Graduation coming soon -- low self-confidence

Nursing Students General Students


I'm sure I'm not the only one to ever go through the wide range of emotions that come with graduating nursing school. But honestly, I don't ever remember being this scared about anything in my life. In just a couple weeks, I will be graduating from nursing school. I already have a job lined out that is on the same floor I've been on as a Nurse Extern and a CNA. Last summer, I externed on the floor and my preceptor went to the manager about how well I did with the patients, and that led to a formal job offer as a CNA from the manager herself. Now the manager has wanted me as a nurse ever since the beginning of this semester, which I accepted, but the nervousness and incredible fear of actually being a nurse is finally taking over. Everyone in my class is much more outgoing and talkative than I am, and they are all so excited about getting on the floor. I am much more shy and quiet and still have issues with confidence. It makes me wonder if my personality is even cut out for this. Plus, I'm so terrified that once I'm on the floor, something will go wrong that I will have missed, or I'll end up freezing from being so overwhelmed. Does anyone have advice on how not to psych myself out completely? Even better, are there really any nurses who are more shy and reserved? All the nurses I've seen throughout school are more A-type personalities, so it has left me even more confused

The fear you have, in the form of mild stress, will help keep your patients and license safe. Just because you are now the primary nurse for a group doesn't mean you aren't allowed to ask questions anymore. No one should practice on an island out of fear of being shamed or belittled. Peers want you to demonstrate an ability to think critically: What is your concern? What assessment data are you working with? What interventions have you tried or plan to try, and why? Think 'SBAR.'

Nurses are constantly reading people. They form judgments quickly. This may seem unfair, but it is more of an adaptive tool to understand each teammate's strengths and weaknesses. If you have a habit of not speaking up, coworkers assume you either: 1) know nothing, or 2) know everything ("The new grad is fine. S/he doesn't ask for help. Well, they worked here as a student, so that's probably why.") Both conclusions are wrong--even harmful.

I graduated with nearly debilitating impostor syndrome and anxiety, and was also described as "quiet" (re: shy) throughout school. To top it off, I admittedly entered the profession with relatively little life experience. Some preceptors were harsh in their criticism, taking the "tough love" route. Other instructors were more compassionate, but still firm. And then there were staff nurses with decades of experience who suggested I simply wasn't cut out for this field. As someone with a tendency to internalize the bad and not believe (or recognize) the good, receiving these comments almost made me want to quit. But I am grateful to everyone who ever approached me with honest feedback.

On the theory side, From Novice to Expert by Patricia Benner gives the beginner nurse an idea of what clinical growth looks like. Refer to this framework from time to time. Ask yourself what stage you're at. Think of examples from specific shifts. Regarding personality, I agree most nurses are Type A. It's because our work--and society in general--favors assertiveness, often conflating confidence with competence. This is understandable when someone's life is literally in your hands. One nurse educator had my new grad cohort assess our "mind styles" using the Gregorc model. I realized my results were different based on whether I answered as my "true self" versus the way I am at work. So even if, like me, you are naturally introverted, you can't seem unsure of yourself at the bedside. You must learn to communicate, show what you know and, if necessary, fake it till you make it.

The truth is that you are expected to be more task-oriented in the beginning. Lists are your friend. Ask questions if you feel unsure. Copy the best workers. Return-demonstrate skills with supervision. Review the unfamiliar. Try to place your patient's vulnerability above your own self-consciousness. And don't forget to be kind to yourself. Don't neglect your health. Breathe. You deserve to be there. You have the education, the foundation. It is up to you to get the best training you can. Great nurses never stop learning.

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