I’ve heard NCLEX instructors say things like:
Don’t memorize content, understand the content.”
You need to memorize this whole book.”
If you know ‘The Why’, then you aren’t memorizing, you’re understanding.”
I think all these statements are confusing because what is it? Do you memorize nursing content? Or are you supposed to understand the nursing content? Well, it’s both!
An example of Understanding CHF vs. Memorizing content for CHF
It’s always better to understand content instead of just memorizing a bunch of content. For example, if you understand a simple patho and cause of congestive heart failure (CHF) then you won’t really be memorizing the signs and symptoms of CHF. Instead you will be understanding the symptoms of CHF.
CHF is basically a heart that doesn’t pump well, and therefore causing the body to hold onto fluids. Don’t just memorize that statement, understand it! And try to say it in your own words.
The signs and symptoms of CHF are from fluid volume overload: edema, tachycardia, high blood pressure and shortness of breath. Am I going to memorize those signs and symptoms? No way! Instead, I’m going to understand why they are the symptoms.
If a patient is holding onto fluids then I will see edema because edema is extra fluids.
I will see high blood pressure because a higher volume in a smaller area causes higher pressures (do you know the hose analogy?).
I will see tachycardia because the heart is trying to push the extra fluid through as fast as it can.
I will see shortness of breath because the extra fluid can start to back up into the lungs. (There is a difference between left and right sided heart failure, but I’m not going to get into that right now.)
Do you see how you aren’t memorizing the signs and symptoms, but you are understanding them?
I do memorize some content also. And you should memorize content also, because frankly it’s too complicated to understand ‘the why’ of something. And memorizing can just be easier.
For CHF, I memorized that BNP is a lab value that is high when there is an exacerbation of heart failure. I also memorized that furosemide is a loop diuretic that causes the patient to urinate and get rid of the extra fluids. There is a mechanism of action I should probably know concerning the medication and exactly how and why the body gets rid of fluids, but I just never committed it to memory. Mostly I don’t care and it never seemed to make much of a difference in the quality of care I give a patient or how I answer NCLEX questions. You may argue with me that it’s important to know, but I don’t like to waste brain power when I already have plenty that I have to know.
But I do know WHY I give furosemide to a patient with CHF – of course! It’s to get rid of the extra fluids. I also know that it can lower potassium. I can’t remember exactly what is happening in the kidneys to cause the patient to get rid of extra potassium, so that means I just memorized to check potassium and that it can be decreased.
Topics you should understand (& not just memorize)
- Understand what causes diseases (if you know this, then you can understand why you see signs and symptoms)
- why you see signs and symptoms of diseases
- why you should give a med
- why you should do an intervention
- why the patient is going for a diagnostic test
Topics you should memorize
- What meds are for
- Lab values
- What it means if lab values are high or low
- Ethical principles
- Diets and Foods
- A lot of diagnostic tests for maternity
- “Signs” like Chadwick’s sign and Turner’s sign
Topics I neither memorize or understand
- the mechanism of action for most meds
- details of chemical reactions in the body regarding electrolytes
You have to do both some memorizing and understanding. Sometimes you won’t feel like understanding, so it’s still OK to memorize. But in the big scheme of things and caring for real people and real patients, you want to understand WHY you are doing something even if you memorize why you do it.
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