instructor says nursing is not for me..

[Orlette]

First of all I apologize for the long post!!

So I passed my first semester with good grades. (mostly A's with B being the lowest) The clinical teacher in our first semester said my skills are better than most people's, I just lack self-confidence, that I am going to be a good nurse.

It is now second semester and we are doing our clinical at retirement residence. I participate in group discussions, and for our presentation to the residents, I spent the greatest amount of time and took the biggest part of it (I was actually interested in the topic and wanted to give residents the most useful and interesting information). My marks in other subjects are also very good.

Yesturday I learned that our coordinator of the program wants to talk to me. I had no idea what it would be about, and so i was slightly nervous. It turned out I was nervous for a reason. The coordinator said that the clinical instructructor is very concerned with the way I act in clinical, and that at the moment I am failing it.

Her reasons are that I do not "mingle" with residents, for instance I do not talk to them in the mourning and afternoon. That she constantly has to encourage me to talk to residents (I remember she mentioned it once, in a matter of fact way, and I asked her what I should talk to them about), ..That I do not know how to talk to people at all (instructor told my coordinator that "I actually once asked her if I should invite the patient to get his blood pressure taken when we were doing the blood pressure clinic!").

I do realise that the two things that I said were kind of silly, but I did not realise that that would put me on a contract, and would mean that nursing is not for me (the coordinator said that), since the clinical instructor never showed any signs of being upset and never told me anything about .. well.. anything.. Whenever she talked to me she was always smiling, not a hint that there was anything wrong. And now the coordinator telling me that I should probably switch from nursing, that she is questioning if nursing is for me, that I am on the point of failing, and if I don't change a 100% i will fail. I also mentioned something about psychiatric nursing, and she said I won't be able to do that since I don't know how to talk to people.

It is true that I am a bit shy, and unless a conversation has purpose and direction to it it is hard for me to know what to say.. (to make a small talk about nothing in particular in other words).. But is being outgoing really the most important thing in nursing?

I am polite, and sensitive to other people, as well I have great interest and knowledge in the areas of nursing i am interested in which I am willing to apply to help patients.. And as i said I do not have a problem obtaining specific information, if the conversation has some sort of purpose.. The instructor said however that no patient will let me do a procedure or give me any information unless I first build a "trusting relationship" with him/her.

So my question is--Is small talk essnetial for nursing?? ( i mean, I always introduce myself, I am always polite and I always ask patients how they are and all that, I just find it kind of awkward and even sometimes inappropriate (just for myself) to ask them questions about their life, their family, their health, if there is no specific reason for asking such questions.. Efficiency, rationality, reasonability, logic and relevancy are all the core aspects of my personality which will be hard to change.

So to sum this up--I am bad at small talk, and at converations without purpose and/or specific direction, should I be a nurse, or is my coordinator right?

[Despareux]

Using your weaknesses is going to do nothing but make those weaknesses a strength. A person's strengths can also become weaknesses if you're current weaknesses are not balanced with your strengths. Everyone has personal sacrifices they have to make to get to their own victories and perhaps, conforming will be one of yours. I hope everything works out for you.

[Orlette]

I want to mention something I have been saying in the INTJ personality thread (which I am), because I think it is relevant to the "thrapeutic communication" topic:

I believe that logically,the best thing a nurse can say to facilitate the sharing of information by the client is this: "It is in your best interest to tell me all about your symptoms, as withholding the information may lead to wrong diagnosis, which will in turn lead to adverse effects by and/or the delay of effective treatment, resulting in potentially severe complications and possible [slow and painful, (ok doesn't have to be)] death". Pretty logical, truthfull.. and I'm sure more effective than all the therapeutic communication techniques put together;) .

As for trusting relationships for performing procedures.. the wording can be pretty much the same: "I hope you are aware that not letting me perform the procedure means you are not receiving proper treatment which may result in the onset of potentially severe complications and possible death from the condition.." I know doesn't sound nice and fluffy, but less time consuming (meaning you can dedicate this time to actually doing the procedures, and to patients who actually need it), more effective, and in the end for your client's own good..

[tsm007]

I want to mention something I have been saying in the INTJ personality thread (which I am), because I think it is relevant to the "thrapeutic communication" topic:

I believe that logically,the best thing a nurse can say to facilitate the sharing of information by the client is this: "It is in your best interest to tell me all about your symptoms, as withholding the information may lead to wrong diagnosis, which will in turn lead to adverse effects by and/or the delay of effective treatment, resulting in potentially severe complications and possible [slow and painful, (ok doesn't have to be)] death". Pretty logical, truthfull.. and I'm sure more effective than all the therapeutic communication techniques put together;) .

As for trusting relationships for performing procedures.. the wording can be pretty much the same: "I hope you are aware that not letting me perform the procedure means you are not receiving proper treatment which may result in the onset of potentially severe complications and possible death from the condition.." I know doesn't sound nice and fluffy, but less time consuming (meaning you can dedicate this time to actually doing the procedures, and to patients who actually need it), more effective, and in the end for your client's own good..

If you approached me like that as a nursing student I assure you as a patient I would complain to someone. I do not mean to sound harsh, but you sound like an uncaring dictator with that approach. That is not therapeutic. It is almost threatening and it is most certainly uncaring. From this response and others you have made I do not believe your issues are with small talk, but rather how you talk to clients and your approach with them. I am having a hard time coming up with suggestions for you because you are clearly missing something if you do not see the flaws in this approach.

[Psychcns]

Agree with previous post. As a nurse, your connection with the client needs to be empathic. You need to put yourself in their shoes. They need to feel supported. Your proposed approach sounds like you are reading a legal document..

[coco.nut]

This sounds like you are reading them their rights. That is not what pts need. If logic was the answer to curing health problems....

It seems you've been having problems functioning in clinicals for a few months from your previous thread https://allnurses.com/general-nursing-student/good-theory-trouble-634653.html. You have received a lot of advice from people, but it seems you are missing the fundamentals here: you need to show interest and caring in your patients as people, not just things to practice skills on or lecture. Nursing is holistic, that includes theraputic speech. If you really don't understand this and have such an aversion to building relationships, I don't think nursing is the right choice for you.

[EveRose]

I want to mention something I have been saying in the INTJ personality thread (which I am), because I think it is relevant to the "thrapeutic communication" topic:

I believe that logically,the best thing a nurse can say to facilitate the sharing of information by the client is this: "It is in your best interest to tell me all about your symptoms, as withholding the information may lead to wrong diagnosis, which will in turn lead to adverse effects by and/or the delay of effective treatment, resulting in potentially severe complications and possible [slow and painful, (ok doesn't have to be)] death". Pretty logical, truthfull.. and I'm sure more effective than all the therapeutic communication techniques put together;) .

As for trusting relationships for performing procedures.. the wording can be pretty much the same: "I hope you are aware that not letting me perform the procedure means you are not receiving proper treatment which may result in the onset of potentially severe complications and possible death from the condition.." I know doesn't sound nice and fluffy, but less time consuming (meaning you can dedicate this time to actually doing the procedures, and to patients who actually need it), more effective, and in the end for your client's own good..

If this is how you truly think that you should be communicating with your patients then I can understand your clinical instructors concern. Your logical and truthful comes across as condescending and threatening not the best way to facilitate communication. Building a trusting relationship doesn't have to be nice and fluffy but borderline assault isn't the way either. (Some instructors could consider threatening the patient with complications unless they let you perform a procedure assault by definition)

The basis for therapeutic communication is empathy, logic has nothing to do with it. If you can't see where the problem lies in your above post then IMO nursing really isn't for you.

[zoidberg, BSN, RN]

being an INTJ does not make you unable to be compassionate and unable to be anything but logical. Just like someone who tests more on the feeling side of things is not unable to use logic. Don't put yourself in a box, it will only hinder your growth as a human being.

[fltnrse2, ASN, RN]

Good to hear from you Orletta,

I would like to make a comment on the posting by ms. Co-Co Nut. Althought I would like to think you are honest and in the best interest of this young lady to chime in with your "opinion" that you don't think she belongs in nursing either. Oh please, Ms. CoCo-Nut not all of us we raised in a loving home like "leave it to Beaver" and what some take for granite , others have never experienced before. I see the problem is quite the opposite in the case of nurses. Now you might not think it a tad strange to stick your hand in areas of a compete stranger and never think any more of it. Why is that?? Because many not all have poor to nill boundaries, that is why we can do what we do. While there are those who want to kick this young women to the curb and move on, I couldn't disagree with you more. I don't think anyone has ever been damaged by encouragement, however the curb side of the street is always full. The last think this young lady needs are complete strangers telling her what she should do with her life...you don't know this young lady from Adam and I think it somewhat out of line to opine such an opinion as if she is a long lost cousin. After all it is her life, and just maybe with kindness, emotional support and encouragement she will come into her own becoming a very fine, skilled and tender nurse. Just put one foot in front of the other and before you know it you will come to your own conclusion. I don't really care with all due respect what any one else thinks, no one can deside your future better than you can. Let me hear from you, and how you are doing. FLTNRSE

[Wrench Party]

I am also a strong INTJ, and found it really hard to talk to people who were different than me several years ago.

I started volunteering with a non-profit, and over time learned to talk to the variety of people we served.

I'm still a little apprehensive about talking to my patients in clinicals, but I often find a simple smile and

something like "hi, I'm so and so, I'm a student nurse from __ and here to learn all I can, I was thinking we can do this today,

does that sound good? what can I help you with?, my clinical instructor and your RN will help me answer any questions you may have..." etc. etc.

Usually the instructors have vetted the patients beforehand, and most of mine have been eager to talk and

tell us about their histories.

Obviously you do care, you just need to be patient and let that side of you come out! :)

[SHGR, MSN, RN, CNS]

I am also a strong INTJ, and found it really hard to talk to people who were different than me several years ago.

I started volunteering with a non-profit, and over time learned to talk to the variety of people we served.

I so can relate to the above, though I am INFP- but volunteering as an English Language Partner reaaaaaally helped my social skills. It was amazing- I guess because the "small talk" had a total purpose- helping others learn English. Really, that experience changed my life and I can't recommend it enough for someone who wants to practice conversation.

Even if you end up working on a vent unit where everyone is sedated, you will still need to make small talk with your co-workers if you want them to work smoothly with you. It's a skill, just like any other skill- some are born with it (the lucky ones), some learn it from parents with solid social skills, and some learn it painfully and painstakingly in adulthood. It will take practice, but if you want to get better at it, you can.

Obviously you do care, you just need to be patient and let that side of you come out! :)

[coco.nut]

Fltnrse2,

Posting in a public place is eliciting advice from strangers, that was the purpose. She also had feedback from her instructors and those that know her, which I agree is most likely better than anything we will tell her as we do not know her personally or the entire situation.

I am no PollyAnna, nor some "Leave It to Beaver" spawn ("you don't know this young lady from Adam" nor do you know me to suggest this). I am not a chatty person in real life and small talk was not easy for me to do at first either, but I realize the importance this can have with patient care. From her posts, she has said it was clinical was boring, felt lost and did not see the reasoning behind the small talk. If you read my first post on the first page, I gave her some positive tips on how I go about the interacting w/ patients. My concern for her is that she doesn't seem to understand the reasoning behind therapeutic talk. If she thinks that her example conversations with patients in the above post is the best way to communicate,she might be happier and more comfortable in another area of health care, perhaps one where she can concentrate more on the academic aspects (as she stated she did well in this). I never said she couldn't learn how to be more empathetic with patients, but first she needs to understand why it's important in order to implement it.