unsure in clinical

Students General Students

Published

I am a senior in an ADN program and I am still unsure of myself in clinical. I am a creature of habit and feel uncomfortable with change. Meaning, every clinical rotation, I have panic attacks, and doubt myself. I usually pull myself together and am very good with the patients but still have a hard time trusting my vital signs--mostly BP. I am so anal (as most of us are) that I get all worked up and wonder if I am exact in what I am hearing. I always get good clinical evals but I doubt myself. I can give an injection with no problem and even a catheter, but BP scares the **** out of me! Any advice on how to do this? Some times I get confused with the movement of the needle and the sound I hear. Am I being TOO anal and thus letting my anxiety control my senses? I have no previous exp. in the medical field and I do feel behind those who were/are CNA's. Also, I have trouble finding pedal pulses. I cannot even find my own! I do find the patient's but it takes me forever!

Thanks--Liz

caliotter3

38,333 Posts

I've got news for you, you're not the only one who has trouble with pedal pulses. That is why they developed the doppler. You say you can do injections, but get rattled over BPs? Suggest you get your own BP cuff and stethoscope (if you don't already have these) and start practicing on anybody in your household. Husbands, boy friends, and brothers, are good for this exercise. Just do it over and over so that the physical act of placing the equipment where it goes starts to feel natural. You will get used to it. Just give yourself some time. Be thankful that you are passing the clinicals as there are people that are lost and fail out. You are doing well enough to pass, so you are learning something. Practice anxiety relief techniques, like breathing exercises and imagery. You'll be ok.

David's Harp

137 Posts

I'd second the above poster's advice - get a BP cuff and practice, and this will definitely demystify what I agree is a tricky basic skill. Sometimes the floor's manual cuff can be tought to work with; the ones on the floor where I do my externship tend to deflate on their own once they get inflated past 140 or so (not particularly handy on a telemetry floor, y'know?), or are otherwise problematic to work with. Having your own kit with you can take a subtle bit of stress out of it all.

Keep in mind, too, that some people's BPs are just plain hard to hear (my wife's, for instance), no matter what amount of experience you have under your belt. Then there's the people that won't (read: can't) stay still for it, and environmental noise, etc...

I am a senior in an ADN program and I am still unsure of myself in clinical. I am a creature of habit and feel uncomfortable with change. Meaning, every clinical rotation, I have panic attacks, and doubt myself. I usually pull myself together and am very good with the patients but still have a hard time trusting my vital signs--mostly BP. I am so anal (as most of us are) that I get all worked up and wonder if I am exact in what I am hearing. I always get good clinical evals but I doubt myself. I can give an injection with no problem and even a catheter, but BP scares the **** out of me! Any advice on how to do this? Some times I get confused with the movement of the needle and the sound I hear. Am I being TOO anal and thus letting my anxiety control my senses? I have no previous exp. in the medical field and I do feel behind those who were/are CNA's. Also, I have trouble finding pedal pulses. I cannot even find my own! I do find the patient's but it takes me forever!

Thanks--Liz

kharing

113 Posts

I'm an RT student, but during clinicals our clinical director recommends that we keep an active journal. We have to evaluate every hospital we rotate through - I carry a small notebook and write EVERYTHING down. It's great because when I get home I can look up information that I didn't recall or understand during clinicals.

In regards to blood pressure - is there a clinical lab at your program? Many students come in on their off time to practice skills in lab. Good Luck!!!

Psqrd

206 Posts

Specializes in Cardiac/ED.

I'm a second semester but I have worked previously as an EMT, my suggestion for pedal pulses is that most of the people that I have observed doing it press too hard my trick (at least I call it mine) is that I press firm then release to a point where the pads of my finger tips are just barely touching the skin where I believe that I am most likely to find the pulse. This usually works.

Your BP situation...has got me stumped...I guess what the other poster have suggested may help...but I feel that by the fourth semester practice may not be the solution to your problem. I feel that you may be experiencing the self fulfilling prophecy, you expect difficulty so then you have difficulty. Try the 2 step technique...if you are not familiar with it, it is when you pump up the cuff with no stethoscope but by palp. Go 30mm over the systolic, when you don't feel it anymore then deflate to confirm that reading. then you use the stethoscope only inflating to the 30 over spot and deflate from there. This gives you much more of an idea of when you should hear the sound so you don't burn yourself up with anticipation.

I hope this helps good luck and congrats on your soon to be graduation.

P

lizzybeth

32 Posts

Thank you all for your replies. I have a feeling this BP anxiety may be part of my perfectionist personality. I need to practice practice practice!!!

+ Add a Comment