Friday, 29 April 2016

Sometimes, we are our own worst enemy. Since joining Allnurses and reading the posts, over the past year, I have noticed some vitriolic hatred. However, I am not talking about comments between members (although this does happen from time to time), but rather the self-reflections on this site (albeit, usually incorrect ones). Often, I would see this self-hatred among members who wish to apply to nursing school, but believe that their backgrounds are too minimal [insert low grades, test scores, clinical hours, minority group representation, or other values] and/or abnormal [insert age, non-nursing histories, or other atypical histories]. And while some factors could make a potential applicant ineligible for admission, many can be improved upon and/or make a candidate unique. The goal of this article is to disparage those negative beliefs and instill the idea that nursing school is possible…with a little hard work. Here are some common (summarized) writings from members on Allnurses (for clarification, I combined multiple scenarios into each section) and responses to those posts that could help get an applicant in the door:


#1 – My cumulative and/or prerequisite GPA is terrible and I either do not meet the minimum requirements or barely meet the minimum requirements. I may or may not have repeated courses or accrued a huge amount of credits that did not help the situation.

As a disclaimer, there probably are a couple academic situations that will not be addressed in this article. However, I’ll try to address some of the frequent GPA downfalls. The first can be poor prerequisite grades, especially in the sciences. Now there are a number of reasons on why you could have done poorly in anatomy and physiology, microbiology, chemistry, statistics, etc. The first that comes up among pre-nursing students is you were trying to do too much. Instead of focusing on anatomy and physiology, statistics, and maybe one non-nursing prerequisite, you decided it was a great idea to go explore the city/college nightlife, join every student organization on campus, work two full-time jobs, and join the circus, all while taking those three courses, as a full-time student. And you realized sometime during the semester/quarter, while taking your final, or shortly after the semester/quarter ended, that you did not know the material as well as you should (be honest with yourself if you believe the professor was out to get you) and thusly, you did poorly. To resolve this issue, you need to retake the class, but eliminate all the distractions you can. That means holding off on those get-togethers, student organization attendances, facebook sessions, etc. and focus on school.

The second most common reason I see people failing the prerequisites is because they lack a solid foundation to do well in them. Meaning, they take microbiology and lack the basic understanding of how bacteria function and how to categorize organisms (taxonomy). Or for statistics, they have trouble with the normal distribution curve because of poor arithmetic backgrounds. The good news is that most schools have resources available for students to get help, including from professors, student tutoring centers, etc. Along with that, places on the internet, like Khan Academy and other Youtube teaching channels, can offer ways for students to get caught up with the material. I’d also add that reading the textbook (along with studying the lectures) can help. If you have already received a grade in the class, I’d use those resources for the next quarter/semester retake. You could even create or use a playlist of educational videos, as a pseudo-refresher course, before school starts. If a nursing school prefers a more advanced course over a retake, I would work on getting a solid understanding of the introductory material, before moving on. If you have taken a repeat and were still unsuccessful in the course, then you need to reevaluate where you’re going wrong. That means following the overloaded schedule and/or poor foundation advice stated above.

Now let’s say that you are applying to a program that factors in your cumulative GPA, then those retakes, if needed, could help rectify the situation. However, if the retakes are not needed or they are not accepted under a grade replacement policy, then you need to see if you can take a few other courses to show you can perform well, as a student. If the nursing department/school will only consider the cumulative GPA and not upward trends, then you’ll need to figure out how many credits/courses are needed with high grades to change your GPA to an acceptable number. If you are really adamant about joining that program, but have a low GPA and a large amount of credits/courses on your transcript, it could take a while. In that case, you might want to consider programs that do not have that cumulative GPA requirement.

#2 – I’m terrible at tests and worried about my nursing program admissions test. I may have taken the test before and didn’t perform that well. I may also need a fairly high score to enter the program.

First of all, take a deep breath. Second, you have to figure out why you are scared or what went wrong, depending on your situation. If you lack the knowledge to do well on the English section, then you might need to work on understanding the rules of grammar and how to break down sentences. For reading comprehension, I would work on analyzing different articles for the key points (such as author opinion, main idea) and being able to make logical conclusions from the information given. If the sciences are giving you trouble, then you need to review the key concepts of each topic covered on the test (like information about the periodic table or how protein is made). If math is tricky for you, then I would review the rules that apply to each type of problem, make sure I read through all the steps and information associated with each problem, and try to practice as many problems as you can, until you feel confident with each topic (math word problems, for example). That last point is especially important for all subjects on the exam. Practice, practice, practice, which includes those practice exams you’ll find with the prep material. This process applies to first time test takers and people retaking the test. If after all that independent studying you’re still making mistakes, try to conserve some of the practice material (including the exams). Then, go use your school resources listed above using that material (maybe use textbook resources as well) and maybe consider someone to privately tutor you. The issue might not even be related to studying, and might just be test anxiety. If that’s the case, I’d consider methods to keep you calm on test day. There are many approaches to this issue, but some ideas include: not drinking five cups of coffee before an exam, knowing that this one test result will not be an end-all to your nursing career, gaining pride in knowing that a test does not define who you are, and gaining confidence (hopefully through practice) that you can do well on the test. There are always events out of our control and sometimes you can end up on test day, with one hour of sleep. If that’s the case, you have to judge how well you think you will do on the test (some people can manage, others can’t), depending on how urgently you need to take that test.

#3 – I don’t have any clinical experiences, so how am I supposed to get a reference/letter of recommendation from a nurse? Or if I do have a clinical position, how do I get a reference/letter of recommendation, when I rarely talk to the nurses?

If you don’t have any volunteer/work clinical experience, get some working with nurses as quickly as possible, especially if the application cycle is coming up (but make sure you meet the requirements). The problem is in many areas, there are many volunteer applicants for hospital volunteer spots. Strangely, in those same places, you’d probably find many CNA/NAC openings that you’d work with nurses (depending on the state, you might be able to work while getting your CNA/NAC license, and you can check on that with employers and/or the state), where you can get that clinical experience or those clinical hours and get paid. You can also volunteer in many other healthcare communities outside the hospital, such as community health centers, nursing homes, etc. However, I’d probably try to get as close to patient care as possible.

Next, you need to start getting to know the nursing staff for the reference/letter of recommendation, by helping them out however you can and chatting with them, if that’s ever possible. Find out which nurse (you probably need a letter of recommendation/reference from an RN) is the friendliest and most professional and get to know that person, while trying to make his/her life a little bit easier (maybe you can alleviate some of their work as a CNA/NAC, getting them food, if they don’t get a break…). After he/she has gotten to know you and agrees to write the letter, please provide some sort of outline or draft that answers everything that the school/department of nursing is asking and your resume in a meeting with the nurse, and make sure everything is included with that letter. If you believe the letter they wrote is pretty good, then send it in and please write them a thank you card. If you need them as a reference, maybe ask them what they would say about your characteristics and why you would be a good nurse. Then, ask for their contact information (make sure they can give good answers, though).

#4 – I am part of a minority in nursing (ethnic, age, sex/gender…) and don’t feel like I would be welcomed. Should I bother with pursuing the field?

Well, I can’t answer that for you. Having talked with many nurses, what I will say is that nursing is an incredible field, where you can do some pretty amazing stuff. But, in order to do that, you will probably encounter some prejudice along the way from admissions staff, instructors, patients, non-medical people, or fellow healthcare providers, once you’re a registered nurse. If you feel proud about what you do, then try to be an environment that does foster diversity and do stand up for yourself, in a professional manner. One specific thing I will mention about prejudice is for those in a minority age group is that if you are mentally and physically capable of pursuing nursing, then being older than most students should not stop you. I have encountered plenty of nurses in their 60s and 70s and some even older than that, that are great nurses.

#5 – I am a career changer, where my background is in something completely unrelated to nursing. For example, I am a mechanical engineer that works for a major defense contractor, where I work with engine parts. Obviously, it is not related at all to nursing. How can I convince an admissions committee to admit me into their program?

The same way you would if you were any other applicant. You need to take the prerequisites and do well in those classes. Then, you’ll need to take an admissions test, if it’s required. During that time, again if required, you’ll be gaining clinical experience (volunteer or paid) and seeing what it is like to be a registered nurse. You’ll also want to be completing the other requirements, like getting a reference/letter of recommendation. Then when you apply, assuming there’s an essay that asks for your motivation for being a nurse, you can talk about your clinical experiences and what you can contribute to nursing, with your engineering background (or insert any other non-related profession here).

#6 – I didn’t get in anywhere and I applied to so many different programs. Nursing has been my dream, ever since I was little. Should I give up?

No, but you need to figure out what went wrong. If you applied to all top tier schools and you didn’t get an interview or proctored essay invite, that should probably tell you that one of your admissions materials (grades, test scores, letter of recommendation…) was inadequate (or you forgot to submit something or submitted something extra that was not asked) and you will need to spend time improving that aspect of your application. If you did get an invite, then I’m guessing you were pretty darn close, but fell slightly short, in being compared to other applicants. I’d work on answering questions for an interview (see below) or working on your writing skills (using sample essay prompts, for example) for the proctored essay, if you are considering reapplying. If there was no proctored essay/interview and you were well below the admissions averages (GPA, for example), then you could work on those aspects, using the advice above. Also, see if the program offers any feedback and/or advising.

#7 – I suck at interviews. I have no idea what they are thinking or if I am saying the right things. I also mumble a lot and get nervous. What can I do about the nursing interview?

First, research the schools goals/mission and then look at your strengths and weaknesses (that latter part will be particularly important if they ask what your greatest weakness is). Try to write out answers to potential interview questions, like why you want to go into nursing, what important characteristics you need to have as a nurse, what makes you a great candidate, why do you want to go to that school, what your career goals are, what your greatest strengths and weaknesses are, has there ever been a time where you had to make a difficult decision (i.e. a decision about safety, reporting a friend that stole something), and so on. Then, after writing these answers down, rehearse them with your friends, family, and dog (though not in public). Then, dress the part for the interview.

Although this list is not exhaustive, it should give many people a good idea of where to go. And it is always a good idea to seek out advice from the admissions office, if possible. If you need to improve somewhere, make a goal and stick to it. But, also be realistic about your goals. I hate to say it, but sometimes if you get into a great school, but not the number one ranked nursing program, and pass the NCLEX, then you’ll still be an RN. Even better, you won’t need to spend a year reapplying to try and get into that other program. And once you get into a nursing program that employers and you are okay with, or maybe in a program that employers are okay with if you continue your education (RN-to-BSN, for example), then try to enjoy life and not worry about what could have been. Life is too short.

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