Anxious About Clinicals

lovingtheunloved, ASN, RN · Jul 12, 2019

I have a severe anxiety disorder, and I’ve fortunately learned to manage it well, but holy smokes was nursing school hard because of it! What I wish I would have known then:

Take good care of yourself, and make sure you keep all your appointments with the doctor managing your meds. Call them if you start to struggle. Eat well, make time for some physical activity, and do something at least once a week that relieves stress.

Good luck to you!

Sunflower117, ASN · Jul 12, 2019

Thank you again everyone. I am currently a nurses aide working in home care and everyone says I'll do fine interacting with patients. It's really the nurses that intimidate me! Lol but I'm working on trying to have a more positive attitude and not let those anxious thoughts prevent me from doing something I really want to do. I'm excited! I can't explain how much I appreciate you all chiming in! Thank you!

TriciaJ, RN · Jul 13, 2019

Try to keep in mind that nurses are people, not separate beings. You're just learning how to do a job, not get admitted to an exclusive club. Like others have said, some will be very warm toward students; some won't. They have their own stressors; some days will be high stress for them, some not. They'll respond to it in different ways, some better than others.

How to respond if someone makes you feel dumb? Start out by expecting to feel dumb; that takes away a lot of power anyone has to make you feel that way. Know that every day you're getting a bit less dumb and that even seasoned nurses have days where they feel completely dumb.

You got great advice to offer to help with the grunt work. Some days you'll find yourself just doing grunt work; other days you'll be included in some pretty good learning experiences as a result.

The more time you spend empathizing with others (like sick patients and stressed nurses) the less time you'll have to worry about feeling anxious or dumb. I suspect you'll do just fine.

maggie0, BSN, RN · Jul 14, 2019

I'm going into my last year of nursing school, and have a year of clinicals under my belt now. I was also terrified of clinicals, and have struggled with anxiety/social anxiety/shyness. However, the nurses I've worked with were GREAT. The worst I can say about any nurse is that he or she ignored us, but that's about them and their own stress.

(The was one kind of cranky and abrasive nurse that all of us students were afraid of. I decided I was going to win her over, because even though she was rough around the edges, she seemed to like to teach students what she knew. So, I thanked her whenever she taught me something or even when she corrected me in her brusque way. Whenever she asked, "Does anyone want to help with a discharge/turning a patient/etc?" I'd be quick to volunteer. It made the shift go by fast and I learned a ton from her. A TON.)

One of the great things about nursing for a shy or anxious person is that it's not about YOU, it's about the patient. Focus like a laser on what the patient needs, wants, and what is going on with them. If the patient doesn't need anything or is asleep, go answer call bells or find your classmates and see what they need. Ask to help the aides! They will appreciate it.

I guess my point is, don't avoid the interactions that make you anxious. Face them, give them your best shot, and you'll do GREAT. xo

TriciaJ, RN · Jul 22, 2019

On 7/14/2019 at 10:46 AM, maggieellis said:
I'm going into my last year of nursing school, and have a year of clinicals under my belt now. I was also terrified of clinicals, and have struggled with anxiety/social anxiety/shyness. However, the nurses I've worked with were GREAT. The worst I can say about any nurse is that he or she ignored us, but that's about them and their own stress.
(The was one kind of cranky and abrasive nurse that all of us students were afraid of. I decided I was going to win her over, because even though she was rough around the edges, she seemed to like to teach students what she knew. So, I thanked her whenever she taught me something or even when she corrected me in her brusque way. Whenever she asked, "Does anyone want to help with a discharge/turning a patient/etc?" I'd be quick to volunteer. It made the shift go by fast and I learned a ton from her. A TON.)
One of the great things about nursing for a shy or anxious person is that it's not about YOU, it's about the patient. Focus like a laser on what the patient needs, wants, and what is going on with them. If the patient doesn't need anything or is asleep, go answer call bells or find your classmates and see what they need. Ask to help the aides! They will appreciate it.
I guess my point is, don't avoid the interactions that make you anxious. Face them, give them your best shot, and you'll do GREAT. xo

You've nailed it. I see a solid and fulfilling career for you.

Mcorrie · Jul 23, 2019

On 7/10/2019 at 10:29 AM, Luchador said:
Congrats Jamie!
I'm starting my final year next month. With your anxiety you want to
Be on time or a little early for clinicals. Set 2 alarms if you have to. Don't be late!
During clinicals keep your head down, follow the rules and avoid drama, gossip and all that crap.
Even if you are a model student there will be plenty of occasions for anxiety so I would make sure that you do everything you can to be a model student and not bring any extra stress on to yourself

I definitely agree with the above.

Also, try not to be so hard on yourself. I'm in my 4th year of my program and my 3rd year was hell, mainly because I knocked my own confidence and started overthinking everything. For me this also meant that anytime I was asked something my anxiety would set off and I would completely blank which led to further anxiety and the odd breakdown.

Do what you can to learn what you can and just remember that everything is a learning process and it takes time.

I had one of my instructors yesterday, who is a nurse practitioner, tell us that she initially started as an LPN, then went back for her BSN, then her crictical care, then her masters. She said at each step she asked herself "how was I even a ____ before? I knew nothing", and it repeated at every step. Nursing school will give you the bare bones, foundational knowledge that you need but a lot of what you learn will occur in clinicals and in practice after graduating. The most important thing is to keep learning and keep an open mind.

Also, in response to others who have said that nurses eat their young, it can be true. However, a few classmates have noticed that if they approach situations with the basis that they want to learn, and recognize that others have more experience and knowledge, sometimes it can be helpful.

Ex. a classmate (RN student) was working on a team with her RN and an LPN, the LPN was initially rude, but when my classmate approached from a "I want to learn anything I can from you" standpoint, the LPN felt validated and took a different approach to her afterwards.

That isn't to say that it will work for everything, but it may.

Also, I've cried, been anxious, and come close to fainting at clinical, and I've even called in for a mental health day one clinical day because it was sorely needed and the anxiety was making my physically ill.

Having the occasional struggle or mental health concern does not mean you cannot do it, it just means you're human like anyone else.

Also, one thing that I sometimes find helpful is picking songs that are upbeat and give you motivation to listen to on your way to clinical, to keep yourself in a more positive 'i can do this' mindset for the day.

Crash_Cart · Jul 23, 2019

On 7/14/2019 at 12:46 PM, maggieellis said:
Focus like a laser on what the patient needs, wants, and what is going on with them. If the patient doesn't need anything or is asleep, go answer call bells or find your classmates and see what they need. Ask to help the aides! They will appreciate it.

^^^

This.

What annoys staff (and some clinical instructors) is when students stand around like plaster statues with a deer in the headlights stare on their faces, not knowing what to do with themselves.

Just jump into the zoo and look for ways you can help out. ?

FullGlass, BSN, MSN, NP · Jul 23, 2019

Congratulations on starting nursing school!

It is normal to feel nervous about starting clinicals. At least at my school, the first clinical is designed to be relatively easy and the students worked in pairs for the first few days of the first clinical, which helped a lot.

The clinicals will get more demanding as you progress in the program, but they are doable.

Since I'm not a morning person, the hardest thing for me was getting up super early - make sure to set 2 alarms, go to bed early, and if possible, drive or ride the bus to the clinical site before it actually starts so you know how to get there and how long it takes.

Make sure you have the instructor's contact info and the other students' as well in case you are running late. Make sure you clarify with the instructor how to contact her if that happens or if you are sick.

As for your anxiety, make sure you contact student health to sigh up for talk therapy, as you may need this support during school.

Make a point of getting to know your academic advisor as well so you have someone to talk to.

You are not alone - many nursing students suffer from anxiety and/or depression. I do, and made it!

Most nursing instructors want you to succeed. If you start to have problems, let them know right away - don't be ashamed! The sooner you talk to them, the sooner they can help you and coach you. You are sure to find one or two instructors that you really take a shine to, so build on those relationships.

Good luck!

happerhiker44 · Aug 1, 2019

In addition to talking to your instructor about this, one thing that I recommend you do if able is get a job as a nursing assistant (PCA/PCT) at a hospital (per diem/part time--whichever you can handle). If you have time before you start school.

I have been a PCA almost two years now, (I did a year full time prior to starting my nursing program because my hospital has a program to help nursing students financially which requires full time employment for one year).

I have to say this helped me immensely with first year of nursing school. As for clinicals, it gave me the confidence in many ways--because I know the process admission, I know how to turn people with numerous drains and broken bones/people who are quadriplegic/paraplegic, etc. I've seen majority of the drains and chest tubes. It gave me background knowledge of blood pressure parameters to certain conditions (in the case I don't have a chance to see in the orders), it also helped me understand what the important questions are that we need to ask and prioritization as well.

So my advice is to you is, if you can, get a job in hospital it may help reduce a lot of potential anxiety. This doesn't only help with clinical though, it helps with the classes too-working my floor has given me so much knowledge, and made it easier to remember the things the professors would teach because I could connect something I learned when I'd go to work.

Along with that, try to be as involved with the patient your given as possible, don't be afraid to ask questions. Get a read on the nurse that's taking care of the patient, if they seem willing to teach or explain things, try to ask questions and be proactive. In the case the nurse isn't overly friendly and appears like they don't want to deal with a student (sadly this happens a lot, even though they too were students once) try to ask your instructor and make tons of initiative to with the patient, and tell the nurse ahead what your going to do with your instructor. Communication is key and I know nurses (either the "annoyed ones" or the nice ones) appreciate students that communicate and are considerate.

I've had those nurses that are annoyed, and have managed to stay on a good side with them, and a lot of them still would allow me to do things with them.

Because you care so much, you will do great!

I knew a lot of the skills we got tested on the first semester, and helped me with the knowledge during the classes as well beyond the foundations of nursing.

Having just those skills ahead of time made me feel less anxious about

allnurses Guide · Aug 1, 2019

I had a student on her very first day of clinicals stay up far too late working on her care plan. It was..... not very good. When I was critiquing it, she lost it. Full blown tears, sobbing, etc. I was so embarrassed for her I couldn't say anything, her fellow students comforted her.

Later that day, we had a tourist who spoke German having to go for a cardiac cath, and as my student was a German speaker, (I volunteered her), she got to go into the lab and translate for the whole procedure. She came out thrilled to death (bad pun) with the day.

So, even if you have a moment or two, you have the whole shift to get better in, and show that that one episode is not all of you.

My student has since graduated and is doing great!

Queen Tiye, RN · Aug 3, 2019

Clinicals are awesome. It’s great that you’re getting ahead of possible anxiety in order to succeed. Ninety-nine percent of my preceptors were great, the other 1% just weren’t in the teaching mood but no one was out right mean. If you go in there ready to learn, confident in your ability to learn and serve your patients you will shine. Also just being a well-rounded, assertive adult helps to deter people from coming at you the wrong way. People read energy — while humility and willingness to learn are important remember you’re not a child but an adult and behave accordingly and you likely won’t have problems with people making you feel dumb.

**CommunityRNBSN, BSN, RN** · Aug 3, 2019

In re: your fear of breaking down.

My mantra was, “I can be anxious and still do this.” “I can still attend clinical if I am anxious/panicking.” You can even complete a task while crying! Hey, it’s not the most professional thing in the world, but if you have to, you can.

It’s not going to do much good to try to “calm down” before the first day of clinical. You’ll probably be a nervous wreck! Which is fine, and you can still survive it.

Set yourself up for success by giving yourself extra time, having a gentle breakfast, no caffeine. And then just pick up your stethoscope and your anxiety, and go for it!