Don't feel ready!

Biol20fan · Oct 23, 2008

We had our clinical orientation at the Long-term Care Facility and we start tending to clients next week and I just don't feel ready. Practicing skills in lab on "dummies" is one thing....doing them to real people is another story. Everytime i think about it i go blank and can't remember what to do! I'm really scared and have been doubting my career choice all day wondering if i've made the right decision and what will my instructor say if i just stand there and can't make myself move to do what i need to do. I feel so conflicted right now. I'm doing fine in the classes, though i don't feel like i'm really retaining much info. I test and then move on and it's hard for me to recall alot of stuff from previous chapters. I just don't feel like I know what I need to know to actually be on the floor. Is this normal? Has anyone else had these same feelings? Does it go away? For instance I understand how to do a NG tube and/or a catheter....but doing it on a real person terrifies me! I keep telling myself I only have 10 clinical days and surely I can get through this, right???? lol I'm just so unsure of my capabilities right now and I really hate feeling this way.

First of all, take a deep breath...and then realize that at one point or another, we have all been in the same boat! Skills lab is nothing at all like working on a real patient. And the good thing is, most patients are very, well, patient with you and will understand that you are a nurse (and in most cases, they will have to give consent for you to be part of their treatment).

The way I've described clinicals is that it's almost like starting a new job, sometimes twice a semester! You should have a nurse training you, as well as your instructor. Of course you will be nervous before doing anything you haven't done before! But I tell you, it's so awesome when you end up performing a skill that you haven't done before. Often times some of the steps end up being done differently than they teach you in skills, which can be frustrating. As long as you go with the flow, listen to your nurses and your instructor, you should be fine. The great thing about clinicals is that you are finally getting to apply theory to practice, which can be very exciting.

I'm on my third clinical rotation right now, and I'm just barely starting to feel like I have a clue. You can get through this, you will get through this. I'm not saying that it's all wine and roses, but you need to have some faith in yourself! :heartbeat

Check back in with us, and let us know how your first day went!

Lindalou76 · Oct 23, 2008

We're not working with nurses at all. There are 7 of us and we have 1 instructor. She's is VERY nice and will help us in anyway and is not the type of instructor to leave you on your own. We are only doing simple things like bed bath's, wound care, tube feedings and most ADL's I just feel like I can't remember how to do anything now that we're going to have to do it "for real". lol I mean we've only been in class for like 2 months....just seems too soon to me!!!!!! I'm going to watch all my skill video's again and I'm hoping that will give me a little more confidence. Also, my client doesn't really talk, she is not in good condition at all. Very fragile, i was scared to death to even take her bp, but i did take her pulse today so i did get something accomplished even though it was something simple. I actually enjoyed being in the long-term care facility today, and i just love people (especially older people because they are so excited to receive the attention)........i'm just scared to do my nursing duties since this will be the real deal. If i could watch a nurse or CNA do them first i think i would feel better, but since we should know what to do we're not really given any kind of demonstration. I guess i'm just thinking about it too hard. I will watch my skills video's and just do my best next week. My instructor knows i'm very nervous and if i need help i know she will help me. I also have a partner who said she will drag my a** through this clinical if she has too! lol We're gonna help eachother get through this so i guess i just need to have a little faith! Thanks for the response, you made me feel a little better! I'm going to read some more posts on here cause that always makes me feel better too.......:wink2:

Jess_Missouri_RN · Oct 24, 2008

I was going to suggest pairing up with a partner or two. I do this. My last rotation I paired up with another and we would grab one another if we needed assistance or whatever, it really helps. Good luck!

Biol20fan · Oct 24, 2008

I also have a partner who said she will drag my a** through this clinical if she has too! :wink2:

ROFLMAO!!!

It's always good to have someone who has your dorsal side, ain't it?

Every new thing you do will be scary and exciting...and you will be able to get through it all. :yeah:

Lindalou76 · Oct 25, 2008

Thanks for the replies. I may have to go talk to someone on Monday if I don't feel any better. I already feel the downward spiral starting and am wanting to flee the situation and don't know if i can stop it. I'm not sure if i should talk to my clinical instructor or my advisor (both are great ladies). I don't want to sound like a whiny student to them but this is truly how i'm feeling and i just feel like i want to quit. I just don't have the confidence that i can give good quality care this week in the nursing home and that frightens me alot! If i could follow someone around for a day or two and watch them do the skills i think i could do it and feel better, but we have to do it our first day and that's that. My patient is very fragile and can barely speak and the thought of me giving her a breast exam during the physical assessment makes me feel like i'm violating her! I know that probably sounds silly, but that is how i am feeling. It's one thing seeing all these skills in the book and then performing them on mannequin's but doing them on real people is really freaking me out!!!!!!!! I'm really embarrassed to go to my instructor and/or advisor but i'm scared if i don't go talk to them that i'm just not gonna show up to clinical out of straight fear. Am i crazy? Am i not cut out to be a nurse? I just don't know what to do........ :bluecry1: Any advice is greatly appreciated!!!!!!!! thank you!

jpeters84 · Oct 25, 2008

I have to say that last week I felt the same exact way that you do now. Practicing skills for 10 minutes on a dummy did not instill a lot of confidence in my ability to perform them once we went to the hospital. To make things worse, I did a really bad job on my skills check-off. My confidence was at an all-time low. And you know what? When I stepped foot into that hospital for the first time this morning at 5:45am I was excited not nervous. All my fellow students who had passed their skills check off with flying colors were shaking in their boots but I just couldn't believe that after all these years here I am at the hospital and they are actually going to allow me to work there as a student. It was awesome and I did just fine.

Walking into the room and introducing yourself to the patient and getting going is the hardest part, but than you're off and running and it's so much fun. So please plaease please don't be nervous. Have confidence that you know some skills, that you will work a great deal over the next couple weeks in the hospital at getting proficient at them, but that you've finally made it and don't be so afraid, so nervous, that you miss out on the awesomeness of the experience. Plus when in doubt don't be afraid to ask. No one is going to expect you to go in there and be a rock-star on your first day. Have the pattern and rhythm of vitals down, that will get you going, and than just take it from there. You will do great!

emmy27 · Oct 25, 2008

Thanks for the replies. I may have to go talk to someone on Monday if I don't feel any better. I already feel the downward spiral starting and am wanting to flee the situation and don't know if i can stop it. I'm not sure if i should talk to my clinical instructor or my advisor (both are great ladies). I don't want to sound like a whiny student to them but this is truly how i'm feeling and i just feel like i want to quit. I just don't have the confidence that i can give good quality care this week in the nursing home and that frightens me alot! If i could follow someone around for a day or two and watch them do the skills i think i could do it and feel better, but we have to do it our first day and that's that. My patient is very fragile and can barely speak and the thought of me giving her a breast exam during the physical assessment makes me feel like i'm violating her! I know that probably sounds silly, but that is how i am feeling. It's one thing seeing all these skills in the book and then performing them on mannequin's but doing them on real people is really freaking me out!!!!!!!! I'm really embarrassed to go to my instructor and/or advisor but i'm scared if i don't go talk to them that i'm just not gonna show up to clinical out of straight fear. Am i crazy? Am i not cut out to be a nurse? I just don't know what to do........ Any advice is greatly appreciated!!!!!!!! thank you!

You're not crazy, but first-day jitters are something everyone goes through, and the only way past it is to just do it. The only way you'll get better at performing skills on real people is by performing skills on real people.

Will you make mistakes? Possibly.

Are there many mistakes you can make assisting a nursing home resident with ADLs that are irreversible or lethal? Not really.

Everything you're likely to need to do at a LTC facility as a first semester student is pretty simple when you're actually in there doing it. You may not be graceful doing it or efficient doing it, but you'll get it done, and you'll be better the next time, and the next, until you can't remember a time you couldn't do it all with your eyes closed.

At our school they give us this cheesy thing in the student handbook about how we start out as "little L learners" with "big T" instructors, and over time we become more and more competent and more and more responsible for our own abilities, until we're "big L learners" and our instructors are "little T" instructors who are really just there to guide us to the point where we're ready to become RNs. It's cheesy, but it's true- everyone starts out basically incompetent, and you just have to deal with the short period of feeling like you know nothing and expose yourself to the opportunities to learn. Which is what clinical is- an opportunity to learn, NOT to step on to the floor a fully-fledged nurse! Nobody expects you to know everything or anything like it the first day.

Don't be afraid to ask for help (it's easier to get in real trouble by NOT asking for needed help than by asking for it), don't be afraid to make mistakes, don't let your fear of failure stop you from trying, and DON'T not go! Everyone (even the crankiest, most dragon-like charge nurses you'll ever meet) has been there. You'll look back on it (probably quite soon) and laugh about being nervous over things that will soon be second nature.

You can do it! Good luck, enjoy your first clinical, and keep us posted.

Lindalou76 · Oct 26, 2008

Well we're basically expected to do everything on our patient's this week that we've done in skill lab in the last 2 months (NG tubes, tube feedings, catheters, bed-baths, total physical assessments, wound care, ambulating patient's, all vital signs (I am so afraid my patient's skin will tear just from putting the cuff on tight enough to get a BP reading, i tried the other day but couldn't finish cause she started moaning and it scared me cause i thought i might hurt her) and administering meds (this is the one thing the instructors will be right beside us for, but nothing else really). Obviously, if we have issues they will come help us, but they won't hold our hand at all! I really need my hand held the first day or two so that is the problem i'm having. I'm just really starting to think nursing is not for me. I thought it was because i love people of all ages, and i like to help people but i may have a problem doing the really invasive or sensitive stuff like catheters, breast exams during physical assessments (mainly because my pt can't talk and i would really feel like i'm violating her, I can just imagine her looking up at me like "what are you doing to me"), etc. I think I would feel different if for the first few days we were shadowing a nurse or having an instructor with us showing us exactly what to do and then having us do it, but that's just not how it is so i'm am really taken off-gaurd by this. I'm thinking maybe I didn't think long enough or research nursing enough before making a decision to start nursing school. I'm more embarrassed than anything that i will have to tell my instructors, friends and family that i just don't think i'm cut out for this. Well see what the week brings. I think i'm going to talk to my advisor on Monday, then my clinical instructor and just go from there, but right now i don't have very high hopes. Kinda sucks i'm doing so well in the class, havn't failed anything..........i think clinicals are just too soon for me. I'm still praying there's a chance I'll get through this week and look back on this and laugh, but i'm trying to be realistic too. Thanks to anyone who took the time to respond, i appreciate you trying to encourage me and get me out of this funk! lol

SunnyAndrsn · Oct 26, 2008

You are feeling totally normal! Yes, it does get better, but it takes awhile. Being in clinicals really does help you retain your coursework because you're seeing things up close and personal.

Good luck, you WILL be fine.

We had our clinical orientation at the Long-term Care Facility and we start tending to clients next week and I just don't feel ready. Practicing skills in lab on "dummies" is one thing....doing them to real people is another story. Everytime i think about it i go blank and can't remember what to do! I'm really scared and have been doubting my career choice all day wondering if i've made the right decision and what will my instructor say if i just stand there and can't make myself move to do what i need to do. I feel so conflicted right now. I'm doing fine in the classes, though i don't feel like i'm really retaining much info. I test and then move on and it's hard for me to recall alot of stuff from previous chapters. I just don't feel like I know what I need to know to actually be on the floor. Is this normal? Has anyone else had these same feelings? Does it go away? For instance I understand how to do a NG tube and/or a catheter....but doing it on a real person terrifies me! I keep telling myself I only have 10 clinical days and surely I can get through this, right???? lol I'm just so unsure of my capabilities right now and I really hate feeling this way.

emmy27 · Oct 26, 2008

Well we're basically expected to do everything on our patient's this week that we've done in skill lab in the last 2 months (NG tubes, tube feedings, catheters, bed-baths, total physical assessments, wound care, ambulating patient's, all vital signs (I am so afraid my patient's skin will tear just from putting the cuff on tight enough to get a BP reading, i tried the other day but couldn't finish cause she started moaning and it scared me cause i thought i might hurt her) and administering meds (this is the one thing the instructors will be right beside us for, but nothing else really). Obviously, if we have issues they will come help us, but they won't hold our hand at all! I really need my hand held the first day or two so that is the problem i'm having.

Don't think of it as "We've learned twelve procedures and OMG NEXT WEEK I HAVE TO DO THEM ALL". It's not going to be like that. You'll have to assess your patient, yes, and possibly do a bed bath/change sheets, but as to everything else... well, the chances of you having to put in a catheter, an NG tube, and change a dressing all on the same day in first-semester clinicals are pretty darn slim. I'm nearly done with my second semester of clinicals, and I've cathed somebody in clinical exactly once- and I volunteered to do that on a patient that I wasn't assigned in order to get the experience! None of my patients or my classmates patients has ever needed an NG tube inserted while we were on the floor. Wound care is slightly more common, but again, the chances of your one patient needing their dressing changed while you're there aren't that high. I work on a med-surg floor as an extern and the nurses are really good about letting me do invasive procedures when they're needed but I still regularly go a whole shift without sticking anything in anybody. Life in the hospital is not the same as a skills test in the lab!

I'm not saying you never get to do anything in clinicals, and you will eventually do nearly all the procedures you learn in clinicals, but honestly, at least at first, you'll spend more time learning how to read a chart, figuring out where to put dirty laundry, and trying to make yourself look busy than you will performing invasive procedures. A lot more time.

And when you do get around to doing them, it won't be nearly as scary as you think. You're working under your instructor's license, so if she's got half a brain she'll make sure that she, or at a minimum another staff nurse, is present when you do an invasive procedure. And if she HASN'T got half a brain, you're well within your rights to ask her (calmly, not panicking) to be present to ensure that you're doing it properly. Stop as you gather supplies and explain the procedure to her (good instructors will ask you to do this anyway, but you can always volunteer the information and make sure you're not forgetting something).

You can do this. Everyone- every. single. nurse.- started out brand new and terrified on their first day of clinicals. Don't quit before you've even tried!

Oh- I just wanted to add: when it comes to her not being able to talk and feeling like you're "violating" her- try talking to her while you do what you need to, explaining it and so on. It will help keep you calm and on track with your assessment, it may reassure her (depending on her mental condition) and it will help remind you that she's a normal person despite her inability to speak and that you're doing something to help her, NOT violating her. I find it really helpful and sometimes even patients who seem like they don't know what's going on seem to benefit from it. I had a patient at work who was delirious with a physical illness and really, really difficult, but I made a point of talking to her even while she was at the peeing-on-everybody-trying-to-climb-over-the-bed-rails stage and later when she came back around to normal awareness she called me the "nice tech" and thanked me even though she didn't know my name or most of what had gone on the last few days.

You obviously care a lot about human dignity and your ability to provide excellent care, and those qualities will make you a wonderful nurse. Hang in there!

isneyk · Oct 26, 2008

Just like everything else that is new to you, it does feel awkward.

First day might be full of anxiety, but it'll get less & less as days go bye.

You'll get through it smooth as a silk if you believe in yourself.

Keep your chin up. You'll do fine. :nurse: