I'm having some trouble in a clinical course with one of my instructors... My confidence is somewhat low, but I feel like she hasn't given me a real chance to demonstrate what I am capable of.
For example, I was going to do an IV start on a patient. Before we went into the patient's room, I asked if I should explain what I was going to do beforehand.... She didn't think this was necessary, but then at the bedside she told me exactly what to do for every single step. I felt like I didn't get a chance to demonstrate what I actually knew about the skill. I also felt like having everything described in front of the patient may have been scary for this pt. I understand that some of this was necessary, but maybe not for every step. I should have been able to insert the IV bevel up with a 30-45 degree angle and then lower w/ flashback on my own without being told all of that right in front of the patient. I get flustered easily (which I realize is something I need to improve on), but this just made it worse... especially since she had a different way of doing things than I was taught. During the skill, I was able to insert the IV ok and advance the cathlon but ran into problems when she told me to hold on to the cathlon and "not to let go." I felt so frazzled about what I was doing... She started holding on to the cathlon, so I thought it would be okay to let go... anyhow, this didn't work out so well..... Afterwards, I expressed my disappointment about my performance to the instructor but I think this just reinforced my low level of confidence....
Another example: During an admission of a patient w/ a language barrier, I didn't feel like I had a chance to demonstrate what I actually knew about communication. As soon as we ran into trouble, the instructor told me exactly what to say next... She didn't pause and allow me to work through it. I could have worked through this on my own! She even told me when to thank another student for helping me out... I could have done this myself!
In the first half of the course, I barely saw my instructor because we were on another unit... (long story). Now she is telling me that she doesn't think I have the confidence to preceptor in the ICU... but I feel that her judgment is based on situations in which she didn't give me an opportunity to show what I know.
My confidence is low, but I will do whatever it takes to be successful. She tells me she "doesn't want me to fail" but I'm in my 4th year and have been very successful so far and earned this placement. I know I will have to deal with lots of scary equipment in the ICU and that this will take some getting used to. But I don't think the teacher is judging me based on a fair assessment of my capabilities....
What should I do? I am so frustrated and at a loss of what to do as I only have a few more clinical days left to change her mind.
I can understand your frustration. I had a different instructor for all of my clinicals and each had their own way of doing things which would slightly differ from what my books said. I finally came to the conclusion (after much confusion and annoyance) that my instructors were not wrong or trying to intentionally confuse me. They taught me the ways that worked best for them so I was able to see that there are different approaches that can be taken to get to the same goal. You can have a talk with your instructor if you would prefer a different teaching/learning style but it sounds like he/she is doing a great job.
do you still have a choice to do the icu? if you do and that is what you want then do it.
i wouldn't go over her head though, unless she were trying to fail you. don't rock the boat, soon enough you will be out of school and you wont have to deal with her anymore.
It would help if you had a meeting with this instructor and told her what you said here. Get to a clear understanding. Best to deal with it now before final evaluation time when it will be too late. If you feel that the situation is not the way it should be, then speak up, to her.
1) the preceptor is the experienced nurse you will shadow. you don't preceptor anywhere. you do a preceptorship, perhaps.
2) in two consecutive sentences you say you're unhappy because she told you her perception was that you lack confidence and then you say that you lack confidence. so... um, i'm having a hard time seeing your beef. it sounds as if she might have you pegged correctly.
i know you think we are not understanding you. you want a chance to demonstrate what you can do and figure out on your own without intervention and instruction, which you perceive as interference. if you were in your instructor's shoes, though, you might see a student who is not as proficient as expected and gives every evidence of being hesitant, therefore might have her confidence bolstered by success after being guided through some things.
if you explain this to your instructor and ask her, very nicely, to stand back a bit and wait to see what you do, explaining that you can understand why she might think you lacking in confidence but you just want to be sure of yourself before you act, that might help the communication between you.
I had a similar frustration when I did my CNA. The voice in my head told my instructor, "dude shut up! I'm doing it right. I know what I'm doing. Stop interrupting me!" The my speaking voice said, "thank you for your help." My voice of reason said, "well, what else can I learn from her talking at me?"
Next time you work with this instructor clarify before you work with the patient exactly what direction you want. "I feel confident doing X and as long as you feel I am doing fine, I would appreciate if you waited till I was finished to give me feedback. I feel I'll be able to have a more patient centered interaction if you give me a little more space.
"BUT this all depends on whether you can actually do these things safely enough. Good luck.
What I understood from your post is that you know that you are unsure of yourself sometimes, and that you want to do better. That is the first step forward. It sounds to me like your instructor might just notice that you are unsure of yourself and because of that she is guiding you through skills more closely than someone that takes charge and doesn't give it a second thought. This is not a bad thing- although I totally understand your frustration. You are being assessed based on your performance, but don't feel you are being given a chance to perform in the first place. What I would do, is ask the teacher where she feels you could improve. Then find out if there is a time that you could meet with her in a skills lab and practice those skills. Let her know that being in the ICU is really important to you and that you would do whatever practice it takes to become competent enough to make her comfortable with you doing the rotation.
When I was in the first semester of my senior year one of my clinical instructors hovered over me consistently when I was setting up IVs while everyone else was able to do it on their own. This made me feel bad about myself and unsure of the skill because I knew there was a reason she was watching me more closely. I asked her what I could do to improve and she said practice, practice, practice... you are unsure of yourself, and that makes me unsure of you. So I did exactly what I'm telling you to do- I went to the skills lab with her outside of class, I prepared & hung IV's will all the different sets of tubing & sizes of bags until I was blue in the face... and the next week she was no longer tagging along while I hung IVs.
Sometimes it's the little things that make a major impact. Keep your head up, practice makes a world of a difference!!
If you are going to do a preceptorship in an ICU, get used to someone hovering and talking your way thru things. Sometimes you have to go with the flow. Also, if you are sending out the vibe that you are unsure of yourself then the instructed is picking up on this. And if your preceptor on the ICU picks up on this then you may not be able to finish on the unit. Just food for thought. Have you sat down with this instructed and asked her how you can improve and tips for increase your confidence?
I don't see what you are complaining about either. My instructor walks us through step by step also. You have to remember you are practicing under her license. If something goes wrong the instructor can loose her nursing license and the school can loose their accreditation. I think you are being a little too hard on the instructor. She is only doing her job. It takes a special person to be a nurse and an even more special nurse to be an instructor. Learn from her and take in the information. I love my instructor and I have learned so much from her.
This has nothing to do with whether I like the instructor or not. I actually do. As far as safety is concerned, I can understand that she needs to show me how to do the IV. However, talking to a patient with a language barrier was not a safety issue, and she didn't have to tell me how to do this. She could have given me a chance here.
I think I'm learning that I shouldn't let others know that I have self doubt. It's ok to ask questions when I'm unsure... but I should never show a lack of confidence in myself.
GrnTea, some of what you said is correct... but some of it is taken out of context... Yes, I agree with the instructor that my confidence could use a boost. No, I don't agree with her that I should not preceptorSHIP in the ICU - I work hard at school and will do whatever it takes to succeed.
one thing that occurred to me is do you speak like a native in a foreign language or as a person who has had _ semesters of that language? i'm not trying to be rude or difficult, but after getting nothing but a's in
any of the three different foreign languages i studied in junior high through college, and being understood
reasonably well when i traveled outside the us, i married a linguist.
when we travel around the world, i can make my needs known...usually, but they know i'm an american. when
he who lived, studied, and taught abroad for several years speaks, he is presumed to be native. by comparison,
i sound like a college student practicing her new vocabulary words.
you need that keenly honed familiarity and ease with other languages in order to safely get a history and assessment.
you need that keenly honed familiarity and ease with other languages in order to safely get a history and assessment.
my instructor was struggling to understand the patient just as much as i was... there's tricks with communication that one can use that go beyond spoken language. i could have made an effort but was held back.
Melissa0181
48 Posts
I can understand your frustration. I had a different instructor for all of my clinicals and each had their own way of doing things which would slightly differ from what my books said. I finally came to the conclusion (after much confusion and annoyance) that my instructors were not wrong or trying to intentionally confuse me. They taught me the ways that worked best for them so I was able to see that there are different approaches that can be taken to get to the same goal. You can have a talk with your instructor if you would prefer a different teaching/learning style but it sounds like he/she is doing a great job.