Lack of Confidence/Self esteem. I cried at Clinicals tonight

RN2Bn2006 · Nov 30, 2004

Oh and one more thing I fogot. I'm also a pushover when it comes to dealing with other nurses. Is there a way to toughen up. I want to be more assertive, and need to be in order to be a good nurse - to stand up for my patients! I am just awful with confrontations. Any advice or ideas?

Paula B

jax · Nov 30, 2004

When I was a new nurse I was the same.

It is rather confronting to approach complete strangers and ask them very personal questions and touch their body, especially if all your skills are new and you're not brimming with confidence.

The only thing that cured me was time and repetition.

People pick up on a new nurses/students anxiety, I always explained what my position was, what I wished to do, and asked permission from the patient.

Most people are lovely and help you out , there are a few pigs out there, but that is their problem, not yours.

As far as dealing with other nurses, if I had a problem as a student, I'd go to my facilitator and let him/her fight my battle for me if it was going to be difficult. Maybe a cowards way out, but look listen and learn, soon you'll be wondering what you were so anxious about. Honestly it does get easier, a lot easier.

mac23 · Nov 30, 2004

Oh and one more thing I fogot. I'm also a pushover when it comes to dealing with other nurses. Is there a way to toughen up. I want to be more assertive, and need to be in order to be a good nurse - to stand up for my patients! I am just awful with confrontations. Any advice or ideas?
Paula B

This was me exactly in nursing school. Only exception was my instructor wasn't as kind as yours is. I ended up getting a job as a nursing assistant and it helped me a lot. I remember going to clinicals and my classmates spend a lot of time with their patients and I was always the first one done. It got better once I was more confident in my skills (both people and nursing). I was EXTREMELY shy but I knew I had to talk to people so I just forced myself to do it. Now it's not so hard.

As far as dealing with the nurses just keep telling yourself you are there to learn and contiune to ask what they are doing; why they are doing it, if you can help etc etc etc. Talk with you classmates and see what helps them; take the suggestions you think may help you and try them.

Continue to talk to your instructor. The best way to get better is to practice. Hang in there it does get better.

**canoehead, BSN, RN** · Nov 30, 2004

I was incredibly shy too- could not IMAGINE walking up to a person and asking them what color their BM's were...or what consistency!!!? let alone their sex lives OMG!

Just trust that most any question asked respectfully is OK. If you are asked "why do you need to know that?" tell them honestly. I've had to ask some bizarre questions- working in OB and the ER, and people really are OK with it. They understand. And lots of those patients are even more forgiving if they know you are a student, so go ahead and get in there.

jaimealmostRN · Nov 30, 2004

Even though I'm already assigned to pts, I still ask them if its OK if I spend the day with them along side of their regular nurse. I've never had anyone refuse and they usually feel empowered that they can say 'yes' or 'no'. I also tell them that I am a student so everything I do is checked by my instructor or their nurse and then usually say something like, "hey you have me all to yourself today." And like other posters said, practice makes perfect. I always feel funny with the pts my age too, esp. when I'm doing something invasive like an inj. or blood draws. But keep trying!

eak16 · Nov 30, 2004

I felt the same way... nursing school just sucks sometimes. Yes, sometimes it is inconvenient for the patient to have two assessments. But that is the reality of training- nurses have been training just like you are for a hundred years, and if there were no patients willing to have students learn from them then eventually the supply of nurses would dry up. I often felt like i was doing more harm than good- especially in psych clinical- (when i had to ask eleven pages of questions to a person with a very painful past) Just one of hte many reasons why nursing school is uniquely draining and difficult. But trust me it gets MUCH better.

Tweety, BSN, RN · Nov 30, 2004

I was pretty mushy when I started, but when I graduated was a changed and completely different person.

You sound very self-aware, with that self-awareness you can turn that around. Don't feel you can't change.

Sometimes when I'm doing an admission, I realize the ER nurses, the ER docs, and the primary MD have probably asked the same questions. I ask them to kindly bear with me while I ask some questions and look them over. It's part of the job, most patients love the attention and feel good that someone cares, so don't feel you're "bothering them". Often you'll come across the grumpy and apathetic patient that lets you know the feel bothered, can't let that bother you.

P_RN, ADN, RN · Nov 30, 2004

I felt the same way when I was a student. My being shy would be as a raving lunatic compared to how introverted I was (still am). Cry? Yes at school, at home, PLUS about the first 6 months I worked in the hospital. Funny thing I found the physical assessment fairly easy. Use your eyes and ears. Let them know you are learning. Write down every freckle, every love handle every anything you see.

I remember one classmate who assessed his patient (male) as having hysterectomies when he meant hemorrhoids! Just nerves. The instructor told him in front of the whole class that men don't have uteri. He replied no one does after a hysterectomy! (I think he's a doc now.-proctologist).

Anyhoo don't feel out of step. We've been there and survived and you will too.

RN2Bn2006 · Nov 30, 2004

Thanks you guys. I got up this morning and checked this board to see if anyone had replied, and I was shocked & excited that all of you took the time to encourage me. I am very glad that some of you were like me, and actually overcame it. It gives me hope, and encouragement to know it can happen! I really think my lack of confidence stems from my lack of knowledge. (which will get better) I've just got to work on my assertiveness. I think the only way to get over it is to pick the patients I don't really want to "make" me get in there and do it. If I keep trying to avoid them, it's only going to get worse in my opinion. Tomorrow I am just going to pop in his room, say "Good Morning, I'm here to do your P/A, and take off" (ok this is positive thinking, because I'm still worried about it) ha ha. But hey, I have no choice, My instructer was very patient with me, and helpful, but she expects me to get with the program.

Again thanks to you all. At least I know i'm not the only one who went through this.

Paula

Antikigirl, ASN, RN · Nov 30, 2004

I have never been a shy person, but I must have looked like a doe in the headlights when I walked into that first patient's room...the reality hit me like a brick wall and I was stunned! LOL! Oh this is very normal!!! It is like you are in study mode...learning your facts, you walk in and BOOM...hello wow...a real live patient...oh man what do I do (while all the information flys out of some oriface never to return..LOL!).

What helped me, especially with assessments is I took a extra course in just head to toe assessments (was available at my community college). Oh that class was a blast, and really focused my attention on a systematic way of doing it that I could remember and use! I felt too many times that I would walk in and immediately started focusing on a 'probelm' area instead of looking at the whole person...this class helped me to make my assessments routine (with practice) so I don't forget an area, and helped me to find new things that may be underlying conditions as well! Oh and not to mention doing an overview of looking at a room, any tubes, and making sure everything was set up right!

Once I was comfortable with doing a systematic head to toe, things just fit into place! I found I was a creature that needs a routine..and I found my starting routine and ran with it! Took practice and knowing how I learn and work...and that takes time!

As far as other nurses...well that comes with experience as well! While I was a student I really got walked all over...patients and nurses alike, but I was learning...and I had to focus on the learning and take some slack I felt, I called it 'going through the grind'. I would just make sure I documented really well so that if anything was to be brought up or go wrong that my actions were documented and I would use that to stand up for myself or figure out what it was I did! After some time of doing it...I found my backbone in each patient and after many of them was able to actually defend myself and let it be known that I was a strong and rather diplomatic person! (and on rare rare occassions a down right B when called for!).

Take this time to get to know your patients, since you have the time (even if it doesn't feel like it). When your nurse is doing something and you aren't there, talk with a patient..never stand around idle, use your time :). It is amazing what assessment techiques you use in just watching someones facial/body language, hearing them speak, ambulating or simply moving themselves in bed!

Heck, so many of my assessment techs don't involve steths, pulse ox, or even touching...much of it is watching actively...even as much as watching a smile and making sure it is equal (which is fun because I get to make someone smile!), assesssing pain by seeing them adjust themselves in bed so they are in position to speak to me (you know, like sitting up in bed more when someone walks in a room...use this!)...or even just hearing a life story that tells me how compliant someone may be with their treatments they have been given to do at home....it is all assessment, and can be actually quite fun!!!! (I don't like doing things the 'norm' sometimes...so I used this and am quite a little spy by just watching someone talk, walk, eat, or move! I feel like a little detective..and that was fun for me!).

All this takes time to learn, but I started doing it little by little in clinicals! Now it comes very naturally...the trick was...I made it fun by the way I learned and what I found was my strong points! Humor and being very observant were my keys...now time for you to find yours..and the best place...clinicals with an open mind :).

Good luck to you...and have fun too, you learn so much by having fun while you do it (not to mention remember it better!!!).

frann · Nov 30, 2004

I was the same way too!!!

Just take a deep breath, get some privacy with the patient. this is your time to learn. You-as a nurse are so important to the patient.Now with the younger group. You can start educ. on prevention-ie DVT's-talk about that,

pneumonia- turn cough and deep breath. etc. these are important. If someone is in for something minor, you can educate them on how to avoid complications of hospitalization.

You have got to psyc. yourself up. Ask questions, get nosy.

I remember when I had my resp. rotation-trachs. I was so scared of them. Now they are just a hole in trachea. I did my ob rotation and my instructer was showing me how to do check, well she didn't catch on but I blacked out.

I had to lean against wall. I had never seen someone elses privates-except for lol :rotfl:

Good luck