My Clinical Instructor does not trust me

[konp]

Hi everyone,

I need some input and comments/ advice about my situation in clinical right now. I am in an ADN program and I am in my first semester of the program; to be exact, I am in my seventh week of fall 2011 semester. I am having a problem with my clinical professor right now. He is a nice guy, but it seems like he likes and has good attitude toward everyone in my clinical group except for me. He is nice to me but it seems like he does not trust me when I am doing my job at our clinical site.

On the first day of clinical, he paired the students in my clinical group while the other clinical instructors of my class cohort did not. He said that he wanted to "help" the group out by pairing us up since this is our first day of clinical. I was glad that he paired my clinical group since I was nervous on my first day. However, when he was pairing us up on the first day, he paired me up with one of my classmate who is very outspoken and is not shy at all. My clinical instructor said that he paired me up because I am the shy one in the group and needs to "work on my communication skill." First of all, I agree with him that I am somewhat shy and I do need to work on my communication skill since English was my second language. BUT what I didn't like was how he commented that to everyone in my clinical group and it embarrassed me so much that I was frustrating the whole entire day to the point where I didn't remember the lab skill that I learned in lab skill. Plus, my partner is one of the top students in the class and he and I are very different in many ways; we are different in our personality (he is very loud and outspoken while I am more quiet and calm). So my first day of clinical turned out to be a horrible day when I expected it to be otherwise . From that day on, I get really intimidated with meeting him and dread to go to clinical because of him. I really like going to clinical but the thought of meeting the instructor make me nervous. He obviously doesn't have any confidence in me and I see that in his eyes whenever we talk to each other.

Today, he gave me a progress note(it's a note that said that I did something wrong in clinical and if I get more of this, I get kicked out of the program) and I accepted it since I did violate some HIPAA violation. For this nursing course, it is only required that the students take care of one patient during the clinical site but my instructor gave two patients to my clinical group today; therefore, as a newbie I was nervous so I couldn't manage it.

What I didn't like was our talk after the clinical time today. He pulled me aside and asked me a bunch of questions that made me feel so uncomfortable and bad about myself. He asked me if I had any anxiety disorder and I was like no; I get nervous but otherwise it's not too serious. Then he asked me about my family and asked if I have any family problems and I shared how I do have some family problems and how my parents expected me to make my own money and not to depend on them financially. Then he asked me if my family has any history of mental disorder and that shocked me right there. He was basically asking me if I have any mental disorder in an indirect way. After the conversation, I thought about what we were talking and I realized how my clinical professor thinks that I might have a mental disorder I am so angry at the fact that he even made me to question about my sanity. This clinical experience is so new to me and I am getting use to it but having a clinical instructor who doesn't believe in me is NOT helping me to get any better.

Also, I know one reason on why I am nervous in clinical. The students in my clinical groups are some of the top students in the class. They are getting As, are much older than me (I'm 24 and they are in their 40s and 30s), and worked in a medical setting before while I never have any hands-on experience in the medical field. Some of the students in the clinical group volunteered in hospital, worked as an EMT, and even worked as a secretary in the hospital. They obviously have confidence when they provide the care for their patient. When we are at the clinical site, I feel like I am the lost sheep in the bunch while the rest of the other students seem to know exactly what to do. Here is something about me, I get intimidated when I surround myself with people who has more expertise than me in a specific area. I feel like my clinical instructor is comparing myself to these students in my group and I know that I can provide the same care as these students but maybe at a slower rate than them. I talked to my friends in the other clinical group and they said that the other students are just afraid and anxious as me and that I was unlucky to be put in the clinical group with the top students in the class.

To sum up, I guess my question is how do I deal with a clinical instructor who has no confidence or trust in me?

[tcvnurse, BSN, RN]

Sorry you are having a hard time. However, the HIPAA thing is a BIG deal. Nurses get fired over it everyday.

It seems to me, if the clinical instructor is asking about anxiety--which you say you have, and asking if you have stress at home--which you admit you do------He is asking these questions for a reason. It may be coming across in your behavior at clinical. He may be trying to encourage you to seek counciling.

My advice is to study hard. Participate in class. Maybe ask your instructor if he has any suggestions for improvement. Let him know that you are aware of your personal issues and are addressing them, and that you wont let it interfere with patient care.

Best of luck.

[arte_suave]

Well, first off he definitely paired you up with the outspoken person because you even agreed you are somewhat shy. He wanted you to learn and probably thought you would feel more comfortable with someone who is not afraid to take the reins of communication should you falter due to feeling shy, anxious, or unsure when dealing with a patient. Shyness doesn't work in nursing because communication is needed in our profession to extract needed information about the health and wellness of our patients.

Secondly, you mentioned twice in your letter about other people being smarter/better than you and wrote a whole paragraph about your clinical peers being far superior because of this or that. Then you even admitted to feeling intimidated. I mean I could tell just from the way you wrote your post that you feel insecure about your skills and knowledge, so what makes you think your clinical instructor can't smell that a mile away?

It is not that your clinical instructor does not trust you, it is that you clearly do not trust yourself and he can see this. His job is to make mold you into a nurse but he is not going to put you in certain situations until you feel confident in your skills because it makes no difference if he believes in you if you don't believe in yourself first.

My advice is this, you made it in, you can make it out. Stop focusing on how skilled the others are and put work into yourself. If you don't feel confident then fake it till you make it. You have to understand that even though we are nursing students, for the most part, patients respect and expect us to take care of them and keep them safe. They don't see the scared, nervous nursing student unless we show them. They see a healthcare professional in training who has the knowledge and expertise to be trusted by the hospital to care for them.

Trust me, everyone in your clinical is a little scared and nervous, they just hide it better. Be confident in yourself and stop worrying about if other people are confident in you and the rest will come.

[NCRNMDM, ASN, RN]

I agree with Arte_Suave. Your instructor knows that you don't trust yourself, and he is trying to build confidence in you. However, he is also weary of you because you don't trust yourself, and he doesn't know what kind of care you will give yet. You have to be confident as a nurse. You have to know how to respond in emergencies, and you have to know that you are doing the right thing. You've learned skills in your skills lab, you've checked them off, and you know them. My advice is take a deep breath, forget all the other students in your group, and give your patients the best care you can. Don't worry that they seem to know more than you, don't worry that they give care faster than you, don't worry about any of it. Everyone should be a little nervous when they first start clinical, and I'm sure the students in your group are. If they aren't nervous and they are giving quick patient care, then it won't be long until they do something wrong. When you get your patient assignment just focus on those patients. Don't focus on other students or the instructor or the staff in the hospital. Take your time, stay calm, and provide good care. When your instructor sees you confidently giving care, he will see the change and begin to challenge you more and more.

[classicdame, MSN, EdD]

are the others really smarter? How would you know?? Just because they are outspoken does not mean they are smarter. If you think the instructor crossed a line professionally then he should be reported. You might need to talk to the Dean to see what you can do to improve relations with the instructor.

[BeenThereDoneThat74, MSN, RN]

As a professor, I agree with everyone's replies here. It may not be what you want to hear, but we'd be doing you no justice by saying "poor you, he really is picking on you".

As an instructor, many of us are pretty good at reading our students. Some professors like to pair students up on the first day, to get an idea of their ability to work together. You mentioned your partner was nothing like you... if I were your instructor, and sensed you were shy and lacked confidence, the last person I'd pair you up with would be someone like yourself. This was no coincidence that this was your partner. I too, have done this very thing. My hope is that the weaker student (whether it be in skills, communication or whatever) learn by example from the stronger student. It is no way meant to make you feel bad.

Reagarding your anxiety: that's another thing we can often pick up on. it is our job to make sure that you are in the best possible position to succeed. If we recognize something, we can't just look the other way. Sometimes it is difficult to cross the line of privacy, and I always tell my students "you can tell me as much or as little as you'd like. But the more I know about what's going on with you, the better I can help you to get through this difficult time." If a student reveals to me that they are having a problem, it is my obligation to steer them in the right direction to get help. Unfortuantely, many students act as you do: they get offended that they are being "diagnosed" by their professor as having a mental health issue. There is a big difference between being mentally ill and having issues dealing with the stressors in your life (ie, nursing school/family/work). He's not calling you a psycho, he's merely suggesting you need to talk to someone.

Your clinical group is usually formed by luck, not by ability: stop thinking of yourself as the weakest one in the group. It's not an excuse. Your instructor cannot compare you to them, he should be comparing you to the standard that is expected of the first semester student. If you make an error, violate a basic principle (HIPAA is huge, btw), or do not meet a behavioral objecticve, then you don't pass (or you get written up, whatever your school's policy may be). It has nothing to do with the rest of your group, it's all about you.

And regarding your thread title: before I even read your story, I said to myself "I don't trust too many of my students either. No offense, but you are a 101 student. It takes a while for a student to earn the instructor's trust. Even if that has happened, there are things that I will NEVER let a student do without me, even the best ones.

[athrun340]

As an instructor, many of us are pretty good at reading our students. Some professors like to pair students up on the first day, to get an idea of their ability to work together. You mentioned your partner was nothing like you... if I were your instructor, and sensed you were shy and lacked confidence, the last person I'd pair you up with would be someone like yourself. This was no coincidence that this was your partner. I too, have done this very thing. My hope is that the weaker student (whether it be in skills, communication or whatever) learn by example from the stronger student. It is no way meant to make you feel bad.

.

I agree with the rest of your post except for this part. If a person is shy and lacked confidence and you pair him/her up with a very confident and outspoken student, that's only going to intimidate the shy person even more. A shy person is not going to change into a confident, outspoken person overnight. In my opinion, the best thing you can do is pair a shy student to another quiet student who is very confident. By doing this the shy student can relate to his/her partner because they have something in common and hopefully the shy student will start to pick up the "confident" quality of his/her partner. Just a suggestion coming from an introvert.

To the OP. I can feel your pain. As an introvert, clinicals can be hard especially when English is your second language. It seems like you and your professor started off on the wrong foot when he mentioned to your clinical group that you needed to work on your communication skill. I can understand why you were embarrassed. My advice to you is have a thick skin. I know that's hard to do but you have to do it. Don't dwell on the past. It's not that your clinical instructor doesn't trust you. It's just that he can see your weaknesses and he wanted to address it. What you need to do is work on these weaknesses.

Nursing school is very stressful for someone who does not have a hospital background. Why? because you don't know even the most basic things and how things run are in the hospital. It can definitely cause alot of anxiety to the student and to top it all sometimes clinical instructors forget about this. This is why i always advice my fellow nursing students to work as a CNA before they enter nursing school so when they get to clinicals, they are more comfortable and they have an idea of how things are run in the hospital. This way there will be no barrier to learning such as nervousness or anxiety. However, it seems thats too late now. My advice is that you follow arte_suave's advice .. "Fake it til you make it." Also when you're in clinical, try to absorb as much information/experience as you can. Ask a lot of questions to your classmates who are more experienced than you and to your clinical instructor most especially. Don't try to avoid your CI. I know you said you feel intimidated talking to him but you have to overcome this. The worst thing you can do is to avoid him during clinical. Show him that you're willing to learn and that you want to be a nurse. Also practice your skills until you master it. For example, vital signs, you have to practice it over and over again until you feel comfortable doing it. This is true for other skills as well. So when your CI sees you performing these skills in the clinical setting, you won't feel nervous. As for patient contact, just interact with them like you're talking to a friend. Obviously you have to be professional.. but just be confident. They dont bite haha and do not be scared to touch a patient. Lastly, be a leader. When you take care of a patient, your patient expects you to lead them. For example, when you're giving a bath or you're transferring a patient, always give your patient instructions on what they're supposed to do. Don't just stand there and not say anything. Give them instructions step by step so your patient will feel comfortable..

Remember as you gain more experience, the more comfortable you will be in a clinical setting. Feel free to pm me if you have any questions. Trust me i can understand where you're coming from.

[SnMrsSmiley]

actually in my experience as a former very shy timid person, it helps to bring me out of my shell to be with a loud confident person. Monkey see monkey do.

this sounds rude and insensitive but what im about to say is meant from the heart : grow up. Suck it up and paste a smile on your face and get it done.

if it were easy then everybody would be a nurse. Overcoming your own insecurities takes a little digging deep and telling yourself to just DO it and when you have done it you will be so proud of yourself. As my mother would say "quit whining about it and quit thinking your not as good as the person standing beside you"

If i could get over myself (as painfully shy as I was, I used to throw up everyday before class from anxiety) then trust me you can to.

You only make it harder on yourself when you let your anxiety show. Your patients, classmates, instructors etc.. will NEVER trust you if you dont trust yourself.

[ImThatGuy, BSN, RN]

I don't trust 3/4 of my instructors!

[NurseMaybeBaby]

It's not your instructor's job to trust you, it's his job to teach you and protect the patients. That being said, I agree with everyone else that you seem extremely concerned about your own abilities. Nursing is not black and white and it's not easy. He wants you to build confidence in yourself. He does sound like a bit of a jerk, but take it as an opportunity to step up to the plate. Try and shake off his comments and figure out how to turn them into something positive. The clinical situation is very intimidating, but it will get easier. Good luck to you!

[gummybear20]

Hi, I know it has been a while for you, but I am experiencing a very similar situation right now. My instructor comes by at least 2-3 times per shift, to ask me "What's going on with your patient?". And I couldn't tell him anything everytime, because there is nothing going on with my patients and they are fine at the moment. And at the post-clinical conference where we are all gathered and talk about our day, he mentioned that "Some of you still can't tell me about your patient, and it is your third quarter and I expect you to reach this level of professionalism..." and I know he was talking about me, because everyone in my group is pretty good at talking about clinical situations. And English is also my second language, so whenever he asks me that question, I am like, what does he want me to tell him, specifically??

[Here.I.Stand, BSN, RN]

My instructor comes by at least 2-3 times per shift, to ask me "What's going on with your patient?". And I couldn't tell him anything everytime, because there is nothing going on with my patients and they are fine at the moment........oup is pretty good at talking about clinical situations. ........whenever he asks me that question, I am like, what does he want me to tell him, specifically??

He is asking because it's an essential skill. If you are working in LTC and need to call the provider, your call may be returned by someone who has never met the pt. It will be your responsibility to "tell them about your pt." That's not limited to LTC either; at my hospital the family practice service takes call for the medical floor.

Again, the on-call MD may have never met the pt. Or in the hospital if your pt codes, the code team will need you to tell them about your pt.

There is always something to say -- people who are totally fine do not get hospitalized.