Frozen on the First Day of Clinicals

Worried you don't know what you are doing? You are so not alone! The fear is real, no matter how prepared you are. Here's a story of how my fear paralyzed me, and some tips to face it head-on.

Frozen on the First Day of Clinicals

No Prior Experience

I had never even been in a hospital before.  I was never a CNA.  I didn't volunteer as a candy striper.  I did not know what it meant to care for other adults.  I was only 22 years old.  Prior life experience included years of babysitting and working as a hostess.  I didn't hear my call to be a nurse until my freshman year in college and was ill-prepared with real-life experience.  I had school to focus on and did not think I needed to get my feet wet in the field to understand it. I thought I'd figure it out as I go. That I'd be able to apply everything I was learning quickly in real life.  Ha. Ha. Ha.  Little did I know.

Deer in the Headlights

My anxiety on the first day of clinicals was over the top.  I do not remember being excited; instead, I was full of dread.  What was I doing? Who was I kidding thinking I could pull this nurse thing off?  I could not even walk into my patient's room to say “good morning."  I was literally pacing in front of their door.  Back and forth.  I was pretending to look yet again at the medication/supply cart parked in front.  I went to the bathroom five times.  Any distraction to avoid going in.  My heart was going to beat right out of my chest.   

Angel Instructor

My instructor caught me pacing.  I thought I was going to be in trouble.  I felt stupid and ashamed for not being braver.  I was preparing to defend my distractions with excuses.  But rather than shaming me, she knowingly smiled.  Without a word, she linked her arm in mine and walked me into the room.  We said “good morning” together.  She showed me how to place my hands on my first patient.  She was confident yet soft.  She listened, and she guided.  I was in awe by how easy she made it seem.  Her assurance opened the door, literally and figuratively, for me to find my own. 

Pay it Forward

My instructor gave me the most powerful gift that day.  She held space for me to find comfort and confidence in something so entirely new and unknown.   It allowed me to stand a little straighter and hold my head a little higher each time I walked into a patient's room.  I was not devoid of anxiety, but I was no longer paralyzed by it. 

This day made a lasting impression on my career.  I held on to it anytime I precepted a student or new grad, offering the same grace and kindness that she showed to me.  I was proud to support and encourage them through all of their doubts and struggles.  It was rewarding to watch them grow and feel more confident because of that.  It's like giving someone the key to the door that stands in their way. It is an honor, really.

So this I say to you. If you have found yourself questioning what the heck you are doing on your first day of clinicals,  remember to stand up a little straighter and hold your head a little higher.  Just walk in and say, “Good morning," and the rest will fall into place.

Tips for Reducing First Day Fear

  • Have your supplies, materials, scrubs, and anything you need for your first shift prepared and ready to go.
  • Get a good night's sleep the night before.
  • Eat a well-balanced meal.  Don’t drink too much coffee!
  • Arrive early to get your bearings.
  • Breathe.  Breathe.  Keep breathing.
  • Do not be afraid to ask questions.  No one expects you to know what you are doing.  In fact, it is usually the opposite.  They assume you don’t know much yet.  You will be surprised by how many people will be happy to support you. 

Carry on, clinical warrior!

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kdstarwrites

About kdstarwrites, BSN, RN

Caitlin has been an oncology/infusion nurse for 15 years. Recently she decided to switch paths to allow for a better-balanced life, where family, joy, and wellness are the priority. She is now a freelance nurse healthcare content writer enjoying educating on a greater scale, inspired by her nursing experience.

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Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.

 Posted this a long time ago. This will help.

https://allnurses.com/general-nursing-student/who-knew-my-754941.html

Who forgets the first day of clinical? Even if you've been a CNA or a candy-striper, getting up and putting on that spandy-new student nurse uniform and shoes, walking into the hospital, and meeting your new classmates on your first floor is ... . 

Oh, who are we kidding. Many of us don't remember a lot about our first days, really. Some had genuinely horrible experiences they laughed about later -- much later-- and most of us, meh, maybe not so much. But I did actually have a career-changing experience on my very first day of clinical, and if I haven't told you about it before, sit down a minute and indulge an old bat. It might surprise you. Heck, it surprises me even now.
We were sophomores in college. We picked up our uniforms at the downtown store the week before, individually, sight unseen; we dressed in the dark, and self-consciously made our way by subway or bus to the big hospital, finding the right building, riding the dark and creaky elevator to the sixth floor. We were excited but scared, with the usual wondering whether this was really the good idea it seemed a year --or gosh, a week-- ago. We assembled in the hall in front of the nursing station and met our instructor for the first time. We exhaled a sigh of relief when she smiled kindly at us, noticing that we had sort of been holding our collective breaths.
"Good morning. I am Mrs. Vartanian and I will be your clinical instructor on Colly Six." She read off our names alphabetically and peered at us over her glasses when we said, "Here" in small voices. She showed us the lay of the land and set us to passing out the breakfast trays, following up and down the halls looking for all the world like a big Rhode Island Red hen keeping an eye on eight chicks in the barnyard. After the trays went out she herded us all into the clean utility room. It was a cozy fit. 
She showed us where things were, pointing out the various shelves: cath kits, gloves, wound packing supplies, liters of solutions. Then she picked up a huge brown glass bottle labeled "STERILE APPLICATORS" and unscrewed its lid. Applicators, we saw, were sorta like Q-Tips, but 6" long ones with wooden stems, cotton end down. About about a hundred and fifty of them, about an inch down below the lip of the glass. "How would you get one of these out without contaminating the rest of them?" she said.
Eyes looked rapidly right and left. Feet shuffled a little, quietly, those soft-soled so-white Nursemates. We had done a lab on sterile technique but this wasn't one of the things we practiced until our gloves were wringing wet inside. What to say? What if we get it wrong? What would happen to us?
Finally one of us said, hesitantly, "Pick one out with sterile forceps?" Mrs. Vartanian smiled and said firmly, "Good. Who can think of another way?" 
Another way? What another way? We thought there was only one way to do any nursing task. Hadn't we just spent a week in lab getting each item on the check-off list perfect? But...she wanted us to think of another way. Slowly, we started thinking. "Sterile gloves?" "The sterile scissors in a suture kit?" "Try to tip one out onto a sterile field? Even if there was more than one?" And as each new answer came, she smiled and nodded. 
Standing in the middle of the group I felt a terrific idea forming. It give me goosebumps. We were free to think of different ways to do things, so long as we had a good rationale. No, that's not it: We had to think of different ways. Knowing the why of things, you know how to apply them. There can be another way.
And so ever since that day I've looked for different ways to do things. When I was an ICU nurse I thought about the many physiological processes going on so I could choose a useful intervention. When I taught students I tried to explain things in several different ways, figuring each student would catch on to at least one of them. When I did case management I thought about the why and how of the challenges of explaining to employers and insurance adjusters. 
Now I'm in independent practice and I have different challenges. But you know, to this day it surprises me to feel goosebumps when I figure something out. I hear Mrs. Vartanian's voice just as it was that day, making me bold, defining my whole career in then-unknowable ways. "Who can think of another way?"

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Specializes in Community health.

I recently had some students on the floor to help with Covid vaccinations. I’ll say that what we nurses really want is for you to be friendly, have a smile, and offer to help with things. These were first year students and some of them had never even given a shot before. But when I said “Okay can somebody grab the supplies?” they were racing for it. “Does anybody speak Spanish?” One of them took it in high school and could help a little.  They were great at communicating with the patients and they were eager to learn. I told them I’d happily help with references or whatever they needed because they were a pleasure to have— even though they didn’t “know anything.” 
 

Edited to add: One of the students said that his goal is to work in ICU, and another oncology. So I know that neither of them has a passion for our community health “unwashed masses.”  And yet they threw themselves into the day’s work, rather than saying “Well this isn’t real nursing, I need to learn how to use a ventilator.”  Attitude is everything. 

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