I feel so incompetent and dumb

JoseQuinones · Jul 9, 2015

I don't see the problem. The doctor waited till after the patient left to speak with you about your confidence issue. That means they had some regard for your feelings. You entered a high stress, high responsibility field. Lives are on the line. You work with smart, driven people. Suck it up, buttercup.

LadyFree28, BSN, LPN, RN · Jul 9, 2015

Emergency is a very different kind of animal; providers and nurses have to be very direct and work in an anticipatory process; having a high level of assertiveness is necessary in order to interact with pts, families, and providers to get things done.

The doctor spoke to you in private and was very direct in your actions that you confirm to be true-you are soft spoken and you are new-meaning you are a beginner nurse in a specialty (think Pat Benner), so your feelings and confidence will be shaky, and you are experiencing that.

Embracing what you know-and don't know is the key to building a great practice; also harnessing what you know and being comfortable with your previous practice-and building on that will help boost your confidence; you know if a person is going to go south because you have assessment skills developed during your clinical base in Med-Surg; also teaching, and dealing with challenging families and populations-I am SURE you have those skills still with you-they don't leave because you are in a new specialty-you join the old with the new and shape your practice...that had been working with me as I am new to the ED as well.

Take the pointers into consideration; don't internalize it with your doubts-show yourself that you can take this knowledge and work on honing your assertiveness and being your best advocate and your patients advocate as well.

Best wishes.

Mattskiematt · Jul 9, 2015

Well, I experienced the same back when I was newly hired as a nurse, I felt incompetent too. What I did was I tried to improve at all aspects, take their criticisms as constructive and meet their expectations. Everyone has a unique learning curve, once you get a jive of it I'm sure you'll be okay. Good luck and believe in yourself more.

SubSippi · Jul 9, 2015

You're mistaking criticism for not being nice. Regardless of if she was right or not, it sounds like the doc was trying to give you some advice she thought might help.

Switching jobs is tough. You're not just learning a new specialty, you're learning how to work with a whole new group of people. Keep at it, you'll get the hang of it.

Mattskiematt · Jul 9, 2015

I would say it's a matter of perspective. I try hard to make myself optimistic. I would say that there's a thin line between being picked at and receiving areas of improvement. I cannot judge with just one scenario, and given that only scenario, I would take it as a critique.

NurseOnAMotorcycle, ASN, RN · Jul 9, 2015

I felt the same way when I first started. It felt like nursing school/new grad all over again.

This will pass. In the meantime, if you feel like you are nervous about poking a patient then go out of your way to do all of the IVs and phlebotomy that you can on everyone's patients. :barefoot: Force yourself out of your (dis)comfort zone until you feel like you can handle just about any veins that need access. :yes:

Also, learn to love ports! One needle in the already marked "bullseye" gets you instant access and saves the pts a lot of painful needles. Just be sure to always numb the skin first!

Chemo+Port.jpg

Hopefully you have someone to go to when the "New Specialty Blues" start to get you. I can work in almost any crappy circumstances as long as I have good coworkers who support each other. If not.. hey you've always got allnurses. :) :shy:

(Don't ask. I'm in a picture kind of mood, I guess.)

sockov, ADN, ASN, BSN, CNA, LVN · Jul 9, 2015

I'm new to the ED. I came from ICU to ED and I feel new all over again. I have to regain different assessment skills, and not try to be so in depth with the patient. My preceptor says to get in and get out. Focus on the problem they came for, we are not their PCP. That is a hard adjustment for me since I like to focus on everything. It will take more than one year to feel confident in the ED in my opinion. Each day seems to get better though. Hang in there and give it a good, long try. Hold your head up, don't let others see you upset about things. Just thank them for helping you and move on. Pretty soon, you will be in that position where you are training another new nurse to the ED, and then you can remember how you felt "new" and not precept in that way.

:-)

Ruby Vee, BSN · Jul 9, 2015

Hi fellow nurses!
I am a nurse with 3 years of med/surg experience behind me and I started in the ED a little over 3 months ago.
I am officially off orientation and I feel so unprepared and dumb. On top of that there are a few ED docs who prey on my more quiet, non-confrontational behavior and make me feel so so dumb. It seems like they do it on purpose. Yesterday I missed an IV while one of the doctors was watching (on a really hard stick) and after we left the room she proceeded to tell me that I am too timid when I tell the patient I am going to stick them and that if I don't seem confident then the patient will be more anxious and it will e harder for them to endure the IV stick. Um...OK?? I felt so terrible afterwards because this isn't the first time she hasn't been very nice.
I dont know if I'm in the wrong profession or if these feelings are normal. Did anyone else experience bullying or these feelings when they started in the ED?

The ED doc was right -- and it wasn't bullying. If you're too timid, the patient will be more anxious and more anxiety makes it more difficult to endure potentially painful experiences. At least she left the patient room before approaching you. And "not very nice" is in the eye of the beholder. You may not like what she had to say or even how she said it, but she was doing you a real favor by telling you what you're not doing well. She didn't have to do that, but she took the risk of doing so anyway. I hope you thanked her for the feedback. If you haven't, you should. If you react poorly when people give you feedback, they'll be hesitant to do so again . . . and then the first time you find out that you ALWAYS set up rooms wrong is when your manager is telling you that you may be a poor fit. You don't want that to happen.

You're just off orientation in a new specialty -- of course you feel dumb and unprepared. You're inexperienced -- you SHOULD feel dumb and unprepared most of the time. If you didn't, you'd be dangerous. As you gain experience, the feelings of being dumb and unprepared will come up less and less until one day you feel confident that you got this. (And then the next day something happens and you feel dumb and unprepared again.)

Please jump off the victim bandwagon. You haven't described any bullying -- you HAVE described an ED doc who is willing to give you feedback to help you grow. That's a precious resource.

annie.rn · Jul 9, 2015

Try to change your perspective on the situation. Instead of assuming the doctors are against you, consider that perhaps they see you as a skilled nurse but one who lacks confidence. They know that if you continue to doubt yourself and "feel dumb" you will most likely not succeed in the E.R.. They like you and want you to stick around so they are pushing you to step out of your comfort zone and become more assertive.

IVRUS, BSN, RN · Jul 10, 2015

I come from the day and time when nurses would be sitting down charting, and a doctor would walk in, and we would promptly get up to give them our seat... Oh, so many eons ago.. But through the years, I've developed a thick skin, and what they say, or who they are only phases me to the extent of their expertise/professionalism and bedside manner. If they are supurb at this, then I give them a greater consideration. There are some MD's who are just trying to help.. I believe that in this case, she was offering you some crucial advice. If your patient isn't confident with your skills, they may vasovagel which manifests itself with vasoconstriction.. when this happens, all the luck in the world won't help you. So, try to display confidence. Since this person has said "negative" things before, maybe they are trying to toughen you up.

Mat/rnm · Jul 10, 2015

I personally think the doctor's message was the good one but the way it was passed may have been a demoralizing one. As a new nurse, you are likely to meet a lot of these people who may make you feel somehow dumb, but your attitude should not change negatively. Always take the message that they portray and leave their lack of communication skills to them to improve on. We unfortunately learn as we go and there is no where to hide. You are going to feel different as you gain confidence and you will wonder what was so difficult the first time you came in...THEY CALL IT NURSING... :lol2: ...all the best dear!