I'm currently a second year student and getting ready to go on my first clinical placement as a second year in two weeks time. I'm really, really looking forward to placement, especially now that we have a larger repertoire of skills to perform. I'll be going to a medical oncology ward and I'm looking forward to learning about different aspects of cancer and participating in cancer care. However - I have had problems with my clinicals in the past. Prior to my last placement (August, 2009) I posted here seeking opinions and advice from seasoned nurses as to how to improve myself and I received some absolutely astounding feedback. I am sure that the feedback I received and the reflection that it prompted within myself played a significant role in my passing that placement, though it was still a very close call. You can read that post HERE
if you're interested.
Anyway, the reason I am posting today is that while I'm incredibly excited about going on this next placement, I'm also acutely aware that even though my practical and procedural skills are up to par I still have a lot of deficits regarding my ability to practice professionally and appropriately within the scope of a student nurse. I was hoping for some advice and prompting from those more experienced that I am to help my prepare myself to do well on this placement and improve on the areas that I am still lagging behind in, even after three clinical placements.
Slowly, and after much exposure, I have begun to understand the "culture" of nursing and the place of the student nurse within that culture. Right or wrong, I have developed the impression that nursing can be, all to often, a very cut throat profession with a good dose of passive-aggressiveness and that students are almost always at the very bottom of the food chain. (I'm not suggesting that all nurses are like this. I am insinuating that this has been my experience so far.) While this makes me very sad, I have come to accept that the culture of the nursing workplace may be the ultimate downside to the career of my dreams. However, I'm willing to work through that, which, I guess, is why I'm here and asking for your help.
I am, by nature, an outspoken person. Further, I'm incredibly passionate about nursing and really want to be as involved as I can in the activities of the ward, though often this means simply observing. Unfortunately, as a bottom feeder in the nursing world, my outspoken, enthusiastic and sometimes loud personality does not sit well with the nurses who have had the unfortunate luck of landing a student on their shift. Being proactive and enthusiastic is often interpreted as just plain getting in the way and I find it difficult to balance meeting my learning needs with not getting in the way and stepping on anybody's toes. However on the other hand, keeping quiet and out of the way is detrimental to my learning and just plain looks bad for a student! Confidence is often interpreted as overconfidence (which I've learnt is a really, really bad image to present and sends nurses running the other way) and I'm not sure how to project a balance of confidence in the skills I do have with uncertainty about skills I'm still unsure of and appropriately ask for assistance without getting in anyone's way.
I often feel like the simplest way to just pass each clinical to keep quiet, shut up, don't ask questions and just watch unless someone asks you to do otherwise. Obviously it's not ideally appropriate but so often I come up short about the best way to meet my learning needs, not get in the way and just plain pass.
I know this hasn't been a very clear post. I am so very unsure of what the exact nature of my problem is, which makes it difficult to ask for help. I really hope that there is something - anything - in this that AllNurses members can offer me feedback on. I'd really appreciate your thoughts and opinions prior to my upcoming clinical. More than just passing, I was to be a good nurse and make a good impression. & I don't think I have the knowledge or the skills to do that within the culture of nursing. I'm hoping that your feedback will help me find my feet a little bit more and help me take the next steps toward preparing for my clinical.