Anxiety in the Clinical Setting

[BlueChocolateCat]

I have encontered many posts on the pre-nursing student and general nursing student pages that include extreme anxiety over the fear of mutilating, killing, or causing harm to their patients.

Many posts include phrases such as "their life is my hands" and "there is too much responsibility".

I am a junior in a BSN program and I work as an aide in a critical care unit. I have to admit, I do not feel the extreme anxiety that seems to be bothering so many other nursing students. I recognize my level of responsibility and dedication to the elimination of mistakes, but I also know that I am not the sole care provider and I work as part of the healthcare team.

*EDIT* Please remove the word "extreme" out of the poll question. It doesnt exactly make sense with that word in there, and allnurses.com doesnt let me edit the poll question.

Polll question should be:

Do you feel anxiety over your responsibilities as a nursing student in the clinical setting?

[danceyrun]

I am a junior in a BSN program and I work as an aide in a critical care unit. I have to admit, I do not feel the extreme anxiety that seems to be bothering so many other nursing students.

You don't feel anxious because you are a critical care NA. I bet you would feel differently if you had never set foot in a hospital before nursing school.

[ChristineN, BSN, RN]

You don't feel anxious because you are a critical care NA. I bet you would feel differently if you had never set foot in a hospital before nursing school.

I agree. IMO students who work as aides, do an internship, etc becoming more confident and less anxious in the clinical setting than students whose only patient interactions are in clinical. Be glad you have had this opportunity to work as an aide and try to support your fellow students.

[Skips, MSN, RN]

I definitely think I'm at a huge disadvantage to my peers that already have tech experience in the hospital. I do my best and try to stick to doing good work, though.

[BlueChocolateCat]

In response, I do feel some anxiety in the clinical setting as a student. No doubt is it stressful. And at every oppritunity I do everything I can to support my fellow classmates.

[nurseprnRN, BSN, RN]

Some of you have heard me tell this story before, maybe even recently because I posted it on another thread about anxiety. I was several years out of school and had been staff in this fabulous ICU for three, and I was actually pretty good at it. One day I was in the break room with Sarah, a nurse of more than a decade's experience in the unit, one who could take every kind of patient that rolled up the hall, who was never flustered, always expert, always willing to teach and explain. I asked her when I would stop feeling scared when I sat in report. She smiled and said that every day before report started she felt a pang of anxiety, but that it passed when she started working. She said that when that little stab of fear went away she would have to go somewhere else, because it's what keeps us awake and sharp. I never, ever forgot that (and here I am telling that story again, smumble-mumble years later), and I am happy to pass it along to you.

As a former instructor and staff development manager I can tell you that I was scared to death of a student or new grad who had no anxiety at all. They were most often the former CNAs or techs who "were just here for the credential because they already knew everything a nurse did." These people know how to do a lot of manipulative skills (to the frequent but misguided envy of their peers) but are clueless--and very difficult to teach about-- what nursing is, because they've already made up their minds that it's just "skills." They were completely blind to the real skills involved in nursing: assessment, planning, autonomy, personal responsibility. It was all about "following doctor's orders" and being slick with a Foley insertion or NG, and getting all their patients "done up" by 10:00 am. That, dears, is CNA talk. Having someone like that in the RN role -- now, that was scary.

[soxgirl2008]

I'm a CNA on a surgical floor and in my 1st semester of clinical. I feel some anxiety. Not as much as others who haven't worked in healthcare because I'm used to the environment and interacting with patients, but I do feel anxiety about doing assessments and passing meds, because I want to do everything right and I want to be a good RN and I want to get into that mindset of thinking like an RN. It's not so much anxiety as feeling overwhelmed.

If I had never worked in healthcare though I would probably be very anxious. I remember how anxious I was when I started as a CNA, and I can't imagine starting nursing clinicals with no healthcare experience. It's extremely overwhelming if you've never worked in healthcare and suddenly you're passing medications and putting in IVs and I can see why a lot of students are anxious.

[SleeepyRN]

Some of you have heard me tell this story before, maybe even recently because I posted it on another thread about anxiety. I was several years out of school and had been staff in this fabulous ICU for three, and I was actually pretty good at it. One day I was in the break room with Sarah, a nurse of more than a decade's experience in the unit, one who could take every kind of patient that rolled up the hall, who was never flustered, always expert, always willing to teach and explain. I asked her when I would stop feeling scared when I sat in report. She smiled and said that every day before report started she felt a pang of anxiety, but that it passed when she started working. She said that when that little stab of fear went away she would have to go somewhere else, because it's what keeps us awake and sharp. I never, ever forgot that (and here I am telling that story again, smumble-mumble years later), and I am happy to pass it along to you.As a former instructor and staff development manager I can tell you that I was scared to death of a student or new grad who had no anxiety at all. They were most often the former CNAs or techs who "were just here for the credential because they already knew everything a nurse did." These people know how to do a lot of manipulative skills (to the frequent but misguided envy of their peers) but are clueless--and very difficult to teach about-- what nursing is, because they've already made up their minds that it's just "skills." They were completely blind to the real skills involved in nursing: assessment, planning, autonomy, personal responsibility. It was all about "following doctor's orders" and being slick with a Foley insertion or NG, and getting all their patients "done up" by 10:00 am. That, dears, is CNA talk. Having someone like that in the RN role -- now, that was scary.

GrnTea:I wish you would show this side of yourself more often :) I'll be honest, I'm often off put by your posts. On the other hand, I have read many many of them helping nursing students, new grads, and lending support to peers. Cheers to this post and the many that are like it.

[Racer15, BSN, RN]

I never felt that anxious in school because I was working under my instructor AND a nurse. My patients were also never critical. I had help out the wazoo if I needed it. As a new nurse....liiitttle bit more anxiety.

[tigerlogic]

I agree that know-it-all CNAs who think nursing is just more tasks are a dangerous breed. However, comfort building rapport and not freaking out about touching people's bodies is a learning curve. It's not a former-CNAs vs naive students question as much as its a willingness to gain a new perspective question. Im grateful for my CNA experience and have tried to critically think about patient care from the beginning, even without enough information and the bounds of CNA scope. As I go through nursing school I apply that information as best I can, even though I can't act on it. Having spent more time thinking about critical problems helps lower anxiety but also makes me more aware of how much more there is to learn!

[mzrainydayz, BSN, RN]

Just go in to your patient room and do what you have learned/been taught. Just make sure patient safety comes first. I am in med surg right now and I have a little anxiety because I don't know before hand what type of patient I am going to have, but when I get in the room I tell myself do what is best for the patient and I am surprised at myself sometimes because I can recall and think like a nurse.

[thelittledoe]

I am currently a PCA on a med-surg floor and I think it will give me a bit of an upperhand as opposed to my classmates. I initially chose to become a PCA because I wanted to make positively sure that this was the right track for me. This is a career change from paralegal work and because I disliked that so much I wanted to make sure that nursing is the career for me.

I have only been a PCA on the floor for several weeks now but I am learning so much from my fellow PCAs as well as the nurses. All the nurses know that I am in school for my BSN and are so (thankfully) helpful and let me watch/help them insert IVs, administer medications, make nursing diagnoses, etc. I still have anxiety about a career in nursing, but as GrnTea put it, if you don't have that pang of anxiety before starting your work day it wouldn't be the same. Luckily for me, this anxiety is lessened because every time I have a general question about something that happened in clinical, lecture or lab and I don't get a chance to ask my professor/preceptor, I do have that chance at work to ask the nurses. It is a blessing to have such helpful co-workers who want you to succeed!