Please help me!!!

  1. I am in my second semester of my junior year of a BSN program and I am taking Med-surg right now. We are going to the hospital twice a week now. I had a little experience with clinical last semester but basically Med-surg is the beginning of my clinical experience and it hasn't gone too well. I am so disorganized, which suprises me because I am a very organized person. I always forget to assess certain things even though I have the sheet with me. I feel like I don't know what I am supposed to be doing at all, and I know some of that is normal because I am just starting out, but the others seem to have a better idea of what they are supposed to do than me. Also, I get nervous about meeting my patients for the first time because I am shy and I don't know what to say. I guess I just think too much about what I am supposed to say or do and I should probably just do it. I could prepare for clinical until I was blue in the face but by the time I get to clinical I will freeze up and forget. This really concerns me because I am a good student ( I got all A's in my nursing classes last semester) but I just can't seem to get it together for clinical. Some days I just wonder if I will ever be able to become a nurse and if I made the wrong decision to go to nursing school. I really want to do well in clinical because I want to be a good nurse, but I guess I don't know how to do that. Any suggestions you may have to help me would be greatly appreciated.
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  2. 12 Comments

  3. by   colleen10
    Hi KM4,

    I haven't gone through clinicals yet but I do know what it's like to be shy. The problems you are having with the patients, are you affraid to speak with them because you are shy or does it make you uncomfortable to talk to them about their illnesses? Maybe if you think about why you don't want to approach them you can think of ways to combat it. I agree with you that part of your problem may be that you "think" too much about what you will say to them. I used to do that too and once I stopped thinking about what I would say and just said it I was a more personable person. My responses to people didn't appear to be "canned" and they were more receptive to me in the end making it easier for me to speak to them.

    To begin to combat your shyness try this exercise. Whenever you are out, whether it be at the grocery store, gas station, or in an elevator, try to be personable to the people you meet. Say you're in the check out line at the grocery store - ask the casheir "how's your day going" or even just a friendly and sincere hello or goodbye is sufficient. You don't have to start an in depth conversation and you certainly wouldn't be able to anyway, but if you do little things like this you will eventually feel more comfortable meeting and greeting people and it will come naturally. Social settings like these aren't very stressful because you don't have to sit and talk with them for a long period of time and heck, you probably won't ever see them again.

    I would speak with my professor too. She's probably had students in the past with the same type of problem and she can probably give you advice on how to interact with the patients.

    Good Luck and try to be yourself. It's obvious that you care about the patients you just need to work on conveying that to them. The hosptial setting is new to every student nurse so don't think that you should have this inate ability to know how to interact with the patients.

    "Shyness is nice and shyness can stop you, from doing all the things in life you'd like to." - The Smiths
  4. by   sgavette
    I have been out of school for 3 years not but remember how it feels doing clinical. I was always so nervous but it did get to the point where when I was with my patients I could just be myself, not like how I felt around my instructors.

    To help me not forget things, I made up a paper that had everything listed on it such as lung sounds, bowel sounds, edema, etc. Everything was on this list so all I would have to do is go down the list.

    Good luck with school.

    Sharon
  5. by   MRed94
    The most important thing you HAVE to do:

    Remember to BREATHE. In, out, in, out.....that's it!

    I think everyone in the world who has gone through clinicals has had some of these problems.

    That's why we are STUDENTS. To LEARN how to do this stuff that the SEASONED nurses do like clockwork...................

    It will come. Just continue on, USE your notes when you NEED to.....that is what they are for, and the patients KNOW that you are a student.

    If you forget something, and have to go back and do it........Just go back, say, Hi! It's me again, need to check something else....and do it...............

    Don't be so hard on yourself. It will come.

    Take care,

    Marla
  6. by   MRed94
    Check the threads:

    Feeling green, and Poor organizational skills.

    These both contain very valuable information.

    Take care,

    Marla
  7. by   marieoct62
    I was in the same boat as you were last September. It was the beginning of my junior year and the only clinical I had up to then was a few trips to our local nursing home.

    I really did not have a problem talking with my patience as I have the gift of gab and can small talk with anyone (Thank God).

    My advice to you is don't be so hard on yourself. If you have a flow sheet it basically goes through everything you need to check. In the morning go in check on your patient and introduce yourself. Then go out and get the flow sheet give it a once over and then go into the room to start your assessments. You really don't have to go through them in order but head to toe is best most of the time.

    As far as feeling uncomfortable talking with the patient, Just pretend it is your mom or dad, grandma or grandpa. Most people I have found like the small conversation and helps to relieve the stress they are feeling.

    You sound like a caring person, just be yourself and as time goes on you will get the hang of it.
  8. by   betts
    One song can spark a moment,
    One flower can wake the dream.

    One tree can start a forest,
    One bird can herald spring.

    One smile begins a friendship,
    One handclasp lifts a soul.

    One star can guide a ship at sea,
    One word can frame the goal.

    One vote can change a nation,
    One sunbeam lights a room.

    One candle wipes out darkness,
    One laugh will conquer gloom.

    One step must start each journey,
    One word must start each prayer.

    One hope will raise our spirits,
    One touch can show you care.

    One voice can speak with wisdom,
    One heart can know what's true.

    One life can make the difference,
    You see, IT'S UP TO YOU!

    NEVER SAY NEVER and GRASP YOUR DREAM.....All of us here Believe In You!
  9. by   GPatty
    HI....
    I'm the one who was "feeling green" about my clinicals.
    Let me tell you that it does get easier as time goes on. You will start to remember things, and talking to your patient willl begin to come naturally. I promise. Give yourself some leeway....heck, I still forget things, and I have to go back and check...but shoot, don't we all? It'll get easier, just hang in there and don't give up!
    Hugs,
    Julie
  10. by   Km41566
    Thanks so much for all your advice. I am feeling better about clinical than I did on Thursday. I got a failing grade on my care plan that I turned in last week and I was not too happy about it but I don't think the first one counts. This week I tried to be more complete in my paperwork and asked questions so I could do my care plan right. Hopefully, I will pass this time.
    Also, I do feel that my shyness does stop me from doing things that I would like to do sometimes, but I am making improvements in that area. I am less shy than I used to be.
  11. by   marieoct62
    Okay first off let me say I must of been half asleep when I posted earlier, I noticed that I spelt patients (patience) I don't know if that was a freudian slip because KM I was thinking you need patience with yourself. Oh well I am usually a great speller.

    When I started my junior year and was getting my books I asked if there were any books NOT on my required list that would help me and the book store advised this book on care plans. This book was and still is my Bible to writing a care plan. I am telling everyone it is well worth the $44.95 I guarantee that you will use it for every med surg patient.

    It is called "Nursing Care Plans" Guidelines for individualizing patient care edition 5 Authors Marilynn E. Doenges-Mary Frances Moorhouse-Alice C. Geissler.

    I would strongly advise anyone writing care plans to get this book. First it is divided into categories Cardiovascular, Neurological,Gastrointestinal etc...

    then it is Broken down by nursing diagnosis e.g. Nutrition: altered, risk for less than body requirements etc...

    then it goes on to give actions interventions and the rationales behind the interventions. It is all there in black and white. All you have to do is decide what ND you are using for your patient.
  12. by   peaceful2100
    Oh I know the feeling, I been there done and done that. While, I still get butterflies in my stomach it is much, much easier for me now to walk into the room and say Good morning my name is Tonya. I am a student nurse and I will be working with your nurse _______ to help take care of you this morning. Then before I start anything. I ask them how was their night, how are they feeling now and is there anything I can get for you right now. If they say no and it is close to breakfast then I say how about help for a bath or at least some water and a face cloth to wash your face and maybe your tooth brush for help with brushing your teeth. Then I do the most important assessment before breakfast like neuro, cardiac, respiratory and other important things and save other things that the nurses don't even do but the school wants you to do for after breakfast. I have a hard time striking up conversation with people still but I always find something like the lastest current event, or if in their chart I see they have children I will ask do they have children and sometimes they will start sharing stories about their children, grandchildren they may have. Also a suggestion that marie said was act like the patients are your family how would you want your family/friends to be treated. I have been a shy person all my life, everytime I would go the store someone would make eye contact with me I was so shy I would turn the other way or run the other way. However, nursing school has made me almost a complete new person I am not so shy anymore and some one has already made some suggestions but one that a friend gave me a long time ago that has really helped me was I would make a habit of saying smiling, saying hi how are you doing to at LEAST five people everyday and now I do that with many people without problems. If you don't already do that I encourage you to do that. It will get better. Just hang in there.

    I also failed my first care plan but I learned how to do them just like everyone else can and I keep getting better and better at care plans. Care plans although they do require thought they will get easier for you to do. If you have not already planned to do so plan to save your care plans that way by the time you graduate you can compare your care plans from your junior year with your senior year and see what great improvements you have made. You will even see improvements from the beginning of the rotation you are in now till the end.
  13. by   ADN 2002
    I was in the exact same boat you're in, Km41566, only it was last year at this time for me. I was in a new clinical site, doing 12 hour clinicals (after having only done 6 hour clinicals the semester before) and I had an instructor that could easily intimidate me. I was a wreck every time I went to do an assessment! I had a really hard time coordinating my pt's care - every time I went to do something or assess something, something else would come up and I would have to wait and I'd never get back to it. That semester was really hard, but thanks to that instructor, I learned A LOT! I couldn't believe the amount of information I learned that semester.

    Now, I'm in my last semester of my ADN program, and assessments don't scare me anymore. (See, it does get easier!) You just have to think of it as any other "normal" part of your nursing care. I also used to prepare and prepare for clinical day, but I found that being overprepared, trying to stick to the plan was a lot harder than doing things as they came to me, and you develop your own style after a while.

    It all boils down to how you deal with people - when I go into a patient's room for the first time, I introduce myself as a student nurse and tell them I'd like to take care of them today if that would be okay with them (this kind of gives them a say in their care, and nobody's ever told me "no, you can't take care of me"). Then I just talk to them for a few minutes about whatever - something on the television at the moment, about the flowers someone sent them, about the weather, whatever. Then I tell them a little about what I'll be doing today - bath, linen change, assessment, and whatever else they need. I think this kind of thing puts the patient more at ease, and it'll put you at ease with them.

    If you're not a really social person (and there was a time where the thought of going up and talking to someone I didn't know scared the pants off me) - just do what the others here have suggested. Something I do: whenever you're checking out at a store or paying the bill at a restaurant, tell the cashier hi and when you're leaving, wish them a nice day. I used to work in retail and got into the habit of doing this, and it's really worked out well in my clinical experiences. And, it'll make you more comfortable with people in general, it'll make you feel good, and it might make somebody else's day a little bit better.
  14. by   zacarias
    Wow!

    I've enjoyed this thread so much. Seeing that other people have felt the way I do is so comforting!
    Km, I'm very much like you. I get good grades in the theory of nursing but in clinical, I often feel like a fish out of water. I get so nervous that during pre-conference (I see people laughing and the teacher talking but I have no idea what's going on because I realize in a few moments I will go meet my new patients and have to care for them! Me who doesn't know anything will have to care for someone who just had surgery! LOL) Anyway, I know I will get better at it as I notice little things about myself as times goes on.
    It's so easy to miss part of an assessment only to remember it later when it's too late. I think a flow sheet is a great idea. I think I'll make one up someday when I have time! LOL
    It will get easier I swear. I'm so shy too, but I just be myself when I walk into the room and most people respond to it. I make jokes about being a student (for instance: now let's see why isn't this working? referring to the Dynamap) just to get the humor going and the relationship to develop. Of course I assess the patient's cognition and perception of the whole healthcare experience before I instigate such humor.
    Do you have a clinical "buddy"? A fellow student that you can ask questions to or have help you any time during your day helps dramatically.
    Good luck, and remember you are so not alone in these feelings!

    Z

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