Had My First Clinical-Now I'm Stressing

[missninaRN]

I had my first clinical this week and at the time it seemed to go really well. In fact, I thought it was great. I got to do my first head to toe on a client, changed my first brief, helped several residents get up and dressed. I really did love it.

Then I got home and started to over-analyze everything I did/didn't do. My resident was in a lot of pain and it hurt every time we moved or changed them. I feel bad about that. I had a hard time hearing their BP and am worrying now that it wasn't accurate-though it was well within the normal range and a variation of 2 to 4 beats wouldn't have moved it out of normal range. And the resident was on O2 so now I'm worrying about that cannula. Did I put it in the nose correctly? Did I put it in upside down? What if I did put it in upside down and no one has checked it since then? Will the resident be in O2 deficit? Surely someone would have checked it or had to remove and replace it since I was there?

Do you see what I am doing here? I am so perfectionistic and so paranoid about causing harm that I could just sit here for hours thinking up things I may not have done correctly.

Will this get easier? And really, what about that cannula? What if it is still upside down? Do I need to call my instructor about it?

Somebody please calm me down!

[llg, PhD, RN]

When you left the clinical site, you turned the care of your patient over to someone else. That person would have done an assessment and would have discovered anything that needed attention. When THAT person left the scene, he/she would have handed off the care to someone else ... who would have done an assessment and discovered anything that needed attention at that time.

That's why assessment is so important. As each person comes on duty, it is their responsibility to assess the patient. If you trust your colleagues, you can count on them to find anything that you may have missed before too much time has passed. People make mistakes and miss things all the time -- but because EACH caregiver is responsible for assessing the patient, a "back-up system" catches those mistakes and corrects them in a timely manner.

No one is perfect. You WILL make mistakes and miss things during the course of your career. Everybody does. You have to accept that and move on. Know that you've done your best and that there are systems in place to reassess the patient regularly to assure that no little problems become big ones. Knowing that -- and trusting our colleagues -- is how we all sleep at night.

Good luck to you.

llg

[Tweety, BSN, RN]

You did a great job. Good advice, as always, from llg. A good look at your is not a bad idea, but not to the point where you obsess.

Good luck!

[Halinja, BSN, RN]

As each person comes on duty, it is their responsibility to assess the patient.

No one is perfect.

llg

Yup, what llg said.

I did the same sort of second guessing myself the first few clinicals. Still do a little. But it is comforting knowing that someone else will be looking at that patient.

By the same token, you'll feel better about your own performance if you remember to do a thorough assessment every time you come to clinical. First thing. Assess the patient, and our instructors always stress...look at the IV's if they're on them. Is it running at the right rate, does it have the right fluids, is the tubing ok? (One of my fellow students didn't think to do that and when she went back in the room later, there was a huge puddle on the floor. The IV was running at the right rate...it just wasn't hooked up to the patient)

If you're worried about a nasal cannula while you're on the floor....check the patient's O2 Sat. If its good, then probably the cannula's fine. If it isn't so good...might want to recheck the cannula.

[SoulShine75]

I know exactly how you feel as well as most other nursing students. You're a student nurse, not a new nurse so go a little easier on yourself. The more you have clinical, the more you'll learn and the more comfortable you'll get.

If you don't believe me then read my blog..it's all about my nursing school experiences. We all have been where you are...heck I still am. Be easier on yourself. At least you're worrying about your pt's, I can't say that for most.

http://my-journey-as-a-student-nurse.blogspot.com/