Ask A Nurse: What Are The Hardest Classes You’ll Take In Nursing School?

Question: What are some of the hardest classes students take in nursing school?

Answer: Most nursing students go for a bachelor of science in nursing (BSN), which takes full-time students about four years. Between the science courses, labs, and supervised clinical rotations, it's heavy, and the advanced scientific material is where many students struggle. We asked nursing instructors which classes give students the most trouble.

Hardest Prerequisite Courses

Prerequisites build the foundation for everything that follows, and "prerequisite" doesn't mean easy. Two show up in nearly every program, and they often predict whether a student can handle what comes later.

• Anatomy and Physiology (1 & 2): You may have taken this in high school, but nursing professors expect it at an advanced level. The curriculum runs through the skeletal, muscular, neurological, and cardiovascular systems and more, usually with a lab where you use the scientific method, dissect specimens, or examine tissues under a microscope.
• Organic Chemistry: This covers the natural processes in carbon-based compounds, including how carbohydrates, proteins, vitamins, and drugs act on the body. Like A&P, it usually carries a lab.

Hardest Nursing School Classes

Once the prerequisites are behind them, students hit advanced coursework that pulls from anatomy, physiology, biology, and chemistry all at once, with heavy memorization and writing.

• Pathophysiology: Students learn how each anatomical system works and how disease and injury disrupt it. "In practice, this directly relates not only to a patient's medical condition, but also the medications your patient needs and how different illnesses will affect their overall health in relation to their comorbidities," says Alaina Ross, an RN and expert contributor to Test Prep Insight.
• Pharmacology: The sheer scope is what makes it hard. "It becomes one of the hardest classes for nursing students due to the depth and amount of knowledge needed," says Megan Lynch, RN and instructor at Pima Community College. The FDA lists over 20,000 approved prescription drug products. The CDC reports that 48.6% of people took at least one prescription medication in the last 30 days, and 24% took three or more. Students have to know trade and generic names, classifications, uses, and common side effects. "Pharmacology goes beyond simply memorizing drug names, and forces learners to think critically about the drug and how it works within the patient," Lynch explains. No matter the specialty, every nurse needs it.
• Medical Surgical 1 (Adult Health 1): This covers common adult disorders and builds on earlier anatomical knowledge. "This course is considered difficult because it is the first course where students must combine what they have learned in chunks in previous courses, and put it all together as they apply it to a disease process," says Nicole Beaver, RN and instructor at Hunt School of Nursing at Gardner-Webb University. Her advice: prepare hard. Compare the book against the lecture slides, use any pre-lecture questions to focus your reading, and if there aren't any, ask someone who already passed the class. She also points students to Kaplan as a study resource.
• Evidence-Based Practice: This course "involves taking a deep look at interdisciplinary healthcare research to establish a position on best-practice standards," says Laura Fero, Dean of Nursing at St. Catherine University. "The nursing profession is based on science and new evidence is continuously being published. This class offers the student the ability to analyze this to determine how best to treat patients." It's reading-heavy and demands clear, concise scientific writing. "Students have to be motivated to search, read, synthesize, and apply their new knowledge. It may feel overwhelming at times, but trust what you have learned and be confident in holding the best standards of care for those you serve," Fero says.

How to Get Through the Hard Classes

Intimidating, yes, but passable with the right tools.

Break it down

Pace yourself instead of cramming, especially in memorization-heavy classes. "No one can learn 100 drugs in two days," Lynch says. "But they can learn 10 drugs a day for two weeks." Take your syllabus, split the material into daily sections, and review previous days as you go.

Make flashcards

"Make lots and lots of flashcards and memorize the heck out of the different bodily systems and their processes," Ross says about pathophysiology, though it applies everywhere. Writing the definitions out helps you remember, and flashcards make it easy to study with classmates.

Learn prefixes and suffixes

Many medical terms come from Latin, so words with similar meanings share prefixes and endings. "You can chunk together many classes of drugs using their telltale beginnings or endings, such as 'cycline' or 'caine,'" Lynch says. "These drugs are very similar, thus have many of the same side effects and nursing considerations."

Use mnemonics

Memory tricks help you recall concepts through association. Lynch's example: "Motrin (Ibuprofen) helps me painlessly write papers, I-B-proofing." Or use ACHES for the warning signs of contraception side effects:

• Abdominal pain
• Chest pain
• Headaches
• Eye problems
• Severe leg pains

Picture-mnemonic apps like Picmonic can help too.

Consider the "why"

Memorizing facts gets you through exams, but understand the meaning behind each term, process, and concept. "Try to understand the 'why' behind how medications work in certain scenarios and not in others," Ross says. "Having a deeper understanding of the information behind the numbers will help you crush this class."

Prep before class

Read ahead, take notes, and bring your questions to the lecture. Professors give you the curriculum plan, so use it.

Manage your time

Critical for anyone juggling school and work. Lynch comes back to chunking: "Chunk drug classes, study time, and the overwhelming amount of material." And when it gets heavy, Fero says to remember why you started. "Trust what you have learned and be confident in holding the best standards of care for those you serve."