Help With Serious Doubts

[Lilac]

Okay, so I'm in my last semester of the PN course, and I am having very, very serious doubts. Granted, we still have a couple of clinical rotations to go, but I am stressing over the fact that I don't feel even basically prepared. Is it uncommon to get to your last semester without EVER having given an injection of any sort???

Also, I figured by this time, I would feel that assessments and patient care would start clicking-feeling a little more routine. Yet, I feel all thumbs most clinical days.

My grades are good, and I am passing clinicals. My instructors tell me that I give safe care.

Yet I feel SOOO INADEQUATE!

I know that part of it is my personality. I'm nervous about new situations and it takes me a while to settle in. It seems like just about the time I get comfortable and confident in one clinical situation, we move onto another, and the same darn thing starts all over again.

I'm so worked up, I can't sleep at night, then have to operate on coffee all day.

I am envious of my fellow students who have worked in health care in the past. They are moving steadily ahead, and I feel kind of like I'm starting to take steps backward.

Is this normal to feel like this? I worked really hard to get to this point, but I don't know if I have what it takes to be a good nurse. Yes, I love working with people, and would like to be able to make a decent living (marriage problems are adding to the pressure to do so), but I DON'T want to press forward if I can't give safe care!!People mean too much to me!

What really concerns me is that where I live, they are phasing LPNs out of the hospital setting this year. My only options are LTC-with a high nurse/pt ratio, and office nursing. It's recommended on here quite often to work in med/surg before doing office work, yet that option isnt' available here. I really wonder how effective I would be in LTC.

Is this just last semester jitters? Has anyone else felt this way and survived?Should I maybe work as a CNA for awhile to get to feeling more comfortable in the healthcare setting?

[TheCommuter, BSN, RN]

Your feelings of reluctance and insecurity are quite normal. I attended a fast track LVN program about 2 years ago, and had completed school without ever having inserted a cath, etc. The school's main objective was to get everyone to pass the NCLEX. I ended up learning most of my skills on the job. However, we practiced giving injections on each other while in class, and this was very early on in the school year.

Even though LTC involves more patients, it is relatively easy because your patients tend to be low-acuity, in stable condition, and with predictable outcomes. The most time-consuming aspect of LTC is the med pass, and that becomes very speedy as you gain experience. Think of it in these terms: 1 or 2 critically-ill patients can take up all your time in ICU, or 30 stable patients in LTC can take up a very small amount of your time. It's not the number of patients that matters; rather, it's the acuity level that counts.

[Lilac]

Hi The Commuter,

Thank you for your reply (and sorry it took me so long to respond-I've been swamped with schoolwork).

I am glad to hear my current feelings are normal for this stage.And thanks for the information on LTC.I really enjoyed my LTC clinical rotation, yet every nurse I've ever talked to has said "Don't go the LTC route."I'm glad to hear someone give a different perspective on it.

We have only practiced injections on practice pads in lab. But, I do have one last rotation in med/surg, so maybe I'll get a chance to do an injection then.

I had my clinical instructor watch me perform my assessments this week. She said I did fine-I just need more confidence.So, I'll just take it day by day. I plan to stick with school unless they kick me out-then I'll just take it as a sign that I'm not supposed to be a nurse. At least with the training I have already received, I can sit for the CNA exam without having to do the clinical portion.

[catlvr]

Hi Lilac, I have two more months in my LPN program, and felt that I was totally unprepared to do a single thing (despite good grades), but have been very fortunate to get a super clinical instructor for the rest of my course. I've heard from many nurses that while skills are important, the purpose of school is to get you up to speed to be able to understand the disease process and drugs...and that you will learn the skills once you start to work (just what TheCommuter said!). I used stress about this, but finally accept that so many good nurses wouldn't give me bad advice (:

Best of luck to you,

e