Stages of Labor NCLEX Review

Stage 1

Defined as the first onset of contractions through the complete dilation of the cervix, with 3 separate phases. Stage 1 is the longest phase. Throughout this phase, keep in mind the following interventions:

  • Monitor maternal and fetal vital signs.
  • Continually assess FHR before, during, and after contractions.
  • Assess fetal descent, cervical dilation, and effacement.
  • Assess fetal station presentation and position.
  • Encourage frequent position changes and/or ambulation if not contraindicated.
  • Involve patient and support person in labor process and what to expect.

Latent Phase

To start, I will add another definition here, prodromal labor. This is latent phase labor that has lasted several days.

The latent phase is usually defined by:

  • Cervical dilation is 1 to 4 cm.
  • Uterine contractions occur q15-30 mins and last 15-30 sec.
  • Lasts an average length of 5-8 hrs
  • Contractions are of mild intensity

In this stage, mom’s will most likely be feeling a variety of emotions. They are also usually able to participate in their own care and may not quite ask for pain control interventions at this time. Keep in mind that each mom is unique and requires individual assessment!

Active Phase

This phase consists of:

  • Cervical dilation of 4 to 7 cm.
  • Uterine contractions q3-5 min and last 30-60 sec.
  • Lasts an average length of 2-5 hrs.
  • Some fetal descent.
  • Contractions are moderate-strong intensity.

During this phase of labor, mom’s behavior will start to shift. She will start breathing heavier and may not be able to talk through contractions. She will benefit from a quiet environment and pain control interventions. Pain interventions do not have to be medication, as promoting comfort with back rubs, sacral pressure, and position changes can be effective and beneficial.

Transition Phase

This phase is arguably the “most difficult” phase of labor.

  • Cervical dilation is 8 to 10 cm.
  • Uterine contractions occur q2-3 min and last 45-90 sec in duration.
  • The contractions are of strong intensity.
  • Fetal descent.

During this phase, mom may have increased anxiety, apprehension, and discomfort. She will experience increased pressure, bloody show, and may verbalize the urge to push. Contrary to the active phase of labor, she may not want to be touched. Rest is encouraged between contractions.

Stage 2

Stage 2 is defined as the period from complete cervical dilation and effacement to the delivery of the fetus, or “Expulsive” phase.

  • Contractions continue to occur q2-3 min lasting 60-75 sec.
  • Increase in bloody show occurs.
  • Mom will experience voluntary or involuntary urge to “bear down.”
  • This stage can last minutes to 4 hours.

Sources of pain during the 2nd stage of labor change from pain in a more generalized area to localized to the distention of the vagina and perineum and pressure on adjacent structures.

It is important to complete assessments every 5 minutes. Normal FHR is 110-160 bpm before, during, and after contractions.

Cardinal movements of labor:

  • Descent
  • Flexion
  • Internal Rotation
  • Extension
  • Restitution
  • External Rotation
  • Expulsion

Stage 3

The process of labor does not stop once the baby has been born! This 3rd stage is from the delivery of the infant to the expulsion of the placenta. Contractions continue to occur until this is completed.
Image source: https://www.newlifeblessings.com/blog/category/placenta

  • Schultze Mechanism: “Shiny shultze” – center of the placenta separates first, and the shiny portion of the placenta emerges first.
  • Duncan Mechanism: “Dirty duncan” – the margin of the placenta separates first and the dull, rough, red portion of the placenta emerges first.

Signs of placental separation:

  • Uterus becomes globular shaped
  • Rise of the fundus in the abdomen
  • Sudden gush or trickle of blood
  • Further protrusion of the umbilical cord out of the vagina

Be sure to continue involving the mother and support person in this stage about the steps of delivering the placenta while also promoting parental-neonatal attachment. The uterine fundus should be firm and should be located 2 fingerbreadths below the umbilicus.

A placenta is considered retained if more than 30 minutes has elapsed since the birth of the infant.

Stage 4

Stage 4 is known as the Recovery Stage. This stage is defined from the delivery of the placenta to the immediate recovery of the mother.

It is important to perform maternal assessments q15min for 1 hour, q30min for 1 hour, and hourly for 2 hours, or according to facility policy. Apply ice packs to the perineum, and massage the uterus as needed to keep it firm.

The mother may also experience chills, a hypotonic bladder, and a variety of emotions related to the birth process. Encourage continued bonding between the infant and parents, and provide breast-feeding support as needed.

References and Additional Resources

All image sources are linked near or under the image on this page. I do not own the rights to images posted on this page.

Continue your NCLEX Review Journey by checking out some of my other NCLEX Review posts!


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How to Answer Priority and Delegation NCLEX Questions

Everytime I see one of these questions, I want to pull my hair out! They intimidate me and I often feel the least prepared for these types of questions. Here I will break down how to answer NCLEX-style priority and delegation questions.

A lot of this material comes from the Saunder’s Comprehensive NCLEX Review💎. If you’ve seen any of my other posts, you have probably run across this book. I wish I would have purchased this book my first semester of school. I bought it my third semester and kicked myself for not getting it sooner. It has been worth every penny to me!

Another great resource is the Brilliant Nurse💎 Course for NCLEX prep. It has practice questions, detailed rationales, videos, strategy sessions, and case studies. The prices are very competitive with other similar online NCLEX-prep websites.

Priority

Prioritizing patient care is an essential nursing skill. It will determine who gets care first, and the order in which you perform your tasks. Often in the clinical setting, it can be easier to spot your priorities because you have access to a lot of information. NCLEX-style questions can be tough simply because you are given 1-2 sentences of limited information with which you must make the decision.

These types of questions can be multiple choice, select all that apply, ordered response, exhibit questions, etc. Any type of question is game!

Priority Guidelines

  • ABC’s – Airway, Breathing, Circulation
  • Remember Maslow’s Hierarchy of Needs
  • Consult your patients about their priorities and needs
  • Use the nursing process to guide you

When you are given a set of choices, read them all before making your decision. Hopefully you can eliminate 1-2 choices right off the bat. After that, use your ABC’s. If any answer choices fall into that, it is probably your answer.

Delegation

The key to answering delegation questions is understanding the scope of practice for yourself and each of your colleagues. You must also analyze the tasks that need to be done and the importance of completing them. Then, assign tasks to a competent individual.

When you assign a task to someone else, the nurse who owns the task is accountable for it.

Always ensure patient safety when delegating tasks. In general, non-invasive interventions such as ambulation and hygiene measures can be delegated to UAP’s (Unlicensed Assistive Personnel). An LPN or LVN can do some invasive procedures such as catheterization and suctioning.

Remember that a Registered Nurse is responsible for assessment, planning care, initiating teaching, and administering medications intravenously.

Never assign an unstable patient to UAP’s or LVN’s.

I hope this helps explain how to approach these questions! Practice makes perfect. Use one of the resources listed above to do practice questions! The more you expose yourself to these tough questions, the better you will get at it!


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Changing Careers (or Majors) to go to Nursing School

When I graduated high school, I wanted to be an Aerospace Engineer and work for NASA. I applied and got accepted to some of the top engineering schools in the country like University of Texas at Austin and Colorado School of Mines. I eventually chose a scholarship at the University of Colorado Boulder. My engineering journey lasted three semesters, and then I discovered that I was entirely unhappy with my life. I had a fancy engineering internship, I had great friends, and I lived in a beautiful city. What on earth could be wrong with that?

The bottom line is that engineering was not for me. It wasn’t God’s plan for me. At first I was upset that I had wasted so much time in that field, but looking back, I have used a lot of those skills in my daily life and my new nursing career.

A Diversion is Not A Waste of Time

There are so many people out there who choose nursing as a second, even third career. Some of my thoughts getting accepted into nursing school at age 24 were, “It’s about time,” and “I can’t believe I didn’t think of this sooner.”

It has taken about three semesters of school for me to be content with all of the other life choices I’ve made. I had a really rough patch, and I made a lot of choices that I regret.

If you have those types of life experiences, deal with the emotions, and use it to your advantage. I’ll use the cliche, learn from your mistakes. I am better able to handle the monstrosity of nursing school because of what I went through to get there. I would not be able to handle nursing school if I went right out of high school. I know that and I am thankful for it.

Tip: Write out your biggest life regrets/bad choices. On a separate piece of paper, write out positive lessons you learned from them. Then burn the first page with your regrets.

Have a Plan Before Quitting Your Current Job

This is something I did NOT do. Although there were many other factors in my quitting engineering school, I did not plan anything out. I left school for about a year before going back. I knew I did not want to do Aerospace, but I wanted to finish a degree. I decided to take some biology classes.

Some more life stuff happened and I switched to online, part-time school. By this time, I knew I wanted to be a nurse. I had spent so much time in the hospital that I fell in love with the art of nursing.

If I had a plan after the first time I left school, I would have been better off. But that didn’t happen. I had no idea how to start. I did zero research. I straight up just quit.

Tip: If you aren’t sure which major you want, take your basics first. Each state has different requirements, so check those out. Get your English, Math, and electives out of the way.

Do Your Research About Nursing

Nursing is a one-of-a-kind career. Nursing school is rigorous and life-changing. You will lose sleep. You will have less time with your family. You will cry. You will want to quit.

Do your research about nursing. There are a lot of misconceptions about what the job entails. If you have friends or family in nursing, ask them questions.

Listen To Your Heart

If you have a passion for it, go for it. If you are 100% sure you want to be a nurse, go for it. Any roadblocks along the way just makes it more fun when you get to your goals.

If you do all of this research and soul-searching and you still aren’t sure, you are an adult and can make your own decisions. However, I can tell you from personal experience that you need your whole heart to make it through nursing. Even when I hate school, I love it. Wouldn’t trade it for anything.

Take some time to better yourself. Read some personal development books. They are not all “if you believe it you can achieve it” cheesy. Take a look at some of my favorites below –>

Thanks for reading!



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How to Study Health Assessment in Nursing School

Assessment is one of the skills that set you apart from a lot of other medical careers. CNA’s, MA’s, Techs, and other UAP’s do not have the assessment skills that registered nurses have. It is one of those skills that is pounded in nursing school, but never truly mastered until years and years of practice. This guide will hopefully give you a better idea of how to study Assessment in Nursing School and answer HESI and NCLEX style questions.

Your textbook may be different, but we used Jarvis’s Physical Examination and Health Assessment, 7th ed.💎

Anatomy & Physiology

Most programs in the United States require A&P I and II. I’ve rarely seen some programs squish all of that in one class. You need to be a master at your anatomy and physiology. Review cardiopulmonary, abdomen, and neuro anatomy before school starts. You will need to be able to pretty much label and/or draw from memory most of your body systems. A lot of people in my class had trouble with Assessment most likely because they were weak in anatomy. I personally had trouble with the cardiovascular system for this very reason.

Vocabulary

There will be a lot of big medical terms that you’ll need to know! Hopefully you’ve picked up a lot from A&P, Patho, and your other Biology classes. When you study, make flashcards of all of the terms you do not know and study them every single day. These words WILL be on your exams, HESI, and NCLEX. Learn them now.

Normal vs. Abnormal

Assessment is all about knowing what you are supposed to be seeing, hearing, and feeling (namely inspecting, auscultating, and palpating). Establishing this foundation is very important! I took notes in two columns. One side was “normal” findings, and the other side was “abnormal” findings.

In your practice, you should be able to tell when something is wrong. You may not know 100% what is going on, but you should be able to tell your doctor over the phone what your findings are.

Study Habits + Repetition

Assessment is a tough subject. It is a lot to chew, especially with your other classes. You need to establish excellent study habits. This means no more going out every weekend, no more binge watching TV. You gotta get up earlier and go to bed later. Check out my Top 10 Study Tips to get some more tips on how to establish excellent study habits!⬇️

Repetition is key with Assessment. I probably studied each set of material more than ten times. I rewrote notes, drew pictures, and answered plenty of practice questions. I made it a goal to know the material inside and out. I probably spent the most amount of time studying for the class during my first semester.

Practice

As much fun reading out of a book is, nursing isn’t all about reading a patient’s chart. You need to practice! Practice on everyone that will let you. Friends, family, strangers (JK, that might be weird). Get used to going through your full head to toe on different people. Talk through your assessment, even if the other person has no idea what you’re saying!

Patience

These skills will come to you. Like I said in the beginning, you will not master these skills until you’ve been in practice for a long time. Don’t be too hard on yourself and don’t be afraid to seek help! As always, I am here to answer your questions!



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FIVE Things I Wish I Knew Before I Started Nursing School

1) Straight-A …Student

If you are/were a straight-A student, get ready to get knocked down a notch or two. I don’t know anybody in my class of about 100 people who have gotten all A’s. I know there were maybe two in the class ahead of us? Point is, get ready for that not to happen.

I came in head-strong thinking, “I know everyone has been saying this but I can do it. I get can all A’s.”

The first round of exams went through and I thought, “Okay. That’s doable.” But then the second and third round came and eventually I was just doing everything I could to stay afloat.

My advice is this: do your best, do not compare yourself to your classmates, and ask for help when you need it. Your grades are not reflective of your capabilities as a nurse.

2) Mental Health > Study Time

“Don’t pound yourself into the ground with studying because self-care is just as important.”

My mentee

Don’t get me wrong, you need to study hard and make it a good habit. But you also need to realize that if you wear yourself out, no amount of studying is going to help you.

Make a study schedule and stick to it. Study every day, schedule breaks and rewards, and do not study outside of your allotted time. I stop studying around 8-9pm every night, and I always get my 7-9 hours of sleep.

3) Roll with the Punches

I had an expectation that nursing school would be organized, the instructions would be clear, and that there would always be a strict schedule. Boy oh boy was I wrong!!

You will have to learn to “roll with the punches.” Don’t sweat the small details. Be ready to adjust and readjust your schedule. Nursing school is very fluid!

I remember one week last semester where they said, “Oh by the way, this small group of people needs to put together a project and present it at this location. And you have five days.” I remember thinking, you want me to do that and my million other things I have going on?

I go to class every day expecting that something else will be thrown our way. That way, I’m not surprised.

4) Nurse-Administrator

The administrative/paperwork stuff added another level of stress to nursing school. The beginning was extra stressful because you have to submit a lot of paperwork to the state board of nursing. It helps to become ultra-organized with your vaccine records, identification documents, health insurance, CPR certifications, background check documents, drug screen, etc. There are 32 separate documents I have submitted JUST to be eligible to register for classes.

You will most likely also submit additional paperwork for each of your clinical sites. You will also be expected to keep up with your resume and portfolio.

If your school tells you to start working on paperwork before school starts, DO IT RIGHT AWAY. If you wait until school starts, you will be stressed out about the administrative stuff and that will cut into your study time.

5) Tick-tick-tick-DONE

When I got my acceptance letter for school, I thought that the two years would take forever, and I questioned whether or not I wanted to commit to two years of my life.

Now I’ll be starting my last semester of school and I cannot believe how fast time has gone by! When did I get here? I feel like I just woke up and now it’s time for me to apply for big girl jobs!

Nursing school keeps you so busy that time passes by really fast. Each week is so jam-packed that seven days don’t seem like enough time.

Don’t forget to enjoy life in those little moments!



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How I SAVE 💰MONEY💰 as a Nursing Student

If you live in the United States, you know that college tuition is an expensive hot button issue. If you have been to college, you most likely have student loans. While loans can be helpful while you’re in school, it can get really scary to think about paying them off. Loans do not typically cover the cost of living, utilities, car notes, etc.

I wanted to put together a little post about a few things I do to save here and there. It may not be much, but hopefully you can find something here that saves you a few dollars!

Honey Gold

I don’t remember how I heard about this website, but it has saved me a lot of money over the years, and I’ve even been able to redeem the points for gift cards. The best part is that the program is free, and there is a super convenient Chrome extension. To be honest, I am NOT an affiliate of the Honey Gold program. But I do have a referral link just in case you want to try it. (I may in the future become an ambassador, but I need more followers. 😀)

Let me show you how it works!!

Just go to www.joinhoney.com, or click on my referral link. It is recommended to install the extension for your browser. I believe it works for nearly any updated browser (Chrome, Safari, Firefox, Microsoft Edge, etc.). Then as you do your regular shopping, Honey will shop for the best price for you! It will automatically apply different discount codes in the shopping cart. If there are no discount codes available, it will most likely give you some sort of “cash back” in the form of points. The little extension icon will turn orange:

All you have to do is click on it, and Honey will do the work for you!

I have yet to find an online store where Honey does not work. You can also add items to a “Droplist,” and Honey will alert you when the price goes down. That way you don’t have to worry about finding the best deal. I’ve used this on many of my textbooks and school supplies.

You can even use it while ordering pizza! Which is pretty cool. I’ve redeemed most of my points for Groupon and Target gift cards.

Textbooks

Don’t pay full price for textbooks. Please don’t do it. We were offered an $800 package for just our first semester books and I am so glad I did not take it. I ended up spending about $315 instead by doing my research and looking for deals.

The first thing I do when I get a textbook list is I google the name of the textbook and PDF. So for example, I would search “psychiatric mental health nursing 8th edition pdf”

I have found several textbooks this way. If I didn’t find the textbook, sometimes I found the supplemental study guide or other resources that accompany the book. ALWAYS search for your books like this first, unless you absolutely 100% need a physical copy of the book.

One of my favorite websites is Book Depository💎. They have very competitive pricing and free shipping. I have never run into any stock or customer service issues with them either. Use this website when you need to keep your books. They are an Amazon company but they do not offer rentals or Kindle versions.

We all know and love Amazon. You can find new, used, Kindle, rentals, etc. If you have been told by upperclassmen that they did not keep the book, I would go ahead and rent it. With Amazon, if you rent a book and then decide you want to keep it, you can buy the book and the cost of the rental is applied toward the purchase.

Abebooks💎 is also another great website. They have low prices and a very large inventory including rare books and fine art. I also enjoy using their advanced search feature that allows you to search by price, publisher date, and edition.

Find Cheap Textbooks - Save on New & Used Textbooks at AbeBooks.com

One last helpful tip is that a lot of school libraries have these textbooks on reserve. If you are really in a pinch, you can head to the library and look for your book. You could probably make photocopies (or use your phone camera) for the pages you need.

School Supplies/Organization

I reuse binders, folders, dividers, anything else I can repurpose. I seldomly purchase brand new supplies for a new semester, unless I know I need it. I buy pens and pencils because I lose them.

I have also started to “go paperless” with my notes. I was getting so frustrated with how much paper sat on my floor at home. Nursing school powerpoints are no joke. Last semester, I created folders on my Mac for each class, exam, and clinical. It’s good for the environment and your back! Our school has printing included in the tuition, but I know many schools who do not.

Some people really need those handwritten notes in order to study. I am one of those people! So instead I bought a cheap whiteboard from Wal-Mart and installed it on my wall. I study on my white board and it wastes zero paper. When I fill it up, I take a picture of my notes with my phone and upload it to the appropriate folder!

My whiteboard at home!

Any papers or notes that the instructors give us are scanned and put in my computer. If I need a paper copy, I keep it in a binder or folder on my bookshelf. This is what my folders look like on my Mac—

Budgeting

Love it or hate it, you gotta do it. Listen, y’all. I rarely spend money on things I don’t need. When I do, it’s because I’m rewarding myself (after finals, getting a new job, winning an award, etc.). To be honest, I AM in a lot of debt. Should I be the best source of financial advice? No. But I am a real nursing student with real life problems, and I just want to share how I’ve managed to stay afloat.

I use excel to break down my income and bills. I give myself a little bit of spending money (for vending machine snacks or the occasional post-test celebratory adult beverage). My opinion is that you still need room to live your life. Just don’t spend $300 on shoes you don’t need if you cannot afford it.

We don’t have cable TV, I’m on the cheapest phone plan my service offers, I make my lunches/dinners 95% of the time, and I only purchase new clothes when the ones I have get so worn out that I have no choice.

I always make a grocery list, I shop at Dollar Tree and Aldi, and our house is barely decorated. I’ve switched (reluctantly) all of my luxury or non-drug store makeup brands to drugstore brands. I even tried to grow some of my own vegetables and herbs, but it turns out I do not have a green thumb. 👎🏻

Some of you make think I’m crazy for having this type of lifestyle, but I am doing what I need to do to make it through school. I know that it is temporary. I know that when I start making a better salary, I’ll have a different budget!

I put a certain percentage of my paychecks toward school. That savings account is non-negotiable and I use it to pay for various school expenses from supplies to scrubs.

I hope you found something here of value to you! What do you do to save money?



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FIVE Things I’ve Learned Working in the Emergency Department

1. Staying on Task

The first few months of working as an intern, I found myself just running around with my head cut off with no sense of direction. I have (mostly) learned the art of writing things down and setting alarms on my watch. I no longer hesitate to delegate to our awesome, amazing, wonderful tech’s. I can methodically organize tasks by patient priority. It feels less chaotic for me! I try to go through four “steps” for each patient:

  1. Initial assessment/ABC’s/Intake
  2. Orders
  3. Maintenance/Repeat Labs/Comfort
  4. Discharge/Transport

I like to write the word “comfort” near the middle of my chicken scratch report sheet. Although not a priority in the emergency room, sometimes getting that patient an extra warm blanket can ease them up and give you time to handle another patient.

2. Using SBAR to Talk to Doctors

Before this job, I had never actually done this. They teach it to us all the time in school but I have always been afraid to do it. My tip? I write down my talking points. Each phone call has gotten smoother, and I usually get what I need for my patients!

An example of my talking points:

S- Mr. X, the 80 y/o male in room 16 who is here for respiratory distress now has an O2 sat of 87% 30 min after the breathing treatment

B- He has a history of HTN and type 2 diabetes

A- BP 142/88, RR 30, HR 94, SpO2 87% on 6LNC, no temp. bibasilar crackles

R- I recommend another breathing treatment and a stat chest x-ray

In school, I felt like they teach us to include everything in our SBAR. There are a lot of situations that would warrant a more thorough SBAR (like giving report to the floor nurse). But when something is needed very quickly in the emergency department, you have to just grab the basics (ABC’s) and run with it.

3. Hospice/Palliative care.

Some of you might be wondering why this is happening in the emergency department. Well you know what. The situation warranted it. We are often on saturation, which means no where else for this family to go for several hours to days. I’ve cried with the families that are waiting for a room somewhere else. I sat with them and ignored the noise and chaos down the hall. I took extra time with the extremely uncomfortable patient to make sure the bed was made perfectly, all trash was picked up, and that the family always had fresh ice water. 

When that family makes a decision for their loved one to be DNR, and we cannot get them a room upstairs, the emergency department becomes the place where the family must start the process of grieving.

4. Confidently Asking for Help

Instead of saying, “I don’t know what I’m doing,” or, “I’m really sucking today,” I say, “Hey, it’s time for morphine, could you pull that for me please?” and “Could you please page respiratory?” My preceptor knows my limits, and I am finally feeling like a real nurse.

Negative self-talk can really hinder your day. I don’t know what I’m doing all the time. But I already know that and I don’t need to bring myself down because of it. I also use statements like, “Could we review this process? I think I misunderstood something.”

ALL. NURSES. NEED. HELP.

If your preceptor says they never ask for help, they are doing their job wrong.

5. Targeted Patient Education.

How often have I ever stopped to thoroughly explain something to a patient? Never in my clinicals, honestly. My preceptor usually does it. And in the ED, it isn’t at the top of the priority list. Patient education does not have to be some crazy 30 minute presentation! I can explain insulin and blood sugar during times of illness. I can explain a sliding scale. And I can do it in about three minutes. So yes, that sounds so simple, but I’ve always been afraid to take that initiative!


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Emergency Room Essentials

I know what you’re thinking – there’s no such thing as a “typical” day in the ED. In fact, the only thing you can rely on is that your day will be unpredictable. As a nurse intern in a busy adult ED, I have quickly figured out which items are essential during my shift, and which ones I really do not need. I do not currently work in a trauma center–we see most of the city’s STEMI’s, CVA’s, and transplant patients. We also see minor fractures, lacerations, dislocations, etc.

Our ED is divided into “Stations,” and each station has somewhat of a different category of patients. The “front rooms” are the most critical, we have a special room for eye trauma, and we have about 40 beds.

My job as a student intern involves shadowing/helping an Emergency Room RN. I’ve gotten to the point now where I am a helpful partner to my preceptor. When we get a new patient, I know exactly what my role is!

My first day, I showed up with a pocket full of extra supplies that only weighed me down throughout the day. I’ve narrowed down my everyday essentials to just 7 items!

  1. Stethoscope. My beautiful Littman III Classic in matte black is my closest friend in the ED. When assessing ABC’s, lung sounds can give you a clue as to what someone’s respiratory status is. It also isn’t uncommon to uncover distant heart sounds indicating cardiac tamponade.
  2. Retractable badge Sharpie. This is my second most used item! It takes out the possibility of setting your pen/marker down somewhere and losing it forever. I use it to label lines, specimen tags, patient belongings, sign EMS handoff, write down vitals on my glove, and the list goes on.
  3. Pen light. Neuro checks are important for ANY type of patient. If a patient comes in with a sprained ankle, I still do a neuro check. No matter what the patient tells you, they could be making something up because they don’t remember what happened. I also use my pen light for Foley placements and quick airway checks.
  4. Trauma shears. Mine can cut through thick leather! Although we are not a trauma center, I have still cut my fair share of clothing. It is also useful for cutting tape, medication packaging, and during wound care.
  5. Saline flushes. Not something you bring from home, but I always grab a handful at the beginning of my shift. You’ll find that you always need one or two when your hands are already full doing something else.
  6. White board marker. Our rooms are supposed to have their own whiteboard markers. We all know this doesn’t happen. Updating the boards aren’t necessarily the top priority, but I try to update them when I can. It helps patients feel more comfortable if they know the names of their care team.
  7. Black pen. This is probably my least used item, and I often lose it, but it’s good to have!

I hope this can help some of my fellow students. I was so nervous on my first ED shift and I had no idea what I would need! I ended up filling my pockets with 4 pens, a small notebook, and all of my other regular clinical supplies. It was just too much.



Brilliant Nurse NCLEX-RN® Test Prep!💎

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Top 10 Study Tips!

1. Make a study schedule and stick to it.

2. Pace yourself. Study every day, even if it’s just for 30 minutes.

3. If you don’t understand something, find a different resource (ask a friend, find a YouTube video, email the instructor, etc.).

4. Study for 50 minutes at a time and take a 10-15 minute break in between.

5. During those breaks, don’t just be on your phone or computer. Get up. Move around. Get your blood flowing!

6. Make time for yourself. If you like to read leisurely, do it. If you work out, do it.

7. SLEEP. for the love of God. Get 7-9 hours of sleep a night.

8. Find a method that works for you. Flashcards, outlines, Quizlet, recording yourself, drawing pictures, etc. It’s all trial and error.

My less than artistic attempt at understanding the cardiac system.

9. DON’T CRAM. If you don’t know the material the night before the test, chances are you won’t know it for the test.

10. Studies show that you need to review material 7 times to retain 90% of the information.


Brilliant Nurse NCLEX-RN® Test Prep!💎

This page may contain affiliate links. This means that, at no cost to you, I may make a commission if you click through and make a purchase. Contact me with any questions!

Nursing Student Summer Tips!

Off for the summer? Here are some productive things you can do! ⛱🌻

1. Do practice NCLEX questions. Yawn. Who wants to do work over the summer? Start by setting a small goal such as 10 questions/day. You’ll find that it won’t take up too much of your time! By the time summer is over, you’ll have done hundreds of questions. I use Saunder’s NCLEX-RN Comprehensive Review for every class and it works wonders! Get a copy of it here💎!

You can also use Brilliant Nurse NCLEX-RN® Test Prep!💎, which is an online interactive experience to prep you for the NCLEX!

2. Update your resume. This can be difficult during the busy school year! Take some time to really go through your resume and send it to a few trusty people for advice.

3. Look for internships and jobs. Set aside some time to gather up information about internships and jobs. Apply for what you can and get your name out there! What is your ideal unit? What is your ideal salary? 

4. Review tough topics. Did you have a hard time with the endocrine system? Cardiac? Psych? You’re not alone. Look over some of these topics in a stress-free environment. No pressure, no due dates, no exams! You may remember more material this way. Go with 20 minutes a few times a week.

5. Relaxxxxxx. You’ve been working so hard. Plan time to treat yo self! 

Happy Summer!⭐️⛱



This post may contain affiliate links. This means that, at no cost to you, I may make a commission if you click through and make a purchase. Contact me with any questions!