The Hardest Class in Nursing School

The Hardest Class in Nursing School

There’s no denying the fact that nursing school is hard, but prospective students tend to wonder: what exactly makes it so hard? There are a number of things at play that make nursing school an incredibly challenging endeavor.


Stressed nursing student at her desk
Sophia M.


January 27, 2022

Nursing school is hard! First, on top of traditional coursework (weekly lectures, quizzes, group projects) you also have clinical hours that involve long days spent gaining real-world experience at the hospital. Nursing school is a major time commitment and it can be hard to work any aspect of your life around it.

In addition to being incredibly time-consuming, the nursing courses themselves are no walk in the park. Being a nurse requires a strong sense of critical thinking and your courses are designed to train you in just that. So, you’ll likely run into exam questions that offer four multiple choice answers, all of which are technically “correct” – however, you are tasked with figuring out which option is the most correct. 

When it comes to the classes themselves, many people wonder which class is the most challenging. This article will delve into some of the hardest aspects of nursing school, including the classes that students struggle with the most, the courses I found to be the most challenging, and some tips to help get you through them.

What Are The Hardest Courses in Nursing School for Most Students?

It is difficult to pinpoint one specific class that students struggle with the most, given that coursework tends to vary across programs. However, there are some classes that seem to be a challenge for many nursing students based on anecdotal evidence. 

Anatomy and Physiology: before we’ve even started 

Interestingly enough, one of the hardest subjects in nursing school comes before you’ve even been accepted into a program — Anatomy and Physiology. This required prerequisite course is only passed by about 50% of those who take it and requires students to memorize many intricate details about the human body and how it functions.

Nursing prerequisites

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Health Assessment: the hardest semester of nursing school

Many nursing students find that the hardest semester of nursing school is the first because adjusting to the demanding schedule feels like a culture shock. Health assessment will likely be one of the initial courses you’ll take in nursing school, and it involves delving into the various body systems and learning how to assess patients from head to toe. Many students struggle with the hands-on nature of this course, given that it is so different from many other typical college courses. 

Med-Surg 1: the deep dive

Med-Surg 1 or Adult Health 1 is typically taken in the second semester of nursing school and involves combining students’ knowledge of the human body with their assessment and critical thinking skills. This course breaks down various conditions within the body and common medical treatment for these conditions. I personally saw three of my fellow nursing students fail this course; however, they had the opportunity to retake it and all still went on to successfully complete nursing school.

Medical surgical nursing and pathophysiology

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Pharmacology: it even sounds scary

It shouldn’t be too surprising that many nursing students consider Pharmacology to be the hardest class in nursing school. Honestly, the name of this course alone makes it sound challenging, and it is. Pharmacology is a course that delves into a vast quantity of medications and challenges students to learn how these medications work inside of the body and when they are indicated for use. 

Pharmacology 1

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The Courses I Found to Be the Most Challenging in Nursing School

Everyone has their own experience, so what you find to be the hardest subject in nursing school will likely be passed with ease by some of your colleagues and vice versa. Below, I’ll break down a few of the courses that I found to be the most challenging and how I got through them. 

Complex Nursing Concepts

My nursing program required a course called “Complex Nursing Concepts” that students took in their fourth semester of the program. This program could also be considered “Adult Health 3” as it came after Adult Health 1 and 2. This course delved into critical care nursing, emergency management, and ICU nursing. I found this course to be particularly challenging because the conditions we learned about were incredibly complicated. 

I came very close to failing this course (keep in mind that anything below a 73% testing average was considered failing for my program) but I managed to make it through. I did very poorly on the first few quizzes and the mid-term, causing me to really have to get my act together during the second half of the course. I realized that I wasn’t making the most of my study time because I was having a hard time focusing. I started to meditate daily to help clear my mind and improve my focus. I stashed my phone away during study sessions and would not let myself check it, other than on dedicated breaks. I would carve out study time and be very intentional with it. I’d look at the time and hold myself to focusing for a 30 minute interval, take a short break, then repeat this process. Breaking up my study time into smaller, more manageable bits made it easier to stay focused. 

Community-Based Learning

My specific nursing program involved a community-based learning portion that required students to complete a certain number of community service hours prior to graduating. This meant my peers and I had to sacrifice even more of our precious time by getting out into the community and completing volunteer hours that didn’t even fully relate to becoming a nurse. 

I found this part of nursing school to be incredibly challenging because it required me to sacrifice so much extra time. It felt so overwhelming to have to spend hours of my time working for free when I had a pile of coursework waiting for me at home and a clinical rotation bright and early the following morning. It also made it very difficult to maintain an actual job while in nursing school. 

Even though it was tough, I really appreciate that this was a part of my nursing school experience. Going out into the community and serving those who needed me was truly satisfying and it really humbled me and put my own life into perspective. I believe this portion of nursing school made me a better nurse and a better person overall. It also forced me to learn incredible time management skills which I still use to this day. 

Tips for Getting Through the Thick of it

It can be very intimidating to hear about how difficult the road to becoming a nurse is, but don’t let this discourage you. There are a lot of reasons why nursing school is as challenging as it is, and ultimately, the goal of these challenges is to produce dedicated nurses who have a strong work ethic and a good sense of integrity. Nursing school teaches the valuable lesson of getting back up when you’re down — this is something I’ll always carry with me in everything I do. 

So, if you’re in the thick of it right now, I want you to remember a few things:

  1. Time management is vital. You have to learn to manage your time if you’re going to stay afloat in a nursing program. Prioritize what is most important to you and make time when it matters. Learn how to make the most of your study time by breaking it down into more manageable pieces. 
  1. Befriend your colleagues. No one in your life will understand how challenging nursing school is better than your fellow classmates will. It is so important that you build friendships within your program, because you likely won’t have much time to hang out with anyone else during your time in nursing school. Also, having study partners helped me so much because it allowed me to talk through my notes. Talking aloud while studying can really help you process information and remember it. 
  1. There is a light at the end of the tunnel. It may seem impossible right now but remember that you will get through it eventually. One day, you’ll get that acceptance letter, complete that course, or walk across that stage with your diploma. Even if it feels like you can’t, you have to just keep moving forward. You can do this.
  1. Remember how far you’ve come. Whether you’re still working on prerequisites or in your very last semester, it is important to take some time to think about how far you’ve come. I’ll never forget driving to take one of my final exams during my fourth semester of nursing school, feeling so afraid of failure. Then something hit me and I thought to myself, I’ve made it to my fourth semester of nursing school and there was once a time when I didn’t even think I’d get into nursing school. This realization completely shifted my mindset because I realized that if I could make it that far, I could definitely pass this exam. No matter where you’ve come from, you’ve come a long way and it is important to try to never lose sight of that. 

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