Last semester of nursing school and very anxious; some advice for success?

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    Hi! I'm new here. Hopefully, I'm posting in the right place. I'm a senior (second/last semester) nursing student who's beginning preceptorship and (hopefully) will graduate in May. I'm pretty sure there are many posts on this website regarding this topic, but I just need some advice. I'm very excited I've gotten this far. It's been a long road, I've worked and studied hard, and I feel that I've grown so much throughout these three or four years in nursing school. However, strangely I'm losing a little confidence and becoming very anxious about this last year since I feel that there is so much I still need to learn and that I'm unprepared. I just feel that my skills aren't good enough yet. And recently, after a nursing skills exam in the skills lab (we had to do this exam and show that we are ready to start our preceptorship), my confidence has plummeted a bit more.

    It's not the fact that I had to remediate on a couple of skills, it had to do with the comments which were said to me by one of the examiners during and after my Clean wet-to-dry (the one where you pack wet gauzes in an open wound and put a dry dressing over it)/Sterile Central line dressing changes. During the procedure, she would say very degrading things like "it's too painful to watch", "you don't know what you're doing", "I'm sorry that you've made it this far with poor skills", that I "shouldn't even be here", that it's "a shock" that I've "made it this far", and that I "shouldn't graduate."

    I admit that my skills aren't perfect, that it takes me a while to learn and perfect something, and that I should've came into the lab more often and practiced the skills I wasn't exposed to much in clinical to ensure I was doing them the way the books/instructors wanted the nursing students to do (ever since the exam, I've been going to the lab more often to work on the skills I need to practice since my schedule this semester is light and I have no job). I understand that, since I'm a senior, there are higher expectations of me and that I should have certain skills mastered. But, it was just humiliating and very discouraging. She would even say these things where people in the lab could hear. Not only that, the more she said those negative things during the examination, the more nervous I'd become and the more mistakes I made. I felt not only embarrassed, but extremely ashamed. However, on the positive side, I passed the skills I had to redo the second time on the same day with a different examiner who was more encouraging. But still, I feel very discouraged and nervous. And with preceptorship coming by very soon, I'm not sure if I'm good enough to be where I'm at. What if I'm going to be a really bad nurse?

    Perhaps I'm just being a little too sensitive. Maybe this was her way of critiquing me and I'm just looking too much into it. Throughout nursing school, confidence was always an issue for me, although I have been working on it and have come a long way since when I first began in the nursing program--I've grown a lot since then and I'm thankful to have family and friends who support me. I know I'm not incompetent and that I work with my patients very well in the clinical setting. It's just, I need to have more faith in myself and my actions. I know this. But after that day, I just can't stop thinking about such comments and it's been bothering me since.

    I apologize for the long post. I guess I'm just really anxious right now. I just want to do the very best I can to prepare myself for graduation and my future career in nursing. If anyone would give me some suggestions and tips to better prepare myself for preceptorship and be successful in my last semester, that would be very much appreciated. Thank you!

    ~
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    Hi, first of all I would say that the lecturer giving negative comments to you is totally the wrong type of person to be teaching! She is there to nurture you not criticise you, if your doing something wrong it is her job to show you the correct way. I would not pay any attention to her snide remarks! Secondly, as I have been told so many times myself, you only really begin learning to be a nurse once you become one, nursing school just teaches you the basics to go out there and find out your way of doing things. If I can give you one piece of advice, it would be not to expect too much of yourself. I am newly qualified and I think I should know everything there is to know about my patients conditions and the fact is I don't and I never will! It's natural to be nervous and afraid, it's people that are overly confident that tend to be a concern. Enjoy yourself and pick up things you can manage to retain and really concentrate on that, once you have become comfortable, move on to the next thing etc. don't do what I did and am still doing 9 months later which is expect too much because this just leaves you highly stressed and your career starts to look like a bad decision, which is a shame because I think nursing is a calling and a lot of hard work, emotional and physical strain, and determination goes into becoming one! Good luck with your preceptorship, I'm sure you will be fantastic!
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    I'm sorry that instructor was so rude and terrible towards you. It's so hard when you're new because you don't know how to judge your level of competence. When I was a new nurse (like during my 1st month), I was trying to flush a pt's IV and it wasn't working so I tried pulling back on the syringe to see if it would draw back at all. I was in the PACU at the time, so it was 1 big open room with a ton of people around. The nurse I was with screamed at me "OMG don't do that! You never pull back on a 24 gauge IV!!!!" Of course now I know she was completely crazy and wrong, but at the time I didn't know any better. I was scared to do anything else the rest of the day. It's so hard when you're new because you just aren't sure.

    I think the best thing you can do is ignore her hurtful comments. (And possibly talk to the dean about what she said. No instructor should ever talk to a student like that.) Focus on practicing any areas where you feel especially weak and then just move on. Hopefully you can work well with the nurse during your practicum and she can give you some feedback on your skills. As long as you're being safe and continuing to learn you will do fine.
    Red35 likes this.
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    Thanks for the feedback and advice! I really appreciate it. It really helps to read encouraging words and stories. I have a tendency to feel that I am the only one in the program who's lagging whenever I go into doubt, which of course is not true because I've met plenty of students who've expressed similar worries, struggles, and doubts. But, like many say, it's all a learning experience, each person learns a different way and has their strengths and weaknesses. I just have to keep that in mind whenever I fall back in a state of doubt. I guess the phrase "nurses eat their young" is no lie. I wonder why it's that way in the nursing culture.

    I thought about discussing this with the dean/head of the nursing department of my school; my family and friends encourage this. But, then I realized that this instructor/manager of the skills lab is retiring after this semester--so she's gone after this. In addition, I've also recently learned that several other students have been scolded by her in a similar fashion as well during the exam. That was a bit of a relief to hear that it wasn't only me. But still, such comments like that were really unexpected and out there. I just have to keep reminding myself that I'm still learning and that I made it this far for a reason and not just out of luck. That, and stop placing myself at high expectations (though it's tough to do when the program constantly reminds us of their expectations on students).

    Again, I appreciate the feedback. I feel more encouraged and less doubtful now. Thank you for your encouraging words
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    I have to tell you that sometimes it is shocking to see a second semester, about-to-graduate nursing student who says she knows she hasn't put in much time in learning lab performing such basic tasks at such a low level. Sometimes it literally is painful to see, and when someone tells you that it's shocking that at this point in your education you don't know how to do them, I advise you to listen up. She may be speaking in generalities, as in, "I am shocked that your program didn't make sure that all students mastered this by now," or it may be more personally aimed. Either way, it's definitely a problem...for your future patients.

    It appears that you did listen, however, and you passed on second try. It appears that you have learned your lesson. Although it may have been tacky of her to critique you harshly in earshot of your peers, remember what my sweet old grandmother used to say: Some of us are put on this earth to be an example to others, one way or another. YOur instructor may have done it deliberately for that purpose, to put the fear of god in the rest of them.

    Sorry you're not getting the sweet, supportive "there, there" you probably wanted; I look at it from the point of view of where you will be in a few very short month. It's disheartening to me, too, but in a different way. If you think your faculty expressed her disappointment in your lack of mastery of simple tasks, just wait until you hear from staffers when you get a real job.

    I wouldn't hide behind that tired old "Nurses eat their young" trope as an excuse, either; I definitely would not look for or employ any coping mechanism that allows you to settle for lowered expectations, it's unbecoming. And as you have observed, it doesn't lead to functionally useful outcomes for you, your peers, or your patients. We need you to be competent out here. {{tough love icon goes here}}
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    I appreciate your honest and constructive input and being as blunt and realistic with the advice you've given me. Thank you for that and allowing me to see a more realistic view. I understand that the main intent for instructors are to prepare us for the real world and wanting us to be competent. And yes, I could imagine the kind of comments I will get from staff members when I begin working in an actual setting; and I could imagine that they'll be much much harsher than what I've gotten--it's something that I'm going to have to learn to take in as constructive criticism rather than something personally.

    Anyways, thank you for your reply. I'll keep your advice in mind and will work harder to ensure I'm prepared for the real world.
    GrnTea likes this.
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    Thank her.


    Seriously, thank her.


    Thank her for every critique, every harsh criticism, every comment that made you feel degraded, every wave of humiliation she caused to wash over you, every snide remark, every time she kept you on your toes and made you second guess yourself.


    Why? Because you'll be a better nurse for it.


    When you are out in the field and on your own, working through the stress, anxiety, judgement and uncertainty is something you MUST do, and do well.

    PS: HANG IN THERE! Home stretch! Woo!


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