Suck at Clinicals...Should I just Quit Now?

[Melcia060]

Hey guys,

I’m in my 1st semester of a RN diploma program. I just can’t seem to do well in clinicals. I can do the 8.5hr lectures, I can study 4-6hrs a day, I can do all the skills in lab, I’ve even learned to survive on 4hrs of sleep a night, but I suck at clinicals. I get on the floor and I’m so nervous I think I could almost puke. I was so confident of myself before I went into this but then I met my clinical instructor. She has this thing w/ my age. She goes on these 5-10min lectures to my whole clinical group about how “19 and 20yr olds aren’t mature enough or responsible enough to be nurses” and about how my generation “has everything handed to them and they still are a bunch of screw-ups.” She is constantly singling me out in my group. It doesn’t help that the other students in my group are a good 7-10+ years older than me and I’m one of the younger ones in the entire program. I thought she might leave me alone after I could answer her questions and prove myself. But I can’t seem to prove myself on the floor. I can answer all the theory questions, but I can’t interact w/ patients. I get in the room w/ them and I feel like I’m ready to throw-up everywhere. I get so nervous and anxious w/ them. I have no previous health care experiences at all, but I’ve been working in food service since I was 16 so I know how to talk w/ strangers. I’m used to meeting people and talking w/ them, but patients are different. I’m on the oncology floor and something happens when I walk in there. The patients look like they’re in so much pain and anguish and I stand there and feel so helpless. I can’t answer any of their questions…not even the simple ones. I can’t make them hurt less and I can’t find a way to relate to them. I am so nervous with them and I don’t know why. I’ve tried to calm myself down, all the deep breathing exercises and count to ten things, but it doesn’t work. I fumble around w/ my stethoscope and try to hear their blood pressures, but I just end up messing it up because I’m so nervous. It doesn’t make any sense because I’m usually bubbly and upbeat w/ strangers. My clinical instructor doesn’t help me at all. She just yells at me for everything I do. Yesterday I asked her for help because I couldn’t hear a BP and she told me “You’re not a competent student nurse, therefore, I’ll have to fail you because you can’t perform simple tasks.” I just learned how to do BPs on Thursday. I feel like I’m sinking horribly in clinicals. I’ve worked so hard to get into this program and I’ve already sacrificed more than I thought I ever would to be here. But I honestly don’t see how I’ll make it the rest of the semester in clinical. I got into nursing because I’ve wanted to work in the NICU since I can remember, but now I’m wondering if I’ve made another huge mistake. Maybe she was right…maybe I am too young to be a good nurse…maybe I can’t handle it. But now I need some help figuring out if I can ever be a good RN or if I should let go of this before I get even deeper over my head…

[moongirl]

dont quit. Your nervousness is getting in the way of your skills and this instructor is the cause, pure and simple.

go to the director of the program and file a complaint and ask for a new CI. YOU are PAYING to be taught how to become a nurse, you are not paying to be humiliated and put down. If you already knew the skills, you wouldnt be there, you are there to learn! You are in a hostile environment, waiting for the next barb, of course you feel like you cant do anything! STAND UP FOR YOURSELF! DO NOT LET THIS WOMAN TAKE AWAY YOUR DREAM. DO NOT

[GeminiTwinRN, BSN]

OK...I'd like to help. Take a deep breath and know that at least in here, we love you!

Here's some advice:

1) find a friend in the group or school- FAST. Ask to practice BP's & any other skills that intimidate you!

2) Don't think that you are going to cure anyone, or particularly bother anyone in oncology unit. Use your people skills (yes, you have them from the food service-trust in that!). If they seem depressed and prefer to be alone, respect it. If you smile and get some chatter in return, maybe they appreciate the distraction! Simply tell them that you are new, and that its a pleasure to help care for them, and ask them perhaps something simple and soft, such as if today is a better day for them. Keep voice soft (not too soft to hear) and kind. With reserved professionalism, you can't go wrong. Its OK to be quiet, its OK to talk about non-nursing things as long as the patient seems to benefit and enjoy the distraction and you aren't long-winded or inappropriate (doesn't sound like chatting too much will be a problem for you!). Some other general conversation openers: Is this a picture of your children? Did someone you know make this blanket for you? Can I help you put some lotion on your feet (if allowed)?

3) You ARE young, but so were tons of my peers and I learned from THEM all the time. I wish we knew it all as we get older, but we don't- and you do too have something to contribute (fresh eyes, the desire to learn, the fact that you are wanting to do this!). Your kindness and youthful energy are pluses- don't believe all the stuff your clinical instructor says.

4) Lastly, speak to your advisor. Ask for suggestions. Speak to your peers, ask for suggestions.

And finally, at this immediate time- you need a hug and reassurance, so go talk to someone who loves you (your mother? best friend? boyfriend/girlfriend?) and tell them that you are in real need to hear about the things about you that they love. Maybe being reminded that you are valuable and have talents will help balance that unkind clinical instructor's feedback. Don't get mad, get even- rise to this challenge!

My best to you!!!

very encouraging, and I agree wholeheartedly!

[ldh, BSN, RN]

Hey guys,

I’m used to meeting people and talking w/ them, but patients are different. I’m on the oncology floor and something happens when I walk in there. The patients look like they’re in so much pain and anguish and I stand there and feel so helpless. I can’t answer any of their questions…not even the simple ones. I can’t make them hurt less and I can’t find a way to relate to them.

Are you in your very first clinical? I'm wondering why they would put you on an oncology floor for your first time. I remember my first clinical in long term care and I thought I'd throw up I was so nervous - didn't know anything. Someone told me to put mrs. so-and-so on the commode and I'm thinking omg "what's a commode??" I remember really being "eased in" to the clinicals - first BP I took was on a resident in a senior's residence and then a month down the road it was gradually in long term care.

I can't imagine being in med/surg or oncology or cardiology for my first clinical - is this something that a lot of schools do? Maybe someone can provide me with some insight on this . . .

I feel for you - I really do!! ((((((hug)))))) I survived my nightmare instructor a few years ago, and challenges in clinicals since then have been minimal in comparison. I figured, if I could get through that, I could get through anything . . .

[UM Review RN, ASN, RN]

Melcia, it really angers me to think that instructors get away with this kind of behavior. But they do, and unfortunately, you might not have seen the last of this type of "teacher."

You need to stand up to her. Not on the outside, but on the inside. When she said that to you, what happened to you on the inside? Did you cave and say, Gee maybe she's right? Because after all, she's the instructor and she must know nursing better than I do?

You probably did because frankly, you would probably not encounter this type of behavior with any other educational program, and you've simply never been taught how to deal with people like this before.

But that's ok, because you're learning.

You need to sit down and look at yourself in the mirror and practice saying this until you can say it with conviction:

"I have a lot to offer these patients. I will do whatever it takes to become a good nurse. I will work hard. Therefore, I am determined to refuse to listen to those people. I can do this, and I will."

Because you see, she made a judgement, a pronouncement against you personally. She was not teaching, she was not constructively critiquing your skills. She overstepped her bounds--you need to realize that she is not God, and she cannot see into the future, even though this instructor would have you students believe she can.

She was simply offering an opinion. You don't have to say a word. Dig your heels in, remain steadfast, and prove her wrong.

I say you CAN do it.

If I made it, anyone can.

[nurse4theplanet, RN]

It is clear, by the very title of this thread, and your description of your situation, that you are lacking in self-confidence. THIS IS NORMAL AS A BEGINNER!

It is normal that you feel like you do not perform well in clinical, that you don't know how to talk to your pts, that you feel helpless, that you should be doing more, etc. etc. Instead of beating yourself over the head about it, which is further damaging your self-confidence...accept your feelings and focus on the areas in which you have improved since your first clinical day (such as charting, organization, reading the doctor's orders, time management, etc. etc.)

You go through a process in nursing school. In the beginning you feel out of control and unorganized, but slowly you begin to build self-confidence with practice, practice, practice...which you won't get if you accept defeat so early. I wanted to quit my entire first semester because I felt just like you do, but now I am soooo thankful that I toughed it out, and I feel alot more confident.

As for your instructor...you may be extra sensitive to her comments because of your bruised ego (so just think about it)...but I do not want to minimize your feelings. I too am young (and I have braces:rolleyes: ), and I HATE it when others judge my competency based on how old I look or use generalizations about my age group to demean me! I would speak to her directly about how you feel, as intimidating as she may be, and express your feelings about nursing and your need to have her acceptence and encouragement. And if that doesn't work, just keep in mind that it is only a temporary assignment and do the best you can.

Please don't quit! Let me recommend two very good books that helped me, "How to Survive (And Maybe Even Love) Nursing School" and "Using Your Head to Land on Your Feet: A Beginners Guide to Critical Thinking"...Good Luck! :mortarboard:

[mybackpages]

You poor thing! I know exactly how you feel!!! Seriously, last semester was my first clinical, and I was in a group of 10, all of whom (aside from me, who had NO hospital experience, even as a patient) had jobs in the hospital, three had jobs on the same floor of our rotation!! We had several weeks of practice in the lab, then were turned loose! My first day on the floor all I got was "Mr. Jones in 3A needs a bath, has to be turned in a log roll, and needs his bandages changed". Thats it! It's a huge hospital!!! I didn't know where to get towels, gauze, water, soap! I tried to hook up his IV pole to take his blood pressure! (Thank god he was delusional and didn't know the difference!) At least I had a wonderful instructor, otherwise I probably would have quit. There is this saying that "nurses eat their young" and as much as I would like to doubt it, my experience tells me it is true. For every one good one, there are two bad.

I have been spoken down to, berrated, humiliated...It doesn't matter how young or inexperienced you are- In my former majors I have a 4.0, wonderful letters from professors- In nursing, it seems this is just the way it is. But don't get me wrong. There are some professors out there that will go the extra mile for you and make you remember why you wanted to get into this profession in the first place. My advice: practice and practice, but in the long run, most hospitals use digital BP cuffs anyhow... :) don't get too stressed, and if you do, stick with it anyhow,because there are many of us right alongside you, and we'll all get through it together.

[nutrition73]

even though you have received some great advice, i just wanted to send a little note your way. every night before my clinicals, i freak out, too. i came into nursing school with community experience, not clinical experience. i almost quit last year because of a med error. it actually ended up being in the patients' favor but i was still so very upset, as you can imagine! the next day, my lecture instructor had heard i was dropping out and urged me to speak with her before i made any "rash" decisions. reading your message, i agree with the others that first, find someone on staff that is supportive. they have been through this and can relate things in a way that we cannot, especially when we are not thinking clearly. my problem was that i felt my skills were supposed to be up where veteran nurses were, when in all actuality, i am new and still learning. i found early on in nursing school, also, that i was not the only one feeling incompetent and freaked out. everyone felt the same way! another point i have read mentioned is practice. get another classmate and practice vitals. i still practice on roommates and other students. just last week, i asked a faculty member to put an iv pump in lab so that i could practice setting up a primary and secondary line. and you know what? i had to do it the next day in clinical! if you have wanted to be in l&d or nicu since as long as you can remember, then hang in there. support, support, support! remember that you are new, inexperienced and you are, and this is most important to keep in mind, learning. it is all a learning experience. if you don't know the answer, be honest and try to find the answer. have you spoken with your instructor in a private area? i had a difficult time with my first clinical instructor and once she knew how freaked out i was and i understood her teaching philosophy, we worked much better together and we have a great relationship. she also saw that i was willing to get extra help with assessment, charting, etc. i empathize with you on your situation with your instructor. i have a classmate that was yelled at last week for whatever reason and she was able to talk with me and we "shared" stories and subsequently was able to put things in perspective.

so....hang in there. 1) ask your clinical director or whoever oversees your programs clinicals to talk. chances are, she or he does not know you are going through this and most likely wants to help. at our program, no one wants to see us fail but can only help if they know we need and want help.

2) talk with other students to hear how they are feeling. i was amazed by how many of my classmates felt the same.

3) practice vitals on everyone and anyone. i bought a cheap bp cuff & can bring with me everywhere.

4) talk positively to yourself. you are there to learn! i tell myself every day at clinicals that i am there to learn, i will have fun, and if i don't know something, i will ask.

one of the best things a teacher told me was to listen and look at my patient. she told me to stop worrying about this and that but to actually listen and look. easier said then done sometimes, i know.

our lives are not determined by what happens to us, but how we react to what happens, not by what life brings to us, but by the attitude we bring to life.

take care

[kar212]

Oh, my heart really goes out to you!!! (((HUGS))) Really, I could have written your post when I started doing clinicals in the fall of 1994. I had just turned 20 and my only experience with working with people was working at Taco Bell! The only difference was that my first nursing instructor was a gem. It was the second instructor that made me really question if I should be a nurse. She even asked me if I really wanted to be a nurse. I felt SO incompetent for the longest time. I felt like an idiot at clinicals. It seemed like I never knew what to do. I had never worked in a hospital. I think it really would have helped if I had.

Later on in the nursing program, I tried when I was able to, to avoid med-surg type of settings (we often had a choice, which I don't think is real common these days!). Anyway, I tried to stick with more community nursing. I figured that's what I'd do since I felt like I wasn't competent in a hospital setting. Anyway, I worked in med-surg for the first couple of years and then got a job on a med/oncology floor. It took me a while to get comfortable there, but after some time, I considered myself a very good nurse.

I can see why you get so anxious going to clinicals. Why wouldn't you be? I mean, your actions determine whether or not you pass. I was nervous that first quarter of school even with my nice instructor. It just makes things a lot worse when your instructor is a jerk. Try and focus on your patient. Try and anticipate their needs (this was a tough one for me as a student!).

Oh, I've had problems with anxiety all my life and boy was it exacerbated by nursing school!

Anyway, my point is, I was certainly not a star nursing student. Today, I'm a very good nurse. Don't let anyone break your spirit. You've worked very hard to get where you are today. Keep going!

Take care,

Karen

[kenny b]

Be very careful here. When you're head-down in it, these problems fill up your whole world. If you give up, you could look back and say, "It was bad, but I could have made it and everything would be fine now." Even if you flunked out and had to go a second round or you have to request a new instructor or what-have-you, it'll be worth it.

The MAIN thing here is to do this with someone (another young student, a family member, another instructor, anyone!)

When was in my math program, I was going for a teaching certificate and one of my instructors asked me and 2 other education majors to leave the class and take the watered down version of his class (designed for education majors). He said (in front of the class) that education majors are not serious about math and we would probably flunk anyway. Well I've never worked so hard in my life and the three of us got the only three A's in his class (he was actually upset about it).

There's no reason to believe that these performance issues are related to your ability. It's almost impossible to learn in this environment, but some very famous and talented people did just that and it adds a special kind of spice to it on graduation day (keep that image in mind).

[Melcia060]

Hey everyone,

I just want to say a BIG thanks to everyone who replied to my post . I am going to stick it out and do my best. But it really comes down to whether I pass clinical or not if I will stay in the program. I *think* I've got the BP thing down now. I bought a cuff this weekend and I've been practicing on everyone that I see, LOL!! It is just so frustrating not having an instructor willing to give you a fair chance, but I'm going to try to plow through to next semester. I think I may try to get a student nurse position at the hospital so I can get more time with patients. Again, thanks to everyone who replied. It helps a lot to know that I'm not the only one who has felt like this and that others have survived their nightmare clinical instructors!! -Mel

[Melcia060]

Are you in your very first clinical? I'm wondering why they would put you on an oncology floor for your first time. I remember my first clinical in long term care and I thought I'd throw up I was so nervous - didn't know anything. Someone told me to put mrs. so-and-so on the commode and I'm thinking omg "what's a commode??" I remember really being "eased in" to the clinicals - first BP I took was on a resident in a senior's residence and then a month down the road it was gradually in long term care.

I can't imagine being in med/surg or oncology or cardiology for my first clinical - is this something that a lot of schools do? Maybe someone can provide me with some insight on this . . .

I feel for you - I really do!! ((((((hug)))))) I survived my nightmare instructor a few years ago, and challenges in clinicals since then have been minimal in comparison. I figured, if I could get through that, I could get through anything . . .

Hey,

Yes, I am in my first clinical. We started clinical the very first week of school. This is the first year that my school is putting first semester students on the oncology floor. I'm not sure why. A lot of nurses and students from local nsg schools have looked at me funny when I told them I was on oncology. One RN even said "Oncology, are you sure?" LOL. I guess it isn't common practice around here. Good to know that you survived your nightmare clinical instructor!! Mel

[Melcia060]

hi, melcia060!

nurses have strong, stout hearts. we don't give up that easily! let me point out that by the time you reach the age of 40 , you'll have 21 years of nursing experience under your belt, a very enviable record! and, you'll still be considered young! :uhoh21: at 60, you will be unique and the mountains of knowledge and experience in nursing that you will have will be something to be really proud of. by then, your clinical instructor will probably have gone to the big hospital in the sky and be but a faint memory. just remember to be kind to those newbies coming up behind you in the way that you should have been treated. anyway, there's always the next school term and, hopefully, a different clinical instructor. remember to keep one foot in front of the other and just keep moving toward the finish line.

http://medicine.osu.edu/exam/ - from ohio state university college of medicine, an interactive guide to physical examination for 8 body systems and includes sounds. has an interactive blood pressure cuff (the link is toward the bottom of the page, "take a blood pressure") where you click on a blood pressure bulb to start the inflation of the cuff. you will then hear and watch the manometer and tell the program what the final blood pressure is by typing in the systolic and diastolic numbers. it re-cycles to give you lots of practice!

daytonite,

thanks for your words and experience!! 21 yrs of nsg experience when i turn 40 sure does sound impressive, lol!! the bp website was great. i can finally see what everyone was talking about when they said "watch it jump." thanks again.--mel

p.s. trust me, i've done a lot of screaming at my instructor in my head already!! lol