Advice needed. I don't know how to fix this.

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Specializes in LTC.

I'm a half way through my LPN course. I've got the best grades in my class. I have some serious anxiety issues that are causing me problems in clinical. I have done ok until this last week. It was my turn to pass meds. I knew this would be hard for me because the instructor would be looking over my shoulder the whole time. I was right. I passed but my instructor all but told me she was disappointed in my performance. She said she thought I would do better because of my grades. I feel like someone has kicked me in the stomach. I want this so much but don't know how to get passed this. When she is watching me I'm like a dear in headlights. All I can think about is that she is watching. My mind is not where it should be (on what I'm doing). I don't know why this was so much more evident when I was passing meds. I've done ok with the other skills I did in front of her.

Any suggestions would be greatly appreciated.

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Specializes in Critical Care; Cardiac; Professional Development.

Nobody gets through nursing school "perfectly". It may not have been the most constructive feedback you could have gotten, but all she was saying is that you need to pay as much attention to practicing your clinical skills as you do your book/lecture learning. The more often you do it, the more confident you will be. Everyone has days like that. :hug:

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Specializes in Home Care.

Like you I had high grades in lecture but I had a clinical instructor who really intimidated me. Whenever I was in clinical with her I felt like she had it in for me. She told me that she didn't think I was capable of being a good nurse.

I learned to not take her words and actions personally, if she was around me I had to deep breathe and count to 10 to calm myself.

Thankfully, she wasn't our instructor for the final check outs. I had a wonderful instructor for the last block of clinical hours who encouraged me and let me feel like I was capable of being a good nurse.

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Specializes in IMCU.

First of all I hope he/she didn't leave it at "disappointed" -- that isn't very useful. Make sure you get specifics.

I wonder if reframing this would help. For me, when my instructor is present. I consider it to be a safety net. Yes, she is evaluating me but she does this constantly. I actually find it comforting when she is in the room. it means if I have a question/problem she is right there.

Another thing I do is a visualization of things before I do them. Of course, this isn't always possible in clinical.

I am lucky I have a first class clinical instructor.

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Specializes in Wound care, Surgery,Infection control.
I'm a half way through my LPN course. I've got the best grades in my class. I have some serious anxiety issues that are causing me problems in clinical. I have done ok until this last week. It was my turn to pass meds. I knew this would be hard for me because the instructor would be looking over my shoulder the whole time. I was right. I passed but my instructor all but told me she was disappointed in my performance. She said she thought I would do better because of my grades. I feel like someone has kicked me in the stomach. I want this so much but don't know how to get passed this. When she is watching me I'm like a dear in headlights. All I can think about is that she is watching. My mind is not where it should be (on what I'm doing). I don't know why this was so much more evident when I was passing meds. I've done ok with the other skills I did in front of her.

Any suggestions would be greatly appreciated.

I have a few suggestions that might be helpful from my experience . Please believe my intention is only to help you. I'm going to start off with congrats for your grades, but book-work and clinical are not the same. You can read page after page about technique, but the only way to become proficient is through repetition in real life situations. Your instructor should be aware of this and her comment concerning your grades served no purpose except to increase your anxiety. You WILL get past this.

Now about your teacher watching you ; she is (or should be) watching everyone. Thats what clinicals are - a time to put what you have learned into practice. Everyone will be watching you, teachers and preceptors are there to observe and demonstrate correct technique. Anxiety is normal, remember your accomplishments and learn from your weaknesses. I have been a nurse for almost 20 years and still get anxious when I put a foley in or start an IV. When things get serious I don't want to be working with a nurse that has become complacent.

Remember this now and remember this always : Check everything twice. There are no stupid questions when it comes to safety.

Keep your mind on what you are doing, but give yourself a break. As a nurse you'll have numerous opportunities to freak out in the future. Take care of yourself !!!!!

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Specializes in LTC.
I have a few suggestions that might be helpful from my experience . Please believe my intention is only to help you. I'm going to start off with congrats for your grades, but book-work and clinical are not the same. You can read page after page about technique, but the only way to become proficient is through repetition in real life situations. Your instructor should be aware of this and her comment concerning your grades served no purpose except to increase your anxiety. You WILL get past this.

Now about your teacher watching you ; she is (or should be) watching everyone. Thats what clinicals are - a time to put what you have learned into practice. Everyone will be watching you, teachers and preceptors are there to observe and demonstrate correct technique. Anxiety is normal, remember your accomplishments and learn from your weaknesses. I have been a nurse for almost 20 years and still get anxious when I put a foley in or start an IV. When things get serious I don't want to be working with a nurse that has become complacent.

Remember this now and remember this always : Check everything twice. There are no stupid questions when it comes to safety.

Keep your mind on what you are doing, but give yourself a break. As a nurse you'll have numerous opportunities to freak out in the future. Take care of yourself !!!!!

Thank you for your comments. Her comments about my grades DID increase my anxiety in a huge way. Partly because I already know I'm better at the academic part of nursing. So what she was saying was in a way one of my worst fears come true. Anyway, we just had class today. We are going back to the hospital for the rest of the week. I'll be doing a lot of praying tonight. I'm very thankful for a place like this to vent.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

I am exactly the same way, wifeandmotheroftwo. I would suggest you separate the two things in your mind, because the assymetry will make you crazy. Unfortunately, your teacher's comment only fuelled your anxiety and shows that she doesn't understand a very common attribute of nursing students, especially those for whom the book learning comes pretty easy.

It's as old as the hills. Stage fright. Performance anxiety. Purpose tremor. That stuff will make the mind of Einstein turn into a quivering bowl of Jello. You may forget your own name. You will suddenly wonder if those numbers are written in Arabic. All of this is a physiological response from your adrenals dumping massive amounts of fight or flight juice into your bloodstream all at once. It really, really s*cks!!

You need to figure out a way to head it off at the pass if possible. Visualizing, actually physically practicing your motions, and psychological "tricks" to break the cycle if it starts. You know the one- first you are nervous, then you get more nervous because you are nervous and. . . what if she sees me shaking oh my!! I read a book a long time ago, with a sort of corny title "Hope and Help For Your Nerves" that teaches you simple strategies to cope with anxiety.

Oddly enough, it may help to tell your teacher that you have this problem. It isn't something you caused. My mother is the same way I am. She told me she almost passed out giving a Red Cross presentation to my FIRST grade class years ago, lol!!!

Best of luck, you can do it! :)

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Specializes in NICU.

My dad always told me to make the butterlies in my stomach fly in formation (he's a retired marine). You're going to have stage fright, especially with a clinic instructor as 'pleasant' as yours is, but make it work for you. Use those nerves to help you be extra diligent and safe. You can only have a first time once, so now that you've gotten that over with, now you can just improve your skills.

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My dad always told me to make the butterlies in my stomach fly in formation (he's a retired marine). You're going to have stage fright, especially with a clinic instructor as 'pleasant' as yours is, but make it work for you. Use those nerves to help you be extra diligent and safe. You can only have a first time once, so now that you've gotten that over with, now you can just improve your skills.

above bolding is mine for emphasis

LOL! That's fantastic, I'm so going to use that in the future! Thank you for sharing!

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Take a step back, Take deep breath, now rethink on the ways you did it. I know she upset you and what she said was wrong but......... sometimes a instructor will say thinks like that to remind you that you are a good student but when you do clinicals you have to take that book cap off and replace with the clinical hat ( yes there is a difference). I failed a class last semester and when I talked with the instructor about it she made the comment that "maybe it wasnt my time to become a RN" ( I have been a LPN for 14 years) I went home, cried, looked over everything and started again this time around I am making higher grades understanding alot more and yes went back to her and thanked her for saying that and also explained that I will pass and graduate just to prove her wrong. Before you do clinicals this may help have a friend or hubby watch you at home do these things explain as you do them, and relax. With them watching you it will help settle your nerves having eyes on you.

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OP - I am going through the same, exact thing in clinicals! You are not alone! I spoke with another instructor about this and she said that even the "A" students (me) were going to make mistakes and to turn it towards a positive thing. Once I make a mistake, I remember for LIFE not to do that again. Everyone makes mistakes, it's learning from them that counts! Good luck in your remaining clinical!!!

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when you are passing meds, do not let anything distract you. make sure you look up the meds before, so you now why they are being given, and if you have to have a recent set if v/s, etc. make sure you check the 5 rights and the rule of 3, it is there for a reason :) the better prepared you are, when you start to freak out, you can just tell yourself you dont need to worry cuz you got it covered! and that teacher was not helpful in saying that...... if she was going to criticize you, she could have turned it into a teachable moment instead of making you feel worse. shame on her, YEAH for you!

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