Help! I'm having trouble with confidence in clinicals. I do great in the class portion but once I step on to the hospital floor, all of a sudden I feel lost. This is my 2nd semester of classes & the first semester of clinicals in the hospital setting. Is this confidence & applying knowledge going to come eventually?! I also do not have experience in healthcare.
Yes, it gets better. Some things you can consider to help it along:
1. ask questions, and constantly look up information. Understand the pathophysiology, the expected labs and medications and treatments.
2. Every time you encounter a patient, think "What needs can I probably anticipate?", "What is the worst case scenario for this patient, and how can I prevent or recognize it?" Consider every area of the nursing process. For example:
Assessment- what should I pay particular attention to on this patient? What assessment findings would indicate that the patient is getting better or worse? When should I reassess?
Diagnosis- for this, in real life we mainly use computerized plans of care. Learn how to customize one on a computer, and learn what their medical and nursing diagnoses mean for the patient.
Planning- Which diagnosis takes the highest priority and why? Which problem is most likely to cause harm to your patient, and how can you address it? How do you plan to measure progress?
Implementing- how will you carry out all the many things the patient needs? Which has highest priority, and how do you know? If you can only accomplish two things today for this patient, what would they be? Be specific. Don't just say educate the patient- say how. Will you demonstrate? Will you use a model? A handout?
Evaluating- did your plan work? How do you know (be specific and measurable)? What will you do now?
In terms of confidence, try to gain experience by working a minimal number of hours as a tech/extern/intern (whatever your facility calls it!) or even as a volunteer. Sometimes just being around patients can really help. I've seen students improve significantly between 1st and 2nd year just from externships.
Most importantly: you are supposed to know some things, material you have previously covered, for example. You are not supposed to know ALL things!! The most dangerous nurse on the floor is the one that thinks they know it all. You will never know it all. You are a student, there to learn. Just because you graduate, doesn't mean you stop being a student. I've practiced for years and learn something new nearly every day. Don't be afraid to say "I don't know, but I can find out." Guess what? I'm an instructor, and I say it often!
Last edit by AOx1 on Sep 26, '11