How do I stop coming off as nervous to patients?

[WavyGravy]

I'm near the end of orientation for my first nursing job ever. I keep hearing from different people(my educator and some of my preceptors) that I need to be more confident. I definitely was very nervous at the start of my orientation, but I feel much better now. The problem is since I've had 6 different preceptors in 5 weeks, I don't think any of them noticed! Like my recent shift, I assessed all of my preceptor's patients and charted the assessments in the morning completely by myself. I felt confident and was making small talk with the patients, but since my preceptor wasn't on the floor she didn't see any of it.

But later on, while I was rounding on a patient her mother asked me how long I've been a nurse because I seemed "a little nervous." I know how bad it is to appear nervous to patients, but I honestly didn't feel nervous at all. I don't know how to fix something that I must be doing unconsciously.

I've seen psychiatrists for bad anxiety in the past, but I don't have one currently. One recommended taking an SSRI, but I didn't want to risk the side effects. I have a prescription for PRN clonazepam, but I don't want to be sedated at work. I was thinking of trying to find a new psychiatrist and asking for a long acting benzo and/or propanolol for anxiety.

I just don't know what to do. It was really disappointing to go from the high from feeling confident to finding out I still appear nervous.

[nutella, MSN, RN]

Generally speaking, talking to a mental health professional is a good idea and in addition to talking to a prescriber about medication you may want to tool into a therapist who targets anxiety with non medication for example with CBT.

But it is also very normal for new nurses to come of as nervous. There are just many things to do and you are transitioning. It sounds that you made some objective progress ! You will gain more confidence when you are off orientation as you will get into a routine and realize that you actually know what you are doing. When you talk with a prescriber about medication make sure to discuss how medication will effect your cognition and such.

[elkpark]

One thing that I have recommended to people over the years is almost silly, but it works for getting "over the hump" of becoming comfortable in a new role -- picture a nurse you know and admire (someone who doesn't seem nervous around clients), and consciously do "an impression" of that individual. How does s/he talk with people and deliver nursing care? Imitate that as closely as you can. It will feel v. phony and artificial at first, but you will find that you feel more comfortable and natural as some time passes, and you'll start moving away from the "impression" and develop your own style.

The transition from nursing student to practicing nurse is notoriously difficult and stressful. But we all survived it, and you will, also. Best wishes!