First clinical rotation finished, "not so glowing" evaluation

nurseprnRN, BSN, RN · Apr 24, 2012

so, you are in nursing school to learn information and techniques to make you an effective nurse. you're at the very beginning of your education.

at this point, it's important for you to realize that this evaluation is a snapshot in time. you have a long way to go and a lot to learn. when you learn it, your competence will rise and your evals improve. evaluations are supposed to give you a bit of a roadmap to improved performance.

this is why you are in school to learn nursing. ask for specific recommendations on resources to help you improve, not merely what you have to do-- how do you learn how to do what you have to do? seek tutoring, speak to your faculty, ask the nurses in clinical.

i am reminded of a haiku my professor daughter had on her office door:

"office hours. no one comes again. perhaps they'll all fail."

do not be that no one.

Neohippy · Apr 24, 2012

Thanks for that, GrnTea. I asked my instructor what I could do differently to improve and basically it's all down to my getting anxious so it's something I have to learn to deal with. She said I am plenty organized but it's just being able to drop what I'm doing when an interruption comes and multitask without getting disoriented. I am open to constructive criticism as I want to do well in clinical and increase my confidence. However, nothing else specific was said to me.

mssjez · Apr 24, 2012

I agree with GrnTea - you're in school, you're not expected to be perfect out of the starting gate. The important thing is that you'd like to do better and are trying to find out how. Trust me, none of those other "naturals" were born able to multitask and figure things out on the fly. Chances are, they had a previous job or other experience that required them to learn that skill and you will too. If it helps, get some friends together and simulate your own scenarios (including the interruptions - which you shouldn't know what they are going to be). Like everyother skill, you'll get better at it if you practice by putting yourself in other scenarios where you have to do it. Good luck!

mindlor · Apr 24, 2012

Spend as much time as you can in the skills lab and practice practice practice......

NCRNMDM, ASN, RN · Apr 24, 2012

Hi folks,
I just finished Fundamentals of Nursing clinical rotation. We all received evaluations from our instructors on our clinical performance. As I struggled with nervousness in clinical, I wasn't expecting a perfect evaluation and expected, even welcomed, some constructive criticism, but it still bummed me out a little nevertheless. I apparently am prepared on paper and do very well on assignments like cast studies, yet it doesn't translate over as well into my clinical performance. For example, I made a med error (gave a med late) and get discombobulated whenever my "routine" is interrupted and get behind and don't prioritize well. Some people are "naturals" in clinical, even without previous medical experience (I don't have previous clinical experience either, BTW). I don't want to compare myself to others...I guess my question is, has anyone else experienced this when they were new in school and how did you overcome it? My mind goes blank when the instructor asks me a question and I make common sense mistakes. I do meditate and try to work on any anxiety before clinicals with self-talk beforehand, yet inevitably it still comes up and I go blank.
Thanks for listening!

Multitasking as a nursing student is a learned skill. Some people have a more natural nack for it, but we all have to figure out what works for us. Do you have a report sheet that you use when taking report? If so, use it and keep it with you, if not, I will send you mine and you can use it if you want. My report sheet is my, "brain" so to speak. I write all my patient's information on it (IV access, IV fluids, recent labs, labs to be drawn, meds, vitals, diagnosis, past medical history, past surgical history, etc).

I also have a sheet for hourly urinary output, and a sheet for hourly IV fluid intake. I keep up with my patient's output, IV intake, and other information using my sheets. When I have a task to do (such as restart an IV, re-vital someone, hang more IV fluids, etc) I write it down on my report sheet to remind myself. When the task is done, I put a check mark beside it, and write the time that I completed it.

Continue to take only one patient until you feel confident that you can handle two. Don't overload yourself, and don't feel like you are dumb, less skilled than anyone else, or not meant for nursing. In time, you will learn to priortize, you'll get a sense of what must be done now, and what can wait, and you will be multitasking like a pro. Good luck!

Neohippy · Apr 24, 2012

Thanks ever so much to everyone for their kind, encouraging words and suggestions! MattRNStudent23, I would love to have those sheets if you could send them to me ([email protected]) and thanks so much for your help! :yelclap:

NCRNMDM, ASN, RN · Apr 24, 2012

I will send you my sheets. Feel free to message me here, or email me, if you have any other problems. I understand what it's like to be an unsure first semester student, and I will be glad to give you any advice that I can.

Scarlettz, BSN, RN · Apr 24, 2012

I received pretty much the same reviews in the past. Basically, you just continue on and try to better yourself. It gets easier with time and familiarity with the facility you are in. The best thing you can do is remain safe and give good patient care. Find what works for you- as far as helping to organize your day. For instance, when you are getting your AM vital signs do the physical assessment right away. Make up your own assessment sheet to fill out so you have all the information that you need to collect.

You also have to realize that sometimes being a student in clinical slows you down. When your clinical instructor has to give meds with 4-5 other students, it can slow down your day. As a nurse, you won't have to wait for your teacher to give meds, lol. And we get so worried about collecting information for our ADPIE that this also slows us down. Don't tell your instructors this, though. Just do the best you can, learn all you can, and try and see this as a learning experience.

I was told I was too quiet, slow, unorganized, and also out of whack when a change of routine occurs. I have never worked in healthcare before - nor do I have any nursing friends or relatives to give me pointers. So, it was all new to me! Things get easier with time and exposure. Some arts you may not master until you have been a nurse for many years. Do better for yourself - don't compare yourself with the others. A great instructor will assess your growth- not compare you to the others.

As the semesters progress, the reviews get easier to hear.

And stick to it! I wanted to quit many times first and second semesters. DON'T! My 3rd and 4th semesters were so much easier. The teachers give you more independence to give meds on your own compared to the first year. This really increases your confidence more (if you know your stuff) and empowers you. You are not as closely scrutinized.

symphie · Apr 25, 2012

It gets better.

I just completed semester 4 of 5 for my BSN and when I started, I had the exact same problems you did. I learned that for me, organization is key, and that my clinical instructor/nurse made a HUGE difference in my anxiety level.

For my organization, I have a piece of paper for each patient. Their vital information is all in the top left of the paper and I have spaces marked out for vitals, meds, treatments ordered, etc. so I can make sure everything gets done. I also STILL have to take my "assessment guide" in the room with me for shift assessments. When I'm practicing on classmates and students, I can do without, but I still haven't gotten over the anxiety enough to trust myself to remember everything I need to assess without a quick reminder. Don't be afraid to use your resources.

As far as anxiety, I learned that who I'm surrounded by makes a HUGE difference. With a clinical instructor focused on assessing my skills, I perform horribly. With a clinical instructor focused on helping you learn (like the one I had for med-surg) I performed much better. Also, nurses that acknowledge that I want to LEARN, not just perform skills, helped me alot. I loved when I was with a nurse who was willing to just let me follow him/her around. I didn't necessarily need them to slow down to let me perform a skill. I just needed them to let me observe how they did things and explain why they were doing what they did. That might just be my style of learning though. I am much more successful if I'm able to observe for quite awhile before diving in hands-on. You have to find what kind of learning style works best for you in a clinical setting since before now you've always been in a classroom setting, and things are very different.

Neohippy · Apr 25, 2012

Thank you, thank you, thank you!!:w00t:

Neohippy · Apr 25, 2012

Symphie, I'm exactly like you in the way I learn--I like to watch first, then I feel more confident to do it myself (with guidance if need be, of course!) We observed a nurse for 1 day, but she was so busy running around and many tasks were delegated out, so by following her I couldn't really observe a whole lot other than charting.

I so appreciate the replies from everyone--my clinical group seemed full of super-competent people and so it is nice to hear others who have also had the same issues as I.

Namaste! :bow: