Bad Clinical Day

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I just had a bad clinical day. Nothing horrible, like making some kind of error that got me written up -- I just didn't finish all that I was assigned to do, got frazzled and confused a couple of times and less than impressed my instructor and the RN I was working with. I tend to get overwhelmed and get like a deer caught in the headlights. I'm in the third semester of an ADN program but I still have to do everything so methodically and instructors are getting (slightly) impatient with me. I still can't open a blister pack without fumbling.

I have a lot of anxiety lately and that's been obvious. It's depressing and I don't know what to do. When I do bad in clinicals I dread them and get anxious and then do worse. Maybe it's my age. Some of the younger gals just seem more confident and nervier. On the other hand they don't seem to treat the patients like they're human beings.

Maybe I should go on medication.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

My advice (I know you didn't ask for any, but. . .) is to just keep putting one foot in front of the other and moving forward. Until you get tapped on the shoulder and told to pick up your books and leave the nursing program, you're still good to go. Everyone is a unique individual and learns in their own way and time and expresses their anxieties in their own way. I'm sure your instructors understand this or you would have gotten a tap on your shoulder and told to leave long ago. Much of this stress and anxiety is the cause of your fumbling. A word of advice though is don't point out that you are nervous or having trouble opening up a blister pack. Your instructor can see that and make that assessment for herself. It will only add to her irritation, if she is irritated with you. If it makes you feel any better, some of those individual dose blister packs are very hard to open. I carry a pair of bandage scissors with me and it works great at opening those SOBs (and I don't mean short of breath) real quickly. I wrote a letter to one of the drug manufacturers years ago about how theirs was so hard to open, couldn't they work on an easier to open package, and got a nasty letter back about how they had done studies and testing and found their packaging to be quite adequate, thank you very much!

It takes time to perfect skills. Give that advice to yourself. Someday when you are experienced and you are watching a student reacting the same as you once did, remember that you started out the very same way.

You don't need to go on medication.

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Specializes in SICU, EMS, Home Health, School Nursing.

I felt like that most of the time I was in nursing school so obviously it isn't an age thing. For me it was the fact that I wanted to do good to impress my instructors, but them standing over my shoulder all the time made me so nervous! I had a few instructors that always made me feel comfortable because they actually made me feel like I was doing a good job. They would compliment me on the things I did right instead of always focusing on the negative like my other instructors did.

Just remember that we have all gone through it and made it, so you can too! Someday if you become a clinical instructor, or if you have a student under you remember how you felt and make it your goal to help your student not feel that way!

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Specializes in Education, Acute, Med/Surg, Tele, etc.

Heck, I can still have days like that now! LOL! Things moving so fast that I can't concentrate on the task at hand!

What I have to do is take a deep breath or a break...if I can't get one I will go to the bathroom for a moment. I will remind myself that doing 1/4 to 1/2 a task is confusing...and not very time managed. I build up my esteem and either ask for help from my charge nurse, get help from a CNA or another RN, or simply say very professionally (which takes practice)...I will get to that as soon as I am able to, I have a few priority tasks at hand I will finish and then I will come and find you (that is for co-workers only). For pts I simply say I will help you with that as soon as I am able to or I will try to find someone to assist you.

I had to learn to do this or I was only getting things 1/2 done and then I couldn't see straight or forgot what it was I only did 1/2 of! It is a skill to learn, and I am glad I learned it for myself and my patients! I am a professional nurse, not a runner racing to the finish line first!

Good luck and believe me we have all been where you are, it is frustrating and quite emotional. Accept yourself for your limitations AND what you can do! Getting a handle on that and sticking with it is the best thing you can do for yourself not only at work/school...but the rest of life!

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Why is it that when we are being watched, that we can't even take a blood pressure without getting all tangled up? I remember when I was first fielding calls from doctors on the phone, that my preceptor would listen in to give advice and I swear it seemed like I was developing a stutter! For goodness sake, I'm almost 50 years old and I answered only about a million calls in my lifetime! So here's the answer: its just downright weird to have everything you do done 'on stage' so to speak, everything watched, everything checked (even your handwriting on a chart and every word you chose to use!). No wonder you can't even open a blister pack without getting your fingers crossed! Also, I learned that some instructors/nurses made me a whole lot more nervous than others. Its not clear why that is, even when they seemed nice enough, but still it was true.

Just try to relax a bit, laugh a bit, and be kinder to yourself. You aren't the first fumbling, mumbling, nervous nursing student that they've seen and you won't be the last. Many a patient survived us all, and perhaps one day you will look back and remember this, and be so much kinder to the new student now by your side!

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Thanks. Today was better.

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Specializes in Telemetry & Obs.

I'm sorry, but this is totally unacceptable behavior....we're forced to take you out back and hang you by your toenails!!!!!!:jester:

I agree with the poster that mentioned how hard it is to do *everything* with an audience. It's understandable to be frustrated, and sadly the only cure is time.

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I was this same way.....exactly..I know how you feel!!!! You will get comfortable as you go along. My instructor I have right now for my last semester is phenomenal.....she told us this..." You are not learning a thing if you are not nervous about something" or something to that effect..not those exact words per say but pretty much that. She has a very very valid point there.........and at the end of every clinical she is going to have each one of us tell her something we learned that day........I think this is a great way to teach...and also she told us "know what you don't know"....like it means challenging yourself with more new stuff each time to build on what we already learned

So don't worry..it will get better!!!!!!!

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Specializes in NICU Level III.

I always fumble with gloves when I'm being watched.. I feel so incompetent when I can't even put on gloves!

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My nervousness has gotten me written up- don't know how to get past this, especially now. I must now be absolutely perfect in pulling the meds (under the microscope) or be out of the program.

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Specializes in ICU/PCU/Infusion.
My nervousness has gotten me written up- don't know how to get past this, especially now. I must now be absolutely perfect in pulling the meds (under the microscope) or be out of the program.

I'm sorry you're having such a rough time. Do you use paper MAR's or are you on computer? I'd suggest taking as much time as you need, be absolutely meticulous and do all of your rights each time as slowly as you need to. You can do this!!

Practice at home with your own medications. As you pull each bottle out, check all aspects against the label.. it may actually help.

Good luck!

Leslie

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Specializes in med surg, tele, ortho, preop, recovery.
I always fumble with gloves when I'm being watched.. I feel so incompetent when I can't even put on gloves!

Sounds like me....I hate it when somebody is watching me while I doing something, especially when there is a line at the pyxis and everybody's gaping at you while you're pulling meds. I'm guaranteed to get klumsy.

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