Gaining confidence

Whispera, MSN, RN · Jan 14, 2015

It's normal to feel unsure when you're new at something. There's been lots written about it. In fact, one of the major nursing theorists, Pat Benner, wrote books about it. Her book, From Novice to Expert, covers it in detail.

Experience will give you more confidence. It can take a couple of years to get past the nervousness you feel in new situations. It will pass though! Then, bad news...if you go to a different specialty, it will be back!

I hate the word normal, but....you are normal, normal, NORMAL!

classicdame, MSN, EdD · Jan 14, 2015

You are normal. And you are smart to recognize and area for improvement. I would ask one of the facility educators to assist you. I do remediation for staff having issues, but I also help individuals. improve their skills. For instance, if a nurse lacks confidence on IV starts I arrange for her to work in Same Day for a day and start a lot of IV's. Or go to another dept. and hang blood. Or whatever is needed. Consider your resources. None of this were born knowing this stuff

Emergent, RN · Jan 14, 2015

I was like this. It took me some time to build up the skills you mention. I tend to have some social anxiety, which contributes. Other people appeared to be hotshots right out of the gate.

One thing I built on is my intelligence. I was a top student who really understood underlying pathophyisiology better than a lot of my peers. I have a really good vocabulary and can converse with highly educated people and be taken seriously. I learned to adapt to speaking to patients on their varying levels, and honed my bedside manner skills to a fine art, winning over patients right and left.

In other words, capitalize on your strengths while gradually improving your skills. I worked in several different areas of nursing over the years and now am a competent ER nurse. No, I'm not the biggest hotshot in our department, but I get the job done, and do it well. And the patients love me. :yes:

wanderlustnurse88, RN · Jan 14, 2015

I feel like I could have written this post. I was so nervous when I finished nursing school. I still hate taking to doctors, managers. I feel uncertain of my skills at times. It does get better as you start to feel more comfortable in the environment. I've also switched jobs a few times and this last time was the easiest since I am already confident in my other learned skills.

toomuchbaloney · Jan 14, 2015

How do we develop expertise and confidence?

practice

and practice some more...

You are socially shy, so you must motivate yourself to speak with the patients and families so that you have opportunity to develop those skills and that confidence.

Everyday you likely learn something new. Celebrate that, reflect upon it, savor the new knowledge and give yourself a pat on the back. When confronted with the opportunity to repeat that new task or to utilize that new knowlegde, jump at it. Rather than reminding yourself that you are not expert at it, remind yourself that you DO know something about it or that you HAVE done it before. Your thought and thinking patterns can cause us to feel uncomfortable even when we shouldn't. Identify those patterns in your life and seek to minimize their influence on your work.

Good luck.

SierraBravo · Jan 15, 2015

I agree with the above posters. However, OP, you stated that you also lack confidence when it comes to critical thinking. I guess I just don't see how one could lack confidence in critical thinking; I can certainly see how one could lack competence in critical thinking. I could see it if you thought critically about something, but were then too timid to offer up your ideas. I feel that, at least in acute care, critical thinking is not optional. And don't get me wrong, I get it that some people are shy but you need to get over that if you're actively taking care of patients.

Unless you address your concerns about your self-reported lack of confidence, you are not going to be able to reach your full potential as a nurse. Regarding transferring to a med/surg unit... Well, I'll give you my opinion in a very factual way. Based on your post, it's 50/50 that you would either sink or swim. Med/surg is not for the faint of heart or the timid. You don't have time to sit there and worry about not being confident, because if you do then you will likely fail at that job. So, med/surg would either force you to become confident because of the sheer pace, or you would simply not be successful in that area of medicine.

With that being said, what do you think the basis of your lack of confidence is? Is it lack of knowledge? I mean, if you work on a med/surg floor you NEED to be able to critically think re: labs, meds, etc... You're also going to be doing patient teaching and speaking with their families. Oh, and you're going to be speaking with providers quite often, too. So, unless you get to the core of why you think you lack confidence, and take steps to correct it, med/surg may not be for you. Incidentally, what area of medicine do you work in right now?

RNperdiem, RN · Jan 15, 2015

Some people are more self-critical than others. It might be part of what makes you different from your more confident-appearing peers. A small error can ruin the day of a self-critical person while their confident peers are praising themselves for leaving patients alive at the end of the shift.

My preceptor told me "you have to crawl before you can walk". Part of the difficulty of being new (and one year in is still new)is the mismatch between your actual skill level and what you aspire to.

Keep practicing. Praise yourself when you do something new. Watch and learn from the nurses you admire.

Katniss88 · Jan 15, 2015

Some people are more self-critical than others. It might be part of what makes you different from your more confident-appearing peers. A small error can ruin the day of a self-critical person while their confident peers are praising themselves for leaving patients alive at the end of the shift.

Whenever I make mistakes in the clinical setting I am definitely self critical of myself and it takes me a while to get over it, but whenever things are going okay then I feel more confident. I hate making mistakes and am afraid of making them because I have someone's life in my hands and there is no room for error. For example, when I was giving report over the phone I forgot to get the name of the nurse and I felt horrible, but my confidence got better later that day when I started an IV on the first stick. A lot of times any mistake I make whether big or small shatters my confidence. In my personal when I make mistakes I think about it for a while and then let it go, but I can't do that when I'm taking care of patients.

I believe I lack confidence in critical thinking skills because I don't have much experience and I am so afraid of making a mistake. In school they push you to think critically and give you opportunities in the clinical setting, but 4 or 5 semesters is not a whole lot of experience. Also, when you are thinking critically during clinicals it's in a safe environment where the instructor will not allow you to make mistakes.

SephRN · Jan 15, 2015

Everybody goes to that kind of process. Just dont stop believing in yourself and improve! Your just starting and its all part of it.

iPink, BSN, RN · Jan 15, 2015

The areas I still struggle with are speaking with patients and their family, talking to doctors, and critical thinking. I really lack confidence in those areas and I know that it shows. I see other nurses who have the same amount of experience as I do, just take charge and have that confidence.

I quoted this part of your post for a few things I wanted to address. You aren't alone in your struggles. A big part of the fears one may have when speaking to family members or MDs is the lack of or limited knowledge. We fear we don't know enough to ask the appropriate questions or know the correct answers to many questions we get asked. But, the more we learn and have conversations with our patients, the more confident we get. The more we study and have discussions about our patients with MDs, the better we become. As you stated at the end of your post, you have come a long way. Guess what, you have more to go and that is ok. We should always be progressing!

The second issue is the comparison. We do it all the time, but we don't always know the person we are secretly admiring life's history. You don't know if the other nurses who have the same amount of experience as you are going through other struggles (internally or emotionally). When I first started, I took the advice of my ANM, I "faked it till I made it." I may have looked cool, calm, and collected outwardly, but I was a nervous wreck internally when speaking to MDs until eventually over time, I was fine both inside and out. I also love talking to my patients and their families because I know my stuff and if I don't, I always get back to them after I've found the answer. Knowledge is power.

Hang in there.

SierraBravo · Jan 15, 2015

Whenever I make mistakes in the clinical setting I am definitely self critical of myself and it takes me a while to get over it, but whenever things are going okay then I feel more confident.

This makes me wonder if you've considered talking to a professional about your issue. Does your institution have an employee assistance program? You're attaching your "self confidence" arbitrarily based on how you think your shift is going. If you continue to think like this, you will never reach your full potential because no matter how hard you try, and no matter how many "good" days you have, there will come a day (and probably more than one) where things don't go well. For example, how will you feel if you have a patient yell at you, or have a patient code? Here's the deal, life is going to happen and you can't possibly control for everything. Also, you're going to have good days and bad days. You need to learn how to deal with whatever the issue is for you.