Thick skin missing

Nurses General Nursing

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Hey all....

Note: this is LONG, but please read and help me....need to pour my heart out and get some encouragement...:crying2:

I am a student nurse who is about to start my 2nd semester of nursing school. I got almost all A's first semester and was voted class president and was feeling pretty confident about everything until....

I got a job as a nursing student PCT in the float pool at a hospital that I hope to get a nurse residency at after I graduate. I really want to work at this hospital, but they will not hire anyone with less than a year of experience unless you are in the residency program. I have heard that working as a student PCT will help you get to know people at the hospital and increase your chances of getting a job when you graduate. This is my first foray into patient care as we got very little in our first semester. I just finished orientation and am terrified to work on my own. Here's why...

First day of orientation included shadowing an RN for 8 hours on a med-surg floor, which honestly was useless to me for orientation to PCT and the 2 nurses I shadowed seemed to consider ME useless because honestly for my first day, I really don't know a damn thing! I didn't get any PCT training, just felt like I got in the way.

Second and third days were great...I worked side by side with 2 PCT's on different units who were very helpful and encouraging. One day was on Trauma ICU and the next was Neurovascular Intermediate. I was starting to feel like I would be just fine....and those girls had said just as much.

Fourth day....last day of orientation. I was put on another med-surg floor where EVERYTHING is done differently. Apparently the "floor" is much different than the "unit." The PCT's I worked with were very critical of everything I did, even if they didn't do those things themselves (i.e. "you MUST positively ID EACH patient EACH time"....which they did not do, but chastized me if they didn't hear me do it). I also got chewed out for asking the patient if they were in any pain...which I told was outside of my scope of practice. I just thought that if they said they were in pain, I could tell the nurse, that's all. I was also told that I was too slow with taking vitals, etc, etc. I did make a couple mistakes, but only because being watched like a hawk makes me extremely nervous and I am more prone to make mistakes (nothing life-threatening, I assure you). I am learning and am slow because things don't come to me in the blink of an eye like it comes to them, having done this a while. I might need an extra few seconds to think before they pounce on me....I'm sure this wasn't second nature to them when they first started.

I was also told by another PCT nursing student that has worked there for 2 years and is a semester ahead of me that I will fail Adult I if I can't do patient care. I can do it, but each floor is different and I am trying to learn all the different routines in 3 actual shifts with another PCT orienting me. The nursing student float pool manager encouraged us to take as many extra days of orientation as we need, which I would love to do, but don't want to take too much advantage of that or overstep the bounds, if you know what I mean.

All this new job stress plus beginning next semester next month makes me an absolute basketcase...and I hear from some new RN's that it is the same situation when you graduate. I am a sensitive person who can get intimidated a bit. Do I need a thicker skin? Am I doing something wrong? Is this common? What should I do? :confused:

Thanks all! I would really appreciate your feedback as I came home crying tonight...at least they didn't see me.

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Specializes in Cardiac Telemetry, Emergency, SAFE.

Well, first off, relax. You seem to be well put together. The PCTs on your last day may have been having a bad day, or they may just have a stick up their buns and thats how they act on a daily basis. I honestly wouldnt worry about it. You will meet people who are hypercritical of you. Youll meet people who are indifferent. You'll meet people who are a-ok. I think anyone would feel flustered if they had someone watching their every move.

I dont think you were doing anything wrong, but just incase, observe how fast and how throughly the seasoned PCTs are doing their taks, and see if you are keeping pace. If youre too slow, believe me youll hear about it. I dont think it was fair for them to tell you that you'd fail b/c you cant do patient care on orientation.

Keep on truckin, honey. Youll be ok. :D

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Specializes in Emergency Room.

Hello :)

I can understand where you are coming from. I am in orientation myself in a fast paced ED.

Im sorry if you feel like you didn't receive adequate orientation to your position. If they take you off orientation just make sure you ask questions prior to doing something if you are not sure.

As for needing the pause before doing a newly learned task. Im sure everyone paused (in their own way) before attempting something new. Eventually things will become second nature and you wont have to pause.

I am not sure if your education is set up similar to mine or not. When I was in school (BSN) we learned patient care duties the very first weeks in our first nursing class (Nursing Assessments). If you were not competent of providing basic patient care duties and head-to-toe assessment then you did NOT pass the first semester. Our second semester we had Nursing Interventions and Theories and it wasnt until our 3rd semester did we have Nursing of Adults. If you are starting your second semester (if your program is similar) then you should have learned all the necessary skills needed to be a PCT. I know in my state, nursing students were eligible to take the CNA test after they completed their first clinical.

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Specializes in Emergency Room.

Also, I have NEVER seen a PCT 'positively ID EACH time'.

I can just see that happening. :lol2:

PCT: "Can you please tell me your name and DOB?"

PT: Mr. Jones 3/15/55

PCT: "Thank you Mr. Jones. I will now proceed to remove you from the bedpan and and get you cleaned up."

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No one started out doing something like an expert. There is a learning curve. Don't worry about being a little slower. Focus on doing things right. The timing will come with experience. Don't worry about the comments. You will always run into the over critical know it all. They tend to forget they were new at something at one point.

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Thanks guys...I really appreciate your feedback

I'm thinking of asking for one more day of orientation on the "floor" as opposed to the "unit." I might feel more comfortable...I just don't want to keep the training wheels on for too long....like overstaying your welcome. Trust me I am all about asking if I don't understand something, perhaps to a fault....sometimes I am worry about asking too many questions because I may appear helpless or get the "eye roll," but it definitely doesn't stop me from asking.

I definitely learned skills in first semester in nursing school...we learned baths, injections, making an occupied bed, foley cath insertion, inserting an IV, vitals, etc. I won't be giving injections or starting an IV because this is not included in my scope of practice. I can do the other things "textbook-style", but get chided for not knowing how to do it the "quick and dirty" way like they do it. I keep getting told that school and real life are 2 different things and this is how things are done in the "real world", but how am I supposed to know any other way than what I was taught when I have no previous experience? Its just frustrating. :( And was I wrong to ask the patient if he/she was painful?

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Specializes in Cardiac Telemetry, Emergency, SAFE.
And was I wrong to ask the patient if he/she was painful?

No, you were not, IMO. The PCTs on my floor approach us with patient concerns all the time whether the pt ourtight said it or they were asked about it.

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Specializes in Emergency & Trauma/Adult ICU.

Don't beat yourself up ... you're learning.

I think a day or two of additional orientation will help you a great deal and will not cause others to look unfavorably at you. This position will advance your comfort level with various aspects of patient interaction and care - it will be a huge asset to you to in the future.

And yes, you need a thicker skin. When shown a different/better way to do something, why not take that as a positive, instead of automatically assuming that the sky is falling? "Hey, thanks for showing me that" can smooth over conversation very well.

Good luck to you. :)

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Blech!

I think almost everyone feels this way when the start. Some more than others, and some say they don't feel this way but I think they're lying.

99.9% chance you are perfectly capable of doing the job, so don't doubt that!!!

I think the good days tend to outnumber the bad days, if you give it long enough!

There's something about the whole nursing/hospital profession that is a breeding ground for bullying. BUT: you do get a thicker skin. (You also get good at learning ways to de-stress at the end of the day). If you can get through it, you'll hopefully be someone who adds something positive to the hospital environment later. :)

AND, if you're having trouble with patient care, good for you getting the PCT job! It's going to help you a ton in clinical later. The PCTs in my class are practically second nursing instructors, as we all go to them to ask questions because when it comes to bullies, instructors can be the worst of all.

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Specializes in ICU/CCU.

Your thick skin will develop in time. Those (horrible) PCTs who predicted your failure in school are of the type who can only feel good about their own meager lives at the expense of other people. They don't think you will fail so much as fear that you will succeed.

So you are not a perfect PCT right off the bat--big whoopdedoo. That is hardly a predictor of how you will perform as a nurse. And in my experience, people who stay PCTs for too long often make substandard nurses as they can't break out of a merely task-oriented mindset and into the realm of critical thinking.

Keep your chin up, take some deep breaths and carry on. In a few years you will be a nurse and having to listen to these harpies or their ilk go on about some other poor newbie. Remember how it felt to be the focus of that kind of negative and gloating scrutiny and do your bit to make new trainees feel welcome and supported.

Good luck, and don't let them get you down.

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Specializes in n/a.

Some people are just like that. They may have had a mean person when they started and felt powerful with a newbie to push around. Don't let it get to you. Just keep trucking!

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It is NOT outside the PCT scope of practice to ask someone if they're in pain. Part of how PCTs are a help to the nurses is they are an extra set of eyes and ears and gather data to report back. I was actually taught pain was considered to be the sixth vital sign, so if you are doing vitals it's doubly ok. I expect my techs to report back any abnormalities, be it an off vital, pain issues, resp issues, distress of any kind, etc.

Sorry, that piece just boggled me. You will be fine, just take the time you need to get more efficient and don't let anyone (yourself included) beat you up over it.

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