Feeling defeated...

[Wubbies]

I am in my first semester of nursing school and almost done!! I have had a relatively smooth semester full of unexpected turns and tons of information!! However, today, I met my match with an extremely difficult patient. Being the slightly paranoid perfectionist I am, I feel that I am going to fail my clinical and for no logical reason except my instructor things I am too compassionate. I had a very old patient today who could do nothing for herself. I did my very first dressing change ever and it was on a pressure ulcer that the RN looked at and said that was way past Stage IV. I thankfully had a classmate helping me today [who has become one of my best friends!] but I froze today. After changing her dressing, she was just yelling and screaming in pain and trying to change her bedding and turning her became a very difficult task. I love nursing and I love people and I love helping people but I hate seeing a person so old and frail in so much pain knowing that there isn't much that you can do for them. I pass no prejudice on any group of people but I have always wanted to be a neonatal/pediatric nurse. I love geriatric patients but I will be the first one to admit that it is slightly terrifying for me to treat them. I have been very lucky that none of my grandparents became nursing home bound or developed dementia, so when I walk into a room of a patient who is total care and has dementia or is confused it scares me. I have never had to deal it in a personal aspect or in anyway whatsoever so I think that may be why I had such a difficult time today.

I absolutely feel like I am going to fail my clinical. I have a great instructor and I have done awesome this entire semester but I fearful I am going to fail. At midterm, I turn out a really good evaluation but my instructor was also quick to point out that, in her opinion, I am too compassionate. I will agree with her that I am an extremely compassionate person and am so towards my patients because I have been on the receiving end of a couple horrible nurses in my 22 years of life!! I know that nursing school is intended to challenge you and sometimes to points you've never been challenged to before but are these normal feelings that I am feeling? I know this one clinical day isn't going to make me fail but I can't help but feeling like I did something wrong today with dealing with the situation.

Perhaps all I am looking for is reassurance from fellow students that are walking in the same shoes as me. My classmates have all reassured we over and over today that I am not going to fail because of this one day.

If anyone has any advice or good words for me I would greatly appreciate it!

[allthingsbright]

Learning to be empathetic instead of sympathetic takes some time so give yourself a break. I am also a softy but have learned to be able to remove myself from the situation emotionally so I CAN take care of my patients. This is your first semester--by the end of school I bet you will be much better at balancing compassion with excellent care.

As far as failing, if your instructor wrote you up, then you need to express to her your willingness to do whatever it takes to pass. On the other hand, if you are just being a pessimist with a failure mentality (which happens to the best of us in nursing school because it is so hard), you need to BE POSITIVE! :) You CAN do it!!!!!!!

[locolorenzo22, BSN, RN]

"too compassionate?" A tough line to walk....compassionate to CARE about your patients is important. but caring TOO much can hinder the tough calls you sometimes have to make. Patient in pain on a PCA and cannot have more meds...I'm feeling for ya, but you've had WAYYYY too much med in the first place, and we'll control your pain as best we can. You have to have a thick skin, or you'll cry everyday...but a good cry once a while helps!

Think positive...no instructor can fail you for caring...if so, I'd have to rethink that school's method of teaching nurses. YOU'LL BE OK!!!! let us know what happens!

[WDWpixieRN, RN]

I'd be surprised if an instructor would fail you for one bad day of clinicals. If that was the case, probably 1/2 of our class would've been gone last semester. I wondered that there were times I came back to the hospital for more after a particularly bad clinical day.

As for your "compassion" issues and geri pts.....I kind of get where you're coming from....I sometimes am not so sure I can do med/surg once I've graduated....crimany, in clinicals so far we've had one, maybe 2 pts, and time to dote on them. I can't imagine thinning myself beyond that with 5, 6 or more pts once I start working as a "real nurse", but I know it's gonna' happen.

I, too, am interested in neonatal and sometimes have a hard time even getting through a regular clinical day.

I think taking a deep breath, maybe stopping in your instructor's office one day next week, and in the interim, doing a lot of "reflecting" would be good uses of this energy!! You sound like you'll make an excellent nurse one day!! :)

[ange26s]

I understand where you are coming from. I love nursing school(what a rollar coaster ride!)I am currently on a long term care unit, and the first day I went to orientation, my eyes got watery.I felt soo bad for those patients. The patients I see weekly have everything.MRSA,COPD,cancer, multiple CVA's,horrible pressure ulcers,etc. EVERY patient on the floor is on contact isolation.We have 1 more clinical and I had 1 patient that was alert and oriented.I was soo worried that I was going to let my emotions get in the way of my care,but now I fear the opposite.Sometimes I feel that I have distanced myself too much.I still have a very caring demeanor,but I try not to let those tears come anymore.I am scared it will cloud my judgement. Someone in my clinical group is very sweet,but i dont like the way that she talks to the patients.To me she talks to them like wounded animals.She is very sweet,but the way she talks to them is like the way you would talk to a 2 yr. that is sad.I just feel like they deserve to be treated like a respected person,not a little baby.I think you will be a great nurse and find your common ground.

[Wubbies]

Thank you for your supportive words!! I appreciate it greatly! I love nursing and I hate that my instructor seems to think it's funny to joke about us failing. It's no laughing matter. If it comes down to her trying to fail me, I have found guidelines in place to appeal the grade. I also emailed the dean of nursing at my college encouraging her to implement a weekly clinical evaluation form instead of just midterm and final. Clinical is the so important and I feel that we, as students, have a right to know our progress weekly. We get immediate feedback on tests and competencies so why not on clinical? I'll keep everyone updated on the outcome!! I will know December 13th! Check back then!!

[future L&Dnurse]

It's a hard thing to learn, how to be empathetic without taking on all that suffering yourself. In my first semester I often went home in tears for my patients and what they were going through. I can't tell you how long it will take for you, but 9 months later I feel like I have learned (enough, not entirely) how to "put it down" at the end of the day and not take so much of that pain home with me. I still feel sad for patients who are suffering, but I don't internalize it the way I did.

I've also realized that I'm not built for palliative/hospice care. Maybe you aren't either. And that's okay.

I'm sorry you had a rough day. Just think about what you DID do to help her though - changing that dressing had to have helped with her suffering, you kept her warm, you gave her medications she needed, you gave her respect and care. Your instructor might be right that you need to learn a little emotional distance - and that's okay too! You're in semester one. This is all brand new and I think we all know that sometimes it is just very emotionally intense. I doubt your instructor will fail you. Hang in there.