26 Top Things to Expect in Nursing School

Written By: Kasee Wiesen DNP, APRN, FNP-C

Nurses are intelligent, trustworthy, and resilient. They deliver high-quality care to their patients, provide education, and advocate for their patients when needed. Nurses are great! With that being said, have you considered a career in nursing? But maybe have felt overwhelmed with the thought of nursing school and not sure what to expect in nursing school? Below, I will list 26 things to expect in nursing school to help ease some of the fear and uncertainty associated with nursing school.

Why is it Important to Know What to Expect in Nursing School?

There are many rumors about nursing school—some are true while others are false, so it is important to know what to expect in nursing school. It takes away some of the surprise and uncertainty of nursing school, which may deter people from pursuing this career.

One of the first things you will learn in nursing school is to ask questions. You will see that asking questions or reaching out for clarification and support is a common theme in nursing school. Remember, you are not alone in the journey, and once you graduate, you will be starting a gratifying career.

What to Expect in Nursing School?

Below, I have provided a list of 26 things to expect in nursing school. These are listed in no particular order and are general statements and may not apply to everyone.

1. Nursing School Interview

Nursing school is challenging, and many people want to become nurses. Therefore, to ensure they have a strong group of students entering their program, they often have multiple requirements, including a minimum GPA, an essay, and a nursing school interview. The purpose of the interview is to determine if you will be a good fit for their program. Below are a few questions to expect in your nursing school interview.

• Why do you want to become a nurse?
• Who are your role models?
• Why did you choose their college?
• What are your core values?
• Why would you be a good fit for their program?
• What qualities do you currently have that will make you a great nurse?

Don’t be intimidated about the interview, but instead, be prepared. Come with questions as well and ask them what you should expect in nursing school. There are many resources available to you online that discuss questions that might come up and how to answer these questions.

2. Reading, Reading and More Reading

One of the first things to expect in nursing school, is to spend a lot of time reading. This may be reading your assigned readings from the textbook, research articles, or ancillary readings that will further support your knowledge and learning. You will also read many patient charts while in clinical—all preparing you for when you practice independently.

The number of assigned pages is often very overwhelming, leading many nursing students not to complete the assigned readings—possibly missing out on important and valuable knowledge they may need. Therefore, my recommendation is to reach out to your instructor, tutor, or students who are farther along in the nursing program and ask for tips to complete the readings. Often, they will offer some tips, tricks, and techniques that can help ensure you stay up on the course readings without falling behind in other areas.

3. Study, Study and Study Some More

One of the next things to expect in nursing school is lots of studying. This is the motto for many nursing students—study, study, and study some more. At times, it feels that the studying will never end—but remember, nursing school does come to an end at some point. There will be some weeks where you feel every waking moment is dedicated to some form of study, and there will be other weeks where you will have more time for yourself. This is important to know ahead of starting nursing school because if you are not prepared to commit the time, there is a chance that you will not succeed. And, studying does serve a purpose. Nursing school's entire goal or objective is to prepare you to work as a nurse. The information you learn is to make you be a safe, competent new graduate nurse—and all the tests are to prepare you to pass the NCLEX.

4. Re-Learning How to Study

Many nursing students will tell you; they had to re-learn how to study once they started nursing school. Nursing school is a unique experience, and study techniques that worked for you in the past may work for you in nursing school, but often you will have to adapt and change a few of your study habits to be more successful. This is expected, and many nursing instructors will tell you this—and continue to tell you this throughout the BSN programs. Many nursing schools and teachers will offer test-taking strategies or even spend a few minutes throughout class offering suggestions on how to study better and prepare for their class tests and how to prepare for the ultimate test—the NCLEX. Remember, you are not alone, and do not hesitate to reach out to your peers, instructors, or tutors for assistance.

5. Tests, Tests, and More Tests

Testing is a popular method to assess knowledge and competency in nursing school. Most nursing didactic courses have multiple tests throughout the year—however, most clinical courses do not have traditional tests but may have test outs for specific skills. Plus, many nursing school programs use various NCLEX prep programs such as HESI or ATI, which leads to more tests throughout the semester. The purpose of these tests is to assess knowledge and teach you good study habits and test-taking skills that will prepare you for the ultimate nursing test…the NCLEX!

6. The Use of Case Studies to Learn Content

Case Studies are an excellent tool and should be expected during nursing school. They can be used in any course, and the same case study can even be used across multiple classes, demonstrating your growth as a nursing student. Case studies are used to apply the information learned in class to real-life scenarios and allow you to think through assessments, diagnoses, and treatments in a safe way. Case studies are also used to develop the critical thinking skills necessary to be an excellent nurse. It is not uncommon that as the student progresses through school, they will have the opportunity to create their own case study based on their experiences in clinical.

7. Lecture Courses

Lecture-style courses are one of the primary class settings for nursing school. There is a misconception that all nursing courses are lecture styled—meaning the instructor talks and the students listen and take notes. A lot of instructors are trying to make their lecture courses more interactive. This is done through case studies, having the students “teach” specific topics, group projects, games, and practice questions. This change is occurring because it has been shown that when students are more engaged in class, they are more likely to participate in class and retain the information—leading to greater success on tests, in the clinical setting, and NCLEX.

8. Group Projects

Group projects are a part of most nursing school curriculums. And while some students love group projects since it allows the work to be divided amongst the team members, other students despise group projects due to the possibility of not all members contributing equally. Regardless of how you feel about them, most likely, you will have completed multiple group projects by the time of graduation—because of the reason it teaches teamwork and communication, two skills that are needed to be a successful nurse. To be a great nurse, you need to know how to work with a team, help your team out when needed and communicate effectively and these are all skills that can be learned through group projects. So, if you are considering nursing school, be prepared to participate in a few group projects throughout your BSN program.

9. Research Papers

If you chose to attend nursing school because you do not like writing papers, you may not want to read what I have to say next. Another thing you should expect during nursing school is research papers—and it is not uncommon for you to have to write at least two research papers throughout your BSN program. There are many reasons why research papers are required, and one of those is to simply further develop your writing skills. This is especially important if you are planning on attending graduate school. As a BSN-prepared nurse, it is also essential to know how to find credible research and apply it to your practice. As a nurse, using evidence-based practice is important to ensure safe practice techniques are used—and research papers help foster those skills.

10. Simulation

The next thing to expect in nursing school is the use of simulation. Simulation is used by many schools to either replace, supplement or enhance students' clinical experience. This became even more true during the beginning of the Covid-19 pandemic. This was due to the inability of students to enter hospitals during the pandemic.

Simulation is an excellent clinical tool for nursing students. It allows students to safely practice technical skills, critical thinking, and decision-making in a safe environment. The student treats the simulation as a real-life experience—allowing them to practice specific situations in a controlled and safe environment. Many students find this awkward or intimidating at first, but after the first couple of times, they start to see the actual value of simulation lab and its benefits on their future nursing career.

11. Early Mornings

Early mornings are not a foreign concept for most nursing students—and should be expected during nursing school. While some of the didactic classes aren’t until late morning or early afternoon—the morning is used to study and prepare for class. Also, early mornings should be expected in nursing school clinicals. Many clinical rotations start between 6 am and 7 am—leading to very early mornings. Clinical starts early for most students because it coincides with when the daytime nurses are getting there—this is important because it allows the student to be present for bedside report and start the day with their patient and nurse.

12. Nursing Clinical Does Not Start Right Away

When starting nursing school, you are often most excited about beginning clinical. This is when you get to be in the hospital applying what you have learned and getting hands-on experience. But, it is important to know that most nursing programs do not start clinical rotations until either the second semester or second year of nursing school. The reason for this delay is to ensure you have a solid foundation when entering the hospital. There are specific skills that are needed for the first clinical rotation. Just be patient because you will have one to two rotations a semester until graduation once your clinical rotations start. Disclaimer—this is not true for all nursing programs, so it may be a question for you to ask when applying to nursing school.

13. Variety of Clinical Settings

One thing to expect in nursing school clinicals is a variety of clinical opportunities—and this is great! The multiple clinical sites allow you to be exposed to different healthcare settings and environments—such as med/surg, OR, ICU, community health, and mental health. This variety allows you multiple opportunities to practice and develop various nursing skills, apply the information you are learning in school, and help you figure out where you want to work after graduation. It may also open your eyes to the numerous settings a nurse can work, including those outside the hospital.

14. Internship or Preceptorship prior to Graduation

Many schools also offer an internship for the senior nursing student—which means the student gets assigned to a nurse and completes a specified number of hours with them. This is generally between 100-120 hours or about 14 shifts—but this will vary depending on your program. The internship is designed to better prepare the nursing student for their career after graduation. You work the entire shift with the nurse—helping you learn time management and how to prioritize your day. You will also observe and even participate more in the communication between the interdisciplinary team caring for the patient. While the internship is an excellent opportunity, please remember that you will not be able to learn everything and be proficient with every skill. It takes time to learn, and most seasoned nurses will tell you they are still learning every day.

15. Feeling Stressed

In nursing school, it is not uncommon to feel stressed. And while it is not unusual, it should not be all the time. There may be weeks where you have two or three tests or a unit that you just can't grasp—leading to more stress. You may have a lot of assignments due one week, or just the balance between school and life one week may just be more stressful. The critical thing to remember—is if you are constantly stressed, or experiencing significant stress, reach out to your instructors, school counselor, therapist, etc. Do not wait until the stress is leaving a negative impact on your life--there are people there who want to help.

16. Lack of Sleep

While this is true for many, I can say from personal experience—I never did this. I cannot function without sleep, and while there were many nights I would only get four or five hours of sleep, I did always prioritize sleep. For me, I know that if I don’t get at least some sleep, I will only do worse the exam, clinical experience, assignment, etc. There are ways to avoid this, and it often revolves around time management and not procrastinating. But just because you don’t pull all-nighters doesn’t mean you still won’t be sleep-deprived. Between the clinical, studying, and life outside of nursing school, there will be many nights/weeks/months where you are functioning on little sleep. Just remember—it is worth it in the end once you start your career as a nurse!

17. Always Hearing About the NCLEX Exam

Another thing to expect in nursing school is hearing about the NCLEX exam. NCLEX, the ultimate test for nurses! This is the national exam that you must pass before obtaining your nursing license. Ask any nurse about the NCLEX, and they will have some sort of advice, story, or thought about the test from when they took it. While the test is challenging—it needs to be because it is the ultimate test to demonstrate competency in nursing—it is very passable.

The primary objective of the nursing program you attend is to pass NCLEX and become a safe and competent nurse. Therefore, you will hear about the NCLEX exam a lot throughout your program. Most nursing programs create their test questions based on the NCLEX style question, and they also use other programs such as HESI or ATI to supplement their course work to better prepare the student to take and pass the NCLEX. While you may be tired of hearing the NCLEX by the time you graduate, know your instructors just want to help you be as prepared as you can be!

18. Walking Around with Note Cards

Now, you might read this point and wonder why, in a world of technology would I walk around with notecards? And while yes, we are in a digital world, note cards are still one of the most common study resources or techniques used by students. I am not entirely sure why this is. But one reason may be how easy they are to transport. Also, for many students, the writing of the information and reviewing the information helps solidify the knowledge. They are also easy to use, low cost, and many students have success using them to study.

19. Support From Your Teachers

The next thing to expect is nursing school is very important to remember-- your instructors are there to support you and want you to succeed. This is true for most, if not all, college instructors, but from personal experience, I feel nursing instructors are extra supportive. They know how hard nursing school is and want you to succeed. With that said, they are not there to just “give” you the answer or allow you to delay submission on an assignment continually. After all, nurses need to know how to manage their time and where to turn for assistance or support, but they still must complete their daily tasks. Therefore, nurses are there for support, encouragement, and guidance, but they still expect you to know the content and complete the assignments.

20. Added Expenses Beyond Tuition

Expect in nursing school that there will be “hidden costs” or added expenses, and these expenses range from clinical supplies to a decrease in income. Below, I provide a few examples of added expenses that may arise while in nursing school.

• You will have to make sure you are up to date with specific/mandatory vaccines, and if you are not, you will have to have them completed before you start.
• You will have to pay for annual immunizations, including the influenza vaccine and the TB test.
• There is also an out-of-pocket expense for clinical attire and supplies, including scrubs, specific shoes, and a stethoscope.
• Cost of textbooks—some nursing programs include this in the tuition, while others you have to pay out of pocket each semester.
• Decrease in income—due to the demand of nursing school, you may not be able to work the same number of hours you did prior to school. This is important to consider when budgeting for the week/month/semester.

21. Realizing Importance of Self-Care

Another thing you can expect in nursing school is to learn the importance of self-care. I am sure you have all heard about the importance of self-care, and I feel it is necessary during nursing school. Self-care looks different for everyone and can include taking a nap, exercising, or reading a book. Regardless of what self-care looks like or means to you, make sure you take time every day to practice a little bit of self-care. It will improve your mood, clear your head and support your overall happiness.

22. Feeling Overwhelmed

Another feeling to expect in nursing school is to feel overwhelmed. You should not feel overwhelmed all the time, but it is not uncommon to have a couple of days or a week here and there where you feel overwhelmed. This is often due to having multiple tests and assignments due, maybe an additional clinical day for simulation, or even outside stressors such as work or family. Just know, it is normal to feel overwhelmed. Reach out to your classmates/friends, instructors, school counselor/therapist, or family when you do. Often, talking to other students or people in your support system will help you put things into perspective.

23. Feeling Lost

Don’t get frustrated if you feel lost at various points in nursing school. This may be related to content currently being covered in one of your classes, not being very comfortable at your current clinical site, or just feeling lost and overwhelmed with your current workload. This is not uncommon, and many nursing students experience this. It is important to recognize what is causing you to feel lost and see what you can do about it. If it is related to content in a class, schedule a time to meet with the teacher. If you feel lost on a clinical floor, let your instructor know, and maybe they can find a nurse for you to follow who loves to teach students. Regardless, don’t give up. Know that other students in your class probably feel very similar and reach out to your classmates and other resources available to you for support and encouragement.

24. Friends and Family Asking you Medical Questions

Another thing to expect in nursing school is for your friends and family to ask you medical-type questions. They may ask you what their medication(s) are for and if they need to take it. They may give you a list of symptoms and ask you what is wrong with them. Or, they may want you to complete some type of assessment on them or even accompany them to their doctor’s appointment due to having a background in the medical field. I think it is important to know this is not uncommon, but make sure you do not give any advice or do anything if you are not comfortable.

25. Using Medical Terminology in Daily Conversation

Do not be surprised if you start using medical terminology with friends, families, or even strangers during your daily conversations. I am guilty of this and have even found myself writing notes or lists using medical abbreviations, forgetting that not everyone knows what PRN means. While this may be confusing for the people around you, it will only help you grow in your nursing career. My advice is to embrace the fact that medical terminology is now part of your daily vocabulary.

26. Life-Long Friendships

Lastly, nursing school leads to lifelong friends--it is tough, and no one understands that more than your nursing friends. In nursing school, you spend a lot of time in class, clinical, and studying—giving you a lot of time to get to know your classmates and develop these friendships. They are a source of support and one of your greatest cheerleaders! You will have friends outside of nursing school, but again, no one will understand nursing school like the friends going through it with you.

What to Expect in Your First Year of Nursing School?

Now that I have provided you a list of 26 things to expect in nursing school. I want to provide a list of examples, of how these will appear throughout your first year of nursing school.

1. Nursing School Orientation

You may be wondering what to expect at nursing school orientation? Nursing school orientation is mandatory for first-year nursing students, but frequently the older students will also attend, even if only for the first couple hours. This is because the first one to two hours is going over school policies, expectations, and any changes that may have occurred over the last year. Orientation will provide information on what to expect in nursing school. It will also allow you to meet all the instructors and support staff. You will also receive more information regarding your nursing school schedule, clinical schedule, and requirements for the nursing program. There may be ice breakers to help you meet the other students in your program. It can be very overwhelming but know that each of your classes will have a more specific orientation and will most likely review some of the information given at the nursing school orientation. As always, if you have any questions or need clarification, reach out to your instructors, program director, or advisor.

2. First Day of Clinical

The first day of clinical is often full of mixed emotions. You are nervous, excited, scared, and anxious all at once. Some of the students may have experience as a certified nursing assistant (CNA) at the bedside. Still, this is their first experience with direct patient contact for most of the students. The first clinical you complete for most programs is to get you comfortable talking with patients, completing basic tasks such as vital signs, hygiene, and communication with the nurse. It is your chance to get comfortable with the idea of nursing, observe your bedside nurse and develop a firmer grasp of the role of nursing.

3. First semester of nursing school

The first semester of nursing school may look slightly different for students depending on their selected program. Ultimately, the goal of the first semester is to introduce the student to nursing. You will often complete a nursing foundations course along with a health assessment course. Some students may also be taking anatomy and pharmacology, but most programs require these to be completed before starting the nursing courses. The first semester may feel slightly overwhelming, and at times have you wondering what you got yourself into. Again, completely normal. As I mentioned above, the first semester is your chance to re-learn how to study, get acquainted with how nursing questions are worded, and start to develop relationships with your peers and instructors.

4. First Year of Nursing School

The first year of nursing school is awesome! It will sometimes feel like a whirlwind, but you have such a sense of achievement once you have completed it. You will learn a lot in your first year of nursing school. You will complete your foundations to nursing course, health assessment courses—and in clinical start to pass medications and complete straightforward assessments and develop care plans. You will learn a lot in the first year, and you will build on that knowledge through the remainder of your nursing program.

5. First Year of Nursing School Exams

The first year of nursing school exams can be a learning curve. Test questions on nursing exams are often worded differently than exams the student may have taken in the past. That is frequently due to the instructor using the NCLEX format when creating their test questions—to better prepare you to take the exam. Therefore, don’t get discouraged if you don’t do well on the first exam for each class. Instead, if you don’t do well as you would have hoped, schedule a time to meet with the instructor and possibly a tutor to ensure you are better prepared for the next exam.

My Final Thoughts

After reading the list above of the 26 things to expect in nursing school, do you have a better idea of what to expect in nursing school? Nursing school is tough. It can be overwhelming, stressful and at times, you may even question your decision to become a nurse. But, becoming a nurse is so rewarding. It provides you with endless opportunities. You can work in different settings, leadership, academia, community/public health, and even advance your degree for more opportunities. Nursing is challenging—but don’t give up! It will be worth it once you have that degree in your hand.

Kasee Wiesen DNP, APRN, FNP-C
Kasee Wiesen is a practicing family nurse practitioner. Her nursing background includes emergency medicine, pediatrics and peri-op. Education is a passion of Kasee’s, and she has taught BSN, RN-BSN and DNP students, and has enjoyed every moment of it!