instructor says nursing is not for me..

[Orlette]

First of all I apologize for the long post!!

So I passed my first semester with good grades. (mostly A's with B being the lowest) The clinical teacher in our first semester said my skills are better than most people's, I just lack self-confidence, that I am going to be a good nurse.

It is now second semester and we are doing our clinical at retirement residence. I participate in group discussions, and for our presentation to the residents, I spent the greatest amount of time and took the biggest part of it (I was actually interested in the topic and wanted to give residents the most useful and interesting information). My marks in other subjects are also very good.

Yesturday I learned that our coordinator of the program wants to talk to me. I had no idea what it would be about, and so i was slightly nervous. It turned out I was nervous for a reason. The coordinator said that the clinical instructructor is very concerned with the way I act in clinical, and that at the moment I am failing it.

Her reasons are that I do not "mingle" with residents, for instance I do not talk to them in the mourning and afternoon. That she constantly has to encourage me to talk to residents (I remember she mentioned it once, in a matter of fact way, and I asked her what I should talk to them about), ..That I do not know how to talk to people at all (instructor told my coordinator that "I actually once asked her if I should invite the patient to get his blood pressure taken when we were doing the blood pressure clinic!").

I do realise that the two things that I said were kind of silly, but I did not realise that that would put me on a contract, and would mean that nursing is not for me (the coordinator said that), since the clinical instructor never showed any signs of being upset and never told me anything about .. well.. anything.. Whenever she talked to me she was always smiling, not a hint that there was anything wrong. And now the coordinator telling me that I should probably switch from nursing, that she is questioning if nursing is for me, that I am on the point of failing, and if I don't change a 100% i will fail. I also mentioned something about psychiatric nursing, and she said I won't be able to do that since I don't know how to talk to people.

It is true that I am a bit shy, and unless a conversation has purpose and direction to it it is hard for me to know what to say.. (to make a small talk about nothing in particular in other words).. But is being outgoing really the most important thing in nursing?

I am polite, and sensitive to other people, as well I have great interest and knowledge in the areas of nursing i am interested in which I am willing to apply to help patients.. And as i said I do not have a problem obtaining specific information, if the conversation has some sort of purpose.. The instructor said however that no patient will let me do a procedure or give me any information unless I first build a "trusting relationship" with him/her.

So my question is--Is small talk essnetial for nursing?? ( i mean, I always introduce myself, I am always polite and I always ask patients how they are and all that, I just find it kind of awkward and even sometimes inappropriate (just for myself) to ask them questions about their life, their family, their health, if there is no specific reason for asking such questions.. Efficiency, rationality, reasonability, logic and relevancy are all the core aspects of my personality which will be hard to change.

So to sum this up--I am bad at small talk, and at converations without purpose and/or specific direction, should I be a nurse, or is my coordinator right?

[TakeTwoAspirin, MSN, RN, APRN]

There is a different between small talk, and being able to engage a patient and gain their trust and confidence. I'm not a big small talker, but I do know how to make a connection with my patients. Why don't you go back to the people who have criticized you and ask for their help? Tell them you want to learn and that you would appreciate their mentoring. It will show that you acknowledge your deficit, and are mature enough to ask for help when you need it. It also shows you are not a quitter and have a commitment to completing school.

[Arianna91]

If nursing is something you really want to do, try harder! :) If you think they are wrong, show them. If I understand correctly you're just in your second semester? I sure didn't have the "people skills" polished in my second semester! Don't let what they've said get to you. It's difficult to improve your communication when you only have one patient in clinicals, and it can be awkward! I have a job as a student nurse at a hospital caring for 10-20 patients and that's really what helped me improve my communication skills. Make it a point to practice! At your job, clinicals, class, etc. Patients love it (most of the time ) when you show that you're really there to care for them and give them attention! I make it a point when I first walk into a patients room to spend at least 5 minutes in there taking vitals, doing I&O's, and talking with them. You're obviously good at the book-smart part of nursing, why should you quit just because someone thinks you don't know how to talk with people? Tell your pts they are your #1 priority for today and ask what you can do to make their day better. Make yourself available, tell them when you will be back to check on them, etc. Practice, practice, practice! Good luck :)

[coco.nut]

Try to remember that while it may feel awkward to ask questions about their family, you are asking even more personal questions during your assessment. Also keep in mind that people in the hospital or residences might not get a lot of visitors and have a lot of time to pass alone, many people welcome the opportunity to converse about themselves with students because their primary nurses often don't have time to do so themselves.

When I am trying to gather the social/financial information for assessment, I usually don't just outright ask, I try to weave it into a conversation about the pt. This lets me build a relationship by showing my interest in the pt and I get the information without sounding like I am rattling off invasive questions. Sometimes they share important information I may not have been able to gather by just sticking to the questions. When you are an RN, you most likely won't have the time to do this, but I view it as a way toactively work improve my communication skills while I have that extra time.

[Orlette]

Why don't you go back to the people who have criticized you and ask for their help? Tell them you want to learn and that you would appreciate their mentoring.

I sort of asked that when my instructor was tellig me that i suck at communication:) She just said "we learned it in level 1 why don't you take a book and read the chapter on communication"... Ok, it tells you a bunch of technical ways to build a converation like "touch, gestures, sounds, personal space, also different types of responses and different types of patients... But once you approach a resident sitting in a chair and resting, not in particular need for something..then.. what do you talk about really.. and WHY? The purpose of the communication techniques listed in the book are to obtain information and make an ill person feel comfortable. But those people do not need any sort of treatment (or they are already receiving it).. Like what's the point.. being approached by an unfamiliar nursing student who will ask about their personal life, I don't think all of them are going to enjoy it.. and.. how do I even start "Hi I am a nursing student, wanna talk?" In other words the whole situation feels pretty fake, tense, and pointless really..

ALSO this makes me wonder about the role of a nurse in general.. (I am just actually wondering, never asked that question of anyone or even myself before). Doctors observe symptoms, diagnose and decide on the treatment, Personal Support Workers do the basic care (taking them to the washroom etc), cooks and nutritional experts are responsible for cooking, etc.. Where does nursing fit in this system?

[MN-Nurse, ASN, RN]

I just find it kind of awkward and even sometimes inappropriate (just for myself) to ask them questions about their life, their family, their health, if there is no specific reason for asking such questions.. Efficiency, rationality, reasonability, logic and relevancy are all the core aspects of my personality which will be hard to change.?

I'd say you've got a pretty good, logical, and relevant reason to ask those questions, and it is this:

YOUR INSTRUCTORS ARE GOING TO KICK YOU OUT OF SCHOOL IF YOU DON'T

If that doesn't give you enough purpose or direction for learning "small talk" then I don't know what will.

You could also look at it this way: As a caregiver, your instructors have noticed you are not meeting your patients psychosocial and spiritual needs. You must correct this.

Or, as Sheldon Cooper's mother would say: It is a non-optional social convention.

Good luck!

[Fiona59]

You do have to be able to chat to them. It's amazing what you can pick up on just talking with them while doing routine care. I once discovered that my patient wasn't in pain but her granddaughter was "helping" her sleep by giving her two percocets before going out with her boyfriend. That way Granny was out like a light while her caregiver was out.

Over the years you pick up things that patients don't often think worth mentioning that really does affect their care.

[NicuGal, MSN, RN]

I agree, you have to make a little small talk because it is amazing what you will learn about you patient.

[tokmom, BSN, RN]

Next time when at the retirement center, go sit down next to a person and make small talk. Mention the weather, their pretty shirt, dress, hair...anything. Older folks love to talk. You can then branch out into their lives...What they did for a living, how they like the retirement place..Heck, you get them going and you can't shut them up (said in a nice way. I love older folks).

Just by having small conversations with the patient, I have helped figure out a diagnosis. Pt's don't always disclose everything and sometimes through casual conversations you can glean valuble information to pass on to the MD.

When I give showers or baths, I will engage in small take. Even during the admission history, I will sit back, give the 101 questions a break, and ask them about little things. It's amazing what you can find out.

[RTsoonRN]

I was just like you, in RT school. I'm one of those people who feels that if there isn't anything to say, why make up idle c**p just to maintain conversation. I'm a very introverted person. But, I have come to love talking to my patients about that "idle c**p" and find it one of the most enjoyable parts of the job. Some of these patients have VERY interesting stories to tell, and whether thy know it or not always have something to teach. It just takes practice and time, but you'll find your niche

[Psychcns]

The only thing I can add is that it is up to you to make the client feel Comfortable with you. If you are feeling awkard they might be feeling awkward too and it is up to you to move things along. Small talk can help. I learned to use small talk to make conversation to help peoplefeel comfortable with me. Keep trying!!

[Kooky Korky, BSN, RN]

Actually, I think she'd be demonstrating that their concerns are true - she can't even figure out how to correct her "problem". I think the Instructor and Coordinator are jerks, BTW, for not being forthright with her much sooner and I think there are jobs for people like the OP in Nursing - like Surgery, Recovery Room, Corrections, perhaps other areas.

Not everyone has to be a jabber bird.