Tips from experienced RNs for putting it all together

I'm a third-quarter BSN nursing student with a strong science background, lots of previous experience in healthcare, and a nurse tech job. I do well in classes, but I am finding it extremely difficult to pull all of the knowledge together to understand real-life patient cases.

For example, at my job, we had a DKA admit from the ED with VERY high SBG....when I looked at the labs, I knew the tests measured, but I just couldn't understand the way the body was reacting in terms of this diagnosis (WBC, electrolyte, bicarb, pH values all over the place), even though we've studied DKA, electrolyte and acid-base balance, and the inflammatory response. Same goes for every case I've seen in clinicals and at my job.

Every experienced RN keeps telling me it will come together, but I'm terrified it won't, without my making an effort while these things are still fresh in my head. I want to be a great RN, and I know it takes effort.

Does anyone have any tips or books they've found helpful for putting it all together?
Truthfully, speaking as an experienced RN it doesn't always come together. EACH case can be different and not 'text book', the cause and effect will not always jump out at you. In time after seeing routine dx's you will get it. But there will always be that odd case that makes completely no sense. There is always something to learn.Keep asking yourself "why".

keep asking "why?" for each case that you see. it's patterns that stick in our memories, not just data points. give yourself time to recognize them.when you've seen a bunch of dkas, it will suddenly occur to you what acidosis makes them all do (hyperventilate) and what we do to them (bicarb, fix cause of acidosis), and why they pee like crazy (high blood glu) and why you have to anticipate a lot of iv fluids for the resulting hypovolemia, why their k+s go nuts (because the insulin drives it into their cells), why they have pvcs (because their k+s are low now), and why they have high wbcs (it's a sign of the infection which is what got them into trouble with their dm in the first place).

Quote from gettingmyBSNI'm a third-quarter BSN nursing student with a strong science background, lots of previous experience in healthcare, and a nurse tech job. I do well in classes, but I am finding it extremely difficult to pull all of the knowledge together to understand real-life patient cases.For example, at my job, we had a DKA admit from the ED with VERY high SBG....when I looked at the labs, I knew the tests measured, but I just couldn't understand the way the body was reacting in terms of this diagnosis (WBC, electrolyte, bicarb, pH values all over the place), even though we've studied DKA, electrolyte and acid-base balance, and the inflammatory response. Same goes for every case I've seen in clinicals and at my job.Every experienced RN keeps telling me it will come together, but I'm terrified it won't, without my making an effort while these things are still fresh in my head. I want to be a great RN, and I know it takes effort.Does anyone have any tips or books they've found helpful for putting it all together?