I'm a graduating nursing student...and I know NOTHING!!!!

Posted
by lostinreality lostinreality (New) New

Hi All,

I am a nursing student graduating this semester with my BSN (BSN = all theory-focused, little (IMHO) clinical experience/hours). I am doing my capstone (final clinical) at a large urban hospital TCU (General & Specialty Surgery unit, msotly post-op).

I am so so so so so so so scared. Anxiety-ridden. Fearful. Terrified. Nervous. Horrified.

Insomnia x last 2 weeks, emesis x 637, diarrhea x I lost count.

I am so afraid that I will meet my preceptor tomorrow and she will be this carniverous, mean, bland battle axe that will quiz me until I pass out and think I'm the dumbest student that ever lived; then recommend that my instructor to fail me. At this point, she could ask me the mechanism of action for metoprolol and I would just stare at her. Obviously, I passed my courses and did well, but I just don't feel up to par with my classmates. I feel like I have learned more as a unit secretary in the ICU I work at than I have in nursing school.

I swear I don't know anything. I know I'm not stupid, but I am so nervous about this. To make things worse, I can be sensitive, so I am worried about being sensitive about my insecurity and will just break down and cry tomorrow. Also, it does not help me when people say "mask your insecurity...act confident". Easier said than done. Trust me...if I could, I would. I have never been able to mask my feelings. I waear my heart on my sleeve. I cannot help it. I realize I need to work on this.

Any advice? Please, I beg of you, help!!! My heaad won't stop spinning....:uhoh3:

:eek::crying2::uhoh21::bluecry1::(:barf01:

Illinurse2010

Illinurse2010

Specializes in LTC. 42 Posts

Apparently you know something--otherwise how would you have passed your hard tests, finals, and skills labs? Stop focusing on what you don't know. You can always read about it or ask another nurse (who may or may not know the answer themselves). Focus on learning from your preceptor and pay attention to your patients. You are going to do great. I bet you were nervous when you started as an ICU secretary too--new jobs are usually like that.

Dinsey

Dinsey

Specializes in Pediatric Heme/Onc/BMT. Has 8 years experience. 112 Posts

I graduated from a similar program (a lot of theory, a huggy/feely business, with less hands-on clinical work than any of us would have liked).

And I did fine in my capstone. I was in the children's emergency department. I passed NCLEX just fine. I'm doing fine in my new grad position.

More than likely, you are a lot more prepared than you think. And the fact that you're scared means that you realize how much you still have to learn - which gives you a headstart over some of your peers who probably think they're all star nurses already.

Relax. Go to bed. You will do a great job. Your preceptor knows you're a student and doesn't expect you to be an expert.

netglow, ASN, RN

4,412 Posts

Geeeeeeeeez Lost! You are freaking me out! I know I've told my self not to read any scary preceptor posts, or scary nclex posts.

:eek:

and... I meant to also put the "Barf" smiley in but cannot find it!

Algardner76

Algardner76

4 Posts

Hang in there. Looking back, I was scared spitless as well! I remember wishing I could have a preceptor hold my hand for a few more months after graduation, however, I made it through just fine! You will make mistakes, you will not know everything (ever!!!), but if you are consciencious, willing to look up what you don't know, ask questions, etc, you WILL succeed! Keep your chin up!

raisonbrancruch

raisonbrancruch

20 Posts

Please, dont you worry! I may just be a high school senior. I dont know what its like. But just advice, you do know alot. You are the one who passed the exams, you are the one who got yourself into this program with a bright outlook. Just remember this is going to be a good day, you will be fine. This is your life, just this moment you need to reflect on the terms in which you have expirenced. Hope it all goes well! I hope to go to nursing school after high school. And no, NOT FOR THE MONEY! I have alot of faith in what I want to achive in life and to learn the responsibiltys that are required. Again, just relax it will be over, success is what you recive.

SunshineBSN

SunshineBSN

64 Posts

Wow, Nursing school is a migraine to all nursing students. I felt the same way. I failed a class before, and my friend failed Capstone so your not alone. Doesnt mean that your stupid. I think all medical fields are tough on you because you are always at the bedside seeing the patients. Most important thing is obviously, priority!!!

You are mentally setting yourself up for failure when you think that way. Best thing to do is pull your instructor aside and share your feelings with how your instructor. If he/she is aware of it, he/she knows that its not bc you didnt study or you didnt know the material but that you are just really scared. Its definitely hard to be confident about this when someone is confronting you about the information. One step at a time!

Edited by SunshineBSN
misspelling

madwife2002, BSN, RN

Specializes in RN, BSN, CHDN. Has 26 years experience. 74 Articles; 4,777 Posts

The expectations of new grads is minimal initially, but after a certain amount of time the expectations rise especially near the time you are going to fly solo.

Dont be hard on yourself you will be surprised at how much you do know, just take deep breaths and think. A lot of work we do is common sense, drugs you will get used to, just focus on your patients and ask questions.

Good luck

Faeriewand, ASN, RN

Specializes in med/surg/tele/neuro/rehab/corrections. Has 12 years experience. 1,800 Posts

I graduated after only 3 semesters of school and felt the same as you. (LVN here) I thought omgosh I know nothing! I understand that this is a common feeling. I experienced all those feelings and symptoms you describe. Also, when I started on the floor I had to keep running to the BR! LOL! I heard nurses ask, "Where is ___?" :chuckle

What you need is something to hold on to that will help you on the floor. Take some 3x5 note cards and place them in your pocket along with a pen. When you are told something, esp a policy/procedure, that you don't know, be sure to write it down on the note card. Fill your note cards up and just keep carrying them in your pocket. Then the next time you encounter such-and-such take out your note card to read what to do next so you don't forget anything.

I was even writing down stuff like what papers/forms to complete and where those were located so I didn't have to keep asking the same questions over and over. (At the nursing station up in the cabinet etc)

some of my cards- Procedure name at top. Information below. some are step by step. sometimes I wrote the why/when.

Pre-placement to a SNF. When/why elderly. after surgery may need more care. may not have help at home. looks neglected

get form from cabinet at nurses station. fax to case management office. fax# pt may have come from a SNF or B&C but not going back to same place.

To CT. (pt going to radiology) chart goes with pt. Radiology depts. IV contrast infusion documentation sheet. Is pt taking glucophage/metformin?

etc etc just little things like that. I would try to write procedures in order. I would forget things and usually I have to be told something 3x to get it right. But this way really helped in the real world.

The cards aren't good for remembering everything like the doctor's faces. Just be sure to ask who everyone is and don't be afraid to go into the room with the doc. You can get a lot of good info that way and they don't mind!

This all seems so sophomoric now but it was important to me when I was new on the floor and it really helped me. I hope it can help you too.

Also, look at the way your preceptor and other nurses organize their brains. Even though you're a student you will be working like a new nurse right? You will need to put your brains down on paper. My wonderful preceptor gave me a pre-printed copy of hers that her husband made on a spread sheet of some sort. Everything is there.

I write down dx, allergies, labs, v/s meds, past hx(for my knowledge) dressings, tx, MD orders, consults, scd's, o2, foley, bs, diet, I&O's, Numeric pain scale for 3x a day, 8 12 1600. When the doc asks me a question I have all the answers right on my clipboard.

First thing-Get pt assignment, make rounds on everyone to introduce yourself, check their IV site, make sure they are ok (any pain?) and let them know to use their call light if they need anything. I often ask how they are on their feet. Are they steady? Can they get up and go to the BR okay? (I know this is info one should get in report) I let the pt know to use the call light to call for assist for the BR if need be.

Then check labs and medications because there could be some early meds due before breakfast. But remember some meds you need to check the HR and BP first before you give. Some have parameters like hold for sbp

Then check their labs to see if there are any abnormal labs. What's the pt's H&H? What are the Mg and K+ lvls? Are they on MG and K+ protocol if they need replacement?

And very important-get a pen with 4 colors! Pt regular info is written in blue. Allergies in red. New stuff for the day can be written in green. Keep a regular black pen too so pt can sign consent with that.

When the doc writes orders get the orders from the chart and copy them. Check them off as they are done. At the end of the day this is your report to the next shift. Doctor X came in to see pt today here are the new orders. Urine has been collected and sent to the lab, dressing change on left heel has been done, new bag of 1/2 NS hung at this time. etc etc.

Of course don't forget your pen-light, steth, scissors and pens. I've lost 3 pens in one day once so carry extras. Your steth will come in handy if you are on a post-op floor because you will be checking for BS before the pt can eat/consume a liquid diet.

You probably know some or a lot of this stuff already. Remember that your preceptor is experienced with new nurses and knows how scared they are. He/she will guide you in the best way possible. I followed mine around like a puppy dog and I see others doing it too. When you are new and nervous you need something to hang on to. I hope some of this will be helpful to you on the floor.

Good luck and keep us posted! :) :heartbeat

erin3900

erin3900

9 Posts

Hey -- I LOVE your idea about writing down things that I've learned on 3x5 cards. I'm going to start doing that myself! That way I can easily carry them around with me on the floor while I'm at clinical. I'm always worried that I"m going to forget what I need to take with me when needing to do certain procedures (e.g., IV starts, NG intubations, etc.)

Thanks for the great idea!

erin3900

erin3900

9 Posts

By the way, would you mind posting a copy of your "brainsheet" that you carry around with you? I'm constantly on the lookout for a good way to organize this information. I would really appreciate it!

MySimplePlan

MySimplePlan

547 Posts

Awesome post, Faeriewand!!!

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