Social Anxiety is likely hurting my evaluations

[kawaiinotme?]

Hi all,

I actually joined this forum specifically because I'm having this issue, but I have read posts on here for a number of years.

I was a teacher from 2008 to 2012, when getting fired from a Catholic school kicked me out of the profession for good (you can explain away years of subbing due to the bad economy, but can't explain when a school just outright fires you for not "fitting into their culture"). So, I decided a comparable profession would be nursing. I genuinely care about people and want to do something meaningful, fulfilling and that will help society.

My problem is that I can't stand actually interacting with my patients. We had our first clinical experience this week and I was nearly in tears from the emotional discomfort I felt while talking to my patient. My clinical instructor had to prompt me several times to "address her psycho-social needs as well as physical" and I just struggled to come up with questions I could ask, or things I could say to her while doing my assessment. I felt so badly, she was confused and crying that she wanted to go home and I've never been good with comforting people I know well-- how the hell am I supposed to comfort a total stranger?

Part of it is that I know if I were in the hospital, I'd want minimal interaction with others. If I were sick, I'd want nothing more than to be left alone to sleep or watch TV or read. I've always had a very hard time interacting with others, both because of social anxiety and a general failure to "see the point" in small talk. I believe this is going to hurt me when it comes time to evaluate my clinical experience.

How do I, as they say, fake it til I make it?

[nlitened]

Have you ever talked to someone about your anxiety and antisocial behavior? Most colleges have counselors you can see. But besides that, dealing with patients/family members/doctors/coworkers/the public, is going to be a part of your job. I could tell you how areas like surgery or PACU would be a good fit for you, but I think you need to deal with the actual problem...your anxiety. Best of luck to you.

[Carpediem1012, BSN, RN]

Empathy is a must in nursing, I believe; being able to put yourself in another's place. It then becomes easy to care for your patient and communicate therapeutically. You say you want to care for others, but do you feel that empathy? I can't imagine dreading talking to patients as a nurse. I am wondering (respectfully) if you do indeed have an issue that needs professional counselling from what you say. Again, I say this with utmost respect, both for you, and others who experience it (including my son), but have you looked into Aspergers? I am seeing some similarities with what you are saying and this disorder. You can still become a wonderful nurse if you can identify this "block" in regards to emotion and feelings if you work on it. But for your patients' sakes (and your own), it's important to consult with someone sooner than later. I wish you the best and please keep is updated. Hugs.

[kawaiinotme?]

The only reason I don't believe it to be Aspergers is because I'm actually supersensitive to the feelings of others based on tone and body language. Sometimes, I'm even oversensitive, because I believe that people are annoyed or "done" talking to me, when they're neither.

I have a therapist and have been working on this "issue" for years. I'm on Viibryd currently for bipolar disorder, but I don't think it's working anymore as I've felt very depressed the past few weeks.

Thank you for the replies, I guess I'll just keep working on it.

[JustBeachyNurse, LPN]

Lack of empathy with autism & aspergers is a myth.

It could be a component or coping mechanism of your bipolar. Perhaps nursing isn't the career for you.

[TheCommuter, BSN, RN]

I've always had a very hard time interacting with others, both because of social anxiety and a general failure to "see the point" in small talk.

I have issues similar to you, but I do not have social anxiety problems.

I used to not see the point in small talk, either. Honestly, I'd rather discuss topics that are more substantive than the overcast weather, the last TV program you watched, or the charm bracelet you're wearing.

However, small talk is the glue that enables us to form and sustain meaningful connections. Small talk is discourse that lets the other person know that you're acknowledging their existence as a fellow human rather than an object on which to complete nursing tasks.

I still dislike small talk, but I'll engage in it because I validate the other person's existence when I show an interest in them and ask questions about their day to day existence. When looking at the big picture, small talk has absolutely nothing to do with the weather or the person's clothing. However, small talk is critical to connecting with patients, families, coworkers, and most normal people in society.

I've been a nurse for almost a decade. The most important lesson I've learned is that social skills will make or break you. Without basic interpersonal skills, your patients are going to be complaining about you to management. Family members are going to complain about you. Coworkers will make your life a living hell. Management will eventually aim to terminate your employment because you're generating too many complaints.

I understand you wouldn't want to be bothered while hospitalized, but most patients will want the nurse to talk to them, comfort them, show an interest in them beyond their diagnosis, and validate their existence. If you cannot do these things, your future career in nursing will be in trouble.

There's a saying: "I do not care how much you know until I know that you care about me." Patients and families place personality above the procedural hands-on skill set. The nurse who simply walks into the room, says hello, and proceeds to complete tasks without talking to the patient or family is conveying that he/she cares far more about the tasks than the patient.

Interpersonal skills will make or break you. In this day and age, reimbursement is closely tied to patient satisfaction scores, so hospitals and other healthcare facilities hire nurses for their soft skills. Good soft skills include superb communication, friendliness, and the ability to de-escalate situations involving emotional patients and families. Without these soft skills you'll be in a world of hurt.

My suggestion is to join a social group such as Toastmasters that will enable you to practice speaking in front of others. Good luck to you.