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Nursing Levels
Education Requirements
Program Costs
Employment
Expert Advice

--------------------------------------------------------------------------------

Nursing Levels
Nursing Levels
Education Requirements
Program Costs
Employment
Expert Advice

Copyright


HOW TO BECOME A NURSE

Nursing is one of the fastest-growing professions today. This guide explains
what you need to do in order to become a nurse, including information about
different types of nurses, nursing school requirements, and nursing licensure.

Healthcare is one of the fastest-growing industries in the country, and nurses
make up a core part of its workforce. Nurses provide general patient care in a
variety of settings, including in hospitals, doctor's offices, and nursing
homes. If you have the aspiration to become a nurse, this guide will help you
navigate the process, answering important questions, such as how long it takes
to become a nurse and what nursing licensure requirements look like.

There are six main steps essential to becoming a nurse:

 * Choose Your Level of Nursing
 * Complete Education Requirements
 * Obtain a Nursing License
 * Find Employment
 * Pursue Advanced Nursing Specializations
 * Join a Nursing Organization

Following these steps, which we will explore in-depth, will help you go a long
way in establishing a successful nursing career.



CHOOSING YOUR LEVEL OF NURSING

The first step to becoming a nurse involves choosing which type of nurse you
wish to be. When choosing between these levels of nursing, there are several
factors that you should consider:

 * Nursing Education, Training, and Salary: First, you want to decide how much
   education and training you want to undergo and how much time you want to
   invest into those processes. Some types of nurses need to complete a
   bachelor's or even a master's degree along with licensure certification,
   while others might only require a diploma. Your level of nursing education
   might affect your future salary, too. RNs require more education and training
   before being able to practice but once employed, they generally receive
   higher wages on average than other nurses. On the other hand, CNAs are
   trained relatively quickly and do not need a post-secondary degree but make
   less than their RN peers.
 * Nursing Job Duties and Environment: Because of how many options and roles
   there are in nursing, it is important for you to determine what you would
   like to do as a nurse. Think about what type of tasks you prefer, such as
   whether you prefer technical tasks or practical ones. For example,
   specialized nursing midwives work primarily with mothers before, during, and
   after childbirth, while CNAs provide general care to all sorts of patients,
   which often involves tasks such as feeding patients and gathering medical
   supplies. Below, we'll dive into the exact job duties of different types of
   nurses so that you can decide which best might fit your nursing career goals.


The primary levels of nursing include:

 * Certified Nurse Assistant (CNA)
 * Licensed Practical Nurse or Licensed Vocational Nurse (LPN or LVN)
 * Registered Nurse (RN)
 * Other advanced nurses of various specializations

Let's take a look at each level in more detail below!




CERTIFIED NURSING ASSISTANT (CNA)

Certified Nursing Assistants are the most basic level of nurses, yet the tasks
performed by CNAs are both physically demanding and indispensable to the care of
patients. This makes CNAs vital to today's healthcare system. CNAs must hold a
CNA license, and the experience you earn as a CNA can help you to pursue a
higher level of nursing in the future.


As suggested by the title, a CNA assists doctors and other nurses in the care of
patients where they perform important daily tasks that include:

 * Answering patient calls
 * Cleaning rooms and making beds
 * Feeding patients according to their medical requirements
 * Maintaining patient hygiene through tasks such as bathing, dressing, or
   toileting patients
 * Reporting changes in patient condition to their superiors.

It should also be noted that, unlike higher levels of nurses, CNAs are not
allowed to administer medication or make any changes to a patient's treatment
plan.

Because CNAs are so personally involved in the daily care routine of patients,
they have a strong role in fostering a positive patient experience through
hospitality, and their manual labor is indispensable to the efficiency of a
patient's care.



LICENSED PRACTICAL NURSE (LPN)

A Licensed Practical Nurse (known as a Licensed Vocational Nurse in California
and Texas) is another level of nursing. Like CNAs, these nurses focus on the
practical care of patients instead of on highly technical care or diagnoses. An
important difference between LPNs/LVNs and CNAs, however, is that LPNs/LVNs can
be licensed to administer medication and start intravenous (IV) drips, although
these rules vary from state to state.


LPNs/LVNs are supervised by an RN or a doctor and help administer the patient
healthcare plan. The duties and tasks of an LPN/LVN include:

 * Monitoring patient health and taking blood pressure
 * Recording patient health and taking patient histories
 * Assisting with medical procedures
 * Consulting with RNs about patient health
 * Providing personal care through tasks, such as bathing, dressing, and
   toileting

The close relationship between LPNs/LVNs and their patients means that these
nurses need to have compassion and the ability to positively communicate to
patients, as they have a strong influence on patient experiences.



REGISTERED NURSE (RN)

Registered Nurses are often the common image people have in mind when they think
of nurses and what they do. Unlike CNAs and LPNs/LVNs, RNs are not limited to
the daily practical care of patients, but instead, play a critical role in the
technical care provided to patients at hospitals and physician's offices.


Some of the most common tasks performed by RNs include:

 * Administering medication and treatments to patients
 * Developing healthcare plans
 * Performing physical exams and diagnostics
 * Collaborating with doctors on patient care
 * Observing and interpreting patient symptoms

RNs have these greater responsibilities in large part because they must undergo
training and education that has a strong emphasis on the study of medicine and
lasts for multiple years. These greater responsibilities entail the overall
management of a patient's care plan, including the coordination of CNAs and
LPNs/LVNs and consulting with doctors, which means that RNs need to have
patience, strong communication skills, and physical endurance.



ADVANCED NURSES

Advanced nurses are highly specialized nurses who focus on a specific type of
patient care. There are many specializations available, and some examples can be
seen in the following list:


 * Certified Nurse Midwife
 * Nurse Practitioner
 * Nursing Informatics
 * Certified Registered Nurse Anesthetist
 * Critical Care Nurse
 * Neonatal Nurse

Advanced nurses commonly work alongside other healthcare professionals like
physicians and RNs to provide their specialized care to patients. However, the
wide range of specializations included among advanced nursing specialties means
that advanced nurses can work in vastly different environments.

For example, critical care nurses often work in intensive care units or in
trauma center emergency departments. On the other hand, midwives work in
maternity wards within hospitals, in birth centers, and even in in-home
settings.



COMPLETING EDUCATION REQUIREMENTS

Once you know what type of nurse you want to be, you then need to understand
what type of education you must complete. Because of the varying
responsibilities and job duties involved in different levels of nursing, the
education requirements for different types of nurses vary significantly. The
chart below shows the type of education that specific types of nurses must
complete and the time it takes to do so.



Level of Nursing Entry-level Education Time Required to Complete CNA
Post-secondary education program 4–12 weeks LPN/LVN Post-secondary education
program 1 year RN Bachelor's degree, associate's degree, or diploma 2–4 years


EDUCATION REQUIREMENTS FOR CNAS

CNAs are expected to complete a post-secondary education program, which results
in the attainment of a certificate or diploma. These training programs typically
last 4-12 weeks and prepare you to receive state certification or licensure.


This comparatively lower level of education requirements allows you to quickly
move from choosing your career path to practicing as a nursing assistant. You
are then able to quickly start gaining experience in your field and earning an
income as a nurse.



EDUCATION REQUIREMENTS FOR LPNS/LVNS

The education requirements for LPNs/LVNs are higher than for CNAs, and you can
expect to spend more time studying and training before being able to practice as
a nurse if you take this route. You will typically need to spend around 1 year
completing an education program that prepares you for state certification and
licensure.

You can find LPN/LVN programs at colleges, technical schools, and even in some
hospitals. Course topics that can be expected in these programs include:

 * First aid
 * Physical education
 * Emergency medical technology
 * Anatomy
 * Nutrition

After completing an LPN/LVN program, you can also choose to attend an LPN-to-RN
program, which involves courses that prepare you to become a fully-fledged RN.

EDUCATION REQUIREMENTS FOR RNS

Completing an RN education involves completing either a Bachelor of Science in
Nursing or an Associate's Degree in Nursing. If you choose the route of a
bachelor's degree in nursing, it will usually take you about 4 years to complete
your degree. If you pursue an associate's degree, it will take around 2 years to
finish.


Classes in BSN and ADN programs commonly include the following subjects:

 * Biology
 * Chemistry
 * Biochemistry
 * Anatomy
 * Physiology
 * Nutrition
 * Health assessment
 * Psychology

Beyond courses that deal with these topics, there are many other subjects that
present opportunities for you, depending on what you want to emphasize in a
study program. For example, you may take more research classes if a more
research-oriented nursing career is desired. There are also some hospitals that
offer in-house nursing programs that take around 2 to 3 years to complete and
provide a diploma upon completion, allowing you to take the next steps toward
becoming a certified RN.

When you choose the ADN or diploma route, you can always later attend an
RN-to-BSN program where you can attain a bachelor's degree. If you already have
a bachelor's degree in another field, there is the option of completing an
accelerated BSN program, which can award a BSN degree in less than 2 years.



NURSING SCHOOL REQUIREMENTS

Entering and completing a BSN or an ADN program at a nursing school is a
significant commitment of time, energy, and money, so it is important you
understand the requirements and costs involved in attending nursing school. At
the same time, if you decide on an LPN/LVN or CNA education program, you should
also be aware of program requirements (although, they are generally lower than
the prerequisites for BSN or ADN programs).

Typical nursing school admission requirements include:

 * A high school diploma or GED
 * A high school GPA of 2.0 for LPN/LVN, 2.5 for ADN, 3.0 for BSN
 * Completed high school lab courses, such as chemistry
 * Good ACT and/or SAT scores (exact requirements vary by school)



NURSING SCHOOL ENTRY TESTS

Along with the standard ACT and/or SAT test scores that are required by colleges
and universities for most students, you should be prepared to take two other
exams as well: the HESI A2 and the TEAS test.

The HESI A2 exam is made up of eight smaller exam sections that address the
following topics:

 * Math
 * Biology
 * Chemistry
 * Anatomy and physiology
 * Physics
 * Vocabulary
 * Reading comprehension
 * Grammar

Similarly, the TEAS test emphasizes student competencies in basic subjects, yet
it is a less comprehensive test. Instead of having eight smaller exam sections,
the TEAS test is only made up of four subtests:

 * Math
 * Science
 * Reading comprehension
 * English language and usage

Receiving good marks on one or both of these tests is often a prerequisite to
admittance into nursing schools.

A good way to prepare for these tests, especially if you are not confident in
the above subject areas, is to get tutoring help. Biology tutoring, physics
tutoring, and other subject area tutoring can make sure that you have mastered
important concepts that these nursing entry tests contain.

Practice tests are also a great tool to prepare to take either of these exams. A
HESI A2 practice test will show you exactly which sections are on the test, as
well as how many questions make up each section and how much time is allotted to
each section. Likewise, a practice exam for the TEAS test will prepare you for
the concepts and topics address on that exam.




COSTS OF NURSING PROGRAMS

The costs for pursuing an education in nursing can vary widely, depending on
which career path you choose. As with other bachelor's and associate's degree
programs, BSN and ADN programs can also be expensive. The prices for various
education programs generally increase based on the length of the program, which
means that CNA training usually costs very little compared to the total tuition
for a BSN degree.

CNA programs can range from a few hundred dollars to a few thousand in total
cost, while LPN/LVN programs can cost anywhere from a few thousand dollars to
over ten thousand.

As with other bachelor's and associate's degree programs, BSN and ADN programs
can also be expensive. ADN tuition costs can reach as high as $20,000, while BSN
tuition can reach $80,000 to $100,000.

Because there is such a wide range of possible costs, you should look carefully
at the costs of specific programs to which you wish to apply.



PAYING FOR NURSING SCHOOL

Although the costs of nursing school can seem daunting, particularly if you take
the ADN or BSN route, there are many ways you can reduce the cost of your
nursing education. Some options for paying for nursing school include federal
financial aid, private financial aid, and military aid.


FEDERAL FINANCIAL AID OPTIONS

There are several federal financial aid options you can use to help you pay for
nursing school. These include:

 * Subsidized and unsubsidized federal loans (that must be paid back)
 * Federal grants (that don't need to be paid back)
 * Scholarships
 * Pell Grants
 * The Nurse Corps Scholarship Program
 * The American Opportunity Credit

There is even the option of pursuing a federal work-study program, in which you
can work a federally sponsored job, usually at your school for a maximum of 20
hours per week, thereby earning a reliable wage to help contribute to the costs
of your education.


PRIVATE FINANCIAL AID OPTIONS

There are also a number of private options available to nursing students.

 * Private Loans: You can obtain private loans from sources like banks and
   credit unions. But be careful with this type of funding, as it can come with
   high-interest rates.
 * Grants: There are numerous grants available to nursing students, such as the
   grants offered by the American Holistic Nurses Association and other
   nursing-focused organizations.
 * Scholarships: There are a ton of nursing scholarships that you can apply for.
   The American Association of Colleges of Nursing and the Nurses Education
   Funds, Inc. are just two organizations that offer scholarships to nursing
   students. These and other such scholarships are often awarded to students
   based on academic merit, but they can also be based on other factors like
   diversity.


MILITARY FINANCIAL AID OPTIONS

If you have served, are serving, or would like to serve in the US Armed Forces,
you may be eligible for different types of financial assistance for active
service people and veterans.

 * The GI Bill: The GI Bill can help get your education expenses covered by the
   military based on a military service commitment. This involves becoming a
   member of the military for a certain amount of time, and the GI Bill can
   cover all education expenses if the service lasts for 3 years. Because this
   entails a significant commitment of time and energy to serving in the US
   military and could even involve overseas deployment, you should give serious
   thought to this option. However, if you do choose the financial aid options
   offered by the US military, you can serve in the US Army, Navy, or Air Force
   and can begin your service before the completion of your nursing degree or
   even afterward. If afterward, then you should plan to pursue a higher nursing
   specialization after enlisting in order to receive assistance paying for your
   already completed education program.



OBTAINING A NURSING LICENSE

After completing your education requirements, the next step in your nursing
career is becoming licensed. As with the education requirements, the specific
licensure requirements vary depending on if you aspire to be a CNA, an LPN/LVN,
or an RN.

 * CNA License: To become a CNA, you must earn a CNA license, which requires the
   completion of a state CNA exam.

 * LPNs/LVN or RN License: To become a licensed LPN/LVN or RN, you need to take
   an NCLEX exam.

There are two main types of NCLEX exams:

 * The NCLEX-RN
 * The NCLEX-PN

If you completed an LPN/LVN program, you need to take the NCLEX-PN exam. If you
completed an RN program, you need to take the NCLEX-RN exam. After you have
passed your exam, you can then apply for your nursing license and start the job
hunt.



FINDING EMPLOYMENT AS A NURSE

The next step in your career path as a nurse is the culmination of all of the
studying, exam-taking, and licensure: getting a job. Expectations for employment
vary based on the type of nurse you are. However, all of the types of nurses
discussed in this guide are expected to see job growth that is faster than the
national average over the following decade.

The following chart shows important employment data from the Bureau of Labor
Statistics (BLS), all of which apply as of May 2019, and includes median annual
wage, job outlook for the coming decade, and the typical amount of education for
entry-level nursing in these categories.



Level of Nursing Median Annual Wage Job Outlook (2019-2029) Typical Entry-Level
Education Nurse Assistants and Orderlies (incl. CNAs) $29,640 8% High-school
diploma and on-the-job training Licensed Practical Nurses and Licensed
Vocational Nurses (LPNs/LVNs) $47,480 9% Post-secondary non-degree award
Registered Nurses (RNs) $73,300 7% Bachelor's degree Advanced Nurses (incl.
Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners) $115,800 45%
Master's degree

Source: Bureau of Labor Statistics (BLS)


EMPLOYMENT FOR NURSES BY STATE

When looking for a job as one of these types of nurses, it is also important to
take note of which states offer the most employment opportunities and the
highest pay, since these can vary significantly from state to state.

States With the Highest Employment: According to the BLS, which has collected
significant data about nursing employment, the state that employs the most
nursing assistants and RNs is California. However, Texas has the highest rates
of employment for LPNs/LVNs, and California comes in second for that category.
In all three of these categories Florida and New York are also among the top 5
states for the number of nurses employed.

States With the Highest Pay: Although some states may have more employment
opportunities than others, it is also important for you to pay attention to
which states offer the highest pay. For both nursing assistants and LPNs/LVNs,
the highest paying state is Alaska, where annual mean wages for these types of
nurses are $40,320 and $63,850, respectively. California offers the highest
wages for RNs, with an annual mean average of $113,240, while it also ranks
among the top 5 for nursing assistants and LPNs/LVNs. Although Texas and Florida
employ some of the highest numbers of nurses compared to other states, they do
not rank in the top 5 in terms of wages for any of these types of nurses.


WORK ENVIRONMENTS FOR NURSES

Although typically imagined working only in hospitals (which account for around
30% of employment for RNs), as a nurse, you can actually work in a variety of
places, such as:

 * Nursing care facilities, where around 16% of all LPNs/LVNs work
 * Physician's offices, with each usually requiring the work of multiple nurses
 * Assisted living and continuing care retirement communities, which account for
   16% of all jobs for nursing assistants like CNAs
 * Home healthcare services, which account for nearly 12% of employment for RNs
 * Schools, where RNs can work as Certified School Nurses

Some RNs even work as travel nurses, which means that they work in various
locations around the country on a short-term basis in order to address staffing
shortages that can arise in some cities and regions.

Your place of employment will be an important factor in your nursing career
because they offer vastly different experiences. If you work with a home
healthcare service, you can expect a daily routine that differs from what could
be expected from working in a physician's office.

As an RN, you would expect to have different career experiences when working as
a travel nurse in many hospitals around the country as opposed to working in
only one hospital. It is vital that you consider what kind of workplace
environment would be best for your individual career goals and personal values.



ADVANCED NURSING SPECIALIZATIONS

As mentioned previously, there are many potential nursing specializations that
you can pursue. These specializations generally require additional education,
training, and certification than are expected from other levels of nursing. Yet,
they also tend to bring higher wages as compared to less specialized nurses.
There is also no standardized education or training path that equally applies to
all forms of advanced nursing.

This means it is critical for you to look up the specific requirements of your
desired nursing specialization in order to be prepared to take the necessary
steps to become that type of advanced nurse. Some specializations are open to
more nurses and are easier to acquire, while others are stricter paths. Many
types of advanced nursing require prior experience as an RN, while other
specializations can be sought after by those with minimal nursing experience.

These are some questions to keep in mind as you choose what kind of nursing
specialization to pursue:

 * What kind of working environment would I like? (e.g. trauma centers, home
   services, etc.)
 * What kind of care would I like to provide? (e.g. general care, care to women,
   etc.)
 * What is the highest level of education I would be willing to attain? (e.g.
   master's degree or doctorate degree)

Since there are so many possibilities for becoming an advanced nurse, here are
two examples of nursing specializations and what steps are involved with each:

Certified Nurse Midwife: The education for Certified Nurse-Midwives (CNMs)
focuses on healthcare for women and infants, and these nurses typically need to
have completed a master's degree. While many midwife degree programs encourage
applicants to have a background in nursing, they also commonly accept applicants
with no practical nursing background. This means that even if you have a
bachelor's degree in a field other than nursing and you are not an RN or any
other type of nurse, you can still become a CNM. CNM programs include not just
education and research but also hands-on training and experience in clinical
settings.

Nurse Practitioner: The path to becoming a Nurse Practitioner (NP) is stricter
and typically requires you to have experience as an RN. If you wish to become an
NP, you must earn a master's degree or a doctorate in nursing. Because a BSN
must be held before you embark on the path of graduate education in nursing, you
will be required to complete an RN-to-BSN program if you only have an ADN or
another nursing diploma.



JOINING A NURSING ORGANIZATION

An important yet often overlooked step in developing a successful nursing career
is joining a professional nursing organization, which provide great benefits to
members. Some nursing organizations are even available to those who haven't yet
enrolled in their nursing school programs, which makes them accessible to even
those just starting the path toward a career in nursing.

Some of the benefits of these organizations include:

Networking: Nursing organizations provide you the opportunity to network with
other nurses. This can be a great way to form friendships with other nurses and
to learn about what other types of nurses do and experience. Networking can also
help you learn about new job opportunities.

Mentorship: Another benefit of nursing organizations is mentorship, and this is
especially important to those who are just starting their education or practice.
Mentorship allows more experienced nurses to share methods and experiences with
you. Through mentorship, you can receive guidance on how to navigate common
issues faced in this line of work.

Continuing Education: These organizations also provide opportunities to further
your career in nursing through continuing education, as they often provide
members with access to seminars, courses, and conferences that address new
topics in nursing. Some nursing organizations also publish journals that present
new research, discuss compelling topics in nursing, and even post job listings
for nursing positions.





EXPERT ANSWERS TO COMMON QUESTIONS ABOUT RESOURCES FOR NURSING STUDENTS

Ask the Experts

Navigating nursing school is exciting, but it can also be confusing and
difficult. At Study.com, we're committed to helping students along their
educational and career paths. To help future nurses prepare, we posed the
following questions to coordinators, professors, and student leaders in the
field of nursing.

 * Why did you get into the field of nursing?
 * What advice do you have for a student who is preparing to become a nurse?
 * What tips do you have for preparing for and passing the nursing exams?
 * What tips and tricks do you have for easing the financial burden of nursing
   school?
 * How do you recommend nursing students find support and community among their
   peers and other nurses?
 * What are your most helpful self-care tips for nurses during challenging
   times, from a tough case to supporting patients during COVID-19?

You can read their biographies and responses below.


LORA WALTER, DNP, RNC-NIC

Dr. Lora Walter is an Assistant Professor of Nursing and the coordinator for the
Pathways to Nursing track at Chatham University in Pittsburgh, Pennsylvania. She
earned her BSN, MSN, and DNP degrees at Chatham University. As a professional
registered nurse, Dr. Walter worked in a level III neonatal intensive care unit
(NICU) for 8 years. Her scholarly agenda focuses on family-centered care in the
NICU and student engagement using technological and student-centered pedagogies
in nursing education.


WHY DID YOU GET INTO THE FIELD OF NURSING?

I had to find a new career after 23 years in the airline industry. My sister is
a nurse practitioner and inspired me to become a nurse. I graduated from a
Diploma Nursing School and passed the NCLEX-RN. I immediately began working in
the neonatal intensive care unit (NICU) as an RN. I continued my education by
earning BSN, MSN, and DNP degrees from Chatham University. I loved working at
the bedside supporting the critically ill infants and their parents. I found my
true passion in teaching, mentoring, and advising nursing students. My only
regret changing careers to nursing is that I did not do it sooner. Nursing is a
flourishing field with a multitude of opportunities and directions to pursue.


WHAT ADVICE DO YOU HAVE FOR A STUDENT WHO IS PREPARING TO BECOME A NURSE?

Nursing requires critical thinking and clinical reasoning. This is often
referred to as “thinking like a nurse.” I tell my students to prepare for exams
that assess application of knowledge, not just memorization of information.
Students should have a solid understanding of anatomy and physiology, medical
terminology, and math skills. I also tell my students to get exposure in a
healthcare setting. This could be as a volunteer, shadowing a nurse, or working
in some capacity like a Nurse’s Aide or Patient Care Technician.


WHAT TIPS DO YOU HAVE FOR PREPARING FOR AND PASSING THE NURSING EXAMS?

Most nursing schools use NCLEX-RN style questions in their nursing exams. There
are great resources for answering these types of questions. They involve
critical thinking, which is a skill that students need to master. Information is
presented in class, but application of that knowledge is required to pass
nursing exams. My students find study groups extremely helpful. In these groups
students can share their perspectives and openly discuss application of the
information they learned.


WHAT TIPS AND TRICKS DO YOU HAVE FOR EASING THE FINANCIAL BURDEN OF NURSING
SCHOOL?

There are a lot of scholarships available, especially for students agreeing to
work in rural areas after earning their RN. Some schools offer tuition
forgiveness plans if a student agrees to work for the hospital system for two
years after graduating. Most schools have financial aid personnel to assist
students in finding good financial support opportunities.


HOW DO YOU RECOMMEND NURSING STUDENTS FIND SUPPORT AND COMMUNITY AMONG THEIR
PEERS AND OTHER NURSES?

Study groups are a great way to support each other. No one understands the
material, circumstances, and expectations better than a peer. My students belong
to a mentorship club which was created to promote peer support through
mentoring. Senior nursing students have a lot to offer the newer students and
are passionate about helping them. I recommend forming study groups or informal
clubs that promote learning, community, and mentorship.


WHAT ARE YOUR MOST HELPFUL SELF-CARE TIPS FOR NURSES DURING CHALLENGING TIMES,
FROM A TOUGH CASE TO SUPPORTING PATIENTS DURING COVID-19?

Self-care is extremely important. In my career as a Flight Attendant, I told
parents before each flight to put their oxygen mask on first and then assist
their child in an emergency. This holds true in nursing as well. You cannot be a
good support for your patients and families unless you are physically, mentally,
and emotionally healthy. Most healthcare systems offer great support for their
nurses. Take advantage of any opportunity to care for yourself so you can
provide excellent patient care. Also, as in nursing school, peer support is
critical in the clinical setting. Leaning on and supporting your peers will give
you strength and confidence to care for patients in difficult situations like
those presented during the COVID-19 pandemic.


MICHELE PEDULLA, DNP, APRN, CPNP-PC, CNE

Dr. Michele Pedulla has been a nurse for over 30 years. She has worked as an RN
in acute care, APRN in primary care, and in the academic setting, serving as an
expert in a variety of fields including pediatrics, advanced practice nursing,
nursing education, and nursing administration. Some of her self-care activities
include attending sporting events, theme parks, theater, and enjoying the
outdoors with family.


WHY DID YOU GET INTO THE FIELD OF NURSING?

As a student in college, I was on track for pre-medicine. In my final semester,
I felt that there was something "off" with my academic plan and talked with
several nursing students I knew. They were very positive about their decision in
nursing and, as they described their classes, clinical experiences, and mentors,
I realized that I needed to investigate this a bit more. I met with the nursing
admissions team and, after careful consideration, made the decision to change my
major to nursing and, to this day, I have not regretted it!


WHAT TIPS DO YOU HAVE FOR PREPARING FOR AND PASSING THE NURSING EXAMS?

Making the decision to become a nurse or to further your career path in nursing
is like a full-time job. Preparing for NCLEX or any other certification
examinations starts with your first class. Develop solid study habits from the
beginning. This may include blocking time on your schedule each week for
studying, using flashcards and study guides to help organize the material, and
having a study partner. Take advantage of office hours and study sessions hosted
by your professors. Forming excellent study habits from the start and continuing
to perfect these through school are some of the best tips for success.


HOW DO YOU RECOMMEND NURSING STUDENTS FIND SUPPORT AND COMMUNITY AMONG THEIR
PEERS AND OTHER NURSES?

Be involved with the Student Nurses Association in your school. Become a member
of the American Nurses Association (ANA) and participate in local, regional, and
national events. Once you are invited, consider joining Sigma Theta Tau
International and participate in your local chapter and, if possible, the global
events. Most, if not all, associations offer a reduced rate for students and
offer events geared toward students at least annually.


WHAT ARE YOUR MOST HELPFUL SELF-CARE TIPS FOR NURSES DURING CHALLENGING TIMES,
FROM A TOUGH CASE TO SUPPORTING PATIENTS DURING COVID-19?

As healthcare providers, we are focused on helping others and forget about the
need to help ourselves. Self-care is mandated by the ANA Code of Ethics. It is
critical that we stay mentally and physically healthy, now more than ever.
Remember to take time to exercise, sleep, eat, and spend time with family and
friends on a regular basis. Self-care will replenish the nurse's empathy and
compassion so that we will be able to continue to care for all in these
challenging times.


MICHELLE FULKERSON, DNP, RN

Dr. Michelle Fulkerson, DNP, RN has worked as a hospital-based nursing educator,
adjunct faculty in the clinical setting, and is currently an assistant professor
of nursing at Huntington University in Northeast Indiana. Michelle is board
certified in nursing professional development, psychiatric nursing, and nursing
education.


WHY DID YOU GET INTO THE FIELD OF NURSING?

I have wanted to be a nurse since the age of 8! I’m not sure where the idea came
from to start with, but as I got older, I helped to care for my grandmother who
had cancer. My grandpa taught me a lot about caring for her, and then I knew for
sure that I wanted to be a nurse and take care of people the same way he cared
for her.


WHAT ADVICE DO YOU HAVE FOR A STUDENT WHO IS PREPARING TO BECOME A NURSE?

Take as many human science classes in high school as you can. They will be good
preparation for prerequisites to nursing programs. Be prepared to work hard!

Nursing schools have high expectations, but research schools in your area to see
who you best fit in with. Ask to sit in on a lecture and ask about resources
throughout the campus for help with difficult courses or support for
individualized learning needs.


HOW DO YOU RECOMMEND NURSING STUDENTS FIND SUPPORT AND COMMUNITY AMONG THEIR
PEERS AND OTHER NURSES?

Be involved in campus activities. This will help you to feel like part of a
community, learn about resources, find study groups, and even feel like part of
a new family.

In nursing courses, seek out people to study with who have similar successful
study habits to your own. Sometimes just studying with your friends will not
help if they don’t study the way you need to study. Everyone learns a little bit
different and has different study needs.

When shadowing or working with nurses, don’t be afraid to ask questions. Find
your passion in nursing and where you fit in. That knowledge will guide you to
finding an area in nursing where you can enjoy your role and grow
professionally.


WHAT ARE YOUR MOST HELPFUL SELF-CARE TIPS FOR NURSES DURING CHALLENGING TIMES,
FROM A TOUGH CASE TO SUPPORTING PATIENTS DURING COVID-19?

 * Think of your absolute favorite thing to do to relax and make sure you take
   the time to do it!
 * Find a mentor at work to talk to about difficult cases or being overwhelmed.
 * Try not to take work home with you. There will always be patients you really
   worry about, but when you go home that time is for you and your family. Talk
   to someone at work before leaving for the day. Talk about your sadness,
   frustrations, uncertainties, and your joys… then leave those unpleasant
   things behind.
 * Do not be afraid to ask for help if you need it. Whether it’s at work or it’s
   seeing a therapist after work. If needed, ask for employee assistive services
   at your place of employment or find a therapist who works with healthcare
   staff.
 * Know your resources! Do you have a nurse lead on your unit who can help you
   with prioritization when you are overwhelmed? Is there a nursing assistant
   who can help you with patient care? Do you have a nurse educator to talk to
   about learning new medications, procedures, and treatments?
 * Be flexible. Accept change and know that you will never know everything.
   Healthcare is an ever-changing profession and requires life-long learning.


LYNDA OLENDER, PHD, RN, FNYAM, ANP, NEA-BC

As a Distinguished Nurse Lecturer at Hunter Bellevue School of Nursing, Dr.
Olender brings her extensive clinical and administrative background to the
classroom. She has served as a Clinical Nurse Specialist, and Nurse Practitioner
(in VAMC and in Private Practice), as an Education Manager across multiple
health care agencies, as a Consultant for Creative Healthcare Management
(implementing Relationship Based Care and Shared Governance world-wide), and an
Assistant Professor of Nursing at New York and Seton Hall Universities.


WHAT ADVICE DO YOU HAVE FOR A STUDENT WHO IS PREPARING TO BECOME A NURSE?

Volunteer or if able, get a job as a nurses assistant in a hospital. Nursing
programs do not include enough clinical time. In that way you can familiarize
yourself with the type of work you will be involved with as a nurse.


WHAT TIPS DO YOU HAVE FOR PREPARING FOR AND PASSING THE NURSING EXAMS?

Purchase NCLEX EXAMINATION Prep Books and Practice, Practice, Practice!.


WHAT TIPS AND TRICKS DO YOU HAVE FOR EASING THE FINANCIAL BURDEN OF NURSING
SCHOOL?

Go to Financial Aid Office and apply no matter what your income is. Also, check
with student nurse organization and parents organizations to see what they
offer. If you work part time in a healthcare agency, they may provide tuition
support or tuition reimbursement. Also the VA hospitals have residency programs
that pay students as residents on site.


WHAT ARE YOUR MOST HELPFUL SELF-CARE TIPS FOR NURSES DURING CHALLENGING TIMES,
FROM A TOUGH CASE TO SUPPORTING PATIENTS DURING COVID-19?

Meet with staff you work with to put a self care program in place on your unit.
It should include processes for breaks, vacation requests and scheduling
processes. Also have a birthday breakfast once monthly to celebrate your
colleagues birthdays. Have fun!


SUZANNE WRIGHT, PHD, CRNA, CHSE, CPPS, FAANA

Dr. Suzanne Wright is an Associate Professor, Certified Registered Nurse
Anesthetist and Chair of the School of Nursing at Old Dominion University. She
earned a PhD in Health Related Sciences from Virginia Commonwealth University.
Her research interests include patient safety, student success in higher
education and program evaluation.


WHY DID YOU GET INTO THE FIELD OF NURSING?

I chose to be a nurse because the job duties and rewards align well with my
talents, interests, values, and personality.


WHAT ADVICE DO YOU HAVE FOR A STUDENT WHO IS PREPARING TO BECOME A NURSE?

Take the time to learn about what it means to be a nurse. Engage in
self-reflection to be sure what you will be asked to do and sacrifice aligns
well with your interests, values and talents.


WHAT TIPS DO YOU HAVE FOR PREPARING FOR AND PASSING THE NURSING EXAMS?

You must be honest about your willingness to commit to in-depth study. Nursing
school is challenging but those who invest their resources into the learning
process are extremely successful and enjoy a rewarding career. Become a nurse
only if caring for others brings you great reward.


WHAT TIPS AND TRICKS DO YOU HAVE FOR EASING THE FINANCIAL BURDEN OF NURSING
SCHOOL?

Students should plan for expenses related to higher education as soon as
possible and invest their resources accordingly. Because the nursing workforce
demands more workers, funding is often available through scholarships, grants,
and work-study. Additionally, students should plan to save for college to the
greatest degree possible.


MICHAEL L. WILLIAMS, PHD, RN, CCRN, CNE

Michael L. Williams is the Director of the School of Nursing at Eastern Michigan
University. Since graduating with his A.D.N. in 1984, he has worked as a bedside
ICU nurse and continues to do so part-time. In 2001, he served as the President
of the American Association of Critical-Care Nurses. He has been an expertise
teacher, administrator, and mentor to many faculty, staff, and students.


WHY DID YOU GET INTO THE FIELD OF NURSING?

My plan to be a nurse wasn’t my original college goal. I loved chemistry in high
school and began that as my initial major in college. But as fate would have it,
in looking for a summer job, I could only find work in a nursing home as a
nurse’s aide. I had no training, other than first aid and had much to learn.
But, I feel in love with the care I was able to provide to these geriatric
residents. I got to know them, their families that visited, and realized the
privilege and honor it was to provide them with care. At that moment, nursing
became a viable option for me and I sought out others who were nurses that
encouraged me to pursue it as a career. After graduating with my BS degree in
medical technology, I went on to get an A.D.N., then an MSN and ultimately a PhD
in nursing. I started as a new nurse in an ICU and have worked in ICU for 37
years; along with my position as a director of a school of nursing. Recently, I
provided care to a retired nurse whom I had the privilege of meeting and working
with 31 years ago. It was truly an honor to care for her.


WHAT ADVICE DO YOU HAVE FOR A STUDENT WHO IS PREPARING TO BECOME A NURSE?

There are so many things I wish I had known when I decided to become a nurse.
First and foremost, you must have a true commitment to caring for others. As a
nurse, you will need to use your cognitive, psychomotor, and interpersonal
skills in whatever field you choose. It is important to have intellect, but also
you must also be sensitive to human conditions and adjust your approach using
your interpersonal skills at the same time using your psychomotor skills to do
your job. It is both physically and emotionally demanding work; as it should
be—patients are entrusting their lives to you! So being intellectually curious
and embracing lifelong learning are a requirement of being an outstanding nurse,
but you must also have the compassion and temperament to work with people with
different beliefs, values, and resources. You must also learn to take care of
yourself; as your physical and mental health are important too.


WHAT TIPS DO YOU HAVE FOR PREPARING FOR AND PASSING THE NURSING EXAMS?

You must READ the assigned readings and spend time understanding the content of
the reading; not just surface reading, but deep reading for true comprehension.
I would suggest students read and take notes as they read. Read for content you
don’t know! Too often, when people find something they’re reading easy, it’s
because they already know it and no learning is really taking place. Read your
text, compare it to your notes from class or resources given to you by your
professors and be able to reconcile any dissonance you experience—ASK if you
don’t understand a concept. You should immerse yourself in your work—you have to
spend time with these complex concepts in order to master them. Simple
memorization won’t work, even if it’s worked in the past. In preparing for
exams, I recommend you write out your notes from your class and combine them
with your notes from your readings. Then, pretend you are instructing others on
the class content. Role play that you are the instructor explaining the content
to another student. In this way, you must know it or you cannot adequately
explain it. I used to review my notes and give lectures to my cat! And last, in
taking the exams, you must be deliberate and work through the question.
Determine what the question is asking, know the difference between the case and
the stem. And when practicing exam taking, I recommend that the answers be
hidden and you treat the question like a fill-in-the-blank. Use a piece of paper
to cover up your options and write down what you know about the case, the
disease, the symptoms, and its treatment. Chances are once you’ve written down
things you know about the situation, the answer will pop out at you. And lastly,
don’t change your answers unless you’re absolutely certain you darkened in the
wrong answer. If you’re uncertain, don’t change it—chances are your instinct was
right!


HOW DO YOU RECOMMEND NURSING STUDENTS FIND SUPPORT AND COMMUNITY AMONG THEIR
PEERS AND OTHER NURSES?

Nursing school is so incredibly competitive and stressful to gain admission.
Remember—you earned you spot in the program so now is the time to collaborate
and rely on each other. Get to know your classmates, join your nursing student
association, and create friends. Remind each other of assignments and quizzes.
Health occupations education is significantly different than many of you have
previously experienced. It’s more than simply studying and taking an exam. It’s
getting up at 5:00am to get ready for clinical and studying late into the night.
It’s also about being on the top of your game in clinical—where it really
counts. Building friendships and collaborative relationships with your peers is
crucial—it will make it easier for all of you. Also, do go to your professor’s
office (virtually or in-person) during office hours. Come prepared to ask about
difficult concepts and things you don’t understand. They want to help you. Be
careful relying too much on nurses who went to school more than five years
ago—our profession and the knowledge base is changing rapidly. Things we used to
teach are obsolete and their information might just confuse you. Explain to your
family the complexity of what you’re undergoing in nursing school. Unless,
they’ve attended a health professional program, many don’t have any idea the
rigor of the program or the volume of knowledge you must have to be a nurse. And
always, be kind to yourself!


WHAT ARE YOUR MOST HELPFUL SELF-CARE TIPS FOR NURSES DURING CHALLENGING TIMES,
FROM A TOUGH CASE TO SUPPORTING PATIENTS DURING COVID-19?

The most important self-care strategy stars with knowing yourself in many ways.
Are you a morning person or do you like to stay up late at night? How will you
fit in everything you need to do—attend class, study, make dinner, help the kids
with their homework, spend time with your family and friends, and many other
things. What are you willing to forego while you’re in nursing school? Perhaps
this is the time, you hire a babysitter so you can go to the library to study or
you hire a housekeeper to assist with things in the home. What is your partner
or children willing to help with to create a balance? Eating right, sleeping,
and exercising are all things known to be beneficial to one’s self-care.
Mindfulness, being in nature, taking time to read a novel, travel, and/or other
activities that you find restorative are unique to you. Find them and practice
them. It’s ok to turn off your computer, turn off your electronic devices, and
listen to the birds chirping. Supporting patients through COVID-19 or reacting
to a tough case is hard. It is physically and emotionally draining. It is
incredibly sad when you’ve worked with a patient for weeks on end with slow
progression and signs of improvement only to have them deteriorate and succumb
to it. It’s ok to be sad. It’s ok to cry. It’s ok to be mad. Many of us have
said “I hate Covid!” over and over. Support each other. Allow them time to
react, to be sad, to be mad, and to simply be. Seek out mental health experts to
support you and others. The ongoing overwhelming stress we are all experiencing
in every aspect of our lives has us on edge, grinding our teeth, sleeping
restlessly through the night or waking up early unrefreshed. YOU are important
too! Look inside yourself for peace and strength and reach out to others to help
them. We are in this together!

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