Published Nov 8, 2004
I am a first yr nursing student and I am in my first semester of clinical. I do everything I am told and treat the pts well and take care of them. I am in a telemetry unit. It is hard and overwhelming sometimes but I do what I am supposed to. I thought I was dong well until my recent mid-semester review. I was told my my instructor I was 1 point away from failing the clinical. I was shocked as were the rest of the students in my clinical group. I asked why I was doing so badly and my instructor listed a few things. I ALWAYS put gloves on for everything but one time I was dong a flush and there was blood in the line and my instructor said to go get another flush and "hurry!" so I ran to get another and in my haste forgot the gloves when starting the flush the 2nd time. I was mortified. Then one day I brought my scissors to class and left them in my backpack. (in the hospital unit) but when I needed them I borrowed another students scissors so I would not have to go get mine and I got written up for not brining all equipment to class. Then another time I had a pt with a GI bleed and alsziemer's that had a bowel prep earlier in the day. Every time she stood up she was incontinent. I was cleaning up messes on the floor, the pt, bed, chair, commode, everything the whole night. Well, I was getting her meds ready and the primary RN had just been in there and my instructor walked into the room with me and saw some disposable slippers on the floor and wrote me up for it. I knew I did not leave them on the floor so i asked and found the primary did it. I got written up for it though. I was also written up for sheets and stuff on the floor. BUT, I was cleaning up the site and this is why. As soon as I was done cleaning I made sure the stuff was in the laundry bin. I just wanted to be sure the pt was situated in a chair and that there was no risk of her stepping on a wet floor and falling while I was dumping the dirty stuff in the bin outside of the room.
And the big thing my instructor told me was that I am too nervous. She said it interferes with my interactions with staff and pt. She said I talk too fats. (That happens to be my personality but anyway) I need to know how to not exclude nervousness and show more confidence. I have the head knowledge but I get nervous the first time I do anything and my prof does not want to see that. If I fail this clinical I am out of the program and the 3 yrs and tons of $$ I spent is all for nothing. I have wanted this my entire life! I am in my thirties and I want this so bad. Any advice will be helpful. Please. I am begging you. I have to still give shots yet and drips. have not done them yet. I know I have studied it but the first time I do it I do not want to look nervous. I feel like every time I ask my instructor a question she gets mad at me and snaps at me. Others in the group as many questions as well but she responds better to them. I asked my prof why she gets frustrated with me all the time and she said that she knows I am smart and have a lot of knowledge but I do not show it. SO I guess when i ask questions she thinks I should know the answer already. I really do not think that is fair. Sometimes I do "half" know the answer but I want to be sure because I do not want to do things wrong or mess up so I ask. I am a first yr NS and in my first clinical and a hard unit at that. Shouldn't;t I have the same opportunity to mess up like the other students? There is a girl in our clinical who has missed 3 clinicals, 2 lectures and at least 1 sim lab and she has not proven to anyone in the class that she would be a good nurse. She interviewed a pt for 6 hours one day and did not even give the pt his/her meds. She is still in the class after her interview!! That makes me mad that I am doing either the same as her in pass/fail or worse cuz you can't get worse than my 1 point before failing. I cried for 2 days after the review. Please help me to get over my timidness and fear. I need you all now please....
lil' girl, LPN
Don't doubt yourself, go in there and do what needs to be done. Forget the instructor, I think that sometimes they tend to forget that they were students themselves. Also, she may be just as nervous as you are about you making a mistake, it is her name on the line. Just get in there and block (easier said than done) the instructor out of your mind. If she calls you on something make sure you can back up your actions. Good luck
Ask the instructor if she would sit with you and discuss what she thinks may be helpful to change. Ask her for suggestions.
Also, I've learned from one of my current instructors to never just ask a question. Instead, make a statement adn follow up with a question...
i.e. "I've done this, this and this and I think this is the next step, but I'm not quite sure. Then they know that you know your stuff, but that you are just stumped.
It sounds like you have a difficult clinical instructor. I had one who focused on one or two students and criticized every little thing they did wrong. She was much less strict with the rest of us. It was really unfair.
Like your instructor, she did not like students to appear nervous. I learned to look confident on the outside even though I was really nervous. You know, fake it till you make it. Most patients have no idea what you should be doing, so as long as you look confident, they think you are doing a great job. With your instructor, if she walks into the room and finds you rushing around looking flustered, she is going to think you don't know what to do. If she walks in and you look confident and serene and are calmly doing something, she will think you have things under control, even if you don't.
Perhaps by asking a lot of questions, you are adding to her impression that you are uncertain and lack confidence. Nursing school is mostly about survival. Learning should be the top priority but often it comes down to doing whatever it takes to pass. Figure out what is important to your instructor and focus on those areas. You just need to get through these last few weeks.
Good luck and I"m sure you will make a wonderful nurse!
Maggie in NC
You're probably not going to like what I have to say but, I gotta...
You're obviously a caring person who wants to do it right. You just get caught up in the moment and let the sterile side of nursing take second place. ALWAYS ALWAYS follow the rules of maintaining a sterile field. Slow down-even in crisis. It does you no good to do it fast and wrong, especially at the cost of your health and safety or a patients health and safety.
If the instructor writes you up for something you didn't do, stop her right then and explain your position. You have to stand up for yourself. Especially now. You can't go backwards but, going forward, you need to make the person who did it take responsibility for it. Good lord women, we all make enough mistakes without taking on other people's errors.
Go sit down with your instructor and talk. Ask for help in the form of an action plan. You want specific dates and actions you can complete in order to stay competitive in the program. Don't just do this until you get out of your current situation, make it a point to continue asking for feedback weekly/biweekly-whatever your instructor will agree to. It will give you both a chance to get to know each other (and get through the timid/communication issues), keep you from being blindsided in the future, and show you're committment, maturity, and openess to change. You aren't asking for favoritism, you're asking what you can do to improve your performance because YOU SINCERELY WANT TO.
Would a prescription of something to take the edge off when you're clinicals help you? Don't get me wrong, I don't think drugs are the answer to everything but, I am an extreme type A personality and I KNOW I need something, otherwise, I talk a mile a minute and pace the floor, which drives all meticulous, quiet, slightly introverted nurses (AND INSTRUCTORS) INSANE.
Please don't compare yourself to others. Worry about YOU and YOUR performance, attendance, grades, etc. All the irresponsible things others do will catch up to them. Do your best, give it your all, and hold your head high!
Best of luck to you.
Fake it till you make it worked for me. No matter how freaked out I felt, I just never let them see it. Pretend to be calm and confident....heck, I still do it and no one can tell!
I am right there with you - well I am in my final semester, but still I know what you are going through.
I too have been called timid my instructors - 2 of them. So of course it has been my mission to get over my timidness.
I have not had an instructor as critical as yours however. I would feel greatly intimidated as I am sure you do.
The biggest thing that helped me develop my comfort zone was to work as a PCT at a hospital. Being a PCT has helped me to develop the skills of being comfortable with a patient and with their basic care. My clinicals for nursing school helped me to develop my nursing skills, assessment, meds, etc. When you are a student with no hospital experience it is very easy to be overwhelmed when you are knee deep in doo.
I totally agree with the fake til ya make motto. Keep smiling, try not to sweat.
My most humiliating momemt happened at my last clinical. I had to start an IV with my instructor present. Well lets just say she thought I was making the patient anxious due to my lack of confidence.......she took over. I don't even have the words to describe what I felt. But I can tell you the next time I start an IV with my instructor, I will act like I totally know what I am doing. Fake it til you make it.
Anyway - I don't want to ramble. I know what you are going through.
My best advice is to keep you shoulders straight and stand tall. This is what you want to do and what you know you are meant to do. We all make mistakes. When your instructor offers "constructive critism", take it and thank her very much. Maybe also bring up any other things you are concerned about, that you may not be doing up to snuff.
You can do it!!!!
What is a PCT? You said you worked as a PCT and I am not sure what that is. Is it like an LNA?
Think everything through before clinical.
Prep your meds
When talking things through about patients with your instructor let her know what you think you are seeing about that patient. (It makes you look like you are on your A game.)
It is her responsibility to teach you. It is your responsibility to be prepared for clinical and ask questions.
Ask the primary nurse for your patient questions and listen. They can give you hints about how to do better.
Ultimately it is "fake it til you make it."
You will pass. Best of luck!
You should make an appointment with you instructor. Explain to her that although it may not show, you are trying very hard. Ask her if there is any advice or feedback that she can share with you to help you perform better in clinical. "How do you remain calm when stressful situations happen?" or "I really want to learn better time management skills, any advice?" MAKE HER FEEL LIKE SHE IS SUPERIOR AND YOU BE SUBMISSIVE. This sounds like the kind of instructor that will like you if you hold her at highest esteem-- she is the all-knowing super nurse of the century!!!
DO NOT MAKE EXCUSES, even if you didn't do anything wrong. In her mind, you left a brief on the ground, even though it was the primary who put it there! Just tell her you have been contemplating and reflecting on all your mistakes, and that you have been learning so much from them.
A PCT is a Patient Care Technician. In my hospital, it is one step above a nursing assistant. At my hospital, I perform all of the Nursing Assistant tasks, but I can also pull IV's, give enemas, do EKG's, insert Foleys and straight caths, do the nasal swab for MRSA, and do simple dressing changes.
I got a job as a nursing assistant because I thought it would help me out in Nursing School, and it has.
I was nervous all through my first level of clinicals (even had the Instructor tell me "I don't want to fail you". I told him that there was no way I was going to let him fail me). I wound up with a B in clinicals. This semester is a completely different turnaround. I'm more confident and I feel better about clinicals. I know I couldn't feel this good about clinicals if I hadn't been promoted to PCT.
Kylee45 Thanks!!~ I was a CNA a number of years ago (10 to be exact) I would love to do the PCT thing while I am in school to earn money to pay for school. :) Do you have to be trained specially for it or do you just have to have your CNA license and apply for it. I think maybe the 3.5 years of nursing school and 1 year of nurse clinical training might help me to get a job as a PCT. I will have to check the hospitals in my area and see if they have this job available. :)
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