Feeling defeated...

Published

Specializes in Gyn Onc, ICU, School Nursing, Health Education.

I had my final mental health evaluation yesterday and received a B. All of my written assignments were 98%, but she didn't feel my performance working with patients was at the level it should be by now. It isn't so much the grade, but the comments she made. Everything said "student needs to grow in this area." We were only on the floor twice due to Covid and mostly observed. She rated everything a B and basically said that I need to improve greatly before going into my final semester next fall. It was confusing and I sat there almost in tears. On the floor, we only took vitals, talked with our patients, and passed meds, the rest was observing groups and interactions. My patients seemed to like our interactions, one even colored me a picture with a sweet note. I received As in my previous med surg clinicals, although I will say we didn't learn a lot except for how to be a PCT. I left our meeting feeling defeated with the feeling that she felt that I won't be a good nurse. And she would know, as she is one! I am now questioning everything and wondering if I can really do this. I know this sounds really whiny, but as I said, it wasn't the grade, it was more how she made me feel and the comments she made. And, sadly, I really like her! She was an amazing instructor! I plan on talking to her more next week, but just wondered if anyone has had a similar experience and how you picked yourself back up and sought out learning and growth opportunities??

Up Vote Up Vote ×
Specializes in Wiping tears.

I failed my exam by one point. It hurt. I studied. I thought I understood the materials. Anyways, I don't know really. My professor hasn't commented about my clinical skills. It's my theory that gets me.  She is making sure I understand what's going about my patient(s), why giving medications, and what's my goal for the patient(s). These questions are asked before I start my day. Everyone has an opportunity to do be asked or to ask questions. She is fabulous and has a few decades of acute care experience.

I wouldn't be cared so much about being told that I have a lot of room to improve. I'd be so scared of getting booted out for failing my exams.  I'd say I've been trying to function as a nurse. I'm not overconfident. When I started my clinicals, my clinical instructors and floor nurses gave me the best experiences. I still do. I'm given more autonomy nowadays, but I do miss my CI though. I don't know many nursing skills but I can pass meds that I'm familiar with (I have an app for the medications), inject medications, and can insert IVs comfortably. The floor nurse is always there, so it's not that terrifying.

I'm not used to failing an exam that I put my time in. I don't know what else to do right now except taking one day off per week without my books. 

1
Up Vote Up Vote ×

You got a B, and were told that you needed to improve in some areas with your patient interactions. If I were you, I would not take the grade or the instructor's comments too hard. It is common for instructors to tell students that they need to improve, because they don't want you to think you know it all just because you got a good grade or completed a course. From your explanation, it seems like you are probably doing just fine and will make  a perfectly good nurse. Now, if the instructor pulled you aside and told you that they had concerns about your competency, safety, or clinical judgment, then I would worry. 

Don't let one person's analysis of your work make or break you. No matter how much you like them. 

Keep going! You can do this! 

5
Up Vote Up Vote ×
Specializes in Sleep medicine,Floor nursing, OR, Trauma.
On 3/13/2021 at 12:51 PM, Piper98 said:

I had my final mental health evaluation yesterday and received a B. All of my written assignments were 98%, but she didn't feel my performance working with patients was at the level it should be by now. It isn't so much the grade, but the comments she made. Everything said "student needs to grow in this area." We were only on the floor twice due to Covid and mostly observed. She rated everything a B and basically said that I need to improve greatly before going into my final semester next fall. It was confusing and I sat there almost in tears. On the floor, we only took vitals, talked with our patients, and passed meds, the rest was observing groups and interactions. My patients seemed to like our interactions, one even colored me a picture with a sweet note. I received As in my previous med surg clinicals, although I will say we didn't learn a lot except for how to be a PCT. I left our meeting feeling defeated with the feeling that she felt that I won't be a good nurse. And she would know, as she is one! I am now questioning everything and wondering if I can really do this. I know this sounds really whiny, but as I said, it wasn't the grade, it was more how she made me feel and the comments she made. And, sadly, I really like her! She was an amazing instructor! I plan on talking to her more next week, but just wondered if anyone has had a similar experience and how you picked yourself back up and sought out learning and growth opportunities??

Step number one:  Have your moment.   

It's okay to feel hurt by these comments and everyone has this moment at least once in their student life/nursing career.  

Step number two:  Collect data.

Shelve emotions because this can sting. 

When you meet with her, one on one<--very important, ask her if she could help you better understand how and what way you need to improve.  Ask her for examples and ways you could have better handled/addressed the situation.  Engage her in what she says and repeat back so you have a grasp of what she is looking for and she can rest assured you are going to take what she said to heart.  

I promise you that if you approach her openly and with the attitude of "Help me be better" versus "How could you say such rotten things to me?" she will be more than willing to help and turn this into a great teachable moment.

Step number three: Incorporate feedback into practice.

Mentally reheorifice the feedback you were given.   Put feedback to work in live practice. 

Let's run the scenario of the feedback being, "You were too casual with the patient."  Okay.  It happens.  How can we improve?  "So when you took the patient's blood pressure, I noticed that you were using familiars/pet names like "honey"."  This is valid.  It happens to the best of us.  Now, we need to incorporate that feedback into practice.  We can do that in the comfort of our own home by mentally practicing that interaction and changing our wording. When we get out to hands-on, those mental rehearsals will actually help curb some of that behavior.  

Here is what I want you to take away from this entire experience:  

Growth hurts.  Remember when you were a kidlet and you sprouted three feet in six months?  Hurt like all hell, right?  But look at you now!

Diamonds are made under intense pressure.  But first, a diamond was a lump of a coal.  It takes time and pressure to evolve to something sparkly, "flawless", and tougher than nails.

Feedback is a rare and precious gift.  Don't waste it.  We spend our lives with a perception of ourselves that is not accurate.  To be given the view of how others see us can be pure gold!  Seize the moment.

Lastly and most importantly: You can absolutely do this.  One bad day doesn't make you a bad person.  A mistake doesn't make you less.  Being a nurse is being human first. 

Be as the phoenix and rise once more from the ash.

~~CP~~

6
Up Vote Up Vote ×
Specializes in Wiping tears.

To answer your question, I don't really get hurt when I'm told I need or have to improve on____. I work on them.

I get depressed when I don't do well in class. It seems to affect me tremendously. Breaking up with a boyfriend or bickering with family, I function alright. With all other things that I should be bothered about, it's my school performance that gets me. 

Up Vote Up Vote ×
Specializes in ICU.

As a previous poster said, ask in a respectful manner for specific examples as to how you can improve in the areas mentioned. It really doesn't matter how well you did on written assignments or how inconvenient the working conditions were. Your instructor has likely seen dozens of students pass and fail, and if she sees room for improvement, you would do well to honestly consider her advice.

Up Vote Up Vote ×
Specializes in Community health.

If you already were a pro, you wouldn’t be in school!

1
Up Vote Up Vote ×
Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.

You got a B. That doesn't remotely equate to your instructor saying you won't be "a great nurse." It's way too soon to know that anyway. I can tell you that nursing school grades are one component of nursing competence-- some of the best nursing diagnosticians, practitioners, and teachers I know had so-so grades in college but went on to awesome, exemplary practice. And vice versa- one of my very best students ever came to work at the hospital where I worked clinically (not on any of the floors/units where I had responsibilities) and I heard through the grapevine that she was lazy, slipshod, and always ::thisclose:: to being put on probation for it. Grades look at how well you learn facts and perform when asked to express your mastery of them; clinical grades may be a bit more subjective. Certainly if your instructor was going to mark you severely low, that would be something to get your attention. But a B? Feh, you did fine.

It's also entirely possible that, in addition to the other good suggestions you have here, you can consider that maybe this instructor has higher standards, that she graded everybody in your group lower than they had come to expect, that this year is harder than last year, and/or that psych is, well, different, so what you got good at in earlier rotations didn't translate as well to this setting.

FWIW I got my highest state boards exam grade in the psych section (back in the day when we had to take the exam on clay tablets with bamboo styli) and didn't remotely consider being a psych nurse. I got my lowest score in surgical, and ended up as a clinical specialist in critical care/surgery.

Go forth and do good work.

 

::wavey:: Hi, CP!

1
Up Vote Up Vote ×

I'm confused. It's difficult to tell whether you are just taking this too hard or your instructor's evaluation of you has some inconsistencies.

It isn't a bad idea to ask for another meeting, but you need to be mentally/emotionally prepared for it. You really can't crumple every time you aren't given highest praises.  Skip talking about how the evaluation made you feel and just state you'd like to make a plan for improvement. Ask for specific areas on which you should focus and whether there are preferred ways that past students have been able to improve in those areas. Pay close attention, take notes, etc., Thank her for her time. That's really about it.

Lastly, I hesitate to write this but I feel it is necessary because I wish to increase awareness of some inappropriateness in this profession:

Whatever happens, you need to learn what you can and not worry about the rest. All people are just people, even nursing instructors. I'm having a bit of trouble with:  1) The fact that she passed you despite reportedly feeling that you aren't where you need to be and you need to improve greatly before the fall  2) How, unless you are completely incompetent, such serious concerns are able to be voiced after 2 days being observed observing in the clinical setting and 3) Why this information was given at a final eval and not earlier.

None of these 3  things sit very well with me. So this could be a situation where you listen carefully and say thank you and MOVE ON.

Perhaps you have misunderstood her tone due to the emotions involved in not receiving highest praises. But that has to stop. Try to listen neutrally instead of seeing everything as either praise or insult. This really is not as devastating as it seems in the moment.

You will be okay. Think things over. If you meet with her keep it business-like, which is a skill you will most assuredly need as a nurse.

Best of luck ~

2
Up Vote Up Vote ×

It sounds as if your instructor gave the students the benefit of the doubt by grading a "gentleman's B" and gave the generic 'constructive' criticism to give evidence that she "did her job".  I would not worry about this.  Time to worry when a clinical instructor gives less than satisfactory feedback, puts a target on you that can be seen from 25 miles away, and then tells you that you are failing clinical three days before the end of the term when you can do nothing about it.  Now that is the type of situation, and it happens often, to worry about.

1
Up Vote Up Vote ×
+ Join the Discussion