Fourth Quarter Nursing School Recap

It’s finally winter break, and just like that my fourth quarter in nursing school is over. I took my final this morning and I am so glad to be done with this quarter! I learned a lot, stressed a lot, and it was mostly a blur. Today, like with every quarter in the past, I am breaking down my quarter for you to help future fourth-quarter students get an idea of what to expect. I also know there are some people following along my nursing journey here, so this is the next post in that series.

If you want to check out my previous quarter recaps, check out the links below:

Disclaimer: Every nursing program is different. Just because my school did clinicals a certain way or covered topics this quarter doesn’t mean that other schools do this as well. This is just to help you get an idea of what might be covered during fourth quarter of an ADN program at a community college!

Fourth Quarter Nursing School Recap

Weekly Schedule

Monday: Class from 12 pm- 3 pm weekly. Every other Monday is a unit test.

Tuesday: Off!

Wednesday: Off!

Thursday: Clinical from 6 am- 2 pm. Debrief from 5 pm- 6 pm. Individual meeting 6:30 pm- 7 pm.

Friday: *Virtual* clinical from 8 am- 2 pm.

Overall, I really liked my schedule for this quarter. I know some people in my cohort had clinical and virtual clinical on Tuesday/Wednesdays. Honestly, I would have much rather preferred that and have had Thursday- Sunday to work on school work and take a break. I was pretty busy with the papers and other assignments throughout the quarter during Tuesday/Wednesday, but some weeks when there were no big assignments assigned I actually felt bored (crazy, I know!).

Weekly Workload

Compared to last quarter, the workload did not seem like such a big deal at all. The content was definitely denser, but I didn’t even pick up a textbook this quarter since there were an endless amount of slides, and we didn’t have to do weekly care plans and databases!

  • Pre-class assignments: We did these on Davis Advantage and had around 4 to do each week with a mini quiz every other week. Usually, this took under 10 minutes for the quiz and 15 minutes for the assignments.
  • Watch the prerecorded lectures. There were a ton of modules this quarter and about 4-5 hours to watch each week. I put the videos on 1.5x speed but it still took a bit to get through them.
  • Weekly clinical goals + reflection

In addition to the weekly assignments that we had above, we also had 3 major assignments over the quarter:

  • Pathomap paper (mine ended up being 18 pages! So it was a pretty long paper to write and we needed to include a database and care plan)
  • Synthesis paper (another long paper to write that included 2 care plans and 2 half care plans on top of the database)
  • Care plan (the first assignment of the quarter, pretty straightforward if you’re a nursing student)

On top of the assignments above for my theory course, med-surg nursing concepts 2, we had a 1 credit nutrition class. The nutrition class was pretty minimal and we just needed to answer questions or complete a discussion each week.

Lecture Topics

Last quarter there seemed like there was a new lecture topic each week. This quarter there were four big unit topics that were divided into modules. I feel like my knowledge of nursing care and disease processes have expanded a lot because we really got deep into these topics. Below, I briefly cover what we talked about in each unit.

Unit One: Cardiac

We started off this quarter for three weeks talking about the cardiac system. There is a lot to cover from angina, MIs, EKGs, heart disease, and hypertension to name a few topics. If you’re not yet going into the fourth quarter and are wanting to know what to prepare for, I would say EKGs are a good place to start. You’ll want to know the rate, rhythm, and nursing interventions for different EKGs. There are lots of helpful nursing Youtube videos that cover the different rhythms and different methods for determining the rate.

Unit Two: Respiratory

The next unit that we covered was respiratory. COPD was a big topic for this quarter. Other topics we went over included pneumonia, pulmonary embolism, pneumothorax, and lung cancer. We also went over chest tubes and drainage systems which seemed to be a very important topic for this unit.

Unit Three: Renal

Renal was another big unit that was covered going into the second half of the quarter. One big topic that we went over was determining ABGs. If you are looking for something to prepare for to get ahead in the fourth quarter, it could be helpful to go over deciphering ABGs. There are lots of videos on Youtube for nurses and it’s really easy when you get the hang of it. You’ll want to know nursing interventions for both respiratory alkalosis and acidosis, as well as metabolic acidosis and alkalosis and the symptoms. Other topics that were covered include chronic kidney disease, kidney stones, urinary tract infections, and incontinence.

Unit Four: GI

Our final topic was on GI which also covered a lot. We went over some common disorders like GERD, hernias, as well as some less common diseases like ulcerative colitis and Chron’s disease. Another bigger topic that we talked about was the different types of hepatitis.


Last quarter I had the night shift clinical and this quarter I was on the day. I honestly prefer the day shift clinical much better! I always had horrible brain fog after going to the night shift clinicals for the entire next day. I also felt like I couldn’t really do anything leading up to the clinical and was just waiting around. The day shift was easy since I would leave right after waking up and since we only went until 2 pm, I felt like I still had part of my day left.

Clinical this quarter was spent in the PCU (step-down), cardiology floor, cath lab, short stay unit, and CVICU. The PCU was one step below the ICU and the cardiology floor has patients with general cardiac problems like dysrhythmias. In the cath lab, procedures are done like stent placements which were interesting to watch. In the short stay unit, procedures like colonoscopies and endoscopies are done and the patient is sent home the same day. I was able to do more than 10 IV starts while in this unit which was awesome to practice! Finally, the CVICU is the cardiovascular ICU with critical care patients, some of which are on ventilators. I personally loved the ICU and could see myself there after graduation, even though it was intimidating before going on to the unit (and I didn’t think it would be for me!).

Overall Thoughts

This quarter had a lot less busywork, but more information to study. I feel like you will learn a lot if you are going into the second quarter, but for me, the turning point was last quarter. Clinical was a lot less stressful (thankfully) and going onto the floor on my own is less daunting. Honestly, though I am so ready for a break!

Next quarter my school has psych for half the rotations and med-surg for the second half. We also have two theory classes meaning double the work and double the quizzes. I am excited to see a new specialty though!

I hope this helped you know what to expect for your fourth quarter in nursing school, or hope you just enjoyed the update if you’re following along on my nursing journey! 🙂

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