Feeling so dumb.

[rulguil01]

I don't know how to start. Just wanting to share. I have graduated BSN year 2011, passed the boards but have never practiced my profession as an RN since 2011 till now. Later in 2017, I have chosen to work as an LVN instead in a skilled facility. This is my first nursing job and currently on my 3rd month.

As days go by, I feel so dumb each time that it makes me want to quit and to either go back to school and repeat the entire nursing program. I feel like for those 6 yrs gap that I have been out to school made me feel ineffective to function as an LVN. Deep inside those smile I carry at work is a feeling of embarrassment of not able to put the required work as charge nurse.

First of, I am terrible with handling admission. In my 3 months stay, I had 2 admissions. The 1st one, I was assisted and on the 2nd, I tried to do it on my own. I noticed that I am having a hard time dealing with doctors, hospice, etc. English is not my first language so there are times that its so hard for me to even say the words that I want to say. People say I speak good English but for me, I am just really having a hard time communicating and comprehending. There are times I feel so embarassed, not able to comprehend what they told me because they most of times talk "slang" English. I most of the times feel left out too because they would talk about a case of a pt. and I am just there listening and quiet because first, I cannot express myself well in English and second, I have no idea on what they are talking about. Most of the times, they would talk about care through hospice, or some PT or ST eval and I'm like "what are they talking about?". I feel really dumb not knowing things I'm supposed to. Like literally, everything sounds so new to me that I do not know how to intervene.

Secondly, I noticed, I have a poor nursing judgment. It looks like since I have been out for school for 7 yrs, my nursing skills are gone. I literally would be panicking going through my phone and search because I totally forgot it already. This is really embarassing as there are times I would be just google searching on what to do instead of thinking what I should do as a nurse. I really feel like if this continues, my pt is very unsafe in my hands and worst is, to lose my license because of wrong judgment.

There are also moments that I feel like im inefficient because my CNA's know better than me and who am I to even impose as their charge nurse. It was so hard for me to tell my CNA's on what to do because I myself doesn't know on what to do. Most of the time, I would consult my conurses before deciding because I am totally not knowing on what to do.

There are so many more reasons why I feel so dumb each time but those times where I feel dumbest is where I always try to finish my work and do my best as I can.

[Sour Lemon]

I graduated in 2010, have been working in acute care ever since then, and still look up work-related things up constantly.

I'm a bit curious what your first language is ...because your English seems very understandable, at least in print.

[Crush]

There is always something I will look up now & then. But I am curious as to why you said you have your RN but work as a LVN? What about taking a nursing refresher course? Those are usually not too expensive and short. You can always YouTube things you have forgotten or not done in a while too when you are at home.

Checking things out and looking up info does not make you dumb. It makes you smart enough and caring enough to look it up. But since there was a long gap between school and entering the workforce, a nursing refresher course may be needed as things can and do change. Maybe also subscribing to a nursing magazine can be helpful as well. There are plenty of other resources out there.

Best wishes.

[meanmaryjean, DNP, RN]

rulguil01- I applaud you for being so open about your struggles. And the other posters have given you good advice.

[Nature_walker, ASN, BSN, RN]

Learning English is hard, learning English and medical terms is harder. I give you a ton of credit for becoming a nurse and English not being your first language.

Slang and idioms are the hardest things to learn. To address the slang, is there someone you feel comfortable going to after the conversation and asking them what they meant by ***. I use to teach English to speakers of other languages and one thing that my adult students did was bring in slang that they had heard at work that they were unfamiliar with. It became our topic for the day and we worked on how to use it next time in a conversation. It can be hard to ask what they mean, but if you have someone you trust and can talk to you'll find out what is going on. The learning never stops! I have younger coworkers who use slang now that I am unfamiliar with and I ask them all the time what they mean so next time I know what they are talking about.

Your written English is very nice. I wish you all the best as you go forward.

[rulguil01]

I think my comprehension is really bad. Its hard to explain but I noticed, everytime I talk to someone whose native language is English, I get lost, such as for instance is when the Director said, " They have found a Medicare bed for her". I thought what she meant was, they got her a "real" bed provided by her insurance under Medicare and so, I asked my coworker, "So when is the bed coming?" and my co worker responded, "Oh no, what she meant was they already found a different facility for her where she can be transferred whiich is approved by Medicare". Things like that I am having trouble with. Probably because I don't really have a good grasp of how skilled nursing works or how the process works and I have never really dealt with anything like this before. So far, when it comes to writing, I think I'm better but, there are times I am having hard time to formulate sentences which is bad because it consumes so much of my time. We just had an inservice of what to write and not to write on the chart and I am being careful because there was an instance where our company was sued and has lost a case because of an error in charting.

[rulguil01]

@meanmaryjean: Thank you. It feels good to be reading everyone's advice and the fact that you all took time to write back and share is very much appreciated.

[rulguil01]

@Crush: Your advice is wonderful. I am actually taking into consideration of taking a refresher course or a possibility of repeating my whole BSN program which I finished 6 yrs ago. I have never took my education here in US so there is this feeling of " Why not take the program here this time in US". I lnow it is going to be expensive and might sound impractical but I feel like if you really want it, nothing is really impossible of doing it.

*Although the uni I went before taught us in English medium and have used US based books and a very good approach in teaching, 6 yrs of not applying it has made things rusted. My confidence has been very low and I feel bad when my coworkers would know I graduated as a BSN and yet doesn't show with the work I am producing. I feel challenged mixed with insecurities and embarassment. It is really painful to feel that I have lost most of the nursing knowledge I worked before. I* also regret of not putting my 100% in BSN school and just merely do it with the mind set of just passing it. But now that I am practicing my LVN, with these insecurities of how good my colleagues are challenge me to pursue to be an RN again but this time, a more devoted one in terms of school (if ever I go back) and in also in terms of becoming one into the field.

[rulguil01]

@Nature_walker: Yes indeed. It is really tough for me. There are times I would have a blank stare towards a family member, colleague, a patient or to a doctor. Moments where, while they are talking, I kinda need to put the puzzle together and it would sometime take me awhile to even respond back to them because I want to make sure that I respond appropriately and that I get to understand what they're trying to say. In the past few days, I am learning to ask more and I would tell my co worker if what is the meaning of it or what they meant about it or sometimes, I would paraphrase it to make it not too obvious that I didnt really understand what they said. I am just way too shy most of the times to ask because I feel I ask a dumb question. For instance is one time I saw a note hanging outside the chart saying "Thinning". And Im like hmmmmm thinning? At the back of my head "What? This pt. needs thinning like thickening liquid. Why? I didn't know he has having problem swallong." So... I didn't touch the chart. At first, I was too busy to even handle that and I don't know why they need to have that order. Since the note has been bothering, it came to a point where I ask this one nurse and I told her " Hey I know you're busy but quick question. This tag here says thinning, how do we deal that order?" And this one nurse told me, "Oh dont worry about that. Medical records would handle that since the chart is so bulky that they need to remove some stuffs away from the chart so we have enough space to put a new file on it". I laughed but feeling so embarassed and she asked me why I am laughing. I told her the truth that all this time is I am thinking why the pt needs a thickening liquid well in fact he has no problem swallowing. I thought it was just mispelled or something. She laughed as well but told me, "Thats okay. Sometimes it happens that we interpret things differently" but good thing you asked.

I think my co workers don't realize that they help me so much when I ask simple questions yet, not so simple to me. I just hope they don't get tired of me asking because really, the things I asked maybe simple but not for someone like me whose first language is not English.

[SmilingBluEyes]

I do not think it wise or prudent to work as an LVN/LPN holding an RN credential. You're not paid what you're worth and still held to the standard of practice as an RN.

[rulguil01]

@SmilingBlueyes: I am not a US graduate . I hold a BSN RN license in other country. I challenged the board for LVN in one of US's state knowing that the BRN will not grant me to apply for an RN exam not until I finish prereq and comply to their standard. But yes, I understand what you are saying in terms of salary. I would of gone to get my prerequisite and apply for RN before but the thing is, I am not prepared for it. I am out of school for 6 yrs. My conscience of getting paid for an RN salary (if ever I pass, challenging the board) and not knowing what is safe to do for my patient will surely hunt me. But you knoW what, hopefully next year I get everything straightened out and gain my confidence back to start pursuing RN but this time, here in US.