help...i think i'm failing clinical (kinda long)

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I am a second semester 1st year nursing student and this sememster I have had the hardest time with my clinical rotations. I feel like everything I do is wrong and that I'm not performing as well as my clincial classmates. According to my CI, I don't know the aspects of patient care, I'm unable to manage my time well and I don't know how to prioritize care, I'm not doing complete focused assessments. Now, in February I was placed on a clinical action plan with the nursing school and I worked really, really hard to be deemed satisfactory so that I could join my other classmates on the hospital floor and I'll admit in the beginning, I had real problems but as I've stated I've worked really hard and I feel like all my hard work is going down the drain.

Today for instance, I had two patients, one with pneumonia and one with gastroenteritis. I went into the patient's room with gastroenteritis and did a first look (checked her IV site and what was hanging, asked a few questions) for the patient with pneumonia I listening to her lungs and asked questions about chest pain. I thought I had done well for a first look, well my instructor said that I should have done a focused assessment as a first look which I wasn't aware of; so I think I got a U for that. She said I should have asked about cough and checked the patient's pulse ox but I usually do pulse ox with vitals and all the other stuff with my assessment when I do my head to toe. I feel mixed up because I don't know what she wants or expects. When I said that my patient was on an antibiotic, she asked about the patient's WBC and when I said she was receiving potassium and Lasix, she asked for the lab levels which, of course I didn't have because I wasn't aware that I had to have that info. I couldn't even remember the normal pulse rate. My instructor also said that I stand around a lot like I don't know what I should be doing but when I ask questions about how I should prioritize my patient care; it's like why are you asking this you should know it, so I feeling stupid and there's another U. I don't feel like the enviroment is one where it's easy to ask questions. The instructor keeps saying "I'm here to help you," but in actuality I feel like any questions I have will just fuel her to think that "I'm incompetent." I know I can do this but my self confidence is shattered. I'm trying so hard. I've only had seven clinical days (my own fault because of clincial remediation) compared to the fourteen or so days my clincal classmates have had and I'm trying so hard to get everything to click and I don't know what to do. We only have four more clincal days left and I'm afraid that I'm going to fail. I'm not saying that anyone is setting me up to fail, but it's kind of hard to know what to do when you don't know what you're supposed to do. I start the day optimistic and by noon my confidence is shattered and I feel like crying. Someone please give me some advice.:o

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Hi,

It sounds to me like you are frustrated and afraid. I can sympathize completely! Nursing school is difficult. It sounds like your instructor is telling you how to improve your assessments and what things are most important. Keep in mind that you are a student, so you are not supposed to know everything already!

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Hi....sorry you're having a bad day but whatever you do....don't give up. We're the same distance along in our respective programs and it sounds like there might be a big push to start trying to weed some out before 2nd year starts. Have you tried talking to your prof. one on one in an office setting, not during clinicals?? I've found that with my classmates we all just sorta tucked our tails and went to her office (sorta like going to the principal in grade school) and asked her to help us not fail. It seems like a tough ax is swinging right now but hang in there. Not everyone is doing as great as they might seem in your class.....some just learn to hide it better. I don't know anyone in my class that just thinks they are Nurse Perfect yet and we all face our daily trials and struggles......deep breathing helps (lol). I wish I could help you more but just hang in and do the best you can.....it helps to remember something our nursing prof told us in the beginning. WE WOULD NOT HAVE WASTED TIME FILLING YOUR SEAT WITH YOU IF WE DIDN'T FOR ONE SECOND THINK THAT YOU COULD DO THIS. She also took a folger's coffee can and pasted a white label over the outside of it and drew a big beautiful eyeball on it it is our " I CAN" ....hope this helps, let me know if I can help with anything else ;):balloons:

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Specializes in Cardiac Telemetry, Emergency, SAFE.
She also took a folger's coffee can and pasted a white label over the outside of it and drew a big beautiful eyeball on it it is our " I CAN" ....hope this helps, let me know if I can help with anything else ;):balloons:

Thats a cute idea...:monkeydance:

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Well, I'm going to meet with my CI tommorrow. I don't want to fail and I don't want to get kicked out of the clincial rotations because I've already been on clinical remediation earlier this semester. I feel like I should plead my case. I am working really hard and I only have three more clincial rotations to pull this together. I'm so frustrated and aggravated and afraid that I don't know what to do. I can't even focus on studying and I have a test Thursday. I've dreamed of being a nurse for as long as I can remember and I want this so bad; I just don't understand why it's so difficult.

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I guess it's sorta as I've been told all along ..........nursing school is one of the hardest, most rewarding endeavors that you'll ever pursue. It is truly an entirely new way of learning and cramming and learning some more. Go plead your case and see what happens. I just got 3 more clinical points removed from my grade which is now down to "86" and I'm stressing about that as last semester I had an "A".....I just have to keep reminding myself of what my mother-in-law (one of the best nurses on the planet) says...."know what you call an RN that made "C's" in nursing school????....an RN" =)

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Specializes in Geriatrics, Cardiac, ICU.

Well, I'd advise you learn from your mistakes and listen to what you instructor is tellin you.

She questioned you about Lasix and potassium--well lasix depletes potassium and low levels can be lethal. I'm surprised that concept has not been drilled into your head, I know it has at my school.

Anyway, patients are only on medications because they need them for a certain purpose--when you have a med, you need to know WHY and any labs or VS pertaining to them. That is your job as a nurse.

Next, you need to focus your assessments. Get your health assessment book out and type up a word document that goes over every body system and type up ALL the associated assessments. With your gastoenteritis patient, that meant a full GI assessment and the pneumonia pt. that meant a full resp. assessmant including the pulse ox and asssessment of chest pain and cough.

I think that this is where you are going wrong and you need to look at your patient's total situation.

I hope that helps.

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Well, I'm going to meet with my CI tommorrow. I don't want to fail and I don't want to get kicked out of the clincial rotations because I've already been on clinical remediation earlier this semester. I feel like I should plead my case. I am working really hard and I only have three more clincial rotations to pull this together. I'm so frustrated and aggravated and afraid that I don't know what to do. I can't even focus on studying and I have a test Thursday. I've dreamed of being a nurse for as long as I can remember and I want this so bad; I just don't understand why it's so difficult.

This must be very difficult for you! I have a classmate who is in a similar circumstance and here's what I recommended for her to do: Schedule a time in the immediate future to have a one on one with your CI and communicate to her that you are committed to meeting all of your clinical objectives, and ask her for specific and detailed direction to accomplish this! Let her know that you are determined to do whatever it takes, and that you value her input/suggestions/advice. This will show her that you are taking responsibility for your success and seeking her direction to do so.

And one more thing... you must have more confidence in yourself! I know sometimes this is easier said than done, but if you use positive thinking and try to approach clinical with a "can do" attitude it will go a long way. I just fake it until I make it! LOL

Believe in yourself... you CAN do this!

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