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At the top of my class...but awful in clinical!


I am a second-degree college student (Spanish first) and third semester nursing student. Since the first semester I've been at the very top of my class in the theory portion, often getting the highest exam score etc. Blah Blah Blah. I also ace every skills check-off and usually get a perfect score. HOWEVER.

In clinical, I am a BALL OF NERVES. And this is my third semester. I started our unit today for the semester in an ICU step-down, and felt awkward, uncomfortable, and unsure of myself. I'm great with my patients, and am a very friendly and warm person who loves to take care of other people. When it comes to taking initiative and being independent all day, a lot of times I don't know what to do with myself after I get everything done that I need to do, and have difficulty with some of the few skills I've had the opportunity to practice.

Last semester, when removing a patient's IV, I didn't get all the tape removed and the catheter slowly slid out of the vein at a harsh angle and eventually popped out fully. Not great.

Today, I was hyper-aware of my past mistake and did the exact.same.thing. I've been stressed ever since. I know this may seem like a small thing but I am a perfectionist and get very stressed when I make a mistake. If something goes wrong, I let it ruin my day. I know this isn't rational as I'm a student and in the learning process, but I can't seem to make myself relax.

Does this say anything about my future as a nurse? How long did it take you to get comfortable in clinical and performing skills?

Who thinks you're terrible? You? Or have you received specific feedback from your instructor saying you are awful? I think clinicals (at least for me anyhow) makes one second guess all of your skills and abilities. When you are done with your specific work for the day, check in with your fellow students. See if they need help. Check in with the staff. Offer to make beds take vitals, or tell them you would love to watch/perform any procedures they may have even if it isn't your patient. This is my personal goal for next week. I want to see and do more. The way I figure it, I am the only one who can advocate for my learning.

Edited by Shagce1

I agree with the above.

I am a nursing student as well coming up on my last 3 months of the program. We all understand what it's like to make a mistake like that in clinical and let it upset us, and I am sure all the nurse's that oversee us when we make that mistake understand as well. If you're great with your patients and you get your stuff done and have time to kill then that's something you should be proud of, but once we become employed RN's, we won't have that down time anymore. But it's important that you acknowledge and befriend all the nurse's on the unit and show a spirit of inquiry so that when there is a great learning opportunity, the nurse's will find you so that you can experience it.

Don't sweat the IV thing. With practice, you'll be a pro at it. And plus, the hospitals are now coming out with a universal adhesive for all peripheral IVs because it has an antimicrobial around the edges of it or something like that to reduce the infection risk so you won't have to deal with that messy tape scene anymore except when taping the connector tubing to the arm. Less likely to not remove all the tape. Try alcohol swabs ON TOP of the adhesive when removing it to make it come off easier. I always see people peeling up the tape and wiping the alcohol on the skin as they peel up, but I found it to be more effective when using it on top before I pull the adhesive off and on the skin when peeling up.

I think you are going to be a great nurse!! You have empathy! Think about all those nurses who would just move on never once thinking of the pain they may have caused. You are beating yourself up over something that really the patient probably never noticed! As students we are aware of every little thing we do or could've done better! That's what being a student is! You will be a fantastic caring nurse! I have done a lot of things I think of later that my patients never complained about but I make sure to try and improve! We are human just stick to it and continue to have empathy! Good luck!

I think you're going to be ok. I'm a similar type of student, it sounds like, and my preceptors keep assuring me that the basic fundamental skills will come in time and be second nature. They tell me that keeping an eye on the bigger health picture for a patient is more important, even at this juncture.

Hard to believe it sometimes when I feel like I do a bonehead thing at least once a shift. I'm not endangering patients, but I sure make myself look silly from time to time.

E.g. Most recently, I was looking for some SC pouch to inject heparin on a patient's belly and said "hmm no one mentioned anything about this scar - where did you get it?" Before anyone could respond I realized.... Oooooooh, that's his belly button!

Everyone had a good laugh about that.

Anyway, I'm trying to just keep working hard, keep studying, and staying eyes open for opportunities to learn.

HouTx, BSN, MSN, EdD

Specializes in Critical Care, Education. Has 35 years experience.

You're being too hard on yourself. Taking a wild guess, I surmise that you are on the far end of the "perfectionist" continuum... amiright? Hey, I gave birth to one, so it's pretty easy to recognize once you know the signs - LOL. It would probably help with your performance anxiety if you did a lot of extra time in Sim lab - practicing all those twiddly little things - until you get your groove on. True confession... according to my clinical instructors, I NEVER mastered making an occupied bed. Srsly, I have the old student evaluations to prove it. My ineptitude was a constant source of disparagement. But once I left school, I can never remember this issue coming up at all.

Trust me, there will always be a ton of critical people who will be more than willing to list your failures and shortcomings so you don't need to worry about missing anything you're doing wrong.

brown eyed girl

Specializes in LTC/Sub Acute Rehab.

Let's talk about it. PM me!