Anxiety during clinical - could use some advice

[Philly85]

Hi everyone,

I just wanted to kind of get this off my chest and was wondering if anyone has experienced/is experiencing the same thing and if it ever gets better?

I'm in a part-time nursing program where we only have clinical once every other weekend for one 12-hour shift.

This is my 4th quarter overall and my 3rd quarter of having clinicals. I'm very comfortable with all of the theory and have done very well in the classroom, but I really get super, super anxious several days prior to clinical and then for about the first 3 hours of the actual clinical experience.

I eventually settle down once I find a groove, but I never really feel comfortable and always feel kind of in the way and stupid. I try to do my best to "dive in" and help with everything, but it really is a crap-shoot. One day, I'll feel like I did a good job and the next day, I'll feel like I just did the basics, but didn't really help my patient very much or was a bother to them, etc.

We only get 5 clinical experiences per quarter and then we're onto the next clinical site, so by the time I'm finally starting to feel comfortable, it's time to move on.

I learn by doing, so the fact that I only get to really practice one day every other week makes it hard for me to feel comfortable doing assessments on patients and I feel like an idiot trying to get used to the new facility's DynaMap machines. The other day, the patient looked at me like I was an idiot, b/c their machine was so different from what I was used to and it was my first time.

I just always feel like I'm "getting used to" everything and don't really have a chance to settle in and feel comfortable.

I wish I was able to go to clinicals 3-4 days a week like the students in the full-time program at my school get to do, but I have to work, especially as my employer pays quite a hefty amount towards my tuition.

I suppose that's the trade-off, but it's still frustrating.

Starting next quarter, we'll actually be having 2 clinicals every other weekend (Sat/Sun instead of just Sat), but those will be at different clinical sites, so I feel like it will not really help me feel settled in, but will at least give me more practice in general.

I do practice on my own at home doing pretend assessments out-loud on invisible patients and I review the proper steps in the clinical skills textbook, but it's not the real thing.

I'm hoping this feeling is normal and that once I start working, I can finally get into a groove and feel comfortable. I just hate feeling stupid/out-of-place/useless.

I have had a few really good clinical experiences, especially last quarter, as my clinical instructor was actually a clinical educator for her career and actually made it a point to take us into patient rooms and hold teaching sessions and really work with us one-on-one.

My previous clinical instructor before that and the one I have right now kind of just sent us on our merry way to "help out" the nurses and to "grab her" if we had questions or needed help, which seems like a cop-out to me.

She is asking us questions throughout the day and is planning on doing assessments with us in the room this upcoming week, but I have a feeling there are not going to be planned things every week that we are being taught and that she's just doing the assessments with us this upcoming week so she can do our mid-term evaluation.

Are my expectations too high from my clinical instructor last quarter or is this the norm?

Anyway, I'm sorry, I'm babbling now...If anyone could offer any advice, I would really, really appreciate it.

Thanks for listening! :)

[Fermin Hernandez, ADN, ASN, RN]

Anxiety is very normal. Develop healthy mechanisms for it now, as the job itself may be stressful depending on your field. Some fields of nursing are much less stressful than others, for me.

Breath :)

[KarenMS]

Normal normal normal. If you're feeling more comfortable by your 5th time on a floor, imagine how you'll feel after orienting.

And yes, I've had some instructors who seems sort of checked out, but I don't think it makes much difference in the end. You're not orienting to these floors, you're just trying to learn the flow of the day and some skills here and there. And it sounds like you're doing your best. Everything will be fine.

[Philly85]

Normal normal normal. If you're feeling more comfortable by your 5th time on a floor, imagine how you'll feel after orienting.

And yes, I've had some instructors who seems sort of checked out, but I don't think it makes much difference in the end. You're not orienting to these floors, you're just trying to learn the flow of the day and some skills here and there. And it sounds like you're doing your best. Everything will be fine.

Thank you for your support. I had my second clinical there this past Saturday and the instructor was definitely better this time around and I'm not as terrified of her, lol.

I think I'll be OK :)

[shibaowner, MSN, RN, NP]

I also had high anxiety during my BSN clinicals. My clinical instructors kept telling me "You're too nervous!" which would only make me more nervous! I laugh about this now. Your goal is to pass, that's it. No one expects you to be an expert.

I went straight into an MSN program, and oddly, I was very calm and confident with clinicals in the MSN program.

This, too, will pass! Hang in there and best wishes.

[Philly85]

I also had high anxiety during my BSN clinicals. My clinical instructors kept telling me "You're too nervous!" which would only make me more nervous! I laugh about this now. Your goal is to pass, that's it. No one expects you to be an expert.

I went straight into an MSN program, and oddly, I was very calm and confident with clinicals in the MSN program.

This, too, will pass! Hang in there and best wishes.

Thanks, nice to know I'm not the only one!

[Castiela]

I always found the first day of clinical nerve wracking and hard, but thankfully we always has a second day where you felt more confident. It's a normal feeling. Our charge insists we are doing something wrong if we have zero anxiety on shift, something I don't completely agree with, but I feel like a large part of our job is to assess and worry about the worst that could happen and take steps to prevent it. The anxiety should lessen the more experience you have on the floor, and it sounds like you're doing the right things to keep the material fresh in your mind. I use to practice on my his and and give him "symptom" cards of various disease s&s.

Another thing I found worked is visualizing my anxiety and putting it in a box then putting it on a shelf just before walking in the doors of the hospital. I found it acknowledges the validity of my anxiety but puts it aside so I can focus on th clinical and my patients. Hope that helps!

[HarleyGrandma, RN, EMT-B]

I know your working and going to school, but if you could volunteer a little bit it may help you feel more comfortable. Getting extra time, without a grade on the line, can really help overall learning. I realize you have very little free time but if you could volunteer even a few hours it may pay big dividends.

[Philly85]

I always found the first day of clinical nerve wracking and hard, but thankfully we always has a second day where you felt more confident. It's a normal feeling. Our charge insists we are doing something wrong if we have zero anxiety on shift, something I don't completely agree with, but I feel like a large part of our job is to assess and worry about the worst that could happen and take steps to prevent it. The anxiety should lessen the more experience you have on the floor, and it sounds like you're doing the right things to keep the material fresh in your mind. I use to practice on my his and and give him "symptom" cards of various disease s&s.

Another thing I found worked is visualizing my anxiety and putting it in a box then putting it on a shelf just before walking in the doors of the hospital. I found it acknowledges the validity of my anxiety but puts it aside so I can focus on th clinical and my patients. Hope that helps!

Thank you for your response. I really like that "anxiety in a box" idea, I'm going to have to try that!

[Philly85]

I know your working and going to school, but if you could volunteer a little bit it may help you feel more comfortable. Getting extra time, without a grade on the line, can really help overall learning. I realize you have very little free time but if you could volunteer even a few hours it may pay big dividends.

I spoke w/ our program director and there actually is a volunteer opportunity one night per week for a few hours in a free clinic, so I'm going to see if I can get involved with that. Thanks for your response!