Good at Theory, Trouble with Clinical/Lab

[Orlette]

hi! i am 20 years old and study in the first semester pn program. at first, i loved the program. i loved the classes, i loved doing homework, i felt smart, i got above average grades. for instance the overwhelming majority of the students hated and did not understand the abstract theoretical and philosophical courses, (especially the roy adaptation model that we study). i, on the other hand, understand it easily and pretty much enjoy it. so i was sure i was in the right program...until the clinical had begun. in clinical i do not understand what i am supposed to do, do everything awkwardly, slowly etc. finally the teacher said my performance in clinical is unsatisfactory, that i appear distracted and not paying attention (which is not the case) also that "my communication patterns with clients are vague" and placed me on a contract (which basically means that from now on, if i mess up on any little thing i am out of the program). soon i was placed on a contract in my lab class as well.

but i continue to do great in the theory courses! (psychology, health-care consumer, anatomy and physiology, nursing theory) i am not trying to sound snobbish or anything, but where i can compare my written work (such as posts and threads on our discussion board for marks for psychology for instance) to the threads of most other people, their posts look elementary school level compared to mine. my marks are in the range from a to a+ in these kinds of tasks too. the other day i looked at the thread on pavlovian conditioning posted by my lab partner who the lab and the clinical teachers like and say she is doing a great job, and her thread was so short and primitive and did not even fully fit the concept! and yet she is doing good, and i am already on two contracts, and yes when it comes to lab, she does everything so easily, quickly and effortlessly... compared with her performance, my clumsy and awkward performance looks even more pathetic...

during clinical too it is like my brain freezes, and i either feel hopelessly lost or dreadfully bored. actually i am lost, very nervous and bored all at the same time..

i also have considerable level of performance anxiety. when somebody watches me (which they always do in clinical) i cannot do anything right. they now watch me very closely in lab too, and yesterday i actually started crying when i was trying to do the lab practice and had to leave to calm down for 15 mins, because the teacher was only watching me, she pretty much did not watch other students, and asked me to repeat the same simple procedures like 3 times in a row until the class ended. and the "procedures" were like to practice changing incontinent pads, brushing teeth, washing face and basic stuff like that...

i hate clinicals and i hate lab. we have clinicals on monday and tuesdays, and after that, even though i have 2-3 theory classes on each remaining weekday, on tuesday evenings it feels like the weekend has begun! (...with another 2 hours of lab torture on thursday nights)

so there are three points of view on this.

my psychologist says i should continue no matter what, cause what is undermining my performance is social and performance anxiety and running away from it is the worst thing i can do, it will reinforce it, so i should continue with the program.

my mom says it will get better, that i am only in my first semester and we are only doing the basic stuff now, and later things will get more interesting and i will get used to it too (she is a doctor, she says their first practice days were like that too)+ i will not have to do the practical stuff for the rest of my life, i can be a nurse and do research and pretty much never deal with patients.

my academic advisor, who is a pn, and one of my instructors as well, after a long conversation when i shared all of my feelings and concerns about the situation, says that it looks very much like this job is not for me, that i am clearly more into theory, and if i do not like being watched during my work nursing again is not for me, since my client at least will always be watching what i do. and that it does not get better, nursing is pretty much just this (well, maybe some more complicated procedures will be added later but still) and it does not matter if i am an rn or rpn, or even nurse practitioner it is still work with patients primarily.. she said she is sure most students in the program look forward to clinicals where they can apply themselves and it is theory that is a "burden" to them, and that there will be less and less theory and more and more practice in the following semesters and the fact that i am hating clinicals is a sign nursing is not my thing..

so what do you think? does it look like nursing is not for me? or could it be just the anxiety that ruins everything? did/do you enjoy clinicals? or at least did/do you enjoy clinicals and lab more than theory is it true?

[xtxrn, ASN, RN]

Listen to the people who know you :) You have a professional psychologist who is probably better able to give advice to your specific circumstances

It's hard. I was terrified of clinicals. I did not do well with talking to patients, or making beds, or speaking up in general. I liked lab (our lab supervisor was an RN, who really liked what she did). I liked lectures. I never did "like" clinicals- I just learned to put up with them - LOL.

But listen to the folks who know YOU :)

[sandyfeet]

What do you like about nursing? What brought you to this field? These are important questions to ask yourself because I think it will give you insight into what you should do. For example, I like nursing because I get to talk to people and physically help them. Just by reading your post, I get a feeling that you are really interested in the science of nursing.

I was ready to write a reply saying that maybe you are a fit for nursing academia (teaching theory? research?) until you wrote about your psychologist recommending you continue so that you don't reinforce your performance and social anxiety. I think your psychologist is correct that leaving the program will not help you overcome these problems, but a part of me wonders if nursing school is the correct area to learn these skills. But since I don't know your entire situation, I don't want to discourage you from nursing school if it is something you have always dreamed of doing. I just know that nursing school is stressful for everybody! I feel sympathetic to your anxiety too, because I have horrible test anxiety--horrible, as in tears, hyperventilating, etc. In a sense, I wish you and I could work out a trade because while I hate the tests, I love clinical!

To answer your question: Yes, I enjoy clinical. The longer I have been in the program, the more I have enjoyed it because now I know more of what to do. I feel like clinical is the "reward" for lecture and testing. But I think you need to have both halves (clinical and theory) to be an effective nurse. And you are obviously an intelligent person, so you definitely have the intellectual ability to become a nurse. While I do not mean to degrade your problems in any way, it is almost easier for you to learn to be confident that it would be for another student to learn to be a good student. I say "almost" because again, I totally understand that it would not be an easy fix. Not by any means. But I wish you the best of luck and hope that you can find an area of nursing that works for you.

[anonymousstudent]

What do YOU think?

This paradigm is common, at least so I'm told. The "good at the book work, bad at clinical/lab" experience. I was a little bit like this when I started, mostly because I just didn't have the confidence I needed to succeed at clinical.

Here are some things that help me (and my CI's). I talk. A LOT about what I'm doing. I say what I'm hearing, seeing, observing, and I talk about the conclusions I'm drawing. Your CI can't read your mind. You might be processing at an entirely different level and s/he just can't see that anything is happening. If I'm slow to give meds, I explain that I'm doing my triple check while I'm comparing them once again to the MAR and logging them in. Especially if it's a new set of meds for me and I'm just making sure. We are students, we don't know everything.

Also, in my opinion, multiple choice nursing theory tests and papers written with ample amounts of time and citations galore very minimally reflect your ability to be a good nurse. They are highly controlled and don't vary much. The right choice is hard to find sometimes, but there are patterns and tricks to watch for. With a real patient, who has what seems like endless issues that are all intertwined, things become much harder - much more like real life. Taking that clinical situation and figuring out what is going on with a patient has real value. Not that you'll get it perfect, we already touched on the "you're a student after all" idea, but it takes a lot more work to get to that place than it does to get good grades on NCLEX style questions. Just my 2¢

Hang in there, keep working at it. It's not easy, but it's worth it.

[chevyv, BSN, RN]

Consider becoming a CNA so you can get used to the clinical part of the field. It is night and day from classroom. It sounds like you don't have much experience with the hands on stuff. Becoming a CNA would help immensely with that. Also, head into lab often and talk with the lab instructor. Practice those skills but listen to the lab instructor just as much. They will go out of their way to help you if you are seen there often.

I wouldn't listen to what the school is telling you regarding not being the right field for you. You're young and if this is what you want to accomplish, you will do it.

The worst that can happen would be for them to let you go. It would be awful, but not the end of you. If it happens, figure out a way to get that clinical part down (this is where the CNA part would help you). We will all be here to support you. :redpinkhe:redpinkhe:redpinkhe

[EMT-newbie]

I get over a mild version of this kind of performance anxiety in another field by practicing the physical aspects of tasks on a dummy or some kind of stand in. At the same time I visualize the thing I am doing in situ. It's a technique used by athletes and musicians, visualizing and performing the moves so my brain doesn't freeze up when doing something new.

With a practiced script to follow, anxiety and feeling awkward just fades away. For me, anyways.

[VolunteerCPR]

1) Calling your fellow students' work "elementary school level" and "primitive" will not get you anywhere. These students will likely be saving lives in the future, and you should treat all of your classmates and teachers with more respect.

2) Nursing is about patients. If you don't like patients, and you don't want to work with patients, and you can't find some joy working to help them on a daily basis, it really may not be the field for you. On the other hand, it may just take some getting used to for you, and that was the case for many of us.

[mb1949]

Become a CNA, listen to me, I am an RN now but I struggled through nursing school, I was all thumbs, and felt so uncomfortable during med pass, wound care whatever, but now I don;t even sweat it, you just need practice, they make it so mysterious in school and it is not mysterious at all.

[xtxrn, ASN, RN]

Yeah- if you don't like the patients? Get out. No joke.

[turnforthenurse, MSN, NP]

In the real nursing world, "good writing skills" isn't going to get you anywhere. You need to be able to apply what you have learned in class to your patient(s) in clinical.

Do you not like clinicals because you feel like you are not performing well in them, or do you not like interacting with patients? If performance and anxiety really are the problem, consider getting a job as a CNA. It will definitely make you more comfortable in the healthcare setting and the experience is invaluable in my opinion.

[SnMrsSmiley]

I love clinical and theory!! Im literally having the best time of my life in school. Im exhausted, havent seen my family in almost three months, and I have a laundry pile that looks like a department store exploded in my living room. But im HAPPY. never had so much fun in my life. I may be the only person in my class that gets excited over care plans lol

[*4!#6]

If you are having anxiety issues please try to get on medications if you aren't already. That solved my issues.