How do you overcome nervousness when with patients?

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Specializes in Neuro, Med-surg..

I'm in nursing school going for a BSN. It's my second degree (first was in broadcasting). I have a problem, but I hide it well from my teachers and peers: I get really nervous when I deal with patients during clinical! I try to walk into the room, introduce myself, take vitals, etc., but inside I'm just falling apart. I applied for a CNA job to hopefully help me overcome my anxiety, but in the meantime it's rough.

I find it difficult to tell patients I'm going to do (fill in the blank with procedure of your choice) or even to do it. I wonder if I'm hurting them or if I'm doing it right. I've spent ample time in the skills lab to get my stuff down, but clinical days are still stressful for me.

Any other nursing students get 'nerved up' during clinical or with patients?

Will this get better with experience? (It's only my second semester...)

Everybody goes through this in the beginning. EVERYBODY. It just takes practice and experience to overcome the anxiety. You will experience the same feelings when you start working as a CNA, but at least it will help you to become acclimated to the profession more quickly.

Specializes in ICU.

You'll get more used to interacting with/assessing/touching/speaking with patients...it just takes time, and more patient interactions.

Specializes in Neuro, Med-surg..

I hope you guys are right - it was pretty bad this morning for me! I can't explain it; I don't know if I need to be more assertive or matter-of-fact about what I'm going to do. I feel like I'm too timid. I know patients are at a hospital, not a day spa. Most expect to be bothered regularly by staff. My mind just tends to blank out during clinical - I forget med facts, procedures, whatever. It's embarrassing! Thanks for the advice.

Specializes in LTC, Nursing Management, WCC.
I hope you guys are right - it was pretty bad this morning for me! I can't explain it; I don't know if I need to be more assertive or matter-of-fact about what I'm going to do. I feel like I'm too timid. I know patients are at a hospital, not a day spa. Most expect to be bothered regularly by staff. My mind just tends to blank out during clinical - I forget med facts, procedures, whatever. It's embarrassing! Thanks for the advice.

It is very hard to invade someone's space...especially if it is in the intimate space of 0 - 18 inches. Develop a rapport with your patients ASAP. Use humor appropriately. Ask them questions like, does this hurt? when you are doing something. Or be honest and state it might hurt a bit, like when you place an IV. Just be honest with them. When you introduce yourself, make sure you say you are a student nurse or 2nd year student nurse, etc. I promise it will get better with time. One day you will have to put in a catheter and then you have to be all up in their business. :) Before you enter the room...take a breath and remember to say... I AM the nurse. :up:

Specializes in mental health.

Maybe it's because I'm older but I love talking to patients. There is almost always some common ground...Motorbikes, gardening, travel, fishing, pet goats, what ever... Most

patients love to talk too. It takes their mind off things that may be unpleasant for them. So just jump in there and do it. As for personal space and comfort, it's just a matter of experience and practice. After a while, it will not bother you.

I have noticed two things in clinical that drive me crazy. One is staff who raise their voices when talking to patients. Unless the patient has a hearing problem, it's not polite. The other is the false cheeriness/conversation that is directed at patients. It's nice to talk to people but talking at them is rude. Maybe this will happen to me after working a while, but I hope not.

-KPA

It helps me to remember what I'm bringing them. I'm bringing mercy. Here's an example.

The other day I had to remove a JP drain. Pt had a new LUQ colostomy, a central line, JP line, a NG tube, a foley, and an IV.

It was my first contact with her and I introduced myself and asked her if she was ready to get rid of some tubes. "I sure am!". I want this thing pout of my nose!". I said, "I want to pull it to, but if I did, you'd go to throwing up, and I don't wanna me in here helping you heave with that sore belly, do yopu?". Quickly, she said "No sir". I said , "Well the best one to start on will be that belly line with the bulb on it. It'll be a little uncomfortable coming out, but you'll feel better when its done. And we'll be one step closer to home.". She was ready to go!

You see what I was doing? We were talking about what she wanted....freedom from those tubes.

Please don't take this the wrong way, but don't think about your nerves. Think about theirs! You'll immediately feel more confident and so will the Pt. Nothing to be nervous about. You have been appointed as one of the lucky people chosen to dispense mercy. Its right up there with forgiveness. Wow!

Good luck! Hang tough! You push and I'll pull.

A New Start

Specializes in Cardiac, Rehab.

You sound like me when I was much younger. While I still might get a little twitchy, I'm well past that and its mostly due to age and experience. All the advice I read here is excellent, especially about breaking the ice and starting a conversation oriented around the PT. I really like the "bringing mercy" idea, it doesnt get more PT focused then that.

One thing I don't like is the concept of telling a PT "Good Job" for every little thing. Sounds like I'm talking to a 3 year old. Give yourself some time, it will all come to you.

Specializes in Neuro, Med-surg..

Thanks, Bob, and all the others, for the great advice. It sounds like this will be something I adjust to with experience. Too bad it won't happen sooner rather than later :rolleyes:

Cheers!

Great advice! I also, think you have to build a certain comfort level on your on and it will come to you after putting in a few months..just strike up small talk as well

I went through this initially as well. Part of it came from instructors saying "spend as much time with your patient as possible," which makes you feel obligated to be in the room all the time, hanging out. Even if the patient is comfortable and doesn't need (or maybe want) you in the room for any reason whatsoever.

Staying task oriented, I think, might help you with this. Go into every room with a specific goal (i.e. to do an assessment, ambulate the patient, etc.). If you don't have a reason to go in, don't go in. If you have nothing else to do, tell your instructor the patient is resting comfortably and you'd like something to do, or ask the nurses on the floor if they need help with anything.

Typically, I don't even think of going into a room until I have report,and have given the chart (especially history, orders, and labs) a brief lookover. Gives me a little to chat about with the patient if small talk is necessary.

Very important to just pretend to know what your doing, even when your not confident (within limits, of course).

And most of all, let the patient do all the talking. Trust me, this works. I've found 75% of the patients will talk my arm off. I can barely edge a word in. People love to talk about themselves. Sometimes it's interesting, sometimes it's boring. But it takes the pressure off you, and you simply listening is therapeutic for them.

Specializes in Neuro, Med-surg..
I went through this initially as well. Part of it came from instructors saying "spend as much time with your patient as possible," which makes you feel obligated to be in the room all the time, hanging out. Even if the patient is comfortable and doesn't need (or maybe want) you in the room for any reason whatsoever.

Staying task oriented, I think, might help you with this. Go into every room with a specific goal (i.e. to do an assessment, ambulate the patient, etc.). If you don't have a reason to go in, don't go in. If you have nothing else to do, tell your instructor the patient is resting comfortably and you'd like something to do, or ask the nurses on the floor if they need help with anything.

Typically, I don't even think of going into a room until I have report,and have given the chart (especially history, orders, and labs) a brief lookover. Gives me a little to chat about with the patient if small talk is necessary.

Very important to just pretend to know what your doing, even when your not confident (within limits, of course).

And most of all, let the patient do all the talking. Trust me, this works. I've found 75% of the patients will talk my arm off. I can barely edge a word in. People love to talk about themselves. Sometimes it's interesting, sometimes it's boring. But it takes the pressure off you, and you simply listening is therapeutic for them.

This is some really great advice - I think I'll start checking over the charts prior to entering the patient's room. You're right - most patients want to talk, so I should try to encourage that. I do try to ask the other nurses or my teacher if anybody needs help with anything.

Thanks, H_2_O, and everybody else who responded!

John

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