Disabling feeling of failure- please help!

lovinlife11 · Feb 28, 2013

Gabrielle, nursing school is the most stressful thing you will ever attempt in your life. You're learning to save people's lives. It's clear in your posts that you want to do well and succeed. My best advice is to relax. As an experienced nurse, I would not have attempted to bathe a little lady scratching and biting by myself, the fact that you buddied up to bathe this lady is not a testament to what kind of nurse you will be. Be kind to yourself, keep working hard and most of all do your best to enjoy your learning opportunities. Don't give up, anything worth working hard for will pay off in the end. Best of luck to you!! :)

hodgieRN · Feb 28, 2013

I don't think it's normal and here's why. Everyone has the goal of being the best they can be. We all should. We all set expectations and its natural to react when the expectation isn't met. But, there is a fine line between letting yourself down verses setting unrealistic goals and going off the deep off when something happens. I understand that you want to be a good nurse and I understand that things don't always work out they way we plan, but I don't really understand how you feel incompetent that a pt got medication due to her being crazy and the instructor making it a group effort because the pt was biting you. I don't see how that makes you incompetent. The reason I am saying this is because you are going set yourself up for failure if you place an incident against your pride. So, that being said, I did read that you stated you don't care and wanted to give up nursing school. There are nurses on the floor right now who have that "I'm gonna throw in the towel" every time some little thing happens. When speaking about those two things, I'm going to say get over it and stop crying because you didn't wash the pt by yourself. There are greater things that will happen in your career that will be grounds for losing it. Like when you are working on a pt and nothing you can do will save them, or when a baby dies in the ER because the parent beat them them out of anger, or when a pt has no family there to hold their hand when they are dying..it's only you and it's heartbreaking. However, I can be sympathetic to something else with you. Now, I'm not a psychiatrist, but it sounds to me like there is something else that is bothering you. If you spend each day crying and you are constantly feeling like you aren't living up to your expectations, there's something else there. And that's why I said to get over the bed bath incident and the missing the class by one point because, yes, that should make you upset, but it isn't normal for you to cry every day. The bed bath thing was a just trigger. So, what really going on? Are you ok, because we are hear to listen...

gabriellegoss · Feb 28, 2013

I don't think it's normal and here's why. Everyone has the goal of being the best they can be. We all should. We all set expectations and its natural to react when the expectation isn't met. But there is a fine line between letting yourself down verses setting unrealistic goals and going off the deep off when something happens. I understand that you want to be a good nurse and I understand that things don't always work out they way we plan, but I don't really understand how you feel incompetent that a pt got medication due to her being crazy and the instructor making it a group effort because the pt was biting you. I don't see how that makes you incompetent. The reason I am saying this is because you are going set yourself up for failure if you place an incident against your pride. So, that being said, I did read that you stated you don't care and wanted to give up nursing school. There are nurses on the floor right now who have that "I'm gonna throw in the towel" every time some little thing happens. When speaking about those two things, I'm going to say get over it and stop crying because you didn't wash the pt by yourself. There are greater things that will happen in your career that will be grounds for losing it. Like when you are working on a pt and nothing you can do will save them, or when a baby dies in the ER because the parent beat them them out of anger, or when a pt has no family there to hold their hand when they are dying..it's only you and it's heartbreaking. However, I can be sympathetic to something else with you. Now, I'm not a psychiatrist, but it sounds to me like there is something else that is bothering you. If you spend each day crying and you are constantly feeling like you aren't living up to your expectations, there's something else there. And that's why I said to get over the bed bath incident and the missing the class by one point because, yes, that should make you upset, but it isn't normal for you to cry every day. The bed bath thing was a just trigger. So, what really going on? Are you ok, because we are hear to listen...[/quote']
I really am okay in all other aspects but I have always been a good student and hate feeling like a fool. I know I could have cared for that patient differently but I did not. And I do not spend every day crying, I think you mistook what I said. I meant to say that every time an incident like this occurs I cannot help but wrap my head around it and be upset most of THAT day . I will wake up the next morning with a go get her attitude but it is embarrassing to start crying in front of your classmates over something that seems so silly and mediocre to them.
I am aware that I need to be able to chalk these things up to experience and as you said "get over them", but my question is HOW. How do I transition from feeling like I'm not working up to par and getting upset to the point of crying to "oh well I'll do better next time"? This is difficult for me.

gabriellegoss · Feb 28, 2013

Gabrielle nursing school is the most stressful thing you will ever attempt in your life. You're learning to save people's lives. It's clear in your posts that you want to do well and succeed. My best advice is to relax. As an experienced nurse, I would not have attempted to bathe a little lady scratching and biting by myself, the fact that you buddied up to bathe this lady is not a testament to what kind of nurse you will be. Be kind to yourself, keep working hard and most of all do your best to enjoy your learning opportunities. Don't give up, anything worth working hard for will pay off in the end. Best of luck to you!! :)[/quote']
Thank you for the positive feedback I really appreciate it!

Assailants · Feb 28, 2013

Its extremely difficult to give patients like that bed baths without assistance especially if they are combative, demented, etc. like in your case.

MedChica · Feb 28, 2013

Well, you're talking to people and seem to have a support system. This is good.

Do you take time away from your studies? How's your social life?

Contrary to popular belief, it's possible to socialize and still do well in nursing school.

Also, you really shouldn't feel badly about the elder. I'm not just saying this to make you feel better.

You're seeing the situation from a very limited perspective: That of a student.

"Oh, I tried to bathe this lady and she tried to beat me...and the nurse had to give her xanax and everyone had to assist because I didn't do well...."

No.

Consider this:

-- She has prn's (meds prescribed 'as needed' when pain, increased agitation, psychosis, etc...are observed. In this case, it would be Xanax) for a reason.

-- She was a new admit. It's a new environment. If she has dementia/Alzheimer's, she's probably confused and frightened with being in a new place and surrounded by strangers (which could explain the combative behavior).

There's an 'adjustment period' to contend with...and this is handled in addition to their physical ailment.

Understand that people sometimes 'act out' when they're confused or frightened. When they're thrust into new surroundings. When they feel as if they cannot control their environment...or maintain control over themselves.

When they get used to you and how things operate, they're different people. Until then?

You're meeting their feisty representative. LOL You might have to deal with aggression, distancing, elopement, etc...in the meantime.

It could be said that the little lady had that 0.25 - 0.5 mg of Xanax coming down the line. However, if being handled by several students and instructors was the source of her aggression?

I wouldn't have administered the Xanax. I would've calmed the resident and had ya'll select another pt and sent in a more familiar face (me and/or the PCT) for her BB.

I don't under-medicate my pt's but I don't run around giving people sedatives when non-pharmacological options are available, either. Sure, students must be given opportunity to experience. I just don't agree with...first of all, placing the pt in a position to get riled which, in turn, forces my hand to dope them up...to create an environment conducive to learning.

I'm kind of surprised that no one gave you a heads up. Like, "Oh, yeah...she's a little rowdy. Here's someone on a trach..."

Yes, they're old but elders hit hard (bite and kick), too...LOL

TRUST ME.

-- The little woman's outburst had nothing to do with you. I work psych and my residents will sometimes get in moods and fly off the handle. They can't help that.

I'm under the impression that mental health isn't approached with much focus in most nursing schools. It wasn't in mine. We had a 3 week rotation. More observation than interaction.

IMO, the act of 'redirecting' or dealing with an irritable pt are skills that you'll just have to perfect when you're finally on the floor.

So, don't feel any sort of way about it. Most students wouldn't know how to handle such a patient. Your instructor was correct to step in. It was the only way the situation could've ended.

You had to rec'v help because the resident required it.

You can't always handle pts on your own. It's ok to get help. Sometimes, you have to tag team in order to take care of these guys and get the job done.

gabriellegoss · Feb 28, 2013

Well, you're talking to people and seem to have a support system. This is good.
Do you take time away from your studies? How's your social life?
Contrary to popular belief, it's possible to socialize and still do well in nursing school.
Also, you really shouldn't feel badly about the elder. I'm not just saying this to make you feel better.
You're seeing the situation from a very limited perspective: That of a student.
"Oh, I tried to bathe this lady and she tried to beat me...and the nurse had to give her xanax and everyone had to assist because I didn't do well...."
No.
Consider this:
-- She has prn's (meds prescribed 'as needed' when pain, increased agitation, psychosis, etc...are observed. In this case, it would be Xanax) for a reason.
-- She was a new admit. It's a new environment. If she has dementia/Alzheimer's, she's probably confused and frightened with being in a new place and surrounded by strangers (which could explain the combative behavior).
There's an 'adjustment period' to contend with...and this is handled in addition to their physical ailment.
Understand that people sometimes 'act out' when they're confused or frightened. When they're thrust into new surroundings. When they feel as if they cannot control their environment...or maintain control over themselves.
When they get used to you and how things operate, they're different people. Until then?
You're meeting their feisty representative. LOL You might have to deal with aggression, distancing, elopement, etc...in the meantime.
It could be said that the little lady had that 0.25 - 0.5 mg of Xanax coming down the line. However, if being handled by several students and instructors was the source of her aggression?
I wouldn't have administered the Xanax. I would've calmed the resident and had ya'll select another pt and sent in a more familiar face (me and/or the PCT) for her BB.
I don't under-medicate my pt's but I don't run around giving people sedatives when non-pharmacological options are available, either. Sure, students must be given opportunity to experience. I just don't agree with...first of all, placing the pt in a position to get riled which, in turn, forces my hand to dope them up...to create an environment conducive to learning.
I'm kind of surprised that no one gave you a heads up. Like, "Oh, yeah...she's a little rowdy. Here's someone on a trach..."
Yes, they're old but elders hit hard (bite and kick), too...LOL
TRUST ME.
-- The little woman's outburst had nothing to do with you. I work psych and my residents will sometimes get in moods and fly off the handle. They can't help that.
I'm under the impression that mental health isn't approached with much focus in most nursing schools. It wasn't in mine. We had a 3 week rotation. More observation than interaction.
IMO, the act of 'redirecting' or dealing with an irritable pt are skills that you'll just have to perfect when you're finally on the floor.
So, don't feel any sort of way about it. Most students wouldn't know how to handle such a patient. Your instructor was correct to step in. It was the only way the situation could've ended.
You had to rec'v help because the resident required it.
You can't always handle pts on your own. It's ok to get help. Sometimes, you have to tag team in order to take care of these guys and get the job done.

Thank you for taking the time to respond to my post, it really helped to put the situation into perspective. Half the problem was that my pt's nurse was a float nurse so she knew very little about my pt and her behavior.

I guess I'm just going to have to realize that everything is not going to go as planned- ever! And that that is Okay

gabriellegoss · Feb 28, 2013

And when it comes to social life- I met my boyfriend in my nursing program, and we do clinical a together. He's very supportive and even when I insist on staying in because I am exhausted he helps me to remember its ok to have a little fun

nurseprnRN, BSN, RN · Feb 28, 2013

It has been my experience that the drama queens that hodgie mentioned above, the ones that say they're gonna throw in the towel every time they get some sort of unexpected or frustrating experience, are looking for attention. They love it when people say, "Oh, come on, honey, you're a good nurse, it's not so bad, we need you, you're fine, you're an awesome nurse, it's not your fault ..." They need to hear this over and over and over again for whatever reason (external validation? not getting as much praise as they think they deserve? who the heck knows?), and this is the type of behavior that gets that attention for them. Lather, rinse, repeat.

I don't hear you describing this about yourself in so many words, so I tell it as a cautionary tale. I say this in all charity: If you do find yourself doing this again*, for any reason, seriously think about getting a few sessions with a good counselor to help you nip it in the bud. You do not want to have this pattern get firmly established so early in your career and end up like those folks in hodgie's post.

Good luck to you in your nursing career.

*(your mom, your peers, your BF, us here at AN) (hint-- how many is that? are there more?)

hodgieRN · Mar 2, 2013

I see what you are saying. What I read was that you cried each and every time you didn't live up to your expectations. I was trying to point out that it's not normal to have that type of response if you don't meet every single goal in the fashion that you have laid out. That is kind of what GrnTea was saying about talking to a counselor. To me, that sounds like there is something else that causes a trigger more than here and there. Like I said before, we all get upset if something doesn't go our way, but I don't know if that is just a matter of confidence. The thing I picked up on was not the fact of you getting upset. It was the wording of each and every time. If getting a bad grade or not being able to bath someone the way you predicted is setting you off, then this job will eat at you. When you are taking care of living people, there will be times when a mistake will causes massive guilt, stress, anger, etc. That is why GrnTea mentioned a councelor. If these things are affecting you now, it can be scary to think what will happen when you make a med error...and that will happen. You need to address this now b/c what you are experiecing now is small compared to what you are going to see in the future. There are going to be doctors who are literally screaming at you in front of the entire staff. All we are saying is if there is a confidence issue, there's no shame in discussing it with someone....even your mom can be beneficial. I know you asked how to deal with these things. I don't really know if there a real answer for that. Your skin will grow thicker through the years and you will build self-confidence, but I've seen people that lose it when things don't go their way or lose it if a co-worker disagrees with how you are handling a situation. There will be times when co-workers will write you up for something stupid. This job has so many factors that can go wrong in an instant. There's a great saying in the military "All battle plans are great until the first shot is fired." If there's anything that I can say, I'd tell you to be realistic for the situation at hand. Not that you are being unrealistic, but if other students had to help you with a bed bath, that shouldn't be trigger against your competence, cousing you to cry. They were just helping you out. I still think this is something more than just being upset with yourself. You aren't going to find many people at work that are going to sympathy often. The medical world can be very harsh, so you have to learn to brush stuff off. The more you are questioning your own confidence and the more you are requiring validation from others, the more people will doubt you and question your validity. I would understand you having a bad day and talking about here and getting some encouraging words. That's what we are here for. It's just that I read it happens every time you don't live up to your expectation. Trust me, that can be dangerous. I see it all the time. Nurses get so stressed and they miss really, really important stuff. One thing sets them off and the whole floor is on edge for the rest of the shift. Try and ease down. I hope things get better :)

gabriellegoss · Mar 2, 2013

I guess I worded my initial post wrong- I had never had to deal with such a difficult patient, so it was really challenging for me and I didn't look at it as them helping me, I looked at it as them doing a job that I should have been able to do on my own- but you guys have made me realize that is not the case.