My Confidence Is Shot--need Help Overcoming Fear

Trauma Columnist · Jun 1, 2008

What you are feeling is perfectly normal. However, you have 2 months now to START to hone some skills. Then..you have an ICU consortium which sounds pretty organized where you can CONTINUE to develop skills and finally, you have more orientation where you can CONTINUE to improve your nursing. Don't worry that you don't know everything - its not that bad. Hang in there. A little fear is good for you and your patient as it keeps you on your toes. Just don't let the fear take over...you can do this!

SoundofMusic · Jun 1, 2008

I've been in nursing now about six months, and I STILL feel on some days when I'm at home especially and away from it -- that I know NOTHING.

But somehow, anytime I'm in and with my patients, things come to me at the moment. I remember exactly what to do in many situations just from having my own short experience. It's amazing how that happens. It's stored up there -- you just don't get it out until you need it.

You WILL have scary things happen. I will not lie. You will go home and be scared out of your wits. It will take a few days to process and then you'll move on. You can only do it one shift at a time. But the things I used to fear have become normal to me now and I don't even think of them. Nursing is a lot of little tasks -- just learn each of those tasks one at a time. Plus, you are never alone on orientation -- Never. You are really never alone even off orientation. Someone is always around to help. That's what a charge nurse is for.

I started in the ICU and after 3 months went back to med-surg. I had not had any prior experience, so I really needed time on a floor to get all the basic nursing stuff down first. That could be an option for you, as learning basic nursing PLUs ICU skills can be a lot. Maybe you will decide to stick with the surgical floor for a while longer.

Hopefully you'll have a good preceptorship and that will help. Ours has been pretty good, although there is no way they can teach you everything you need to know if four short months.

I fear a lot -- but "it is what it is" is my favorite saying. I'm as good as I can be at six months. I cannot be a seasoned experienced nurse after only 6 mnths. I"ll be one in about 3-5 years. Until then I'm doing my best and paying attention as much as I can and trying to learn all I can.

RNmaria · Jun 2, 2008

Yes, I too had a similar experience. I was hired for an step-down unit, which was not opened yet, and trained on the ICU. Well, the step-down unit opened-up, and although the ratio was 1:2 - 1:3...it waas still a bit much for me. It was very fast-pased and had such a variety of patients who were more active then I saw int he ICU. Needles to say I am now looking inot other areas of the same hospital so I can focus on my skills before getting back into critical care. There are some new grads who do just fine, but this is not nursing school and frankly, the stuff that I learned and did in the ICU I did not learn in nursing school. At least to that extent!

pasha

mom2michael, MSN, RN, NP · Jun 2, 2008

My first year was odd. It wasn't horrible, it wasn't despicable, it wasn't something I came home at night and said....oh my God how can I do this anymore. It was humbling though. But it was also oddly rewarding. It was so cool to see and experience those things we talked about in school. It was awesome when some crazy bit of information came from my mouth and everyone said...WOW...how did YOU know that. It was great to finally understand that darn A&P class and see how one system effects another and another and another.

This was a gradual process though and something that has progressed not only from one job to another but over TIME. You'll be simply amazed at the difference you feel RIGHT NOW vs. how you feel in 1 year.

No, I was not confident. I'm still not 100% confident each day. Even now when I pull in the parking lot I get a twang in my tummy and I think, good Lord what will I walk into???? However, I used to feel like vomiting and now it's just a twang :yeah:

Your job will always have a learning curve and you'll always feel like you are below the curve. It's good to feel that way, it makes you want to learn more and experience more and you won't suffer from the dreaded *I know everything* plague.

How did I deal with it? I put on my big girl panties and I went to work everyday. Even those days I wanted to call in and stay in bed and cry, I did it anyway.

I asked a million questions and when I didn't get the answer I wanted or thought was correct, I asked another person. I'm a huge self motivated person, so finding out the reason why is big to me. I can do anything you tell me to do, I just have to know why and just because is not the right answer for me.

I think you'll do great, I really do. Use your time on the surgical floor to enhance and develop not only your clinical skills but also your communication skills. Learn the doctors, learn the staff, learn the supplies, learn the meds, learn the flow. Lots of new nurses go to MICU/SICU and they do great. Just make sure to demand a good orientation and a good preceptor. Speak up and speak often, if they don't know it's broken they can't fix it. Get all the education you can, take the toughest patients while on your orientation with a preceptor to help you. Get to know your education person because they will be a huge resource for you. Take all the classes you can find. Read more about things that perplex you when you get a chance. Ask, ask and ask more questions. Participate in every procedure, even if you've done it 20 times already. Never tell anyone you work with *I already know that* instead listen to them, they might teach you something more or something more useful.

Good luck - you'll do great!!!!

SunnyBeach_RN · Jun 3, 2008

THANK YOU, THANK YOU, THANK YOU!!!

I recieved insight from each of your responses :bow: ...

The common theme I think I gathered from your repsonses is that "Confidence" comes w/time--I knew that but I had to have it reinforced :).

I truly appreciate you guys for taking time out to share your experiences and send a little encouragement my way,

I REALLY needed it :nuke:...

Here these are for each of you :flowersfo

:nuke: :nuke: :nuke: :nuke: :nuke: :nuke: :nuke:

Chloe'sinNYNow · Jun 4, 2008

No, I was not confident. I'm still not 100% confident each day. Even now when I pull in the parking lot I get a twang in my tummy and I think, good Lord what will I walk into???? However, I used to feel like vomiting and now it's just a twang
I asked a million questions and when I didn't get the answer I wanted or thought was correct, I asked another person. I'm a huge self motivated person, so finding out the reason why is big to me. I can do anything you tell me to do, I just have to know why and just because is not the right answer for me.

M2M,

I got canned tonight in a 10PM meeting.

I was given "opportunity" to allow me to "prove them incorrect" on my ability to perform off orientation. But I'd be shadowed by /audited by a "proctor" to micromanage my ability to give safe pt care, timely documentation and completely solo w/ no preceptor. All this after driving 45 mins to get there to my 11PM assigned shift.

I was canned because I lack this self-confidence that everyone seems to say comes with time, but no one wants to acknowledge. This was the only bedside nursing I ever saw myself enjoying. But i've been sick to the point of chest pains, and GI issues over this career that I went in to so late in life.

It was also mentioned in the meeting that I was WRONG to seek answers to my questions until I got the answers I was looking for. I was told that I need to respect my chain of command and not ask anyone else after I got an answer (no matter if it was a half-answer for a more detailed question).

Like yourself I need to know how/why things work before I use them or perform in any way.

It blows my mind that so many nurses know how difficult the nursing learning curve process is, but continue to keep things difficult.

How did I get myself here?

Chloe

RN-BSN, BA

jjjoy, LPN · Jun 4, 2008

:icon_hug:

M2M,
I got canned tonight in a 10PM meeting.
RN-BSN, BA

I'm so sorry to hear this. It sounds like it was blow to you. You might want to consider, if you haven't already done this, to start a new thread just for yourself so you can get more support to help you process what happened.

I was "asked" to leave not long after my preceptorship ended... and with no warning, either, except for the ominous call a few hours prior to my shift starting that I needed to come in early for a special meeting. I ended up sneaking into the staff locker room to remove my belonging during the shift I'd been scheduled to work. I was in no shape to talk to any of my former colleagues at that moment. And, no, they didn't offer me any other assignment in the facility.

I knew I still had a long way to go, but the only way to get there is through it, right? It really sucked that that unit wasn't willing to help through it. It sounds like yours wasn't either. But that DOESN'T mean that you're not good enough to warrant it!!!!!!! It just means that that unit/manager, for whatever reason, doesn't feel that you are working out on THIS particular unit in THIS particular instance. Again, that doesn't mean that anything was wrong with YOU, just that someone, somewhere decided it wasn't a good fit.

The next time round will be different not only because it will be in a different environment with different colleagues, but you've also got all this experience that you didn't have before! So next time you start somewhere (assuming you try again, and there's no reason not to!!), you will be that much further ahead! Besides all of the clinical skills and experience you didn't have when you first started out, you all probably have a better idea of how you learn and how you work (or don't work) with different personality styles and may be better able to recognize the type of nurse you want to ally yourself with.

Meanwhile, what did you learn about your learning style? your preferences? strengths? (no need to focus on weaknesses as I imagine that comes pretty natural right now). Did you like the type of patients you were caring for? Was there a subset of patients/conditions that you preferred? Reflecting on that can help you direct your energies for the next job.

But before putting too much energy in "what next" - do take time to take care of yourself (long, bubble baths?) and allow yourself whatever space you need to process this experience. And you could continue coming to allnurses to see that you're not the first or last new nurse to find themselves having to "start over" and that it in no way portends a poor future for you as a nurse - as many successful nurses have been right where you are at the beginning of their careers.

:icon_hug:

Chloe'sinNYNow · Jun 4, 2008

:icon_hug:
I'm so sorry to hear this. It sounds like it was blow to you. You might want to consider, if you haven't already done this, to start a new thread just for yourself so you can get more support to help you process what happened.
I was "asked" to leave not long after my preceptorship ended... and with no warning, either, except for the ominous call a few hours prior to my shift starting that I needed to come in early for a special meeting. I ended up sneaking into the staff locker room to remove my belonging during the shift I'd been scheduled to work. I was in no shape to talk to any of my former colleagues at that moment. And, no, they didn't offer me any other assignment in the facility.
:icon_hug:

Thanks JJJ,

exactly the way it happened for me. But I think this, coupled w/ the actual first clinical experience I've had since becoming licensed last August is enough to tell me I am just not capable of bedside care. I mean I am, but if something criitical or emergent happens, I'm not the type to handle that well. I am very linear and programmed to perform in a stabile environment. I liked OB, but the anxiety of what can go wrong to mom or baby or both in a heartbeat's notice scares the bejeebies outta me.

I liked the assessments and education and skills part of basic care, but I am thinking maybe a desk job? MDS? patient care coordinator? Do these things exist for a gal in my shoes with so little experience and 2 jobs in less than a year?

I have learned that my confidence is shot, to quote this thread. I don't dare try to sell myself in an interview about having experience. So should I even include the past 2 jobs I have had that ended during and then immediatly post orientation on my resume?

Sorry so long. I'm so scared....bubble bath? this ole gal needs a martini and a paycheck!

:scrying:

Chloe

jjjoy, LPN · Jun 4, 2008

First off, Sunnybeach... I don't want to sidetrack your post. If you haven't already, I highly recommend search back through old threads by new nurses. You'll find that MANY new nurses feel "like total idiots" and you'll see that MANY also make it through the tough first six months to a year. That doesn't make it any easier for you, but do know that it doesn't mean that YOU are in any way "less than" other new nurses out there.

Personally, I'd love to see some kind of internship/licensed nurse trainee programs where new nurse interns are not even ALLOWED to accept full responsibility for a full patient load for the first eight months to a year - not just 2-3 months of a fast ramp-up. By having their own license, the new nurse would be less burden on the experienced nurses, but as an intern, they would have designated back-up and less than a full load of responsibilities.

But that's not how it currently works and we have to work with it, like it or not. And by reading previously posted threads, you can find the answers to your questions.

To chloe -

there's absolutely no shame in choosing another direction! I see you have a BSN and BA. Having a bachelor's degree really does open many doors to you outside of the clinical arena. The biggest hurdle is people assuming that you'll want to go back to clinical nursing in a short time. After surveying the different types of nursing out there, I personally decided that I didn't want to be a clinical nurse that badly, nor did I want a job based on clinical nursing expertise. So I started applying for health care related positions that specifically did NOT REQUIRE a nursing license or hands on nursing experience. It meant a pay cut but it was worth it for me to not hate going to work everyday. And because I wasn't so drained and because the work suited my personality and talents, I was able to quickly progress. So professional opportunities are different than if I were practicing nursing, but I think I'm more likely to be take advantage of those opportunities and succeed at those opportunities.

I still toy around with the idea of "going back." But even if things were ideal (long, supported internships, etc), I STILL don't think I'd last long because I LIKE working at my desk. I LIKE being able to plan my day out and not have it changing minute by minute.

Anyway, you can get more details about my or others stories by looking back through old thread.

:icon_hug:

Chloe'sinNYNow · Jun 4, 2008

Jjj,

you've got mail!

Chloe

RN-BSN, BA

mat25:40 · Jun 4, 2008

someone shared this passage recently when I was in a fearful situation as a nursing student. It is from the book of Isaiah 41 verses 10 and 13, NIV: Do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand.....For I am the Lord, your God, who takes hold of your right hand and says to you, Do not fear; I will help you.:wink2: