"just" a student nurse: feeling ineffective/inadequate (for a few reasons)

[nightingale1969]

Hi,

I'm a first-year nursing student in a part-time program and a first-time poster. Gotta say first that I love this website. It's so informative and supportive. Now if I could just tear myself away from it long enough to study for that next exam...

Anyway, we just started a L&D/postpartum rotation. I LOVE it so far, and I'm thinking that this is the way I want to go, or eventually to some related field like the NICU. This is the first time EVER that I've had a long-term goal in mind for my career, so I'm really excited and I want to do this right. The problem is where I seem to stand as a "student nurse" in relation to the moms and families that I'm trying to care for and educate.

From talking to my instructor, being a postpartum nurse is a challenge anyway because it's hard to work your tasks around family visiting time or mom/baby time. But I find it a bit harder because as someone who is "just" a student nurse, and who is perceived as such by the mom, I have much less authority in the mom's and family's eyes to come in and do my tasks as needed. They are far more receptive to their assigned nurse than to me. This has been true of my other rotations to some degree (mostly in elder care up to now), but it seems more obvious now because there are so many more people affected by a baby's arrival......more emotions that I need to keep in mind (privacy, family bonding, mom's protectiveness and emotional lability postpartum, etc.)...and so many more people who are protective of mom and baby. What I'm finding is that on the mom/family side of things, I feel like an INTRUDER. I hate walking in on a mom's bonding with her baby, or on a family visit, so I can try to get my assessments done. Usually what I find is that when mom is alone and I walk in to do what I need to do, she is pretty open and receptive. But when she's with baby and/or family in the room, the mom gets irritated and annoyed (and sometimes the family does too). It makes assessments and teaching very difficult for me, because I hate being given the hairy eyeball by mom and family despite the fact that I'm doing everything as correctly and gently as I can, and explaining the whole time what I am doing. (The fact that the hospital doesn't really enforce postpartum visiting hours doesn't help much, but oh well.)

Of course, taking care of the babies is easy...they can't really resist your care or assessments or procedures, and they certainly can't talk back! :wink2:

I realize that part of it is my problem. As a first-year, I am still learning to prioritize and juggle (especially with 2 patients now -- mom and baby -- instead of just one), and I could better arrange my tasks so that I get as much done as I can while mom is alone, or at least before the whole family comes to visit. I did better this week, but also didn't expect the baby to be rooming in...which meant a lot less time assessing either mom OR baby because mom or family seemed suspicious that I didn't know what I was doing. I tried to time things around the baby's feedings and periods of alertness; around family visiting; around mom's willingness to be assessed; around the baby's circumcision; and around my boundaries as a student nurse. I know, you're all probably either rolling your eyes or laughing at me :rotfl: ...after all, welcome to nursing!! I have said this before and I'll say it again: I don't know how nurses do it. I missed so many things in the process of juggling, though I tried not to. I tried to find my instructor several times so she could observe certain things that I was doing (also giving me more "clout" at the same time with her in the room), but with 5 other students to tend to, she couldn't always be there when I needed her... So that just made it harder to get things done.

This past week was the second week in a row that I didn't get all my assessments done because family was visiting way before regular visiting hours. I talked to my instructor about this, and she did concede that as a student nurse, I have to walk a fine line. If I was mom's regular nurse, I could push harder to get things accomplished. But as a student nurse, not only do I not have that kind of authority, but I also don't want to piss off the patients and families, who would then complain to the hospital about the student nurse who is a pain in the behind, and then my instructor would have to defend me AND the nursing program, etc. etc. etc.

I'm not really sure what I'm looking for here. I mostly need some assurance that THINGS WILL GET BETTER WITH TIME!! I only have a couple more days for this rotation, then it's on to Pedi, where I'm sure similar clashes between my "student" status and parents and family will arise. I definitely need more experience juggling tasks, and being assertive enough to get things done, but with tact and finesse (and without overstepping my bounds as a student). Any tips, experiences, etc. that anyone has would be greatly appreciated!! A friend of mine (a med/surg nurse for 5 years) says that once I'm an RN, I'll be able to go in and do what I need to do with more authority...but I don't know if I can wait that long, I do have to pass clinical

Thanks

[rnsrgr8t]

Greetings Nightingale! What a great post! It sounds to me like you are doing a great job! It is tough being a student and the more experience you get the better you will be. Multitasking is an art that you will learn and it will get easier down the road. Get into a routine with everything you do and make it a habit so you do not have to think about it (this will come with time). When doing assessments, always do it head to toe and that will help you remember everything. I used to make a notecard and visualize my assessment at home. I would go through it step by step in my head over and over and that helped a lot. Relax and remember you are a student and noone expects you to multitask and put out fires like a seasoned nurse. Really watch the other nurses so you can learn all the little tricks they use. Also, when dealing with families, after working in peds for almost 10 years, the more you ooh and aah over the baby, the better you get a long with the family. I love kids, so this comes easy to me. I always try to find one thing I can point out (they have great eyes, eyeleashes, cute outfit etc). I have had some really stand offish, upset families that warmed up to me after I really gushed (sincerely) over their child. Good Luck!

[Daytonite, BSN, RN]

. . .it's also my inexperience with juggling tasks and being assertive and confident (or at least appearing so). i still wonder how we're going to do all those things that the nursing books say we should do...i mean, besides all the "technical" tasks of nursing, being able to actually sit with a patient and discuss the emotional/psychological/social issues of their condition. . .

well, kiddo, it's kind of like being a mom. if you think something is important enough for your kids or your family, you find the time. as you develop experience and mastery over skills, more and more bits of times emerge to do all these little things. i've found myself over the recent past years playing around a lot with time management and how to fit something in to my workday, or spend more time doing something else if i can think of another way to do it. that's become the real attractiveness of nursing to me--the creativeness i can employ in getting all the tasks and work done. don't get me wrong, though. i was all thumbs when i started out. couldn't stick an iv in the side of a barn and often said very untactful things to co-workers and patients--mistakes i learned hard lessons from that hurt me just as deeply as they hurt others. if there was a jail for nurses, i'm sure i'd be an ex-con with a record as long as my arm. but you see, i wonder, if i hadn't gone through all that i did over the years, would i know as much, or be as good as i am now? hard to know. maybe the reason i'm so gung-ho about nursing is because of how much i overcame. and if a blockhead like me can make a success out of a career, others can too!

as for tips, timesavers and help with getting to that level, well, no one knows it all. keep reading what other nurses have to say. everyone has different experiences and different patient situations that come up. when people ask me about iv tips (because that is really one area that i do know a lot about--now!) i can spout off a few off the top of my head, but there are many more buried in my brain that will surface when the right question gets asked that brings up the memory. ask questions of the veterans.