Nursing Q&A: Sierra Hamm

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Sierra Hamm, Online Nursing Guide Q&A Contributor

Sierra Hamm, BSN, RN

Current Position and Past Experience

Sierra works as the primary nurse of a midwifery and family practice, serving women and babies in the clinical and home-birth setting.

Education, Honors and Achievements

Sierra earned her BSN from Eastern Kentucky University. She is certified in neonatal resuscitation (NRP) and in Advanced Life Support Obstetrics (ALSO). Sierra has also received training in order to provide doula care to women..

Where did you attend nursing school?

I attended nursing school at Eastern Kentucky University, graduating with a Bachelor’s of Science in Nursing.

What degrees (nursing or non-nursing) have you earned or are you in the process of earning?

I began my educational career studying Agriculture at the University of Kentucky. I did not complete the degree, and changed majors to nursing after taking a semester off.

What are your education highlights?

  • I worked as a childbirth/ labor support person (A.K.A. a doula) while obtaining my nursing degree. This required me to take additional training and study in order to provide doula care to women.
  • I used my skills I acquired as a doula while in nursing school on patients. One shining moment was when I was completing my neurology clinical at the University of Kentucky, and was able to assist a patient through a sudden migraine and panic attack when her prescription medication was not available. She was able to achieve relaxation and comfort without pharmaceutical intervention.
  • I received the peer nominated “Caring Award” 2 years in a row during nursing school. My fellow nursing students affirmed that I truly care about my patients.
  • I am certified in neonatal resuscitation (NRP).
  • I am certified in Advanced Life Support in Obstetrics (ALSO).

What are your career highlights?

  • I graduated and took the first job offer I received and started working as a Public Home Health Nurse.
  • I was offered (and accepted) my dream job as the primary nurse of a local midwifery and family practice. I attend home births with a certified nurse midwife as her registered nurse. I also attend laboring women who wish to have a hospital birth, as a private duty maternity nurse. This involves providing clinical skills in the home and then transferring with the mother to the hospital setting, where I function in a supportive, nonclinical role. It is a seeming fusion between the science and clinical skills of a registered nurse, and the art and skill of a doula or professional childbirth assistant.
  • I teach private childbirth education classes to our home birth clients, as well as volunteer at a local maternity home teaching childbirth classes.
  • I work privately for a foster care agency teaching medication classes and performing intake evaluations of children newly in state custody.
  • I freelance on the Internet as an RN.

What inspired you to go into the nursing field and do you feel that what drove you then is still driving you now?

I took a semester off from college after a life changing accident. I had time to think and search… I discovered shocking statistics about the state of maternal and neonatal health in the USA, finding that we are ranked below every other industrialized nation for maternal and neonatal mortality. This finding sparked the ultimate question… why? I began researching, and found information about people working trying to solve the crisis… and they are called certified nurse midwives. I knew at that moment that I wanted to be a certified nurse midwife and that this was the question I want[ed] to spend the rest of my life solving and reversing.

What were the most difficult parts of applying to your nursing program(s)?

The most difficult parts of applying to nursing school had to do with being a transfer student. Many of my credits were not applied until I petitioned the dean, which was a very long process.

What are/were the most difficult parts of earning your degree(s)?

  • I loved the pre-nursing courses such as anatomy, chemistry, physiology, statistics and so forth. I made excellent scores in these classes and enjoyed taking them.
  • The actual nursing courses themselves were very difficult. The test questions were written for application of knowledge rather than simply the knowledge itself. Unfortunately, I did not understand how to answer the questions correctly until my second semester of junior year. Once I learned how to answer the questions it became easier.
  • The volume of reading and studying required to become a nurse is tremendous. I would sometimes study 60 hours or more a week, which required much more than reading the chapter in the book and making flash cards.

If you were mentoring a future nursing student, what things would you recommend they focus on and prepare for, before they apply to or attend nursing school?

  • I would recommend [that] they get their bachelor’s first. Research shows that BSN-prepared nurses are safer than ADN, and in order for a hospital to achieve magnet status, they must have BSN nurses.
  • I would recommend they shadow a nurse.
  • I would recommend they pay very close attention in the core sciences such as anatomy, physiology, and chemistry…
  • I would recommend they find a way not to work during nursing school.
  • I would recommend they firmly understand why they want to be a nurse, and write it down in a thesis-like statement, placing it on the mirror or somewhere else they will read it constantly. Because nursing school is very difficult and if you are not grounded in your goals and values, you will not succeed.
  • I would recommend that they go ahead and start learning how NCLEX [test] questions are different than regular [test] questions, and practice answering them.
  • I would implore them to study pathophysiology and pharmacology together, and to review normal physiology and chemistry to review how the body is supposed to function. Then, understanding how the disease process alters the physiology. You simply cannot merely memorize that a beta-blocker is a blood pressure medication. You have to understand how blood pressure is normally regulated in the body including the chemistry and physiology. Then you must understand how the beta-blocker works in the body to produce the therapeutic effect of lower blood pressure. If you understand these things, then you will know the side effects of the medication and [what] will be required of you, not just on the tests, but as an RN.

What advice would you give to a future nursing student who is considering enrolling in an online or distance learning nursing program?

I would advise them to have a mentor or tutor who can help them in-person.

What are the pros and cons of studying nursing online?


  • You do not have the fellowship of other nursing students
  • It is potentially more difficult to ask questions/ clarify misunderstandings
  • Potentially limited use of the lab for practicing clinical skills
  • You miss the college experience


  • You do not have to relocate to go to school
  • You may be able to complete the degree as a part-time student and still work
  • You will save money on transportation and parking.

Do you feel that a nursing degree earned through an online program is any different from one earned in a traditional, on-campus program?

Not necessarily, in fact, many advanced practice nursing degrees (such as the master’s of midwifery), are offered solely online by schools.

What qualities and skills make a successful nursing student?

Perseverance, prioritization, sacrifice, compassion, caring attitude, and self care.

What tips would you give a student for how to best interact with teachers and counselors while attending nursing school?

Be respectful and sit in the front row. Be early to clinical and class, ask questions, and go to class every day.

How much time during the week should a nursing student set aside for studying, tests, labs and/or clinicals?

You need to study 3 hours per credit hour per week. That is basically your whole week. You must make time to perform basic self-care such as eating real food, sleeping enough, exercising (while studying most likely), and having one night and day off from studying per week.

Did you receive any financial aid for your nursing degree(s)? What financial aid options should a nursing student consider?

I received some Pell grants as I was a married, independent student. I also received a scholarship from a local clinic. I still had to take out a loan from the government. If you do not have to borrow, simply don’t. If you live at home with your parents, I recommend you continue to do so to save money. Student loans are terrible, even if you are making a living wage when you get a job as a nurse. Do not take out student loans to buy a car, take a vacation, buy clothes, etc. It is not free money, and I have seen many students fall into this trap!

How can an online or campus-based nursing student become involved in healthcare facilities in their area while attending school (internships, volunteer work)?

Volunteering in the area you think you will like is a great option, if a possibility. Summer is a great time for internships. You can also work as a certified nursing assistant, also known as a tech. Join a nursing club or organization. Take medical mission trips over breaks.

What skills, experience and qualifications do employers focus on when hiring nurses?

They want to see that you have gone above and beyond to become a nurse while still in school (e.g. have a job as a nursing assistant or in healthcare). Magnet hospitals want to hire BSN nurses, or have you commit to returning to school immediately upon hire. Experience outside of your work is great too, such as volunteering and joining nursing organizations. They want to see that your identity is being a nurse, before they hire you.

If you were personally looking to start your nursing education or career over, what would you do differently? What would you do the same?

I would have paid someone to help me understand better how to answer the questions. I would have made much better grades. Although I understood the information, I did not know how to answer the questions. I also would have worked as a CNA.

What do you wish you would have known before starting nursing school or becoming a nurse?

  • Nursing is likely not what you think it is. You are being taught in school how to be a hospital nurse and function in the acute care setting. You are the doctor’s eyes and ears, and they are completely dependent on you to know your patient and to report only relevant information. You are not learning how to take blood pressures and put cute Band-Aids on.
  • You will be taught to be a generalist, and little favor will be shown to you even if you have a preference, as the NCLEX cannot show you favor in that area of nursing.
  • As a BSN prepared nurse, you are taught how to be a manager of the patient and the environment you work in.
  • Nursing doesn’t pay as much as you think it does. It’s a living wage.
  • You will never be paid enough to witness/ perform the things you do as a nurse, from birth to death. You have the most amazing opportunity to care for people and have overwhelming joy, but the equal and opposite is also true.

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