Graduating soon . . . told by preceptors "stop trying to be perfect"

[Southern Magnolia]

So I am a Sr. BSN student. I will be graduating in 54 days (but who's counting). I am a mature student - 2nd degree, 2nd career, married with children. I am an admitted perfectionist and have worked my rear off in nursing school to do well. I have done quite well both in didactic work as well as clinicals.

In my family nursing clinical last semester and again in my senior preceptorship this semester I was told by my preceptors to "stop trying to be perfect" and to "cut yourself some slack". I'm not sure what to do with their feedback. I am obviously perceiving situations differently from the nurses I have worked with.

As I said, I am a perfectionist. I am driven. If I make a mistake I admit it, apologize, try to figure out where or why I went wrong, make a new plan, probably run the new plan by the preceptor, execute, and then reevaluate. As far as my family nursing clinical goes, I was working in a pregnancy prevention program and honestly don't know why that preceptor said that. It was a very fluid situation and I don't think I could have screwed up if I had tried so I really don't know how I was hard on myself. In my senior preceptorship, I was in an NICU and managed to take a full load by my 8th shift or so - so I think I did well though I don't really know what "normal" would be. I received high marks and high praise from both preceptors. I think (thought) I did very well in both situations. Most of the mistakes I have made in clinical are instances where I should have thought of something (the next step or big picture) and didn't or I forgot to chart something - after having been taught to do it. Now, I realize as a senior student next level thinking is usually hit or miss, but I feel like I should say something like "sorry, I should of thought of that. Or "Sorry, I knew that. I'll get that next time." Is this wrong? I did grab the wrong milk for a baby one day but had not done anything with the milk yet or initiated my checks. I had gotten it out and then got called away. And I did apologize and did some inner chastisement because that could have been a big deal. Is my feeling that I need to acknowledge my mistakes and my learning curve making me come off in a bad light?

I guess my problem is that I'm not sure how to take their advice. I will be graduating soon and hopefully will be able to get a new grad residency in a NICU/PICU. When I inevitably forget things or make mistakes is there a better way to handle the situation? How do you handle it when you make a mistake or forget something?

[sunshyne17]

I sympathize with you because our situations are similar. I also am choosing nursing as a second career and have a family (only I am not married).

When you get the feedback "stop trying to be perfect" I think that breaks down into "you can't do everything and be effective" or "it comes with experience" or something along those lines. If you need help, ask. If there is something you can delegate, do so. And when you screw up, acknowledge what you did. "I picked the wrong formula for Baby Williams but caught myself before I gave it to him." You can say that to your preceptor but you don't have to apologize. You made the preceptor aware is all.

Now if a parent came in and saw you feeding baby Williams formula and he's supposed to drink breast milk THEN you apologize. See the difference?

My preceptor told me "you are not going to be able to fully assess each patient at the beginning of a shift." I looked at her like she was crazy! lol How would I know baselines and detect a status change? As time when on, I saw what she meant. She did focused assessments on her patients to save time but never compromised care.

So don't take your comments to heart but reflect. You don't need to be perfect as a nurse - you need to be compassionate, cautious, empathetic, honest etc.

[Esme12, ASN, BSN, RN]

I have met students that literally drive themselves crazy and their preceptors with ....I'm sorry, I'm sorry.... I have met perfectionists that almost paralyze themselves with what if's and checks. Their anxiety is palpable. They make others around them anxious with their apparent frantic demeanor....even if you are not anxious at all.

I think they are saying ....you are going to give yourself grey hairs and age prematurely...you are making those around you anxious......relax...breathe...calm down...((HUGS))

[morte, LPN, LVN]

also, you don't want to appear weak/equivocal/lacking confidence. You will invite the bullies.

[DalekRN]

Trying to be perfect in this profession is so hard because there are.so many variables. There are black and white things like not giving a med too soon or giving the right milk to the right baby of course, but when they say don't try to be perfect, they might be talking about all the gray area stuff in our profession. Like, how to approach a difficult patient, etc... It'll make you burn out less quickly if you follow that advice, whatever it means to your situation.

[Southern Magnolia]

Thank you all for your feedback. I have been chewing on this awhile, and I agree that is probably just a matter of apologizing too much. I hope I wasn't coming off frantic or frazzled. There were certainly shifts that I felt that way, but my perception wasn't that "frantic" was my norm. However, I will watch more closely once I am working to make sure that I'm not creating that kind of environment.

As for bullies, morte, I have reconciled myself to the fact that I am one of those people that attract the attention and ire of those that for whatever reason need to try to intimidate others. I've seen it in my past career and in nursing school. Thankfully, I have always been able to navigate those types of situations by not feeding into it in any way. My attitude with that sort remains the same, despite their attempts to unravel me, and I kill them with kindness. I'm hoping that tactic continues to work. I think when they realize that you are onto their game and not as dumb as you look (or they think you are) then the fun is spoiled and they move on to someone else.

Thanks again for your insights.

[hikernurse]

Something else, if you are focusing on doing everything perfectly, sometimes you miss the forest for the trees. Some things need to be done exactly--for instance you want to keep sterile procedures sterile--but there is a lot that falls under the art of nursing. Working with humans can be pretty messy sometimes; both metaphorically and literally. Keeping things fluid and going with the flow will sometimes get you better results than trying to do everything "right".

[Nurse SMS, MSN, RN]

We had a new nurse we were orienting who ultimately we decided not to bring on full time after all. Why? Because she could NOT let go of the need to be "perfect"...and in doing so was slow, ineffective, unable to separate herself from the perfect NCLEX/nursing school way of doing things and the real world of nursing way. As a result, she was constantly behind, constantly flustered, constantly making more and more mistakes due to this loop she put herself in thinking everything had to be textbook. The apologizing, fluttering, tears, tension and yet stubbornness, inability to learn and move on was so disruptive. She simply was not going to work out and we had to let her go.

[nurseprnRN, BSN, RN]

This reminds me a little bit of the kid who wrote to Dear Abby and said her mom was always on her to pick up her room, do the dishes, and get her homework done. What should she do? And Abby said, "Pick up your room, do the dishes, and get your homework done." :)

You have a whole lot of people who are in a position to know better than you telling you you're doing fine and to stop being such a compulsive perfectionist. So this is what you do: Instead of "Sorry, sorry, sorry," you say, "Thank you, thank you, thank you." And then you listen to the people who tell you you are doing fine and stop being such a compulsive perfectionist. :) Not.done.yet has just given you a great reason why.