I am a first semester student. I have wanted to be a nurse for a very long time. I love to help people, and love the medical field. I am making good grades, not really struggling too hard with tests.
My problem is.......... On my way to clinicals, I have all these positive thoughts, plans & ideas in my head. When I walk in that patients room to do my physical assessment, I turn into a wet noodle. I have no confidence, no self esteem. I am too intimidated to complete my physical assessment at one setting, because i feel like I am "bothering" the patient, because at this point, the "real" RN does the "actual" physical assessment - the one I do is only documented in my school paperwork. I mean heck, these people feel like crap, and I'm asking them all these annoying questions. I honestly don't know what is wrong with me. It's like if I have a little 80 year old lady/man who is incontinent, can't feed their self, etc...... I do fine. It's like I KNOW what I'm doing when it comes to that, but when I have a 50 year old or younger patient that really doesn't need all that much "care" then I feel like I don't know what to do for this person, and dont' know how to help them. I ask if I can do something, and they usually say no. So I feel uncomfortable. I'm not a natural at just waltzing in a room, and being able to do all these things for the patient, and make their life easier. I walk in and fumble around, & end up doing part of my assessment, and then finishing it up later, and I honestly don't know why.
I am very fortunate to have a very caring clinical instructer right now, and tonight when she asked me how my patient was doing, and I finally just said "I don't really know" and she asked me why, I opened up to her. I ended up shedding some tears - not because she was harsh with me, but because I was exposing my weakness, and my insecurities. On the outside - everyone thinks i'm so full of confidence. (NOT) she was very helpful and caring, and wanted to know what I was "scared or intimidated' about, and I honestly couldn't tell her. She basically just told me, I need to go in the patients room, tell them I'm there to do my Physical Assess., and just do it. Have some authority about myself. I am really going to try, and I do feel better after talking to her. I have been struggling with this problem for the whole semester.
My question I guess is did any one else have this problem in the beginning, and was able to overcome it, and now is a good "people person" nurse? Does it come with experience??
I'm sorry this is so long, I just home from clinicals, and it is really on my mind because I have to go back Wednesday, and do a better job.
Also remember - most patients LOVE to help students out!!! THEY want you to learn too! Here they are feeling crummy and some smiling, kind caring person comes in and talks with them, spends a little time with them - and especially for older folks that means the WORLD! Don't think of yourself as imposing on them - think of it as you asking their permission and if they agree, then feel free to do what you need to do!!!!
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:
Ha Ha That's funny!!! Actually my field I want to go into is OB, so I can't wait to do my 1st check. I've had the priviledge of witnessing my sister's 3 children being born, then last month I was there for my best friend giving birth to her son,and any time now, my 15 year old (I know - awful) cousin will give birth which she has asked me to be there. I feel very priviledged to be given the opportunity to witness these special times in their lives. I have studied so much on L/D I feel like I know probably 1/4 of the stuff there is to know, so I already have confidence going into that field. I'm just counting the days until 3rd semester!!! I hope I don't clam up when I get there!!!! That will be my time to shine! (I hope)
Also remember - most patients LOVE to help students out!!! THEY want you to learn too! Here they are feeling crummy and some smiling, kind caring person comes in and talks with them, spends a little time with them - and especially for older folks that means the WORLD! Don't think of yourself as imposing on them - think of it as you asking their permission and if they agree, then feel free to do what you need to do!!!!
I guess that's why I feel comfortable with the little old people. Because I truly care for my patients and what they are going through, and I am able to communicate that to them because I connect with older people. It's mainly the younger ones I have the communication problem with. (go figure???!!!)
back in the dark ages, when I was a nursing student, I also felt uncomfortable with "younger" patients. What I've learned over the years is that some patients really appreciate humor. If you can complete an assessment while conversing with the patient, then the stress is greatly diminished. Unfortunately, some nurses feel the need to keep students "in their place." You're very lucky to have a good clinical instructor. Hang in there, things will become easier with time.
I am 26. when I graduated nursing school I was only 18. I worked in LTC, It took me forever to convience people that I was a nurse not a teenager.(Wish I still had that problem). Anyways it is learned in time, and in baby steps. Practice your introductions to your patient at home. Just what you say and how you say it makes a huge diffrence. Also observe the nurses on the floor and just watch their manurisms(spell?)
I will graduate in May but I remember when I first started doing clinicals i was the same way. My very first clinical I was sooo nervous that I stood in the hall outside my patients room for like 10 minutes before actually going in. It will get better. Now I walk right in, do my thing and dont think a thing about it. Good luck!!
This post has described myself to a Tee. I too was in the RN program at the local community college but failed clinical. I knew my stuff, had a B in class and understood what was expected of me. I was generally well prepared with all my research about the patient, labs, medications etc. But I would go into a room and freeze. It would take me so long to get things done cause I was scared of touching the patient, scared they might break and it was hard for me to talk to them. The hospital staff was not real happy with us being there and most of my instructors were rather gruff I thought. Right now I work as a CNA and I am also a certified home health aide too. I still feel a little lacking of confidence and senior aides will use that as ammo any way they can. They will try to boss you around, tell you that your not doing it right, and sometimes make fun of you. But that only shows their immaturity. Anyway, I plan to attend LPN school and RN school later after I've gained some experience. In a career like this it is an uphill battle everyday to accept that you've done the best for that client and made them happy.
When dealing with other nurses and supervisors, you may find this helpful. Actually make a list of phrases to use when you need to be more aggressive,d take up for yourself or your patient, and even give yourself a little time to consider what is being said. I gather that you have a very helpful nature, and that's good, but you don't want others to be able to use that against you - and they will if you allow them to. So my list in my head reads something like this:
"I'll consider that". (puts you back in charge of the situation)
"No, I don't think I will choose that route"
"Well, that's something to think about. I'll get back to you about it"
" I really find that I can't answer that just right now, but I will think about it and give you my answer later.."
"Now let me see if I am hearing you correctly......"
"And what about your suggestion is an advantage for my patient?"
I don't see an advantage for my patient if I take your suggestion, but thanks anyway.
I'm uncomfortable with that.
Well that is one perspective.
That's an interesing question.
I can't think of all of them now, but I do know that there are a couple of good books out there about questions to ask when you don't know what to say, etc. Sometimes these types of phrases and using silence as a tool have served me very well, especially with those who want to slough their work off on you! Never underestimate the "silent stone faced look" It works like a charm. Also, don't be afraid of confrontations. Sometimes they are necessary, but they should always be about the patient's best interests, not who was "right" or who "won". I hope this has been helpful. One more thing, you might try modulating your voice a bit. All my colleagues know that when my voice tone becomes lower and flat, watch out. I've been pushed as far as I'm willing to go. Good Luck.
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.
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
It's called EXPERIENCE! Nursing school is hard. Some people are great in clinicals, but struggle in the classroom. Some are fine in theory and faint in clinicals. Some people seem like it all comes easy and cry themselves to sleep. It's just freakin' hard.
DO NOT GIVE UP! I know exactly how you feel. For me, the classroom stuff is--well, not easy, exactly, but not very hard. In clinicals, I'm incredibly nervous, even though I deal with patients very comfortably in my job. But my real killer has been careplans--I literally contemplate dropping out every time I do one! But last year, when I was having extreme, paralyzing anxiety on a daily basis, I had a moment of clarity and decided they can throw me out if they want to, but I ain't gonna quit! After that, it got better.
I'm glad you have a sympathetic instructor. That's a huge help. Talk to her (or him). Talk to any instructors willing to listen to you. Talk to classmates. Consider very seriously seeing a counselor (I got a lot of help with anxiety and stress through my smoking cessation class, over the summer).
As for dealing with other nurses, necessity will teach you that. Well, and there's a ton to learn on these boards. I've been telling everyone I know who is even considering nursing school to check out allnurses.com. What a resource!
I do half wonder if one of the hidden agenda in nursing school is to completely destroy every shred of self-confidence you have. Then, if you survive, you know you can handle anything. We talked in sociology about organizations that destroy your identity, then give you a new one. Military basic training was one example. Maybe nursing is another.
One of our assignments in psych nsg. was keeping a journal. I found that very useful. If I had it to do over, I wouldn't wait until psych.
Anyway, best of luck, and hang in there. It gets better. Not easy, but better.
We talked in sociology about organizations that destroy your identity, then give you a new one. Military basic training was one example. Maybe nursing is another.
Nursing is absolutely a socialization process as well as an educational one. Nursing is an odd band of brothers and sisters because we have shared experiences that are exclusionary of the rest of society (those who are not nurses)
About the time you are ready to grauate and feeling pretty confident, you will get hired into a place where you have no comfort level and the socialization process begins all over again so be aware of that.
Just know that you are NOT the only person who has felt this way!!!!!!!! I wish "they" would tell you these things as you get started - but sometimes the best way to learn is to live it rather than be told!!!!
The only lessons Ive really learned cost me money or heartache...I don't remember who said that but it is certainly true in nursing!
When dealing with other nurses and supervisors, you may find this helpful. Actually make a list of phrases to use when you need to be more aggressive,d take up for yourself or your patient, and even give yourself a little time to consider what is being said. I gather that you have a very helpful nature, and that's good, but you don't want others to be able to use that against you - and they will if you allow them to. So my list in my head reads something like this:
"I'll consider that". (puts you back in charge of the situation)
"No, I don't think I will choose that route"
"Well, that's something to think about. I'll get back to you about it"
" I really find that I can't answer that just right now, but I will think about it and give you my answer later.."
"Now let me see if I am hearing you correctly......"
"And what about your suggestion is an advantage for my patient?"
I don't see an advantage for my patient if I take your suggestion, but thanks anyway.
I'm uncomfortable with that.
Well that is one perspective.
That's an interesing question.
I can't think of all of them now, but I do know that there are a couple of good books out there about questions to ask when you don't know what to say, etc. Sometimes these types of phrases and using silence as a tool have served me very well, especially with those who want to slough their work off on you! Never underestimate the "silent stone faced look" It works like a charm. Also, don't be afraid of confrontations. Sometimes they are necessary, but they should always be about the patient's best interests, not who was "right" or who "won". I hope this has been helpful. One more thing, you might try modulating your voice a bit. All my colleagues know that when my voice tone becomes lower and flat, watch out. I've been pushed as far as I'm willing to go. Good Luck.
RN2Bn2006
People respect individuals who know what they are and are what they know.
The phrases above are very good to know and even better to use because once you use one, you will feel a self confidence that you haven't felt before.
One other idea that may help you is to teach. What I mean is in your mind imagine you are teaching a new student how to do what ever it is you are doing. When we are in a teaching role, we instinctively take on a more positive "I can" attitude. Obviously you cannot talk out loud to this imaginary student but you can talk it through in your mind. It is an awesome tool for building self confidence and it helps to keep you on track too!
Oh and it's OK to let go and speak to someone who can help guide you. No one is a rock and holding back on things that upset you leads to un-necessary bad stress. Heck I cry just about every month and at my age. My family calls it menopause I call it prophylactic therapy!!! :rotfl:
Let me tell you that I graduated from nursing school this past May, and I was just like you, very shy and unsure. Believe me, by the time you get to your last clinical, you will feel much more comfortable. Most patients enjoy having two nurses anyway, and will want to help you learn. No one expects you to be an expert, so try not to put so much pressure on yourself. Good luck in nursing school! And remember to lean on your classmates. You need each other.
gauge14iv, MSN, APRN, NP
1,622 Posts
Also remember - most patients LOVE to help students out!!! THEY want you to learn too! Here they are feeling crummy and some smiling, kind caring person comes in and talks with them, spends a little time with them - and especially for older folks that means the WORLD! Don't think of yourself as imposing on them - think of it as you asking their permission and if they agree, then feel free to do what you need to do!!!!