clinical-please tell me it gets easier

with time and practice...

ugh...i'm nearing the end of my first semester and up until last week, hadn't really had much in the way of "real" clinical experience. last week, we got to go for 4 days in a row, and i didn't really get to do too much either because i had a rather easy patient.

TODAY, we got to go to the OR to watch surgeries. my instructor asked if i could do a cath, right out of the blue, so i was a ball of nerves, lol. the patient was a heavy lady and for some reason, they were not able to spread her legs very far apart. first, i screwed up on gloving, i hate for people to stare at me, and they were, the doctor was even in the room which made for even more nerves. so i get the gloves on, and they direct me to where i need to place the cath, and it wouldn't go, for about 1 minute i tried, so one nurse took it and tried, still wouldn't go, i swear it looked like the place, well it wasn't. anyway, they got it and everything went from there. the doctor made some rude comments about the nurses needing to go back to nursing school (he was joking with them i think? not sure) or going home and practicing in front of a mirror. i felt dumb and useless. my instructor said she just wanted me to attempt it, so she was proud of me for not turning it down. i still felt like a dummy.

then, the same patient, i got woozy and had to walk out, i really am useless!

please, please tell me it gets easier. the little practice i have had has been on lovely plastic people. i was really nervous with all the "real" nurses in there watching me, and felt so dumb that i screwed up gloving of all things.

[orrnlori, RN]

First of all, I've taught many a medical students, not just nursing students, how to put in a foley and some of them have been all thumbs. Don't beat yourself up about it. Cathing heavy women is always a chore. Sounds to me like your instructor was very supportive of you. I know when I'm precepting a green student, I'm always happy when one will try to do something, even if they can't quite get it. It's the fact they were brave and tried. How else are you gonna learn?

As far as feeling faint, that was probably due to the mask. When you aren't used to wearing them, they can make you feel woozy and hot. We all feel incompetent sometimes. I've worked in the OR for over 5 years but I rarely if ever do neuro surgery. The other day I got thrown into a neuro room. I was totally incompetent and had two left feet. It happens to all of us. You'll be fine. Also, the docs always tell us to go home and practice on ourselves when we have trouble placing a foley, it's an OR joke older than the hills. I think they learn it in med school. I've heard it at least a half dozen times in the last 5 years. You're doing great. Never let them see you sweat!!!!!

[nurse_robin]

First of all, I've taught many a medical students, not just nursing students, how to put in a foley and some of them have been all thumbs. Don't beat yourself up about it. Cathing heavy women is always a chore. Sounds to me like your instructor was very supportive of you. I know when I'm precepting a green student, I'm always happy when one will try to do something, even if they can't quite get it. It's the fact they were brave and tried. How else are you gonna learn?

As far as feeling faint, that was probably due to the mask. When you aren't used to wearing them, they can make you feel woozy and hot. We all feel incompetent sometimes. I've worked in the OR for over 5 years but I rarely if ever do neuro surgery. The other day I got thrown into a neuro room. I was totally incompetent and had two left feet. It happens to all of us. You'll be fine. Also, the docs always tell us to go home and practice on ourselves when we have trouble placing a foley, it's an OR joke older than the hills. I think they learn it in med school. I've heard it at least a half dozen times in the last 5 years. You're doing great. Never let them see you sweat!!!!!

Wow Lori,

How encouraging! I felt better and it wasn't even me :)

[Carolanne]

Yes, excellent advice above. It's the effort you make to learn at this stage, not the actual result. You feel flustered and inadequate because you want to do well, and you will! Keep trying, learn from each experience, and you will do fine!

[Catma63]

First of all, I've taught many a medical students, not just nursing students, how to put in a foley and some of them have been all thumbs. Don't beat yourself up about it. Cathing heavy women is always a chore. Sounds to me like your instructor was very supportive of you. I know when I'm precepting a green student, I'm always happy when one will try to do something, even if they can't quite get it. It's the fact they were brave and tried. How else are you gonna learn?

As far as feeling faint, that was probably due to the mask. When you aren't used to wearing them, they can make you feel woozy and hot. We all feel incompetent sometimes. I've worked in the OR for over 5 years but I rarely if ever do neuro surgery. The other day I got thrown into a neuro room. I was totally incompetent and had two left feet. It happens to all of us. You'll be fine. Also, the docs always tell us to go home and practice on ourselves when we have trouble placing a foley, it's an OR joke older than the hills. I think they learn it in med school. I've heard it at least a half dozen times in the last 5 years. You're doing great. Never let them see you sweat!!!!!

orrnlori, may I say....I've read many many of your posts and....Well, I had to tell you: I would dearly love to have you as an instructor. Your posts are just always so, so, so.....Okay, how DO I say it? You're just an incredible person. Anyone who is your student (if you're an instructor....?) is blessed, indeed. Could you by chance move to Virginia? Puleeeeeze?

[Catma63]

Yes, excellent advice above. It's the effort you make to learn at this stage, not the actual result. You feel flustered and inadequate because you want to do well, and you will! Keep trying, learn from each experience, and you will do fine!

Almost over for you, Carolanne! How much longer now!?!

[Carolanne]

Almost over for you, Carolanne! How much longer now!?!

Pinning is May 12th pending my passing the final exam. I have accepted a position at my local hospital which I wanted very much. I just want to get through this test ... my grades haven't been the best through this course - cardiac and trauma nursing, a 7 week course which should be at least a full semester. The instructor went through it like a bulldozer and I feel like I've been run over! So lots of studying, lots of self research on the internet and finding other ways of understanding all this stuff, it's been quite an interesting time. But thanks for asking! When do you plan to be done?

[perfectbluebuildings, BSN, RN]

orrnlori, may I say....I've read many many of your posts and....Well, I had to tell you: I would dearly love to have you as an instructor. Your posts are just always so, so, so.....Okay, how DO I say it? You're just an incredible person. Anyone who is your student (if you're an instructor....?) is blessed, indeed. Could you by chance move to Virginia? Puleeeeeze?

I totally agree with you Catma- but she has to come to Kentucky! Just kidding... but you always give me hope Lori!

[meownsmile, BSN, RN]

I have to agree with the others. You tried, thats what counts. Sounds like the doctor needs to take a courtesy pill. As far as im concerned even if it was said in fun it was a rude comment to make in front of a patient and/or to other staff period. There will be others that will be more difficult than your overweight person believe me. There are nurses that have been nurses for years that given the right patient cant get a cath in.

We had a elderly lady one time, 4 of us tried, and we still ended up calling in the urologist to put it in, so dont feel bad. It wasnt even that she had a blockage, it was just not where it was supposed to be. Not one of us guessed they would find it where they did.

[susanmary]

Darlin' you did GREAT handling a very stressful situation. You did your best --don't worry about a thing. Your instructor, although trying to give you some experience, really should not have put you on the spot in front of other docs, nurses, etc. with the cath.

The doctor's comment was inappropriate ... just as it would be inappropriate for a nurse to say (when HE screws up) "perhaps you should go home and practice that surgery in front of a mirror." Come on, manner police!!!

Don't get focused on anyone area -- no fretting allowed! You will learn the technical stuff as you go along. Just keep up with your studies/theory so that you can apply it to your patients & you will do just fine.

[mauser]

"...Could you by chance move to Virginia? Puleeeeeze?..."

Sorry ladies, she is coming to PA!!!!!!!! (I hope, I hope, I hope, I hope)

[colleen10]

Hi Shawna,

I just wanted to say that I think you should be very proud of yourself.

I am finishing up my 1st year of a 2 year program and I have yet to even attempt to put in a foley. For a first semester person, I think that's great.

Remember that everyone has to start somewhere and you only learn by doing.

It's hard to put a foley in, especially in a woman that is overweight, but you will learn and eventually become a pro, it just takes time.

Heck, I still get nervous giving prescribed meds. to my patients. It's just my thing that really makes me nervous and feel like a complete failure, but there are other things that I can do better than anyone else in my class like assessments.

Good luck and don't worry, confidence will come with practice, just in time for you to graduate and then go to the floor where you'll start all over again with the confidence thing.