Starting my 5th Level Preceptorship, and I'm Terrified of Doing Everything Wrong...

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    Hello there! My name is Ashlie, and on Monday, I start my 5th level preceptorship. I have a 3.6 cumulative GPA and even made a 4.0 this past semester (4th level - critical care/psych/management). Before I sound like I'm bragging too much, I have a scary confession. I struggle with common sense. I get so nervous that I feel like an idiot half the time. Sometimes, I can't even figure out how to use simple things out of pure fear/nervousness.

    I'm terrified of my preceptorship. I worry my preceptor will think I'm a bumbling idiot. I literally am sick over how scared and nervous I am. What if I don't know how to do something? I haven't had the chance to do a lot in clinical. I've only given two IM injections, I've never even done an NG tube or a foley. I'm terrible with IVP meds (mixing, diluting, etc). I feel like I get confused easily and that of course makes me even more nervous. How can I combat this? How can I give myself peace of mind before meeting my preceptor on Thursday? I'm going to review everything I'm unsure of and study, study, study it.

    I love nursing. I'm passionate about it. But....I feel like sometimes I'm not smart enough. If I can't figure out the simplest things and I get this nervous, how will I survive the real nursing world? I'm too far now to give up due to fear. I just want to be that smart competent nurse that I see working on the floor.

    I will say this. My instructors have always given me great reviews. The only thing I've ever been told that could be viewed as "negative," is that I need to work on my confidence in clinical. How can I do this? I feel like I'm so dumb sometimes. I want to be a nurse so bad, and a good one at that, but I'm feeling torn over this. What should I expect during my preceptorship? How can I work on my common sense? Is there anything I can do to combat these feelings? Obviously, I can't re-study everything I've ever learned in nursing school in the next few days, but I feel like I should. Nursing is pretty much scaring me to death right now!

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  2. 12 Comments...

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    aweldon001 I am not a nurse yet, but I am currently a Licensed Vet Tech, and we share many similar responsibilities -- with many similar pressures and expectations. It sounds to me like you are psyching yourself out!!! Take your instructors' positive comments to heart and focus on the things you KNOW you are good at. I remember being terrified I was going to kill a patient and feeling like a total fake when I first started out, but I built my confidence by realizing there were some things I was great at, and others I just needed to learn by DOING. I was top of my class in my Vet Tech school, and awesome at placing IV catheters and intubation, but radiographs terrified me!! With time, and slowly building experience, I gained a lot of confidence

    You absolutely cannot put yourself down mentally and then expect to be confident!! You'll be OK
    Last edit by SilverOwl on May 18, '13 : Reason: terminology
    aweldon001 likes this.
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    SilverOwl, as soon as I read the words, "psyching yourself out," I took it to heart. I've had an instructor tell me these exact words before!! You're right though. I need to focus on the positive and go with that. It's so much harder to say I'm going to do it than actually doing it, but I will try. That's how I feel all the time. I worry I will hurt a patient or do something wrong. I feel like there's a written policy/procedure for EVERYTHING, and I worry I won't follow one correctly. It's always a constant worry for me. I'm the same as you though! I'm great at IV's, so maybe I will focus on that when I start freaking out. Thank you for responding and building up my confidence a bit! It means a lot!
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    aweldon,

    I remember very clearly the anxiety you're describing. BREATHE DEEPLY!! You are not the only one!

    Let me tell you something as a preceptor--we don't expect you to know everything. In fact, I don't usually expect my preceptees to know anything for the exact reasons you're describing. We're humans. We get nervous, we get flustered, and when we're put in an unfamiliar situation, it's hard to think fast.

    So my suggestion to you is to let your preceptor know how you feel. Tell him/her that you want lots of explanations and what you're comfortable/ not comfortable with. That is the only way you will start to feel better. It takes time and experience--LOTS of experience--to feel comfortable as a nurse. I didn't really feel like I had my sea legs until I was a year--a full year--into my first job.

    The weight of the world isn't on your shoulders! This is not you flying solo--it's an opportunity to learn. You sound like you're very enthusiatic, which would be all I needed to see if I were your preceptor. I don't care if my preceptees have it down or if they follow me like ducklings--as long as their attitude is right, I love working with them and teaching whatever I can.

    A lot of nursing isn't common sense. It's a 6th sense really that you develop over time along with your assessment/critical thinking skills. That education that's going to keep you from feeling stupid and inadequate? Part 1 is waiting in your 5th level preceptorship. Give yourself a break, be honest with your preceptor, and get ready to learn a lot!
    aweldon001 likes this.
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    Practice makes perfect. Work on the things you struggle with until you know them like the back of your hand.
    aweldon001 likes this.
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    Oh man, I feel like after reading your reply, I was literally able to breathe and relax these tense muscles in my neck! I wish you knew how much it means to me to read this. It it like a weight is being lifted off my shoulders.

    I do worry about not even knowing how to get through some of the simplest tasks, but I'm hoping my preceptor will be as understanding and kind as you. I seriously hope that my preceptor will keep what you said in mind. I want to learn and I want to be able to appear confident and intelligent, but I feel like I'm faking it most of the time. It's hard to think fast like you said, and being put on the spot is the worst!

    I will definitely take your advice and tell my preceptor exactly how I feel. I will be sure to touch base on all the things you mentioned. It definitely makes me feel better that experience is the key, because even though I've been in clinical, I've only got to do a few procedures at best. I feel like if I can get in there and do everything over and over that I will catch on and feel better. This makes me nervous to think my first year will be like this as well, but I'm going to try as hard as I can.

    I feel so much better after reading this. I felt like my preceptor was going to expect me to know every little thing about everything and I've been having mini-panic attacks over it! Learning is good, it's what I WANT out of this. I'm extremely positive and friendly, so I hope this will help.

    Wow...just thank you.....thank you so much, SoldierNurse22. I will look at my preceptorship as PART 1. I love that. I will do everything you said and take it to heart. Thank you so VERY much!!!!!
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    I think after reading these past few comments, that I'm starting to realize that experience and practice are key to easing my stress. I will take your advice. Thank you so much, Stephanie.
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    This is why you have an experienced nurse as a preceptor. I have precepted senior nursing students and I didn't expect them to come in knowing everything or even anything. I expected them to pay attention, to learn and to progress over the course of the semester.

    What specifically do you find difficult about IVP meds? Figure out what the problem is and then you can figure out how to fix it.
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    I do worry about not even knowing how to get through some of the simplest tasks...
    Neither did I. Neither did any of us, actually! People can be born with an inclination toward nursing, but you don't come out of the womb spiking IV bags and programming pumps. It's a process and it's learned at individual rates. The big thing to remember is that you don't have to learn it all right now.

    I want to learn and I want to be able to appear confident and intelligent, but I feel like I'm faking it most of the time. Again, that's the name of the game. Don't pretend you know what you don't know of course, but if you have to feign confidence, that's not a bad idea. If you don't know something, tell your patient as much, but tell them you'll find out for them. That maintains rapport and also will teach you not only the info, but how to find it, which is key! If you are put on the spot, do your best and learn from it. Those people who are really confident and unflappable? They got that way by being put on the spot over and over and eventually, they figured out how to deal with it.

    It definitely makes me feel better that experience is the key, because even though I've been in clinical, I've only got to do a few procedures at best. I feel like if I can get in there and do everything over and over that I will catch on and feel better. This makes me nervous to think my first year will be like this as well, but I'm going to try as hard as I can. Clinical is really good for getting familiarized with things, but most of the time, you don't learn all you need to know by any means in clinical. When you get your first job, you'll be precepted there, too. I was precepted for 3 months before I was able to fly solo. I felt very comfortable by the time I was on my own and I knew I could ask my coworkers for help if I needed it. That's the mark of a good workplace--that teamwork.
    Unfortunately, your first job is always going to be a little nerve-wracking. There is just so much to learn that you can't be taught in school, and can't be taught, PERIOD. Give yourself permission to take your time and go through this process just like all of us have! You'll be better able to perform if you keep this in mind and stay calm.
    Wanna know a secret? I STILL haven't inserted foley! I've been a nurse for 2.5 years. When I get my chance, though, I will be asking another nurse for an assist, you betcha!

    I felt like my preceptor was going to expect me to know every little thing about everything and I've been having mini-panic attacks over it! When I started oncology, I had a preceptor like that. When she asked me questions I didn't know the answer to (specific details of chemotherapy drugs that I had literally just been taught about), I told her I didn't know, but I'd find out. That is all you can do. If you really find that you and your preceptor are having issues, talk to your clinical leader / manager (once you're working).

    Learning is good, it's what I WANT out of this. I'm extremely positive and friendly, so I hope this will help.That will absolutely help. That's all I ask of my preceptees and patients like that personality type.

    I will look at my preceptorship as PART 1. I love that. I will do everything you said and take it to heart. Your life as a nurse will be one big learning experience. Things are constantly changing and improving (hopefully) in medicine, and just to maintain your license, you'll have to complete continuing education credits in order to stay current in practice.
    There was this time when I was a brand new nurse working alone--this was probably in my first week on my own--that I had a patient who needed Tylenol, but he couldn't tolerate PO meds. I chatted with the doc and then talked with the pharmacy and found out that they made Tylenol in IV form. The older nurses had never heard of such a thing. They didn't believe it until they saw it. As I was setting up the infusion, I had half of my coworkers filtering through the room to marvel at it. The point of this story is that you can be a nurse for 30 years and still have something to learn!

    Thank you so VERY much!!!!! You're quite welcome! Feel free to PM me with any questions or anything I can help you with. I really enjoyed precepting and I love students who are eager to learn.
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    You're right. I think I'm trying to shoulder it all and it's freaking me out. I want my preceptor to at least think I have a brain between my ears, lol. I will definitely be paying attention and be ready to learn like you mentioned. I also hope I can write everything down he/she tells me.

    Well, just a few weeks ago I had to push Protonix, so I had to reconstitute it with 10 mL of NS, and I didn't know if I was supposed to push air into the vial of NS before withdrawing and I struggled getting all of the mixed Protonix out of the vial when I was withdrawing it into my syringe. I just felt like an idiot. I've learned about all of these things in school but when I'm doing it with my hands I just get nervous and forget what I'm supposed to do. =/ I will definitely be going over reconstitution and pushing IVP meds before going to clinical though. Thank you.


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