How to gain more confidence.

[nlw1997]

I am a nurse of 2 years. My first six months was in Ortho and then I moved to critical care nursing. I have been there at my current job for a year and few months. I love the job and my coworkers. I do have an issue I am unsure what to do about it. I do not hesitate if unsure of something to ask questions. It has been encouraged and I try to be mindful of what I am asking but do ask my co workers if I am unsure of something. Most of the time I am correct in what I was thinking and usually am asking to get confirmation that I am not missing anything. I feel I am improving but the other day I was called in to talk with the NM and told my coworkers feel I ask to many questions and don't critical think enough. My NM wants me to talk with the clinical Educator to review some things. She assures my that she believes I am a good nurse and have excellent patient care and skills but wants to make me more confident in my decisions. I am trying not to worry but am now afraid every question I ask will be looked at as me not able to do my job. I was a LPN for many years before going back for my RN and as a LPN, I had to run a lot through the RN's. I feel some of my questions are me talking it out and confirming that I miss nothing and is more habit. I am just not sure how to catch myself before I ask the questions. Any suggestions on how to gain more confidence in my decisions?

[ED Nurse, RN]

Asking questions is ok; however, you should be really asking less and less questions as you progress in your career. You have been a nurse for three years and in critical care for over a year- it sounds like you are still requiring a lot of help and reassurance. To be a CC nurse you need to be able to think things through on your own and problem solve. Patient care will suffer if you can't think on the fly and need to seek out a co-worker in those situations. Perception is reality unfortunately, and you have given off the perception to others that you are no competent/confident in your abilities to your co-workers. After a year in CC things should have "clicked" for you, do you not feel that way? Like I said, it's ok to ask questions, everyone does, but the frequency of you needing others to get through your day should not be as great as when you first started. If you want to continue I would meet with the educator and study anything she recommends. CC nursing is not for everyone, so even if this doesn't work out you can take the skills you've learned and apply them in a less critical setting. Good luck.

[nutella, MSN, RN]

Perhaps it is more a habit as opposed to a real need. After working as a LPN for some while it may be still somewhat of your default mode to get reassurance. As a RN with more than a year in critical care you need to become a more independent decision maker. I worked in critical care for around 9 or so years and it did take me a year to be comfortable and two to be entirely ok. It is ok to ask somebody for an opinion if it is complicated or really warranted but for routine matters you should be ok by this point.

You know how to provide care I assume - so you do not need any opinion on that. A big part is also to implement orders and unless you really question something you should have enough judgement to make this happen. I suspect you have gotten just used to the re-assurance and it probably relieves some level of anxiety about "doing something wrong" but critical thinking skills and the responsibility that comes with them are essential in critical care. At some point you want to be mostly independent and secure in your decision making and the only way to get there is to start making it. Your NM indicated you are a good nurse and you are capable.

If you are truly unable to progress and work more independently this setting is perhaps not for you but I guess a lot is just being used to the constant re-assurance which in turn can give you anxiety when you wean that habit off.

Good luck!

[nlw1997]

Thank you for your comment. I do feel I have made real progress since starting. Most of my questions are related to things I had not yet dealt with in the unit and I usually question it to reassure that I am on track with my thinking and not missing something. It is not like I question everything I am doing and need a hand to get through the shift. I feel the questions are more my habit of needing re assurance. I realize that it needs to change but also feel that only being a year in CCU that is was ok to still ask those kind of questions. I do plan to utilize the clinical educator as much as possible when we meet and am looking for suggestions on how other nurses gained their confidence more to not ask questions as much. I belong in critical care and love it , I am a good nurse and have gotten excellent evaluations but I do not want to miss something and that is sometimes why I ask questions. I feel much better about the situation now looking back and know things will be fine. I just need to start showing that I believe in myself.

[VANurse2010]

Thank you for your comment. I do feel I have made real progress since starting. Most of my questions are related to things I had not yet dealt with in the unit and I usually question it to reassure that I am on track with my thinking and not missing something. It is not like I question everything I am doing and need a hand to get through the shift. I feel the questions are more my habit of needing re assurance. I realize that it needs to change but also feel that only being a year in CCU that is was ok to still ask those kind of questions. I do plan to utilize the clinical educator as much as possible when we meet and am looking for suggestions on how other nurses gained their confidence more to not ask questions as much. I belong in critical care and love it , I am a good nurse and have gotten excellent evaluations but I do not want to miss something and that is sometimes why I ask questions. I feel much better about the situation now looking back and know things will be fine. I just need to start showing that I believe in myself.

A lot of ICUs are sharky, maybe you're in one that is. You seem to be appropriate for your level of experience. I don't agree with some of the previous posters' opinions/advice.

[CryssyD]

Maybe you can go in with a plan: Today I am going to make my own assessments and my own decisions; I will tell someone about them if I'm unsure, so that they can backstop me if necessary, but I am going to take charge of my patients and not ask for direction, just confirmation. Start moving away from asking what to think or do, and move toward making up your own mind. At some point you have to take off the training wheels--you're probably more ready than you think. As long as you know what you don't know, you can start being comfortable with what you do know.

[Guest219794]

The best way to be more confident is to have a reason to be confident.

Confidence is useless if it isn't backed up.

Develop competence. Read books and journals. If you aren't already, start studying for and obtain CCRN. Read everything on this site: index Look up anything you don't know. Hang out in the critical care forum here.

Some people just show up and do the job, taking only required trainings. Don't be one of them.