I'm returning to nursing school and need note taking practice, any tips?

Background.on me: I graduated high school ten years ago, I was also able to finish early with honors, not a brag just want to put it out there that I used to be really good at school. However being several years out of practice with school note taking and study habits I know I need help to get back to it. I also am hard of hearing I always have been but it's to the point I wear hearing aids now where as before I stopped school I was still able to hear fine from the middle of the room with no aids.

The problem: I can't seem to take a usable note during class. Lectures are fast paced and have multiple breaks during them because they do last between 2-5 hours. Sometimes in longer lectures the professors will finish early and then class either becomes a study hall or a random question Q&A. After most classes there's a 3-4hr lab that's mostly skills practice at this point with skills check offs at times. I know part of the struggle to take usable notes is because I'm a chicken when it comes to asking to for clarification/repeats when I don't hear clearly. But most of it is either I hyper-focus on the lecture/engaging in class and forget to write more than a word or half a sentence when I know I should; and also that standard note book paper isn't my best option but I am struggling to find the notebook ruling style that made me so much better at notes in high school and then sometimes because my laptop is on my desk with the slides shared by the professor on it I fall into taking notes in a word document without taking the time to format the file so I can make use of it better (eg. changing file name from default document number, writing it as one long paragraph instead of headings and bullet points which is how my brain is pretending its happening)

I am also struggling with organizing the notes I do take, I prefer hand writing notes on loose leaf notebook paper and then either rewriting into a spiral or binder, so I tend to keep paper in a folder that also holds handouts/ lab papers/ policy update sheets, with the intention to go through and organize everything so I have one cohesive note for the week. But the moment I fall behind in doing so I just stop even trying until almost finals when I want to review everything. I also really like having note cards, not necessarily flash cards but like mini cheat sheets/summaries of skills or topics that are more portable and easier to review through out the day. When I was kid my mom and sibling helped me do this mostly by taking a rough draft I made and making a prettier/more legible one. However that's no longer an option as they neither have the time or care to help me with this, not that don't care at all just "you're {I'm} an adult" is their response to me asking.

What this post is asking for: I am looking for tips especially ways to practice note taking while my classes are on a break. I really want to get better at taking notes in general, I've tried watching YouTube and taking notes but those notes are worse than my lecture notes. I know there are other women in college or post-college with ADHD who probably had to figure this out. I'd especially like tips or examples of how to organize all the supplies for note-taking. I tend to keep everything in the backseat of my car or backpack with note cards at home on a table somewhere so my way is useless. I really don't want tech/digital tool recommmendations because digital notes aren't useful to me. I've tried to go paperless and it doesn't work for me.

And it case it wasn't clear I am a woman, I have a 20 years and counting documented ADHD journey that includes currently being on meds which have helped a bunch but not the post to discuss my meds.