instructor says nursing is not for me..

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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?

Specializes in Peds/outpatient FP,derm,allergy/private duty.

It's really odd to me that a coordinator would tell someone they should drop out of the nursing program based on behaviors just one instructor observed and believed was a problem.

I'm a quiet type at work, too so I had to learn how to engage people in conversation without seeming stilted and unnatural. It's a skill you can develop. I did - and it gets easier with practice, like any other skill. Having someone basically say "now go ever there and talk to that resident now! -- and be friendly while you're at it!" is most emphatically not the correct approach. I dare say that instructor could brush up on her communication skills, too :)

You hit on part of the answer yourself when you said your presentation was the longest because you were interested in the topic and it just flowed from there. The same principle is true for "small talk". While you are otherwise interacting while providing care is a more natural time to start a conversation.

It really helps to become observant and you will think of things to talk about - not while you're in a panic. If you like people and are genuinely interested most people will pick up on it and feel comfortable enough to share.

Do you have any supportive friends who could help you do role-play? How about thinking of a few "ice-breaker" questions ahead of time if your mind suddeny goes blank. I armed myself with lots of those when I was a new mother support group leader and absolutely hate talking in front of a group. Thinking it through ahead of time helped me out a lot.

Anyway, those are just some ideas I threw out there- I don't think this means you can't be a nurse.

"... 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?"

WHY?!?!?!? To engage them socially? To connect with them on a personal level? To get to know them beyond their physical needs/diagnoses? Your "WHY?" question baffles me. You're their nurse. You are there to take care of them. That encompasses everything about them! No, you don't have to be their best friend but it will serve you (and more importantly, them) to get to know them on a more personal level. You're not there just to do their wound care, pass their meds, assess them etc.... Those aspects are important, yes. But you're also there to be their nurse. That means taking care of THEM and not just their physical/medical needs.

You call it "small talk" and wonder why you have to do it. I call it nursing and it never crosses my mind that I'm even doing it all let alone wondering why I "have" to. It's not "small talk". It's connecting with your patient. It's eliciting info/assessing on a more subjective level. It gives you the big picture, not just stuff to chart on your head to toe. It's establishing a relationship with your patient that invites trust which may lead to more OBjective info that may alter the patient's care as pointed out previously. Nurses aren't just robots (regardless of what management would like us to be "I'm Mooples and I'll be giving you excellent care today!") who measure that stage II or record those VS or chart a pain number/intervention. Nurses are people who take care of people.

You'll figure it out as you learn. Excellent replies so far to your thread, BTW!

Specializes in EMT, ER, Homehealth, OR.

When I was in LPN school I had an instructor who did not like male nurses and made life diffucult for them. She also stated that nursing was not for me & failed me in clinical. The next clinical instrutor was suprised on what she saw from me in clinical & could not believe that I was the same person per the others eval. That was 22 years ago and today I am have my BSN and serving in the Army as a nurse.

What I am telling you is hang in there and dont let one instructor discourage you from doing something that you want to do. Some instructors just have sometimes of personal issues with people and they can not look past it.

Specializes in Pediatrics, Step-Down.
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?

Nurses observe symptoms, make assessments, review the patient's plan of care/meds/all orders. There is a lot of care that requires a license: giving meds, foley/straight cath insertion, ng tube placement, gtube feeds, trach care, colostomy care, cardiac monitoring, etc. As the nurse you are the eyes and ears for the doctors to diagnose and treat. Doctors usually do not provide direct patient care and rely on nurses to update them if there are any changes in the patient's status. It is also your responsibility to understand the rationale for your patient's plan of care, treatment, meds, etc and if you do not agree or understand something it is your obligation to question it. Your assessments of your patients are not based solely off of vital signs and physical symptoms. It is important that you know about family life, stress in your patient's life, children, job, etc.

As a new nursing student you haven't yet seen what nursing really is and you don't yet feel like you have a role in the hospital. You don't have to ask a million small talk questions, just ask a few really good open ended questions and let your patient guide the conversation to what they want to talk about. Your patients also expect to be asked questions by anyone part of the healthcare team, including nursing students.

I also think your instructor sounds like a jerk for not trying to help you and not being so straight forward with you. Many nursing students, including myself, were scared during their first year of clinicals. I seriously considered quitting nursing in my first clinical: I thought it was all cleaning patients and giving meds. Now I love being a nurse, and it is quite different from my first impression in my first clinical. Keep your head up and push yourself.

Specializes in ED.

There are a lot of great suggestions here. Take them and use them. What your instructor said about "getting the book and reading it" is a load of crap! What it sounds like they want you to do isn't something you can learn from a book so don't beat yourself up if you studied that chapter and still aren't comfy chatting! This is something that does take practice, takes a lot of getting out there and being with people. The PP that suggested the retirement home is right. Maybe if you can volunteer some in a home (in your copious spare time, haha) you can have opportunities to engage people without the stress of clinical work on you. You don't even have to say much to get some of them on a roll. This might help you think of things to say. They will be grateful for your company. Remember that if it helps to lessen any anxiety of saying the wrong thing. Ask simple questions, like where they are from, about their families. Ask something open-ended and they will talk willingly. I bet if you told some of them you have a difficult time making small talk they will give you some great advice as well!

If you can tell your instructors you are taking steps to improve they may be more willing to work with you. You sound like an intelligent well-prepared person and you can use that to your advantage here. Write out an action plan. Make a step-by-step plan on how you are trying to resolve the issue. If you do get to do volunteer time, list it. Also list that you are reading those d*** chapters on communication for crying out loud. That should butter up that smarmy instructor. Make this as official of a document as you can, with a "To" and "From" and "Subject" fields. Request time during office hours and present it like a proposal. Dress up for this meeting and be as professional as possible. Put on a thick layer of chapstick if a little butt-kissing is involved.

Small talk does help a nurse. It does indeed help gain the trust and confidence of not only the patients, but your coworkers. That being said it sounds like you have plenty to offer that not everyone does. It sounds like you put together a well-organized informative presentation. You have skills. You know the material. You will save lives. Don't give up because you could give a d*** about everyone's thoughts on the weather!

Keep us updated!

T

Some people are easier to talk to than others and how they come off can effect your confidence for sure. When I have to approach a patient that seems like they are not on the friendly side, I just smile and introduce myself, ask them how they are and get the patient stuff done like vitals or assessment or whatever and then I just feel them out a little by asking about their family or if they have pictures with them ask them about grand kids or kids or whatever. I think small talk is a big part of bedside nursing because if they don't trust you, you will both be uncomfortable and could miss something important. They will be less likely to tell you if something is wrong and that could be dangerous. You don't have to be their friend, chances are you will never seem them again after they leave your unit, but you definitely have to have a good rapport.

It's skill that is learned just like putting in a foley or starting an IV, some people are a natural and some have to really work on it. My advice to you is to really put yourself out there and start conversations and engage the residents. It's amazing what people are willing to tell you if they know you are a friendly, interested person, especially at retirement centers where they don't see too many unfamiliar faces. School clinicals are your best opportunity to work on this skill because it will be an essential skill to have once you get a job and are on your own, nursing is ALL about the patient.

Specializes in ER, PACU, Med-Surg, Hospice, LTC.

In the real world, I have ZERO time for small talk. Also, not every patient wants small talk! I know I hate it when I am sick.

This stress for small talk seems to be a Nursing school thing. I also experienced an Instructor that felt I wouldn't make it in Nursing school, let alone be a good Nurse. Why? I was a nervous and self-conscious student---and it showed.

Fast forward-I am now in a critical care area and also PT floor manager. So much for not succeeding.

To add-there will always be someone 'critical' of something you do or say, sadly. You can ask someone every day, "Could you give me positive criticism?" and you bet you will get it! This applies to every single nurse.

(Also, I PERSONALLY feel a nurse consistently/constantly critizising is on the border of being a bully)

There was one student in my nursing class who was really socially awkward, to the point that it affected her confidence. She ended up getting dismissed from the program during our OB rotation. At clinicals she managed to make one of the new moms really nervous about her abilities, the patient requested that she not come back in her room or touch her baby. Because of that, and a stupid mistake with drawing up an injectible medication this student was dismissed from our program. I would seriously figure out what you need to do to make yourself look more interested in your patients, even if you are faking it! I don't think that you are necessarily doing anything wrong with holding back from certain interacations with patients, but if your clinical instructor has a problem with you, you need to start being an actor and put yourself out there more. If you are clinically competent and don't upset patients I think it would be wrong for you to be failed over something that may come with more exposure, or like someone replied previous, there are plenty of jobs for nurses that don't involve a lot of patient interaction. Good luck!

Why do you have to communicate? To 1) get to know them 2)elicit pertinent information 3) be a NURSE..nurses are treating the whole body HOLISTICALLY, that means the entire person, not just their diagnosis, meds, etc. You need to be able to address their sexual questions, their spiritual problems, their financial problems, their emotional problems etc... You won't find that out by saying, "Mr Jones I'm going to check your temperature and your blood pressure right now," or by saying, "Mrs Smith can you turn over to let me look at your wound." You might find out by talking to them that their blood pressure is elevated because of pain that they were afraid to mention because they didn't want to bother the busy nurse. You might find out that the wound is not healing because Mrs Smith can't afford to pay for her medicaion or her food that she needs in order for the wound to heal properly. You might even find out that that old man with dimentia used to be the CEO of a very big company, just by asking questions. It's important to know this stuff as a nurse. You bond with the patient and you learn to address their needs appropriately.

More than 25 years ago, as a junior in my BSN program (straight out of high school... I didn't even really know what a nurse did) I made pretty good grades. I did well in my clinicals and never had a problem, but ONE instructor pulled me aside and told me she didn't think I would ever make it as a nurse and I should drop out of school right then and persue a career as a CNA. She told me that was all she felt I had potential for. However, when I asked her why, she really didn't have a good answer. I asked her how she thought I could improve and she didn't really have a good answer. I told her that day that I would be a nurse and a damn good nurse..and she should just watch me soar. I put her nonsense out of my head and continued with my studies. If she had told me specifically what I was doing wrong, or specifically how to change it...I would have made an effort to do so. But just because she didn't "like me" was not a reason for her to tell me I could not do something. And everyone that knows me knows that I am just stubborn enough to prove them wrong... I am proud of the nurse that I have become, and she did not influence my life one way or the other...maybe just made me more determined.

Take some communication classes. Go out with your friends and chit chat. Talk to the guy sitting beside you on the subway and find out how his day went. Go out of your way to talk to the person that is limping across the street due to an ailment. If your instructor told you to talk...then you should talk. I understand that your personality may not be the 'chatty kathy' type, but if you work on it you'll be amazed at how easy it will come to you with some practice.

Maybe you are just in the beginning of your nursing career, but maybe your instructors are really afraid that if you don't get it "right" now, that you will be the quiet type of nurse that will never speak up and ask questions about serious stuff... Like your patient has a PICC line and you've never taken care of one of those before. You don't get a chance to just try it by yourself.. this becomes LIFE and DEATH. You have to get it right the first time with NO mistakes and you have to learn to ASK for help until you feel comfortable. So starting to improve your communication skills now by making small talk is a way to build your confidence so that when you get out in the real world you can be as assertive as you need to be to SAFELY care for your patient.

This is your chance to get it right...be proactive and go do it. If you can't do it, you really don't need to be a nurse, and this may be the way your nursing school weeds you out. Good luck!

I am a shy person, also. I'm also very young and I felt, when I was in nursing school, that it was a little awkward in the beginning because it was harder to connect to some older adults on top of being quiet in general. You want to know what I always asked people to "break the ice" if I didn't connect with them? I'd ask them if they had children, grandchildren, about their spouse, their pets, ect. "Small talk" usually helped form an instant connection, even though I couldn't always relate. I felt like inquiring into who they REALLY are made them feel like I saw them as a person and not an illness. After I got over that, that is when I fell in love with nursing, because I felt like I could develop really great, trusting, working relationships with my patients and they were so grateful to feel like someone cared about them.

sounds like your teacher gave you tough love. given that she didnt seem angry. she definitely went about it in the wrong way though. saying nursing isnt for you is unprofessional. she should be coming up with solutions instead.

anywayyy, i agree with many of the people before me. talking, communicating..etc. very important in nursing. now..do you need small talk such as "how's the weather?". no not quite. but talking to build that rapport and trust are very important.

anything can be learned. so dont let her comments steer you away from your goal. take them into consideration but not to heart. work on your communication skills and do the best you can!

i've seen the shyest people do complete 180's in 1 semester

Specializes in Med/Surge, Psych, LTC, Home Health.

I too am a fairly shy, introverted person at heart. I'm also a psych nurse. You mentioned that you might be

interested in psych; know now that with psych, you will definitely need to learn how to make small talk.

Know also that, with practice, it REALLY does get easier.

I currently work mostly in geropsych, and I love making small talk with these patients. I find that they are

the easiest and most fun patients to talk to. I love to sit down next to an elderly man, and usually the first

thing I ask is, "So, where are you from?". Other things I ask "What did you do for a living?" "How many

children do you have?" "What are your hobbies; what do you like to do?" You can learn some very interesting

things, and with psych patients it is very important to make small talk just to be able to assess their mental

state.

In psych you will treat physical problems, but mostly you will treat what you cannot see; only what you can

hear, by talking to the patient. I love psych!!!!

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