Hardest Nursing Courses

The Hardest Nursing Courses & How to Succeed

If you are planning to enter nursing school, or are a new nursing student, you’ve probably heard disturbing stories about which nursing courses could be difficult to pass. Maybe your mind automatically goes to worse case scenarios, and you’re already worried you won’t ever become an RN – all because you couldn’t pass that one class. But wait. Let’s think this through!

What should I expect when I enroll in nursing school?

Each school will create a criterium that includes what students should know in order to do their future nursing jobs properly and safely. Some schools require pre-requisites that should be completed before admission; others include all courses in one program. Educators know that nurses will need to understand things like the basics of biology – how cells work and replicate, the purpose of each body system, and what happens to the body and its chemistry balance when an organ or system doesn’t perform as it should. Your school’s curriculum will build upon elementary concepts like these, so it’s important to pay close attention to and understand them completely. Students who do will have an easier time passing more difficult courses. And speaking of that…

The cold, hard truth is yes – there will be especially difficult nursing classes to pass in nursing school.

But stop doubting yourself! Not everyone who applies to nursing school is admitted – yet YOU were. Before you were a nursing student, you already demonstrated an aptitude for successfully tackling difficult things just like this. The spots in each year’s nursing class are often limited, so schools will select the students they are pretty confident can make it through.

You may notice that some nursing students struggle, while others seem to pass easily.

There are several reasons for this. If you took science and biology classes in high school, you will likely be well-prepared for those courses in nursing school, even though upper-level courses include material that is more in depth and difficult than at the high school level. If you’re one of those students, you will probably not be too freaked out about taking chemistry and anatomy/physiology in nursing school. But what if you didn’t? Nursing students come from a wide variety of backgrounds, and not all will feel prepared. But that’s what study sessions and effective time management is all about. Perhaps the skills you have are not nursing or science related, but you do know how to buckle down and accept a difficult challenge. Maybe you excel at memorizing, or your natural curiosity leads you to learn new things, and you’re able to grasp difficult concepts in other subjects. Each of these skills will help you overcome any deficit in education or experience you feel you have. Nursing students graduate every year who had little to no prior science or biology course experience. Remember – you can easily tap into the skills you came to nursing school with and apply them there for success.

What nursing classes SHOULD I fear?

Pharmacology, Microbiology, and Anatomy & Physiology each have a well-earned reputation for being difficult to pass. Some students may find Cardiology, Chemistry, or even Mental Health especially trying. As a nursing student, you may think the content of a particular class is easy to grasp, while another student may believe a course you are struggling to pass is easy. Don’t get caught up in thinking too much about it or comparing yourself to another student’s experience. The truth is, ask any nurse what their most difficult nursing class was, and you’ll likely get a variety of answers. Remember: don’t let another’s fears affect your confidence or determine what you are capable of.

So how do I get past that fear?

Confidence will come in time with preparation and perseverance. And don’t underestimate the importance of being patient with yourself. Difficult concepts take time to learn, and that’s to be expected. If it takes you longer than your peers to grasp a difficult concept, that doesn’t mean you will fail the entire course. You can always break these topics down into the smallest ideas, and once those ideas are mastered, you will likely feel more confident about tackling the next, more difficult concept. Master the basics first, then you will master it all. And before you know it, you will look back and realize just how much you’ve learned, one study guide, exam and course at a time.

What are some of the “most difficult” classes in nursing school?

Anatomy and Physiology: This class will explore everything about the human body, including bones, ligaments, tendons, muscles and organs. A&P is a highly visual course. Re-drawing diagrams of these body parts or watching online videos that thoroughly explain these structures will help you better understand how one thing influences or connects with another. Learning the location and functions of the anatomy of the body, as well as there physiology (how they work), will help form the foundation upon which other nursing courses will build. In classes you will take toward the end of your degree program, you will begin to meld all these things together, and you will thank yourself for taking the time to thoroughly grasp anatomy and physiology. It often takes “hands on” experience with a real, live patient to truly understand what you learned in class. With this in mind, use your clinical time during nursing school wisely, as you begin to apply what you’ve learned in real life.

Microbiology: This course is similar to A&P in its complexity, but your focus will be on microsystems and their effects on the body. You will study bacteria, viruses, fungi, protozoa, algae, and archaea – organisms too small to be seen without a microscope. You will learn their characteristics, the diseases they can cause, and which medications may be effective in treating them, such as antibiotics and antifungals. After taking this course, you will better understand why certain labs like blood, urine and sputum tests contain crucial information that will help identify how to most effectively treat patients who have infectious diseases. Just like A&P, this course will likely include a lab section, which some students may find tedious and difficult. But don’t skip it. Your efforts in lab class could be just the thing that helps you better understand, and then pass microbiology.

Pharmacology: Medication administration is one of the most common responsibilities for nurses. Knowledge of medications and which diagnoses they treat will prove useful to you every single day. Although Pharmacology will cover a vast number of medications, along with explanations about how these medications work within the body, there are things you can do to more easily remember them. Start with memorizing specific drug classes and note what prefixes or suffixes they commonly use. For example, blood pressure medications often end in “pine” (amlodipine – calcium antagonist), “pril” (lisinopril – ACE inhibitor), or “lol” (propranolol – beta blocker). The mechanism of action will be apparent for many medications simply by noting the suffix they contain. Remembering which drug class a medication belongs to will also help you know the appropriate nursing considerations, including its potential side effects and contraindications. With time, you will have the ability to review a patient’s medication list and identify many of their diagnoses, based upon what medications they are prescribed.

Helpful hints for any nursing class you find difficult.

Review the syllabus: At the beginning of each semester, carefully review the syllabus, then separate the curriculum into daily and weekly sections. This can keep you from feeling overwhelmed when you realize the amount of knowledge you are expected to learn by the end of the semester. This will also help you focus on the topics you most need to study, and when.

Create flashcards: You don’t have to go high-tech when studying for difficult nursing classes. Purchase index cards, then make flashcards that focus on what you most need to remember. Take notes during each class, then condense notes into bite-sized, paraphrased segments, and add them to each flashcard. You can also use flashcards to review exam questions you missed (with the question on one side and the answer on the back), or for things like medications (with drug names on one side, and mechanism of action and side effects on the other). Flashcards are a quick way to review content when you have a few minutes in your day or for quiz sessions between you and another student. Be sure not to throw those flashcards away after you finish a course. They are valuable tools you can use again when you study for the NCLEX.

Traverse is an app that helps you comprehend and memorize in one smooth flow. Your concept maps, connected notes and smart flashcards are all in one place. Flashcards no longer live in isolation, but connect with your notes and mind maps, reflecting how knowledge is connected.

Use mnemonic devices: This technique can help you easily memorize a lot of information, and there are several types you can utilize.  A word or concept could be incorporated into a concise drawing that ties everything together into a bite-sized visual, using association. Another mnemonic device involves making a word out of the first letter of several concepts you need to remember. ADPIE (“a delicious pie”) can be used to remember the steps of nursing process: Assessment, Diagnosis, Planning, Implementation and Evaluation.  These tools can be especially helpful when learning medications or how a particular disease presents in a patient, and can often be more easily recalled than written paragraphs of explanations can.

Do a quick review AND preview before class: Review flashcards that contain previously learned material, then read ahead for the next class so you will be familiar with the information your instructor will present. If there is a particular unit you think will prove challenging, “star” the section, write notes, and think of which questions you want your instructor to clarify for you. This “offense” approach will prepare you for the new material ahead and, in turn, will boost your confidence during class.

Find videos that explain concepts you’re struggling with: There are many reputable websites online in which to find medical content, and these can be great adjuncts to other study methods. Although your instructor will likely do their best to explain course content in class, sometimes it takes just the right explanation or demonstration to make it click for you.

Read notes aloud: Some students are visual learners, but others are auditory learners. Reading your textbook or flashcards out loud will help solidify what you are learning. You can also record your voice while reading flashcards or notes, then listen to the recording on your commute, or just before you go to sleep at night. Research shows that reviewing material just before sleep enhances memory and recall.

Master time management: Regardless of profession, proficiency in time management is important for a healthy work-life balance, and it will substantially improve your chance of success in nursing school. You will also feel less stressed if you use your time wisely. Schedule books or calendars can be very helpful with planning your day or your week. When you write down your plan on paper, along with how much time is expected to complete it, it is much easier to see how much time is wasted doing non-essential tasks. That said, be sure to schedule time for fun and relaxation. The demands of nursing school will quickly deplete you if you don’t take mental health breaks or make time for physical activity. You may have heard of DBT (Dialectical Behavior Therapy), in which there is a learned skill called “cope ahead.” This refers to anticipating when you may have a challenging day, then taking action to lessen the expected stress of it. For example, when you know the next day will be especially busy, you can prepare your lunch the night before, so you aren’t tempted to skip lunch the next day. If you implement these kinds of things into your routine, your mind and body will thank you for the special care.

Take practice quizzes to assess for weak areas: Ignoring subject areas in which there are learning weaknesses can be lethal to the success of nursing students. Take practice quizzes or review missed exam questions. That information can tell you where your focus should be during your next study session. A technique called “interleaving” can also be helpful. If you’re burned out from studying for one class, switch to another, or review a study guide in a different sequence than the time before. “Spaced repetition” involves spreading out study sessions into shorter periods, instead of “cramming” for three hours. This will help your brain make stronger connections to the material you need to know.

Develop your critical thinking skills: You may have heard about those confusing NCLEX questions you’ll be asked once you have passed nursing school and are taking Boards. Many of those questions have more than one “right” answer, but you will have to choose the “best” answer. What this means is, your critical thinking skills will be put to the test just as much as your nursing knowledge. Because of that, you will practice this skill many times throughout nursing school, with every quiz and exam you take. So don’t fear, you’ll get there – it’s a skill you’ve been developing all along. So while you’re still in nursing school, don’t be afraid to ask your instructor why one answer is a better choice than another. This will give you good insight into how to “think like a nurse” — and pass the NCLEX.


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