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.
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!
Thanks for all the suggestions guys! I have considered getting a parttime CNA job,(as some of you suggested) just to get me more comfortable with patients.
I went to clinicals today and tried to psych myself up - I did better. I just walked in and said, OK it's time for our assessment, and did it. :) I struggled some the rest of the day, but overall it was a good day. The main problem I had is he had used his PCA and was extremely sleepy - would like fall asleep while I was talking to him. Well, I let him rest for awhile, but needed to get his basic needs (bath/hygeine, etc..) done, and I had a hard time "making" myself wake him up. In fact I asked my fellow students if they thought I should wake him up for it - because in my opinion - he needed the sleep (said he didn't sleep good the night before) So I kept peeking in on him. Finally I just decided I was going to wake him up and take care of business because I was running out of time - so I did. He wasn't too thrilled, but just told him I had to get it done.
But I did come to a conclusion - I am 34, and I have worked - since I was 16 years old - and it has always been in a place of business was customer service was #1, so I have been trained, and practicing all these years doing things around the customer's convenience, and making sure "they" are satisfied - so I think I'm having a hard time like doing things like the bath, because I might "disturb" him or make him upset by waking him. Make any sense??????????????
This doesn't help with the confidence area, but from what all you have said, I think I will gain more of that everyday. I just have to get more comfortable with people.
I live in a small town, and they don't offer many unique classes, but if I ever seen one on assertiveness, I'll jump right in.
I think if this nursing school experiences makes me into an assertive, confident person, than I have gained alot.
You guys are great. This board is like my new "fix" I visit it everyday.!!
ohh,,,,,, I'll have to write those down! I think they might come in handy!!:)
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 for all the suggestions guys! I have considered getting a parttime CNA job,(as some of you suggested) just to get me more comfortable with patients.
I went to clinicals today and tried to psych myself up - I did better. I just walked in and said, OK it's time for our assessment, and did it. :) I struggled some the rest of the day, but overall it was a good day. The main problem I had is he had used his PCA and was extremely sleepy - would like fall asleep while I was talking to him. Well, I let him rest for awhile, but needed to get his basic needs (bath/hygeine, etc..) done, and I had a hard time "making" myself wake him up. In fact I asked my fellow students if they thought I should wake him up for it - because in my opinion - he needed the sleep (said he didn't sleep good the night before) So I kept peeking in on him. Finally I just decided I was going to wake him up and take care of business because I was running out of time - so I did. He wasn't too thrilled, but just told him I had to get it done.
But I did come to a conclusion - I am 34, and I have worked - since I was 16 years old - and it has always been in a place of business was customer service was #1, so I have been trained, and practicing all these years doing things around the customer's convenience, and making sure "they" are satisfied - so I think I'm having a hard time like doing things like the bath, because I might "disturb" him or make him upset by waking him. Make any sense??????????????
This doesn't help with the confidence area, but from what all you have said, I think I will gain more of that everyday. I just have to get more comfortable with people.
I live in a small town, and they don't offer many unique classes, but if I ever seen one on assertiveness, I'll jump right in.
I think if this nursing school experiences makes me into an assertive, confident person, than I have gained alot.
You guys are great. This board is like my new "fix" I visit it everyday.!!
Thanks
Paula
One of the first books out on Assertiveness Training is called "When I Say No, I Feel Guilty". Great book. I've read it a couple of times. Recommended it to others who have also used it...for instance, with department stores in resolving purchase disputes. When you know what to say, it's like someone said, you feel more empowered, more confident. Usually, it's just a matter of learning what needs to be said.
As far as announcing to someone that it's time for their bedbath...yeah, that's hard to do sometimes, especially if the patient has a lot of visitors. It always helps--and is usually good for the patient--for them to do as much as they can; with visitors, sometimes I get them involved. I have a "reference experience", too--I took care of my father when we put him in hospice--I helped with everything...and it was a really special experience--to be able to give back to a parent in that way.
As for dealing with nurses--oh, I already mentioned the assertiveness training book--you'll want to learn this stuff--because then you can advocate for your patient so much better. Some of my patients have taught me how to advocate for them--by continuing to bug me! For instance, I had a patient who knew that MS didn't work for her, that she needed dilaudid--it took us a bit to get in touch with her dr--every time she brought it up, we attempted to contact him through a different avenue--but the relief she got from the dilaudid demonstrated to me what proper pain relief can do for a person. I subsequently learned that lesson on another patient, and advocated with the physician (yes, I'm a student--and, normally, would have brought it up with the primary nurse--but the doc and I were both in the patient's room at the same time.)--we got him changed to dilaudid with significant improvement of his pain!
Who is the author of the book? It sounds like something I need to read.
Thanks for your helpful words.
Paula
One of the first books out on Assertiveness Training is called "When I Say No, I Feel Guilty". Great book. I've read it a couple of times. Recommended it to others who have also used it...for instance, with department stores in resolving purchase disputes. When you know what to say, it's like someone said, you feel more empowered, more confident. Usually, it's just a matter of learning what needs to be said.
As far as announcing to someone that it's time for their bedbath...yeah, that's hard to do sometimes, especially if the patient has a lot of visitors. It always helps--and is usually good for the patient--for them to do as much as they can; with visitors, sometimes I get them involved. I have a "reference experience", too--I took care of my father when we put him in hospice--I helped with everything...and it was a really special experience--to be able to give back to a parent in that way.
As for dealing with nurses--oh, I already mentioned the assertiveness training book--you'll want to learn this stuff--because then you can advocate for your patient so much better. Some of my patients have taught me how to advocate for them--by continuing to bug me! For instance, I had a patient who knew that MS didn't work for her, that she needed dilaudid--it took us a bit to get in touch with her dr--every time she brought it up, we attempted to contact him through a different avenue--but the relief she got from the dilaudid demonstrated to me what proper pain relief can do for a person. I subsequently learned that lesson on another patient, and advocated with the physician (yes, I'm a student--and, normally, would have brought it up with the primary nurse--but the doc and I were both in the patient's room at the same time.)--we got him changed to dilaudid with significant improvement of his pain!
Specializes in jack of all trades, master of none.
Your customer service experience will serve you well in this profession, from patient surveys to Press Ganey scores, which go to the "powers that be," to your future evaluations... it won't matter how smart or dumb you were, if you taught the patient to turn, cough, deep breath, how to care for that wound, or check their blood sugar.... it will ALWAYS be HOW you did it, that the patient will remember...."Cheerful, but not TOO cheerful when she showed me how to use my walker" was how I described on one of those surverys, lol....And believe me, the more you are mentioned in a survey, the more positives you get, adds up to a better raise with your eval...
It's not about healthcare anymore, it's about healthcare "with a smile & a thank you"
We don't take care of patients anymore, we wait on them hand & foot, & try to do our cares & our teaching when it is "convenient" for them...
Sometimes, you just have to be firm... Mr X, it is now time for your bath, you can rest undisturbed until lunchtime" But don't forget to do that with a smile, lol, lol....
nursemike, ASN, RN
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