Freaking Out

[longliveavacados]

Im about to go into my second year of nursing school, the school and theory part of it is going ok. I haven't failed anything and I feel confident about test taking. The reason why I'm writing this is the clinical- Its like I don't know anything! Im actually pretty scared of taking care of a patient one day if the second year is just like the first and then I'm just dumped out in the "world of nursing" . What i mean specifically about me not knowing is, the assessment part- when I find abnormalities i don't know what they mean. And when i take care of a critically ill patient thats got 2-3 things going wrong with them, I get scared. Does anybody else feel like this? Im just wondering if this is a normal sensation during school and it clears up once you start to work. Im just a good test taker and I don't feel like my clinical part isn't on par. Thoughts?

[Rose_Queen, BSN, MSN, RN]

Not only is it a normal sensation in school, it's also a normal sensation when you're actually working as a nurse. The common saying is that it will take a year for someone to start feeling competent in their role. That's why so many encourage those who take a job and then start asking if they should look for another to stick with it- it's hard to build up the basics when starting over before they can be built up. It can even be a normal feeling when changing specialties even with nursing experience.

[longliveavacados]

Thank you for responding!

[oceanblue52]

It is totally normal to feel like this! Echoing RoseQueen, even new nurses feel like this sometimes. However, the best advice I learned from a clinical instructor is to really nail down what "normal" is. I fretted about not finding clinically significant findings, but her point is that it's a good learning experience to know baseline. This might happen to you during clinical; don't let it disturb you.

That being said, listen to lung and heart sounds online to get more comfortable with the abnormal sounds. Practice your head to toe until it feels natural, and your focused assessments too. It's overwhelming at first, but go through each body system to learn the abnormalities. What are the abnormal lung sounds? Other signs to look for with inspection palpating and auscultation? Proceed to the heart. Absent pedal pulses. What are some reasons for that? Etc. Break your questions down one at a time and research them. It's less overwhelming that way. Carry a pocket guide like RN notes to clinical if you feel better having a reference.

It is okay if you assess something funny and ask your clinical instructor for a second opinion. As long as you have some basic knowledge to say what that finding could entail, you will be totally fine. Your instructor will likely be pleased that you picked up on it, especially if you can elaborate. Hopefully your school has you look up your patient info the day before, which gives you time to research both actual and potential problems that could pop up. Care plans are tedious, but there is a reason for making students do them. Work hard on them and you will feel much better prepared.

Also don't forget to deep breathe when you feel stressed. It takes very little time and will help during those moments when you feel panicky. You can do this :-)

[missmollie, ADN, BSN, RN]

As the other posters have stated, this is completely normal both in nursing school and as a new nurse. Talk out anything you didn't know with a classmate or two, or in your end of day meeting after clinical. You'll find that others also don't know what to do, or they have thoughts/ideas that you didn't even consider.

The best thing about talking it out with someone is that you can change how you think about a certain disease process. You'll do this as a new nurse too, and it really helps expand your knowledge base.

Best of luck in school!

[NICU Guy, BSN, RN]

Look up Patricia Benner's Nursing Theory "Novice to Expert".

http://www.health.nsw.gov.au/nursing/projects/Documents/novice-expert-benner.pdf

It states that it takes two years to reach the "Competent" level. I think that it is accurate. I am 1 1/2 yrs into my job and things are starting to "click" and starting to feel comfortable.

[AliNajaCat]

Of course you feel like you don't know anything, because you don't. Fortunately, when you get out of school, the place that hires you knows that too, and will not expect you to perform at the same level as a nurse with five or ten years under her belt.

And second year will NOT be like the first. it will be harder. They will expect you to have a good working knowledge of everything you learned in first year, academic and clinical, and be able to apply it a progressively higher level. The last semester will be the hardest for he same reason. Hope you didn't sell your books.

[medic981, ADN, RN, EMT-P]

As a second year nursing student you are supposed to be scared. Scared keeps you on your toes, makes you hyper-aware unless you are debilitated to the point of inaction. My experience as a paramedic was invaluable when it came to giving the hands-on care of patients as a student nurse. I have years of experience caring for critically ill and injured patients. I am still a little nervous when I have reached the limits of my knowledge and expertise when my patient is circling the drain. That feeling didn't change when I was on clinical as a student nurse.

Study, complete your care plans, study, get to know your patient's chart before going on clinical, study, ask questions, study, know it is OK to say "I don't know" and study. Your clinical instructor is there to help you gain experience and keep you out of trouble. As a previous poster mentioned, it will take several years after graduation and obtaining your license before you become competent. Hang in there, at some point, it should all come together. Good luck in your second year of nursing school!