How can I be confident in clinical?

[detrelibre]

I feel like I do well in the classroom portion of nursing school. Reading from a textbook, understanding science, putting it all together and doing well on a test is fine for me. When it comes to clinical though, I find that I am often unsure, lacking confidence, and what kills me is that I'm not able to actually APPLY the textbook knowledge in a real life setting. For example, when I'm studying, I can rattle off the S/S of metabolic acidosis. If I'm in clinical and my instructor asks, I'll suddenly draw a blank. The other day I thought I heard crackles in my patient's lungs and I let my instructor know and she asked me what interventions I would implement if I really did hear crackles and I drew a blank.

I guess what I'm asking is, how can I be a well-rounded nursing student who kicks ass both in the classroom and in the hospital setting? I want to be confident in my answers and be able to apply my classroom knowledge more effectively.

Thanks for reading and I look forward to any insight and/or advice y'all give me.

Muah!

[kris15blue]

Don't worry this comes with time and experience , as a nurse you Learn everyday and you don't ever "know it all" plus the pressure of doctors and being put on the spot makes you nervous. Got to Learn to believe in yourself and have the confidence to speak up for your patients , however like I said this comes with time :) good luck x

[SoldierNurse22, BSN, RN]

I have a phrase for you. "Fake it till you make it".

Fake knowledge? No. Fake the ability to do something you can't? No.

Fake self-confidence and enthusiasm until you actually get some (which may be well into your first year of working as an actual nurse)? ...yes.

[HouTx, BSN, MSN, EdD]

^^^^^ Love this ^^^^

Nurses have to adopt a 'game face' when dealing with patients. If they see that you are unsure, horrified, nervous, repulsed, impatient, etc... it undermines their trust in your ability to help them (AKA Therapeutic Relationship). No matter what the circumstances, we have to come across as calm and confident... keep the heebie jeebies in check until you are out of sight.

It helps to have a few stock phrases that you can use when your teacher asks those questions - you can buy some time with "let me think about this for a moment . . " As a teacher, I also encourage students to 'think aloud'... for instance, in the OP's situation, the student should just say what she is thinking: "Ok, the noise in the lungs is happening with inspiration, that must mean that air rushing through the bronchus is disturbing some fluid or mucus - it is happening at the bottom of the lung, so that is where the fluid is - this could be caused by gravity causing the fluid to drain to the bottom of the lung . . . " and so on.

You can do this!!

[mevsmom]

Create scripts of what to say to each patient and use it on every patient until conversations become more fluid.

When I come into my patients room in the morning I ask them how they slept, how was breakfast, ask about pain, and if you can get them anything. Mean while I'm cleaning up any clutter and taking out their breakfast tray.

I do this with each patient so I get a baseline of info on them and I know that I covered everything.

Create different scripts for each interaction such as med passes, evening shift, ect. It helps remove some tension eventually it will become more fluent.