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The Nursing School Struggle

6 Obstacles That All Students Face

For the past five years, the number of nursing students struggling and looking for 1-to-1 help from expert tutors on Wyzant has been continuously increasing. Many of these students feel defeated and alone, afraid that they will never achieve their dream. In order to help, we needed to know what their biggest challenges were. By analyzing our data, we were able to understand the obstacles they are most likely to face on their path to becoming a nurse. Continue reading below…

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We did an analysis of the primary challenges facing more than 2,500 nursing students who worked with tutors on Wyzant in 2016 and identified six main obstacles. These obstacles, ordered sequentially in time (when they happen on the nursing path) and labeled with the percentage of the more than 2,500 students that were struggling, are familiar to all aspiring nurses:

  • Prerequisites: 16%

  • Entrance exams: 23%

  • Nursing program courses: 19%

  • Passing the NCLEX: 27%

  • Getting a job as a nurse: <1%

  • Advanced nursing degrees: 15%

Prerequisites

The challenges for aspiring nurses start with prerequisite courses, well before they even apply to nursing programs. Here is a list of prerequisite courses our students mentioned, and the percentage that had difficulty with them:

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Not surprising for a healthcare career, science is the most common prerequisite that is difficult for nursing students. However, the fact that math and English are present on this list becomes more interesting after looking at the struggles over the entire journey. If you have trouble with a subject at the prereq stage, then you will likely struggle with the same subject again somewhere further along. So, if you’re an aspiring nurse with prereqs still ahead of you, don’t aim to just get through these foundational classes. Get the help you need to really understand them.

Entrance Exams

Yes, the prereq subjects are back already! Science and math were the most difficult subjects for students during the entrance exam, but English/language/grammar were still a major challenge as well.

To better understand which areas of the entrance exam were most difficult for nursing students, we analyzed just those students who identified specific sections of the exam where they needed help. Some of these students listed more than one subject, so the percentages below total more than 100% (a student who needed help with math may have also needed help with science).

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What surprised us here was the split between math and science. At the prereq stage of the journey 68% of students needed help with science and 27% needed help with math. Now at the entrance exam, we see the inverse with 62% needing help with math and 32% needing help with science. We have a few guesses as to why this is happening, but we don’t actually know. One thought is that nursing students take many science prereqs so they are more prepared for the science portion of the exam. Or maybe, problem-solving questions are more difficult for students and the math questions on the entrance exam require more of these skills, while other questions simply require students to recognize the right fact.

We would like to do further analysis in the future to better understand this shift in difficulty from prereqs to the entrance exam. But for now, if you are a prospective nurse, just know that math will likely be a challenge for you on the entrance exam even if it wasn’t a struggle for you during prereqs.

Nursing Program Coursework

As part of this analysis we also conducted qualitative interviews with current nursing students to understand the nuance in the quantitative data. One thing we learned from these interviews is that students already in a nursing program are overwhelmed with huge amounts of information and too little time to understand it. Although nursing students came to us for help with a specific course, there were a few common themes across all students who struggled during their program.

The major theme was difficulty applying learning. We continued to hear statements like, “I need help thinking like a nurse,” or “I listen and study and I know all the information, but I just can’t understand how to use it on the tests,” or “I need help with NCLEX style questions on the tests. I’m struggling with problem-solving and critical thinking.” Nursing students who are struggling during their nursing program are primarily struggling with the application of learning. They are absorbing information but can’t tie it all together to understand and correctly answer questions about real-world scenarios they will face.

These are the courses that were most difficult for nursing students who came to Wyzant for 1-to-1 help during their nursing programs:

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Science and math struggles are back again! MedSurg requires students to understand anatomy & physiology, chemistry, biology, etc. and how all these sciences work together within the human body during different disease processes. Pharmacology requires students to use algebra and basic math skills for dosage calculations for different medications. In both of these classes, memorization is not enough. Students have to understand the basics of math and science and be able to use them to think critically and problem-solve.

Passing the NCLEX

With 27% of the students in our analysis looking for help, passing the NCLEX is the biggest single obstacle nursing students who came to Wyzant for help faced. For some of these students, their struggles with the NCLEX were still connected to challenges with basic math and science. But not many. By the time nursing students are sitting for the NCLEX they have graduated from a nursing program, which means they had to get through MedSurg, pharmacology, and other difficult courses in their nursing program. In fact, many of the nursing students who struggled with the NCLEX and came to Wyzant for help were surprised they struggled on the NCLEX because they had done well during their nursing program. So if you’re on the path to become a nurse but haven’t taken the NCLEX yet, don’t underestimate it!

The good news is you are likely to pass the NCLEX on your first try. 70% of test takers passed on their first attempt. But if you have to retake the test, you will likely struggle. Only 40% of test takers who retook the test passed.

In our analysis, students who came to us for help with the NCLEX had already failed the test two times on average, but some students had failed 6, 7, or 8 times. So if you’re struggling to pass the NCLEX, you’re not alone! There are many other students in your same situation and it does not mean you aren’t ready to be a nurse. There are lots of reasons why you may have a hard time passing the NCLEX even if you did great in your nursing program.

Here are the common reasons nursing students in our analysis provided for why they were struggling and why they needed help from an expert tutor to pass the NCLEX:

  • I don’t know what I’m doing wrong and I need help identifying my weaknesses.

  • I have terrible test anxiety.

  • I don’t have confidence that I can pass the test.

  • I’ve tried everything I can think of to prepare and I don’t know what else to do.

  • It’s been too long since I graduated nursing school.

  • I know the information but I don’t understand the questions on the test.

  • English is not my first language.I have learning disabilities.

Students can overcome all of these obstacles. We have seen nurses who have failed the NCLEX six or more times get the right help and pass. Don’t let this test stop you from becoming a nurse.

Getting Your First Nursing Job

Getting your first job in any industry is difficult because employers want to hire candidates with experience, but how do you get experience if you can’t get your first job? Yes, new nurses will face this challenge similar to new entrants in every industry. But unlike some other industries, the US has a national nursing shortage. So while you will still have to work hard to find opportunities where you can get experience for your first nursing job, there are lots of jobs available.

The Bureau of Labor Statistics projects more than 1 million unfilled nursing jobs will be available in the U.S. by 2022. The primary drivers of this nursing shortage are the aging baby boomer population who will require more medical care in the coming decades, combined with the aging nursing population in the U.S. who will be retiring in the coming years. Although these trends may pose challenges for the US and its healthcare system, they create opportunity for new and aspiring nurses. Overall job growth in the U.S. is expected to grow at 7% for the next 10 years, but job growth for RNs is projected to grow at 16% and advanced practice nursing jobs are expected to grow at 31%. This doesn’t mean every nurse will find the exact job they want in the specific location they want. Some states will have more unfilled nursing jobs than others. For example, the southern and western US states are expected to face the largest shortages. But in summary, it’s a good time to be a nurse!

Don’t worry if you do struggle to find your first nursing job, others do as well. The students who came to Wyzant for help finding their first nursing job were primarily looking for feedback on their resume, personal statement, or cover letters. If you need help, then ask for it. There are great jobs out there waiting for you.

Advanced Nursing Degrees

We mentioned the growth of advanced practice nursing positions above. Some of the most in-demand and highest paying nursing positions in the coming years will require advanced nursing degrees.

In our analysis, the students pursuing these advanced degrees were often nurses already. Many had been RNs for years, sometimes decades, and they were going back for a BSN because the hospital they work for now requires it. Other times nurses were going back to school in order to access higher paying nursing positions or to specialize in an area of nursing they particularly enjoyed. Regardless of why students enter these advanced programs, many of them will struggle with the same subjects: research, statistics, and writing.

42% of the nursing students who came to Wyzant for help in advanced degrees were struggling with statistics and 20% were struggling with research and writing. Most of these students hadn’t written a research paper in many years and they had mostly managed to avoid taking statistics in the past. But in these programs, students are required to understand and use statistical principles and thinking and some need to use statistical tools like SPSS to analyze data and draw conclusions for research projects, papers, and tests.

But don’t let these challenges scare you away. We’ve seen nurses who are really struggling with statistics, research, and writing get the help they need and succeed in these advanced programs. You can too!

Getting Help

Throughout this article we’ve recommended students get help if they are struggling—which doesn’t mean you have to hire a tutor. We’re all different and learn differently, but with the right help anyone can succeed. In our analysis, we heard many ways students received help along their nursing path. Here are the most common:

  • Professor or instructor

  • Teacher’s Assistant or help lab

  • ClassmateStudy group

  • Online videos

  • Test prep books

  • Test prep courses

  • Expert tutor

Respect for Nurses

We learned so much about nursing students and the struggles they face on their path. In interviews with nursing students we heard almost every one explain that this was what they always wanted to do. Nursing was their calling; they wanted to help other people.

We wanted to share the insights we gained from this analysis to help other prospective nurses with similar career aspirations. The world needs more people like them, especially with the national nursing shortage we are facing. We hope this data and the insights we have shared can help nursing students who are struggling realize they are not alone. We know you can overcome these obstacles and reach your dream of becoming a nurse because we’ve seen others just like you succeed.

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