Advice about Clinical

Nursing Students General Students

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Hi Everyone,

I am at the end of my first semester of nursing school and I just finished up clinicals. During my evaluation my nursing instructor talked to me about my communication skills because she said she's very concerned. I'm a quiet type of person but I feel I have improved throughout the semester in talking with my patients and just being able to walk in their room and introduce myself. I feel I have to work on confidence and communication, but I felt terrible after talking with her. She hasn't decided what to do yet...she might not pass me and I am really worried! I want to move on to the next semester in the fall. I loved clinicals and I really truly want to be a nurse! Has anyone else experienced this before? What can I do?

im so sorry! i dont think you should be failed, your instructor should know and understand that it's only your first semester....normal people are nervous at first!! be strong and confident and keep your chin up.

Wow. I feel for the original poster! You basically described me in my first term of clinicals (through all of clinicals really)! Well, kind of me, overall - still to this day (as a nurse now for almost two years)! It doesn't make me a bad nurse to not be the nurse who is always running their trap about XYZ or thinks they could never be or do wrong. I'm not an unsociable person, just reserved in some instances, especially new situations. It's gotten better with time, experience and along with it - confidence. It will get better, I promise.

The instructor is right that as a nurse you will have to be able to have conversations with physicians, pharmacy, patients, family, PT, OT, so on and so forth. The thing is though, this is a learned art. I didn't really "get" it until my clinical practicum/preceptorship, when I worked 1:1 with an RN. But the thing is, it's one thing to try this as a student, and another to be the new staff member having conversations. We continually change and evolve. It took me a little while to get "good" at knowing how to approach the docs I worked with as a floor nurse. Well, apparently I always (according to my preceptors) did okay or well, but it didn't feel comfortable for a while. Besides. The hospital I work at - we have text paging. Most of the time the floor RNs text residents/NPs etc with a question or nugget of info and sometimes they put orders in without even calling back (PRN blood pressure medication to lower a high SBP for example). Not that we don't talk, but so much of it is also written communication.

Original poster - Keep your head held high. If you have to repeat a course then you have to repeat it (our school made it hard to fail a student in clinicals - most of our students who failed did so because of test scores; clinical instructors had to have serious issues and lots of documentation supporting their recommendation to fail someone). It happens in school, and throughout life - we get set back some. Some people repeat a class, some people have to take the NCLEX more than once, some people have to apply, apply and apply some more for jobs. For each of us, the road to our goals is complicated in some way by something. Best wishes to you! :)

Specializes in Emergency Department.

Look at it this way: if you fail this semester and have to repeat this semester, that's a whole "almost" freebie semester that you can use to work on your assertiveness, your clinical skills, and pick up on some details you didn't get the first time around. In short, while it delays your plans, you very much could end up being a whole lot better for you in the end. In a way, I was in a similar position. I'm repeating a class, but I'm a whole lot better this time around than last time.

I hope that you are able to pass this semester and be able to work on your communication skills over the next semester.

I just passed my Nclex at age 52. I have life experience and am an extrovert, so when I walked into a room, I guess I showed confidence...even though somedays I didn't feel it inside. The last semester, at my final evaulation, my clinical instructor told me that I extruded confidence.....to which I responded with "I don't always feel it." He was surprised to hear me say that. I think every one feel unsure sometimes inside....but that does not mean they are not a good nurse. As you gain experience in nursing skills, you will feel comfortable and will enjoy the communication! Hang in there....it gets better!

What do they call a nurse who happened to be set back a semester? Answer: A nurse! LOL. You will get there!

So, I had a meeting today with my instructor and advisor and they are going to make me retake clinical because I'm quiet. They even think I should see a counselor for shyness. I was so upset when they told me, and I really don't think I'm that shy. I know I could work on my communication skills and being more confident but I'm not afraid of people. Anyway, thanks for all your advice everyone! It makes me feel a little better, at least.

Specializes in Acute Care, Rehab, Palliative.

I am sorry to hear that.But look on the bright side. You will have even more clinical experience under your belt. Try to make the most of it. Best of luck.

Specializes in Pediatrics.

Can you challenge the decision? I'd would highly recommend it.

So I had a meeting today with my instructor and advisor and they are going to make me retake clinical because I'm quiet. They even think I should see a counselor for shyness. I was so upset when they told me, and I really don't think I'm that shy. I know I could work on my communication skills and being more confident but I'm not afraid of people. Anyway, thanks for all your advice everyone! It makes me feel a little better, at least.[/quote']

Spend the summer talking with strangers you meet-wherever you go. Practice out loud in you room what you'd say to a patient. Talk talk talk.

Specializes in Emergency Department.

One way that you can help get over your shyness is to agree to random people. If it's morning time, you can just simply say "good morning" to someone walking by on the sidewalk or in the office or in a supermarket or wherever. That's just one example. That can spark off a conversation about something and just have a spontaneous conversation about nothing at all.

After you greet the person, observe their reaction to it. Some may choose to ignore you, some may choose to engage in conversation, some may simply say "good morning" or whatever back to you and they continue on their way. Watch their body language. You will find out that a person that is willing to engage with you will display certain body language traits and someone that is not willing to engage with you will also display certain body language.

Use the information gathered during your observation to help you guide your self in walking up and greeting patients. The reason is, they are very much like the person on the street that you are simply randomly greeting in that you really do not know who they are and tell you get a chance to talk with them.

Over time, something else you might notice is that you become less uncomfortable meeting someone that you have no idea they are, in effect someone new. You might find yourself greeting people just for the sheer fun of it and perhaps spreading a little joy around the world, in your neck of it anyway!

Something else you might consider is looking at possibly doing some kind of community theater or something of that nature over the summer, because it can result in actively learning how to act in front of an audience, whether your audience is one person or thousands. Every day that I go to clinicals, my audience is usually one person or maybe two people, but in other jobs that I have, my audience has been a little over 60,000 at times. Sometimes, it may actually feel easier to have an audience that big then to be in front of an audience of one.

Just something to think about!

Specializes in APRN, ACNP-BC, CNOR, RNFA.

See if there's a Toastmaster's group in your area. I attended some meetings and loved it. We met at a local deli in the meeting room, and took turns speaking in front of the group. It was usually no more than 12-15 people. Very comfortable. I'm a shy person too, but I've always made it known that I'm a hard worker, and more of a "more work, less talk" type of girl. You'll be fine.

This will help you. You could even share the link with your instructor-- it might benefit someone coming along next year. :)

Susan Cain: The power of introverts | Video on TED.com

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