic obstructive pulmonary disease (COPD)
  • Scarring of the tissue between the lung’s air sacs (pulmonary fibrosis)
  • Obstructive sleep apnea
  • Long-term exposure to high altitudes in people who may be at higher risk of pulmonary hypertension

Sleep apnea causes PAH due to left heart dysfunction with either preserved or diminished ejection fraction. The combination of hypoxic pulmonary vasoconstriction and pulmonary venous hypertension with abnormal production of mediators will result in vascular cell proliferation and aberrant vascular remodeling leading to pulmonary hypertension. 

Pulmonary vascular remodeling in COPD is the main cause of the increase in pulmonary artery pressure and is thought to result from the combined effects of hypoxia, inflammation, and loss of capillaries in severe emphysema.

Group 4: Caused by chronic blood clots

Causes include:

  • Chronic blood clots in the lungs (pulmonary emboli)
  • Other clotting disorders

Group 5: Pulmonary hypertension triggered by other health conditions

Causes include:

  • Blood disorders, including polycythemia vera and essential thrombocythemia
  • Inflammatory disorders such as sarcoidosis and vasculitis
  • Metabolic disorders, including glycogen storage disease
  • Kidney disease
  • Tumors pressing against pulmonary arteries

Signs:

  • Heart sounds: Loud P2 (Closing of the Pulmonic value, Murmur of tricuspid regurgitation
  • The liver will be pulsatile
  • EKG – Right Ventricular Deviation (RVH)
    • Lead 2 peaked P-wave
    •  V1 – Large V wave and maybe an RBBB
  • Echo – This device would measure the change of pressure “Velocity” Measuring the absolute pressure of the Right atrium and the right ventricle. Would also measure the Size of the Right Atrium and Ventricle. 

Complications

Potential complications of pulmonary hypertension include:

  • Right-sided heart enlargement and heart failure (cor pulmonale). In cor pulmonale, the heart’s right ventricle becomes enlarged and has to pump harder than usual to move blood through narrowed or blocked pulmonary arteries.
    • As a result, the heart walls thicken and the right ventricle expands to increase the amount of blood it can hold. But these changes create more strain on the heart, and eventually, the right ventricle fails.
  • Blood clots. Having this kind of hypertension increases the risk of blood clots in the small arteries in the lungs.
  • Arrhythmia can cause irregular heartbeats (arrhythmias), which can lead to a pounding heartbeat (palpitations), dizziness, or fainting. Certain arrhythmias can be life-threatening.
  • Bleeding in the lungs can lead to life-threatening bleeding of the lungs and coughing up blood (hemoptysis).

Pathosiology of PAH and RVF 

  • In order to reduce wall tension caused by the increased afterload of PHTN, hypertrophy of the right ventricle occurs. As a result, coronary flow no longer occurs in diastole despite the increased demand of the hypertrophied right ventricle. 
  • The right ventricle spends more time in isovolumic contraction and relaxation in order to overcome increased pulmonary pressures, which results in a reduction of right heart output and greater energy demand.
  • RV hypertrophy also interferes with the normal motion of the tricuspid valve and together with increased pulmonary pressures results in tricuspid regurgitation. The growth of the right ventricle also impedes the function of the LV as the interventricular septum bulges into the LV. 
  • These changes in the right ventricle all contribute to the reduction of cardiac output, which in turn decreases coronary flow to the RV and causes ischemic damage. Finally, this hypertrophy of the right ventricle accompanied by ischemic damage eventually leads to ventricular dilatation and total right heart failure.

Fun Fact:

Patients with PHTN are at risk for developing sepsis. Patients with low cardiac output may poorly perfuse the bowel, leading to a leaky endothelial barrier that allows bacteria and their toxins to invade, which can result in sepsis.

The effects of sepsis on patients with PHTN can be devastating. Sepsis-induced drops in systemic vascular resistance (SVR) can severely compromise patients with reduced cardiac output from PHTN. 

Sepsis has been shown to cause pulmonary vasoconstriction and dysfunction as well as produce cytokines that reduce right heart contractility. Clinically, sepsis was found to be a leading cause of patient mortality in the ICU for patients with PHTN exacerbations [2].

Interventions

  • Pulmonary vasodilators are used to reduce RV afterload by reducing pulmonary arterial pressures. Vasodilators are effective at reducing RV afterloads, such as IV Prostanoids, Inhaled Nitric oxide cause improvements in cardiac output and oxygenation.
    • Outpatient we can use Sildenafil to cause an increase in nitric oxide that will vasodilate.
  • Inotropes, such as Dobutamine and Milrinone are used to maintain cardiac output in the presence of cardiogenic shock from right heart failure due to this hypertension.
  • Pressure support medications, such as norepinephrine and vasopressin should be used to maintain systemic blood pressure as well as right coronary artery perfusion of the right ventricle.
  • We also can Diuresis these patients to reduce the pressure of fluid overload on a failing right ventricle.
  • Intubation of patients with PHTN and RVF should be avoided as sedatives can depress cardiac function and lower SVR and increased transpulmonary pressures can further lower CO.
  • For patients with end-stage PAH and RVF refractory to optimized medical treatment, lung transplantation with bridging via extracorporeal life support should be considered.
  • Anticoagulation was found beneficial in groups 1 and 4 based on autopsies that there are a lot of blood clots.
  • For stage 4 PAH like we saw during COVID, we refer to a drug called Epoprostenol. Stimulates the Prostacyclin receptor (agonists) and causes Vasodilation.  

SHOW NOTES:

0:00 Cup of Nurses Intro
0:54 Sponsor Ads
1:32 Cup of Nurses Introduction
3:23 Pulmonary Hypertension
6:16 Pulmonary Arterial Hypertension Diagnosis
10:25 Groups of pulmonary hypertension
10:38 Pulmonary arterial hypertension Causes
11:58 Pulmonary hypertension secondary to left heart disease
12:36 Pulmonary hypertension secondary to lung disease
16:20 Pulmonary hypertension caused by chronic blood clots
19:18 Pulmonary hypertension triggered by other health conditions
19:54 Signs of Pulmonary Hypertension
22:44 Complications of Pulmonary Hypertension
25:38 Fun Fact

 

8 Strategies to Pass Nursing School

8 Strategies to Pass Nursing School

8 Strategies to Pass Nursing School

Strategies to pass nursing school can guide you as you go through your time in school, and in this post, we will share eight of them that we find helpful. One of the best jobs in the healthcare world belongs to nurses. Not only do you get to save people’s lives, but it is also a rewarding profession.

You can work in different fields of nursing, choose hours of work, and have the opportunity to rank up on the leadership ladder. Studying to be a nurse is the first step to benefit all of these; surviving nursing school is the second important thing.

Life of a Nursing Student

Being a nursing student is fun! Looking back at my years in nursing school, I can say it was bittersweet, fun, yes, but it brought tears too. I can say from experience that everything I went through as a nursing student was all worth it, and how you want your student nurse life to be is up to you. 

8 Strategies to Pass Nursing School and Enjoy Being a Student Nurse

Suppose this is your first year in nursing school. Congratulations! You have a long way to go till graduation, so make it your goal to pass all levels so you can get your license and work as a real nurse. While you are still studying to be one, here are strategies to tips you can use. [1]

1. Strategies to pass nursing school teaches you to be always prepared.

Readiness should be second nature to student nurses. Being prepared reduces anxieties. Keep in mind that you will always have tests, clinical rotations, and other activities. Organizing your notes and reviewing your lessons after lectures can help you in many ways. Understand that not all of your instructors are the same; some of them love giving pop quizzes. So it would be best if you came to class prepared. 

2. Create a routine that works.

Nursing school is not a race, and if you keep running without any plan, you will burn out. Remember that you will be learning different things in nursing school, go on clinical grounds, and take tons of examinations to test your nursing comprehension. That said, developing a routine for studying, setting time for different tasks, or completing an assignment is essential to your survival. 

3. Strategies to pass nursing helps you focus on your goals.

What drove you to study nursing? Do you have long-term goals? Your answer should be the goal you need to reach. If you want to become one of the best nurses in the country, use that as a goal. Once you know your goals, it’s easier to take steps to meet them. Focusing on your goals also gives you enough reason to make it and graduate. 

4. Be part of a study group.

One of the best strategies to pass nursing school is becoming a member of a study group. Meeting with other nursing students offers fresh insights into the topics you are studying. Not only do you get to learn with like-minded students, but you also get to socialize. It makes learning more accessible, especially if you have a hard time with specific topics. Plus, what will the nursing school be like if you don’t have friends? If you are not part of a study group yet, now is the best time to be. So go out and find them! 

5. Don’t forget to exercise.

Stress is high when you are a nursing student. I remember breaking down one time in nursing school because I had to report on duty for my assigned area for four days straight and then study for an exam on a weekend when I was supposed to be relaxing. In short, the exhaustion got the best of me. It ruined my mood and plans of relaxation. A good friend of mine suggested I take walks or jog when I am feeling stressed.

Although I was not too fond of the idea at first, I gave it a try. Little by little, I felt better; the run helped clear my head and gave me the energy to do other things despite the long hours of nursing rounds. It’s why I recommend that you mix exercising into your schedule. You don’t have to run if you want to, but do take time to do exercises like yoga or follow YouTube workouts.

Keep in mind that exercising elevates your serotonin; you are taking care of yourself and feel happier. It’s one of the best strategies to pass nursing school and help you survive while studying!

6. Eat well and on time.

Besides exercising, you should never skip meals while studying. In my experience, I can say that I am a terrible example. I have a terrible habit of missing meals on time. In my defense, I didn’t have time to eat, so I settled for quick snacks. So by the time I got home, I was dizzy and starving. It went on for months until my mother found out and scolded me about it.

The moral of the story is that don’t skip meals and eat well. Eating correctly and getting enough nourishment helps you stay sharp in school. The nutrients from the food you eat give you energy so you can do all your tasks. 

7. Strategies to pass nursing helps you find a support system.

I’m not going to lie, but nursing school is hard. I have seen some of my classmates give in to the pressure of school work and quit even if they are almost at the finish line. Nursing school is stressful, so you should have a support system to go to if you feel like you’re falling apart.

Having people who can listen to you vent about school life is enough; it’s also pretty cathartic! A support system could also be a support person. It could be a close friend, your parent/s, or someone you look up to. According to Herzing University, your support system plays a vital role in your success. Make sure you have a few people to call in your corner! 

8. Don’t be afraid to ask for help.

No man is an island; you need help if you want to succeed in life. You can also apply this in your time as a student nurse. Asking for help is not a crime, and in nursing school, asking for help is welcome. Understand that each student has different learning styles, and if you are having a hard time understanding a topic, reach out and ask for help. Remember, no one wants you to fail, not your parents and not those involved in your education. [2]

Take the time to talk to your professors, ask questions about a topic you don’t understand. If you don’t like face-to-face discussions, you can always send them an email for clarifications. Keep in mind that you can’t win nursing school if you do it on your own. So, always find the opportunity to ask questions. It’s an excellent strategy to have. 

These Strategies to Pass Nursing School Will Help You Make It!

Don’t be intimated by the things you encounter in nursing school. It will help shape you into the nurse you want to be. Yes, stress is part of it, but always make time to decompress. I believe that there’s no easy way in life or nursing school, but you can always do something about it.

Strapping strategies to pass nursing school under your belt is the best way to go and will help you also in your plans to take NCLEX. So, make sure you have plenty! I hope you find this article helpful, good luck!