2nd day of clinicals & I feel like an idiot...help me gain some confidence!

[pecanpies]

So, I'm that stereotypical student who does great in class & on tests and papers, but who is struggling in clinical. I'm in an accelerated program and we just started our clinicals - yesterday was my second day in the hospital. I had to give a pneumonia vax IM. The PT's daughter had been in the room all day, watching me closely & taking notes about everything I said & did. It's great the PT had an advocate, and we had a good rapport - but it made me very nervous.

Anyways, here's what happened. I went to give the IM injection (in the deltoid) - and the needle didn't go in. It just bounced off the skin. I'm sure my hand was shaking and I just didn't use enough force. I was stunned & just kind of stood & stared for a moment. My instructor was also watching me. He went to go swap out the needle and I was so flustered I asked him to please give it - I didn't want to hurt the PT.

I feel like a complete failure and an IDIOT! I mean, really - who does this? Who can't give a simple IM injection? My confidence is shot. I want to dust myself off & try again, but there's a tiny part of me that's wondering, if I can't do something this simple, am I really cut out for nursing?

Please tell me what you think...be honest with me. Is this a sign that I can't hack it? If not, how do I get over this and get some confidence back so this doesn't happen again?

[amybeets05]

It's your 2nd day! Give yourself a break. Take a few hours and do something you enjoy, like go swim or read a book. Tomorrow is another day.

[okredrobot]

Its only your 2nd clinical experience; don't bend yourself out of shape. Everything comes with experience.

For example, in my first semester I was in a nursing home. I was assigned to a client to do wound care. This was my first time doing wound care on an actual patient, so I was pretty nervous. When I came into the room, it was this irate man who kept yelling and cursing at me. To make matters worse, he spoke Russian...so I could understand him but my professor didn't. I was so nervous, I finished as fast as I could and bolted out of the room ASAP. I thought I did a good job until my professor walks out of the room holding the medicated patch that I was supposed to put on the wound [THE MOST IMPORTANT PART OF HIS WOUND CARE]. I felt like an epic failure. But as a few semesters went by I got the hang of things and now i can do wound care in the most strangest situations and never forget a thing.

Practice makes perfect!

P.S. fling your wrist when you give an injection, it always does the trick. If you have your landmarks correct you won't hurt the patient.

[QuarterLife88, MSN, RN, NP]

You sound like me. Great book learner, in your element in the classroom. Skills...freakout mode. You question whether or not you're barking up the wrong tree and perhaps maybe we shouldn't be in a profession where peoples' lives are in our hands. It's a self-defeating line of thought.

I haven't started clinicals yet, but I just had a CPR class (my thread is a few below this one) and felt inept as well, and took it as a negative sign of future events to come. Someone did point out though, (and I love this comparison) that just like when we first learned to drive we were novice, nervous, newbies, and it takes time to first develop the skills, and more importantly even more time to let them become second nature.

You WILL get it. Your day will come. Practice on fruit. I've seen it done on TV, and it's better than nothing.

eta: Also, I believe the fact that you do care so much and have a drive to improve will make you a better nurse in the long run. jmo.

[JROregon, ASN, BSN, RN]

If you have needles and syringes to practice with, my CI told us to buy a beef tongue. Has the same kind of feel as skeletal muscle. Heck on our second day of clinical most of us were fumbling idiots. They wouldn't let us near medications or injection equipment for several weeks after that.

[CBsMommy]

If this is only your second day of clinicals and you are giving injections, that's awesome! Don't worry about making mistakes, that is exactly what you are in clinicals to do and why your instructors watch (to rescue you and to teach you). My only advice would be watch your instructors and the different nurses' techniques. When I was about to do an IM in the deltoid for the first time, my instructor stopped me and gave me a few pointers. She got our entire clinical group time in a flu shot clinic as well to "perfect" our techniques.

Just remember that we are not born with nursing knowledge. It comes from experience (which includes making mistakes) and from learning. Give yourself a break! Your next IM will be no big deal!!! Good luck and you can do this!

[AgentBeast, BSN, RN]

Same thing happened to me, although I was giving Lovenox SQ in the abdomen and those needles are notoriously dull. Also this dude had skin like leather. Went to stick the needle in him and the freaking thing just bounced back at me, and I used quite a bit of force lol. I just wound up and stuck that baby in there again. Can't change the needle on the lovenox syringe.

That being said I'm surprised they have you jabbing people with needles your second day of clinical. It's your second day of clinical after all you don't have a clue what the hell you are doing. Took me about 5 weeks before things started to "slow down" for me.

[starry_midnight]

I had issues with the needle on a novolog insulin pen in clinical! Felt like such an idiot, but it's all a part of learning and growing your skill set & confidence! Don't let it shake you, you've got this! Good luck! Time, patience & an open mind!!

[KristeyK]

You're LUCKY you're getting to do that on your second day of clinical! As others have already said, stop beating yourself up. Head to the lab if you can, and practice. (Although what we have to practice on is NOTHING like actual skin. I like the idea of oranges, as they're much more realistic.)

Good luck in the future. You'll do FINE.

[tech1000]

Relax! I've been working in a hospital for 3 years as a tech, and still felt like an idiot at times in clinical. As bad as this sounds, don't worry about hurting the patient. They understand that you're a student and you'll be able to tell if the patient really doesn't want you to keep trying something. I've had patients say, "I'd rather have somebody more experienced do this" and it's fine. I've also messed things up and had to retry. They know you're learning. It's only your second day. You'll gain more confidence.

[Turd Ferguson]

The PT's daughter had been in the room all day, watching me closely & taking notes about everything I said & did. It's great the PT had an advocate, and we had a good rapport - but it made me very nervous.

This is very nerve-racking, especially as you are learning. As you grow, you will learn to appreciate family members being in the room with your patient. Nobody performs well in front of an audience when they're new.

Anyways, here's what happened. I went to give the IM injection (in the deltoid) - and the needle didn't go in. It just bounced off the skin.

You will laugh about this in the future, I guarantee it. IM injections take practice, and patient's skin can be very tough. I was taught to treat an IM injection like a throwing dart, you have to be quick, firm, and deliberate.

Please don't lose sleep over this, you are new! Everybody makes mistakes, not everybody learns from their mistakes. It's perfectly normal to feel like you don't know what you're doing, because you don't. Process what happened and learn from it. This will not be the last time you mess up, I promise.

[anonymousstudent]

GO TO LAB. A lot of nursing is book knowledge. But some of it, and the things that people seem to struggle with, are physical skills that you learn with your hands - psychomotor functioning. You can't expect to get that dart if you haven't done it a bajillion times over and over on a fake pad.

Don't beat yourself up and don't listen to that stereotype garbage. You're going to be fine. Get yourself to lab and build up those physical muscle memories (and confidence ). GL!