Love School/Hate Clinical

[CBsMommy]

Ok. I posted a long time ago in a thread far, far away about how much I love school, and I still do, although I'm ready for the summer break.

The problem is clinicals. How can I be so good at school and yet so bad at clinical? I'm afraid to hurt people, even just to give them an injection. I feel bad waking them up so I can do a full assessment. I HATE, HATE, HATE the paperwork involved in clinical and I forget to do things the nurse asks me to do. What the heck is wrong with me?

Anyone else feel this way and eventually get over it?

[jillebean]

I've found that the more I go to clinical, the more confident I become. It's all about doing something unfamiliar, and even though I'm usually scared to death, I fake confidence, and I've found that once I get to do a skill on a REAL person, it all clicks!

I hope things start looking up for you soon!

[CBsMommy]

Thanks. We're almost done with this semester and all of my confidence is shot. I'm thinking about changing my career to a pharmacist at this point! I really hope it gets better! Thanks again for your reply!

[HyperSaurus, RN, BSN]

I used to feel that way about waking up my patient for shots or assessments, and then I realised, if I don't do it, someone else will. I can at least try to be as gentle, competent, and efficient as I can be.

[BluegrassRN]

I have no problem causing people pain--the pain of a shot, the pain of making them get up and walk when they don't want to, the pain of waking up for an assessment. That small pain is going to save them a whole lot of pain (or death) in the near future.

Maybe you aren't looking at the big picture. You're only seeing how what you are doing affects them at that moment. What you aren't thinking about is their longer term health. I look at it this way..how can I possibly feel badly about waking them up to assess them: they are so acutely ill they are in the hospital! If they don't need to be assessed, they don't need to be there. If they are so sick to need assessed, you would be a terrible nurse to just "let them sleep". Would you not give someone O2 because the mask might bother them? Of course not.

Look at your assessments and the short term discomforts you may cause as VITAL to their well being.

[Nurse SMS, MSN, RN]

I agree with the above post. It is a confidence issue to be honest. You need to see yourself as already being a nurse when you are at clinicals. What you have to offer the patient is valuable to their health. I discovered lung crackles on a woman the other day in the posterior and lateral lower right lobe that her "regular" nurse didn't hear, because she didn't do that full of an assessment due to time constraints. What we offer DOES help heal people, even as brand new baby nurses to be. Start trusting what you have learned and stop thinking of yourself as an inconvenience or as the patient doing you a favor. You are already a professional. Think of yourself as one and you will find much of the sense of imposing on patients will go away.

[dstiegyrn]

I felt the same way last semester. I used to want to cry every time I had to go to clinical. I felt like the things we were doing were only to help us learn, and that they really weren't for the benefit of the patient. I actually almost failed clinical because of lack of confidence. I did great in all my classes and loved learning the stuff, I just hated going to clinical. I was even afraid to go into patient rooms by myself.

This semester is completely different. I LOVE clinical. I have confidence in myself, and I feel like I am really helping the patients. I talk to them and try to make their day a little brighter, which I feel like balances out the little bit of discomfort I may cause them with injections or assessments, etc.

My family and fellow classmates helped me get to where I am. They encouraged me and told me how they knew I could do it, I just had to believe in myself. I think that if you really are meant to be a nurse, you'll have that moment where things start to turn around, and you'll go from feeling like it isn't for you, to KNOWING that you want to do this and make a difference.

Good luck!

[HyperSaurus, RN, BSN]

I used to have the worst heartburn before clinic. I feel all of my stress through my stomach, and I already have some what severe GERD. But, I got some really good feedback from an instructor after my first day, and that made alot of difference. They don't expect us to be perfect from the get-go. That's the whole purpose of clinic.

[JBudd, MSN]

Remember your patients are there for a reason, not "just rest"! They are there to be cared for by nurses, who understand that sometimes you do nasty staff for the short term to get the long term benefit. Ignoring the things they need to have done because they are dozing off is not doing them any favors. They can sleep at home, but not get nursing care. (24/7 I mean, no disrespect to home health nurses!)

[GooeyRN, ADN, BSN, CNA, LPN, RN]

Remember, there is no rest in a hospital. They aren't there to rest, there are there for medical care. They can rest and fully recover once discharged. I HATED clinicals... It is better after you graduate, when you don't have a clinical instructor breathing down your neck noticing every TINY inadequacy. It is scary at first not having someone watch you, but it is more relaxing that that FEAR that you may forget to check a pedal pulse or something on someone in for say a nose bleed and fail out of clinical.

[CBsMommy]

I should clarify. We are not doing clinicals in a hospital this semester but LTC. It makes it worse because it's their home, they are older than me (I was taught to respect my elders), some of them don't understand what I'm doing to them due to dementia (I explain everything as I'm going along). For instance, I had to do a fingerstick on a patient twice yesterday (hard stick) and she would suck in her air as I was about to poke her. While I was doing something for them (checking blood sugar), I had to poke her twice, which is something I really don't want to do. Also, I think my instructor expects me to wake up clients for a full head to toe when it's not for the good of the patient but because I need to practice. I just don't think it's right. Hopefully it will get a lot better at the hospital when I know it's not their home (and they are not so frail and fragile).

[HyperSaurus, RN, BSN]

You may not feel it's right, but sometimes what you feel can trick you. Assessments, even on a resident in a long term care facility NEEDS to be done--they are there for a reason. You can make head-to-toe assessments less uncomfortable for you and your patient by streamlining your technique. That's the same with blood sugar checks--we both know what can happen if there is not adequate control. One thing that I have found helps with people who it's hard to get samples from is to squeeze their finger a few times before poking.

You can still respect them while getting done what you need to get done.

To a certain degree, you really are going to need to get over your discomfort if you want to be able to progress and improve your skills.