I know nothing!! - page 2

Hello all, I'm in my third semester in a 2 year program and I'm so worried. My grades are okay (nothing special but okay) but it's clinical I'm worried about. I seem to be doing fine (my evals... Read More

  1. by   Curious1alwys
    I totally feel like this too, in my third semester. I, too, feel dumbfounded and have that deer in the headlights look when someone asks me something I SHOULD know. I feel like a fraud, too. Clinicals freak me out too. It used to be unbearable but now I have this "whatever" attitude. I think I have just maxed out on stress. What I am doing now to combat this is I am trying to find a "cheat sheet" of sorts on the s/sx of the 'biggies' (CHF, MI, HTN, hypotension, hypoglycemia, etc) that has definition, sx, common interventions, etc. AND I am going to work as an extern. Accepting the position has me so nervous, I really almost don't want to do it, kinda like going to the dentist, but I guess I see it as a have to if I am going to be OK after I graduate. If I don't start getting some real experience now, I am going to be screwed. That's how I look at it. Plus, like another poster said, as an Extern you CAN watch a nurse all day. That is invaluable!! I am going to review as much as I can before my start date, especially cardiac, so I don't look like a dips%!!. Especially, insulin types, IM's, procedures. Going to bring my skills list to work and if something comes up, like a foley, I am just going to "wing it". I had opportunities for a few skills in Block I but I was so petrified I turned them down. Now it seems they never come again!!!

    Please know you are NOT the only one!! I have gotten good grades too but I am a crammer. I wonder how much has really stuck! Get out there and get the most experience you can even if being in the hospital makes you cringe. The best way to get over fear is to immerse yourself in what you fear the most!!! Good Luck!
  2. by   4tnerzwife
    I attached a form we use to study called a PO. It is a very helpful tool to study with and use as a reference.
    Let me know if it helps!

    Topic:
    NAME:
    DATE:
    BACKGROUND:
    (Etiology, Pathophysiology, At risk persons or groups)
    MEDICAL MANAGEMENT
    (Surgery, Medications, Treatments etc..)
    NURSING CARE
    RATIONALE
    (Rationale for Nursing Care)



  3. by   4tnerzwife
    the cramming thing must be common in nursing, i think because we don't have time to fully prepare. if you are like me, you work, go to school, have a family, have a smidgen of a life So, the only thing we can do is cram. I seem to do better when i am anxious and worried anyway--its worked this long!
  4. by   cherokeesummer
    Yes I think it would be cool to observe. I really want to watch a few nurses doing their assessments so I can see how they do it but I always feel guilty b/c I'm so far in the program, its like I'm afraid they will say why are you wanting to see this now. But at my next clinical I'm gonna ask, can I just see how you do it so I can get a good idea of time planning/management.

    Of course we are done with clinical for this semester and next semester (our last) is for my preceptorship so I hope I get a nice preceptor!
  5. by   romerog
    I wonder how true that school is just there to facilitate your license but you really only know the skills when you eventually get on the job.
    It's on the job you can put everything together and say, "oh, that's what it's all about." After you survive a year of work, then you get used to it even without really liking it. In time, when you get to truly understand it, you will learn to love it so that the struggle is worth it after all.
  6. by   Halinja
    Quote from Jessica 392
    You know what I would :heartbeat ? One or two days to just shadow a nurse. Watch everything she/he does...what assessments they do and why, etc.
    LOL, I once asked my clinical instructor if I could do that. Follow a nurse the whole day, every single step, with every patient (med/surg floor). Her answer? "you wouldn't understand what she was doing." 'scuse me? I'm inexperienced, not stoooopid.

    Truthfully? I'm in my last year of a BSN. The first clinicals were horrible. I couldn't sleep the night before. I could hardly breathe driving to the hospital. And somewhere between last quarter's clinical and this...it almost magically became okay. I feel like I'm doing actual nursing. I feel like I help. And when I flip the patients chart open to read...it makes sense! now, I still have a LONG way to go. I need tons more real world experience. But it doesn't TERRIFY me the way it used to.
  7. by   RNfromMN
    Quote from Halinja
    LOL, I once asked my clinical instructor if I could do that. Follow a nurse the whole day, every single step, with every patient (med/surg floor). Her answer? "you wouldn't understand what she was doing." 'scuse me? I'm inexperienced, not stoooopid.
    Update: I went to 1 of my CIs on Monday & asked her what she thought about me shadowing a nurse around for a day & she said (in regards to her hospital) that I'd have to run it by the Asst. NM & if it was okay with him, she'd recommend me for doing it. I guess the biggest concern is HIPPA & pt confidentiality...btw, I think the way your CI responded to you was terrible...isn't this the time to ask ?s about what we don't understand?

    Quote from Halinja
    And somewhere between last quarter's clinical and this...it almost magically became okay. I feel like I'm doing actual nursing. I feel like I help. And when I flip the patients chart open to read...it makes sense!
    Well, that's encouraging...& it's the 2nd time I've seen someone post about this "magical" turning point...I just hope mine happens before I graduate
    Last edit by RNfromMN on Dec 6, '06
  8. by   Aunt Bytes
    Yes, it gets better. I felt the same way in clinicals. Like I was an imposter! I actually couldn't believe that patients trusted me to do things to them! Don't they know that I don't know anything? This is the way our clinical instructors made us feel. Stupid.

    Then came the preceptorship during my last semester. That's when all the pieces dropped into place. I finally felt like a nurse! I knew most of the answers, didn't feel stupid for asking questions about things I didn't know, and loved the patient interaction. (all in a level 1 trauma center!)

    So, yes there is hope for you too! Good luck and keep your chin up!
  9. by   carolinapooh
    Quote from mrscurtwkids4
    I think most of the student nursing population has felt this way about feeling incompetent. In fact, just a couple weeks ago, a classmate of mine confided with me as to how terrified she feels and that she feels everyone else knows so much more than she does. BTW, she gets wonderful grades. I told her that she isn't the only one feeling that way. I've heard many others stating the same thing. I think that some are just better at not showing their stress than others. I know I was having a hard time for a while and I've finally kicked in to gear as far as the clinical aspect goes. But for how I'm doing on the exams for our lectures, I'm not doing nearly as well as I should be doing. I comprehend the concepts, but when it comes to answering the exam questions, I seem stupified. It's been totally frustrating when I graduated from the community college with honors only to be stuggling at the university level. It doesn't help when I just don't seem to have enough time to study as thoughly as I know I should with having 4 daughters and a hubby and household to maintain. I really envy some of the younger students who don't have some of those added pressures to deal with on top of trying to get their degree. Anyway, that's my vent. I think most everyone feels incompetent during school, some are just more willing to admit it than others.

    OMIGOD...if only I could come and help you with the bookwork and you could help me with my problem....someone told me the other day that I always look so prepared and competent and ready for lab/class/clinical; you have no idea how much effort it took to keep myself from either giggling or going, "WHAT are you TALKING about?"

    Half the time I feel like a fraud, and like I'm waiting to be exposed or something. Like, at some point they'll figure this out, and I'll be rightfully pilloried in the hospital's cafeteria or something equally ridiculous.

    I have A's and B's in my courses, I love school and know I've made the right decision, my clinical instructor says I'm doing a fantastic job, and my foundations and physical assessment lab instructors tell me the same things...but I still have a hard time with initial assessments (I too dread them every time I have to do one; I have yet another on Friday) and I feel like a blithering, ineffective idiot half the time in the hospital (even though I'm repeatedly told this is not the case at all). The other half of the time I'm fine.

    What is it about walking into someone's room that scares the crap out of me? It takes me ten minutes to be able to start a conversation; I always feel like I'm bugging the poor patient and I can't think of a blessed thing to say. And I'm also convinced that everyone else either knows what they're doing or, if they say they don't, they're much better actors than I am. I feel like I am the nine hundred and forty-seventh person to poke this poor patient today, and the only truly good thing they can say about the whole experience is "Thank God I didn't have to pay for that."

    I don't suck at this. I know that. And I'm a very open and friendly person and my friends (and probably my enemies, if I have any!) would tell you I can have a conversation with a tree (and probably get answers to boot). So why has every single patient I've had caused me to clam up? AARRGH!!! :spin: It's more frustrating than nursing dx's!

    Please - someone - anyone - tell me it gets better!
  10. by   I RN A
    There is a pocket book called RN notes, I got it @ Barnes & Noble and in this book there is everything you need to remember. I don't have time to make my own notes. Thank God, someone already has done it for me.
  11. by   KimmieKoo72
    As the director of my program says to us constantly.. "Fake it till you make it." I know that I feel like a dummy in clinicals and that I don't know the answers to things that I should.. but I get by. It's all about how you present yourself to your instructors and your pts. 50% of the time when instructors ask you questions that you can't answer, they KNOW you can't answer them. They just want you to "expand" your way of thinking. And some of them just love to catch you off guard.. I'm sure of that. lol
    No one is perfect, especially as a student. Clinicals are rough sometimes, but they're supposed to be. If nursing wasn't a challenge, everyone would do it! That's what makes us different!
  12. by   colleennurse
    Quote from jessica 392
    i'm 3rd semester in 2 year program and i hate...i mean, despise going to clinical. i absolutely dread it. bostonjenn, i thought someone had jumped into my body just now while i was studying hematology and posted all my exact thoughts under your name .

    fraud: :yeahthat: totally! i feel like the things i'm doing can be done by...well, a robot , i guess. oooh...i took someone's vitals (it's even more rewarding when a machine or robot does it all for you)...and, oh, wow...i changed somebody's bed while they were in the bathroom (just like a real housekeeper!)...and check it out: i put this funky-looking thing in my ears (just like the one i had when i was a kid) and listened to some funny noises in a couple different places:smiley_aa ...& in a couple hours, i get to cut up somebody's meat and make small talk with them while they eat (just like when i used to babysit!)...and just before bedtime, i get to look at a list of pills, pop them out of their package....all by myself ...put them in somebody's hand & watch them swallow them! i'm a... ? i'm not saying i'm above any of these tasks...i just want to feel the way a nurse is supposed to feel.

    i always feel like i'm doing...okay ...but that if another student was here, she'd/he'd be doing more thorough assessments, or understand my pt's condition better, or know exactly why they're receiving each and every medication they're getting.

    and my grades are fine, too. we're pass/fail for clinical now, but last semester, i even got an a...felt completely undeserving. this year, i finally got the guts to confide in my instructor & tell her how i feel (basically word for word what jenn said) and she told me that a lot of being a nurse is being eyes and ears:redlight: . knowing the hob should be up, knowing if someone's loc is changing, knowing what looks off in an assessment, knowing what vs to check if, say, pt says he's short of breath, etc. it made me feel a little better...this instructor is not known to coddle.

    my biggest hang-up with clinical is initial pt assessments . every day as i'm walking from my car to the hospital, i mentally picture myself running at full speed, screaming, and just charging into my pts room , getting my vitals, doing a quick head to toe, seeing if they need anything, then getting out! it's my most dreaded part of clinical and i just want to get it over with asap. and i don't mind sitting with my pts or talking with them, or giving baths, etc...i just loathe initial assessments . i feel like i don't know what i'm doing. and i always forget at least 2-3 things to check before i leave the room...and i have to go back in, explain to the pt that even though i told them i could leave them alone for awhile to rest, that now i have to "quick" check their pedal pulses, or skin turgor, or lower extremity strength.

    you know what i would :heartbeat ? one or two days to just shadow a nurse. watch everything she/he does...what assessments they do and why, etc.

    i have to believe that once i become a , and am employed at a certain place for awhile, i'll be much more comfortable with these things. if not...god help us all ! this was a bit of a rant...thanks for reading - i'm just so excited that other people feel the same way that i do :icon_hug: (sniff, little tear). everyone i'm in school with just looooves going to clinical. not this girl.
    the things you say you are doing at clinical (changing linens, popping pills out of a package) those are the things that a nurse does on an everyday basis. as far as your assessments, you will not feel confident for a while. i have only been a nurse for 6 months, and i still get another more experienced nurse when i see something that i am not sure of. you may think that some of these things mean nothing, but even something as simple as changing someones bed can make them feel a lot better, especially if someone has not offered to do it for them. once you are working you will not loathe things as you do now, i hated clinical when i was in school, but i like what i do now. you will come up with your own way to get through an assessment (every hospital does it different) and after a few weeks, you will do it all and not forget anything, it will become habit. i think all of your feelings are normal. i still feel stupid sometimes. wait until you are on your own and you give report to a nurse who asks you 5 thousand questions, and you are thinking to yourself, should i know this??? it's normal! good luck!
  13. by   MBARN
    You aren't the only ones that hate clinicals. I feel like I know nothing! I am scared to of the working world. They want us to "ACT" confident when we are with a patient but most tasks we have just witnessed or just did once so how can you feel confident?

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