What nurses DON’T learn in nursing school

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I had this conversation recently with some fellow professionals: We were discussing the increasingly large void between what they teach in nursing school and what you learn in your first job.

It’s become very clear that most school programs are not focused on teaching you how to be a nurse, but teaching you how to pass your boards. They pour enough knowledge into your brain bucket so that you can pass your national exam.

Is that enough? Or is there more to nursing than one final exam?

Some would argue that you can’t become a nurse and learn the “real-world” nursing skills until you’ve passed your boards. Others would argue that’s the only thing some are concerned with learning.

It’s a double-edged sword, isn’t it? We need a passing grade on that exam, but the exam is not reflective of our practice in motion.

Many in the academic world would scoff at those words, but the truth of the matter is that any new grad is barely prepared to handle what gets thrown at them. It’s only when their practice is set in motion do they truly come into their own.

Are other health care professions the same? I wonder.

I also wonder if there are just some things that cannot be taught but will be learned as you progress in the profession? What if we broke it down into a list?

What you must learn in school:

  • Applied anatomy and physiology
  • Basic biology
  • Applicable pharmacology concepts
  • Basic microbiology, mathematics and chemistry

What you will learn once you graduate:

  • Efficient time management
  • Didactic emotional resistance
  • True patience
  • Skill development

I guess you could say there are an infinite number of intangibles that cannot be presented in the traditional classroom. And it’s those intangibles that separate our profession from most others. You have to walk in our shoes to appreciate the climb.

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5 Responses to What nurses DON’T learn in nursing school

  1. Karenf54 RN

    I graduated from my basic program in 1978 & back then we were taught lots more than just what we would need to pass boards. However, I was also fortunate enough to have a 3 month “residency” at my first job. We had some classroom time every day to get us comfortable with time management & developing our skills so we’d be more comfortable on the unit. That made a big difference in my experience the first year out of school.

  2. Nurse Rene RN

    In my ‘basic training program’ we were taught to THINK using the Principles of the courses that Sean has outlined.
    32 years later, when I was discussing the Way we were taught with the RN to BSN Program Director (a PhD) she looked at me with eyes wide open and incredulously asked: ‘You were taught PRINCIPLES?’)
    Yes ma’am, it did happen that way in my lowly 2 year program!

  3. Jet City Jim RN

    Bring back diploma schools! Reading and learning about how nursing was taught really makes me think we have taken a step backwards for the sake of supporting the academic industrial complex. The idea of having class time and clinical time QDx5 would really help cement the skills need to be a good nurse. I felt that at my school they were concerned with one thing and one thing only, having the highest percentage of students pass the NCLEX. (Grad 2011). Graduating in bad economic times without actual clinical experience (1 or 2 days a week doesn’t cut it!) makes for a difficult first job search. I got lucky because I built a networking base in school and my life experience (pre RN career) skills helped me to get the knack of nursing down faster than someone who went from high school straight to college.

  4. antikathistemi Student


    You’ve touched on something I was just thinking about. I just started my first semester of nursing school at an associates degree program and a good majority of the learning resources available to us are focused on preparing to take the NCLEX. The school boasts a 100% NCLEX pass rate in recent years but I’m starting to wonder it that’s reflective of a robust education or just a heavy emphasis on test preparation!

    At the end of the day though, I realize education is a lot of what you make of it. That’s why, like Jet City Jim did, I’m focussed on building my professional network while in school by working in various low-barrier-to-entry healthcare jobs (phlebotomy, ED scribe… etc).