View Full Version : Being Type A

10-11-2007, 01:11 AM
I am a straight A student and it drives me absolutely crazy. I have recently started seeing a therapist to talk about my anxiety, which I hide very well from other students, but on the inside I'm wigging out. Anyone else deal with this?

Part of the problem is my study group. They are all incredibly high achievers and they scare me with how in-depth they study. Literally, when they share their study guides with me, I get so panicky about never being able to memorize all the information (like, 25 pages worth of stuff!) that I end up not studying at all.

My therapist is teaching me some breathing exercises, and how to tune everyone out and focus just before a test (I have a lot of test anxiety) even if it means putting headphones on. I think it's really helping but it's still a huge struggle and I'd like to get it more under control before I start my career.

Not sure why I had the urge to share all this...anyone else have experiences/comments about this?

10-11-2007, 04:21 PM
I know what you mean. Studying for nursing courses is very stressful and I was just like you! I was a straight A student and all that, but now when I get a C+ or a B-, I say positive things like "Hey, it could've been worse, I could've gotten a C-!" Before looking at exam marks or something, I always don't think "I need a B+, I hope I got a B+." Instead, I think lower, like "I hope I got above a C-." Keep your expectations low so even if you do get a B+, you'll be very happy that you didn't get a C-.

Just keep reviewing, reading, re-reading and take deep breaths. If you really know the material and it's in your head, you'll do fantastic.

10-12-2007, 03:06 AM
I'm a type A as well. I think the best thing thus far is that you recognize that what you are doing is detrimental for your health and are seeking help!

I know how you feel as I am also a type A, in a program with multitudes of Type A's.

Perhaps you could look inside yourself and think about what motivates you.. what makes you tick that you need to have straight A's. What are you afraid of?

Good luck!



11-14-2007, 03:19 PM
I am definitely a stereotypical over-achiever, and school has been kind of crazy for me. I'm still pulling in A's in everything, but I cannot for the life of me relax and be happy about them! If I miss 2 questions on a 100 question test I will berate myself for a week. Thoughts of, "I should not have missed that! How could I have picked that answer?" and the like cycle through my head constantly.

The only thing that gives me any peace, honestly, is going into the clinical rotations and taking care of my patients. When I provide for their needs it no longer matters whether I missed 2 questions: I could have made a perfect 100 and that still wouldn't be what makes me a great nurse. It's about something else entirely.

Good luck with therapy. Keep breathing and remind yourself that you're going to be a great nurse, even if you stumble a bit on the way. :)

11-15-2007, 07:58 AM
In nursing school we used to say, "The person who graduates last in this class is still a nurse." (provided they pass NCLEX)

Underachievers of the world unite!

(tee hee)

Kidding aside, I used to stress my grades back in the day but now it doesn't amount to a hill of beans. If you are passionate about what you are studying, and you strive to understand it, you will do great.

(and deep breathing helps - I do it quite often!)

11-15-2007, 12:32 PM
The people with the best grades and those who write the best essays aren't always the best nurses. Being able to apply the theory to practice and demonstrating all of the skills we have spoken about often here are most important and what our patients remember about us afterwards. :)

11-16-2007, 11:51 AM
I used to study really really hard for my unit exams. I'm not a type A personality and I have a dark laid-back side to me that reasoned that if aced my unit exams I wouldn't have to study as hard for my finals. A good semester was one where I only had to make like a 40 or 50 on my final to pass. I always did better then that though.
"A" students become "B" students in Nursing school. It's all those critical thinking questions with the gray area answers. Don't beat yourself up over it...just pass.

Mr Ian
11-19-2007, 01:03 PM
What's an "A"?

My tutor remarked:
"Ian consistently sets himself low standards which he then fails to achieve."

People should aim for lower like I did. Life's not fun if you've no room for improvement....

11-19-2007, 01:56 PM
The people with the best grades and those who write the best essays aren't always the best nurses. Being able to apply the theory to practice and demonstrating all of the skills we have spoken about often here are most important and what our patients remember about us afterwards. :)

Amen to that Julie!

11-22-2007, 11:03 PM
I used to speak with a counselor who suggested something called "Pause Breathing", which I find works far better than taking deep breaths. It's similar to using a paper bag during a panic attack to control blood oxygen levels, except it's actually much more effective.

Works like this:

Take a long, deep breath. Exhale. Count to one then take another deep breath, exhale, count to two. Repeat this until you reach five counts between breaths, then try breathing normally. If you're still anxious, repeat it all over again.

I practice this a lot when I'm stressed out, and I usually calm down by the time I reach the four second paused.

11-25-2007, 09:14 PM
My instructors are very understanding about my problems with this very issue. They're always teasing me about stressing over getting straight A's, telling me, "C equals RN, Jennifer!"

I struggle, struggle, STRUGGLE with allowing myself room to screw up and not be "perfect." And, as another person pointed out, there's a huge difference between making A's in nursing school and being a great nurse. Just because you can pass a test in a classroom doesn't mean that you'll be great in the field. Some things only come with practice, and everyone excels in different arenas. When my classmates rag me for always making great grades I remind them that I often struggle more in the clinical setting than they do. It's all give-and-take, you know?

11-27-2007, 02:02 PM
Funny, we always said 'C' means 'continue' in school.

But really, there is nothing wrong with setting high standards for yourself, even in nursing school. The tests are hard, sure, but they are preparing you for the hardest test you may ever take in your life, one that determines your future in nursing. When you aren't "perfect", take that opportunity to learn the rationale behind what was the correct answer and why the other answers were wrong.

Some units/areas you will excel at, while others you will struggle. Utilize your classmates/study partners who 'get' that area that you are having difficulty with and offer to help someone who is struggling with something you are doing very well with. If your current studying method just isn't working out as you have hoped, try something else. Just remember though that once you hand in that test, it is done. Nothing you can do will change the outcome. So breathe, focus on the positives, and you will eventually come through it all just fine.

12-28-2007, 11:23 AM
Maybe I'm way off base here, but the Type A people in my classes (not always the top test performers, but the ones who really needed to "know it all") were the ones who were the most confident in clinical practice, and the ones who were constantly fighting to pass were the ones who ended up struggling with some basics and who ultimately ended up struggling with the NCLEX, some taking it multiple times. Now, in the end, I'll agree that after years of experience it really doesn't matter, but I'd rather have the nurse who is organized and likes things to be systematic and follows procedures than the scatterbrained nurse (now..where did I leave that pulse oximeter? when trying to figure out whether it's maternal or fetal HR tracing). Type A doesn't have to be about grades, but if that's how it manifests itself, then more power to you! There was one girl who was always getting A's and struggling with AM care in clinicals, and they kicked her out, so the opposite can be true, but overall I want a nurse who can synthesize information from multiple sources and can use systematic thinking in addition to the "gut" feeling we all have... (i.e. this lab value means this and her symptoms mean that, but I just know that even though her platelets have dropped only slightly it's a sign that her preeclampsia is worsening) I way off?

12-28-2007, 12:31 PM
I have to agree with you storknurse, some of the brightest people can be some of the most disorganised. Also academic success doesn't necessarily mean that the person has some of the nursing skills needed particularly at the beginning - dexterity, astuteness, the ability to say the right thing at the right time and not put your foot in it.

12-29-2007, 02:24 AM
I was one of those straight A students in nursing school. Didn't plan to be, and certainly didn't come in with that sort of attitude -- I was always of the philosophy "it doesn't matter what the grade is, what matters is what you learn." I even went to one uni while earning my BA that had narrative grades rather than letter ones -- try explaining those transcripts!

I used to describe my cohort as "obsessive-compulsive over-achievers" (myself included, I guess, once I started expecting those A's of myself). I kept telling myself if didn't matter, but somehow it did start to matter to me, but I still tried to not let it get in the way of my learning--and I recognized that I am a good test-taker and a solid writer, so it's not all intellect, it's also skills.

One of my professors, who is one of the best instructors I ever had and definitely one of my educator role-models did a couple of wonderful thing in her tests: 1) she put up pictures all around the room on test days of peaceful, restful things: meadows of flowers, mountain lakes, ocean sunsets, you get the idea. She also included in her tests, usually 2 or 3 times the instructions "put down your pencil, put your feet flat on the floor, close your eyes and take some relaxing breaths." It was amazing what a help it was to be reminded to relax...I think that's a great tool to have, and whatever works for you to help you get there during a test is great.

You said you get overwhelmed when you see the study guides that others have written, remember, everyone has different styles, and if that isn't your style, don't feel you have to use it! I [/B]never[/B] made any study guides. I reviewed my notes, the text, prior tests in the class, the competencies/objectives (and any other relevant part of the syllabus). I would study with friends, but mostly what we would do is discuss the material -- people would ask questions about material they weren't clear about, and by explaining to another, the information often came clear to the all, including the person doing the explaining. It also helped to see where one's gaps were.

Everyone who has taled about the relative importance of grades is spot on -- yes, if you plan on going on for a graduate degree, it can make a difference, but no patient has ever shown up with a list of multiple choice questions (or answers) written on their arm. Nor are they going to ask you your GPA. Keep in sight your goal -- to provide excellent (safe, competent, compassionate) patient care. There are lots of resources for finding out answers to specific questions: people, books, the internet, etc. It is not imperative that you have all the details at your fingertips at all times. For example, lab values, yes, they're important, but different labs will give slightly different ranges, and most tests come back highlighting values that are out of range and give you ranges. What's important is to know that out of range lab values are important, what are possible, likely causes, and consequences--all things that become second nature with exposure and experience. To take it even further, my idea of what is a worrisome CBC is going to be a bit wacky 'cause I deal with a lot of people with cancer and on chemo. Similarly, what I think of as appropriate analgesia dosing would make a lot of people pale, but when you're dealing with someone who is dying and has metastatic bone pain on top of chronic pain, well, you do what you need to to make someone comfortable. Contextual thinking that is a big part of what you want to learn....and a secret--if you don't use it, you don't remember it. Stork nurse has lots of knowledge that I've long forgotten, 'cause I don't have much to do with many women in general, never mind one's of child bearing age on the other hand, I could give you plenty of suggestions for ways to deal with delirium in an 80 y.o. with ESLD.

Another perspective: my PhD adviser, a brilliant woman and great clinician (and Sigma Theta Tau member) was on academic probation while in her undergraduate nursing program! So clearly, A's are not the be all and end all.

Sorry for going on for so long. I know it doesn't really help to just be told "don't worry about it." But helping to put things in perspective and develop tools to cope with the anxiety does. It sounds like you're doing all the right things to cope. Good luck!

01-09-2008, 09:47 PM

What a great post! I have straight-A-itis. I wound up last semester with an "A" and two "A-"s. I was bothered by the "minuses" even though it was a miracle of God that I even made it through statistics, let alone get an A- in it!

I think I may have passed that on to my kids, unfortunately. My son is in law school and my daughter in a Masters program and we all stress and cry and freak and raise our blood pressures and are sure we have flunked...:bawling:

...and then all get straight As. Go figure. :beer:

I was so burnt from studying full time last semester, I thought "oh good, just one class in Spring." Now I'm sorry I didn't have the money to go full time AGAIN. Hey, it only took two weeks to recover! :curtsey:

01-10-2008, 03:13 AM
The last 6 months of my course fair nearly finished me off. I had 3 modules including my dissertation finishing amost simultaneously. Now just 6 months later I am refreshed, have read a few novels and am secretly wishing I could get into some new studying. Secretly because I promised my husband and the colleagues who saw me so stressed 'never again'! Studying is compulsive and getting good grades breeds the desire for good grades. I was definitely more competitive this time round that I ever was in my 20's when passing was all I was worried about.

01-10-2008, 02:41 PM
And now, in the PhD program, I really, really, don't care. Maybe because, in the scheme of things grades really aren't the issue, and I don't think much of anyone is going to transcripts again. The first B I got I was a bit annoyed, but could see her point. The second one I felt was wrong -- this was an instructor who had her favorites and I felt was not a fair grader. The third one was in Advanced Measurement, and I was thankful to get it it made statistics feel like a walk in the park. What was particularly cool was that the assignments were 4 proposals (for the design of a measurement tool). I barely got a C on the first one, and each one after that was better, ending with a high B. Talk about being able to see one's learning progress!

Now my life is ruled by pass/fail. Comprehensive exams? You either passed, or you didn't. Dissertation credits? pass/fail. All of the big steps left (proposal defense, candidacy exam, dissertation defense) are a matter of your committee either approves and signs off, or you go back and work on it some more. No grades involved, and there are, in essence, "do overs" but what is being judge is purely your own work -- your ideas and synthesis of information, how you organize and articulate the information. Nerve racking but worth it (most days).

01-12-2008, 09:29 PM
I love the idea of pass/fail. We occasionally do those on clinical competency tests, and it's the only time where I feel a sense of freedom from grade anxiety. It's like I have more leeway to prove that I really do know what I'm doing, even if I miss a few things here and there.

01-27-2008, 01:03 PM
To add to my anxiety, 78% is the lowest acceptable grade for passing and you cannot miss more than one medmath problem. Yikes!

04-23-2008, 10:11 PM
Return of the dead thread!

Our minimum pass is 75% cummulative, Bean, and we can miss no math probs on the exams. We also have to have a minimum B cummulative clinical grade. To be honest, however, our program is really not very strict overall.

05-24-2008, 09:13 PM
I'm type A all the way AND I have OCD. I"m not a neat freak or a germ-o-phobe, I'm a check-er. I check my door to make sure it's locked like 100 times a day, I check my phone, I check on my son 5 or 6 times a night, checking checking checking.

If I don't check I start to think about all the terrible stuff I might miss-- when my son was first born and I tried to forego checking on him in his crib I'd start to have thoughts of him blue in his crib, or choking on a button or a toy, and I'd panic and shake and grind my teeth until I got up and checked on him.

I panic if I feel like I haven't checked enough. When I leave the house in the morning I check the door by turning the handle and pushing on it to make sure it's closed, and then I'll go get in my car. And I'll sigh and get out of my car and go check three or four more times because I'm like... did I REALLY check the door? Is it REALLY locked? And if I drive away feeling like I haven't checked good enough I get so panick-y I have to actually turn around and go back and check again.

But this is when it's BAD, like Fall semester when I took Micro and the second half of Anatomy together along with Intermediate Algebra. When I'm stressed, the OCD is worse and my stress level is exacerbated by how EXTREMELY type A I am. I had to go back on my meds the middle of fall into about the middle of this past semester.

I'm managing it pretty well though, now.

Mother Jones, RN
05-26-2008, 11:07 AM
I know that keeping a balance in your life is hard to do when you are in nursing school. Don't forget to take care of yourself, and everything else should fall into place.

MJ :pepsi: