Nervous in clinical. Being too hard on myself?

[pht15]

I'm a first of four semesters nursing student. We had our first clinical this week during which we were assigned a patient. Overall, the experience I had with the patient went well until my instructor was in the room, and I felt very nervous. I keep going over in my head all of the things I did incorrectly or could have done better and somehow drawing the conclusion that because of these little flub-ups, I'm going to fail out of the program. My theory grade is 85%, and I seem to make better grades with each test. However, I have heard that a lot of people fail out of the program during the second semester, as that is when the med-surg component is emphasized a lot, and we really have to know our pathophysiology to do well in lecture. I don't do poorly in theory, I don't think (though what student who is only a few points below making an A-grade is satisfied with a B?), and objectively clinical seems to go OK-- not stellar. In other areas in my life where I have enjoyed the work, as I do in nursing, I have managed to do very well despite initial jitters. It seems, however, based on past experience, that getting comfortable enough in my skin to do a competent job is going to take longer than what the course will require of me.

I have worked really hard not to let anxiety rule my life, and I don't want fear of failure to push me in the wrong direction. So many people have said that I am too hard on myself, and I think in nursing school no one is going to tell me to be less hard on myself.

What are some more realistic expectations of myself in clinical? In theory? In general? lol.

[nurseprnRN, BSN, RN]

You should remember that you are not expected to perform at the expert level in clinical now. If so, you wouldn't be in, like, school. :)

You'll feel better if you prepare by doing your due diligence on your physiology, anatomy, medical terminology, meds, medical diagnoses, and lab skills stuff before you get there.

After that, you're in clinical to PRACTICE. A lot of stuff you'll do just fine with on the first try, and get better and better as the semester goes on. Some other stuff you will feel completely inept on ... and you will get better and better as the semester goes on.

Finally, look around on the floor in your clinical rotation. See all those nurses? Every single one had a first clinical rotation and felt just like you. And of course, all us old folks had MUCH more serious and mean instructors, and had to walk uphill to clinical both ways in the snow, and had to trim the lamp wicks and sharpen the needles too. And we lived.

Feel better?

Welcome to nursing! We're glad you're here.

[Jenngirl34RN]

Added to what Grntea said, use your clinical instructor. Tell him/her what you thought went well, and that you don't feel confident you did as well as could and you want to improve. Ask him/her to give you some tips to make your next assessment better. They are there to help you, but all of the instructors I have had will only offer additional help or advice (beyond just making sure you are safe) if you take the initiative to ask for it.

[LoriRNCM, ADN, ASN, RN]

I still feel that way in fourth semester. Today I hung meds, did IV pushes and PO meds, patient teaching, assessing, interventions, and changed an inner cannula on a trach, not in that order, and I thought for sure I would kill the patient in so doing. But I didn't. Many nurses will tell you they don't feel they become truly competent until they have been on the job for a year.

[pht15]

I guess I just need to get used to feeling dumb? I talked to my fundamentals instructor about my test grades, and asked what I could do to get higher scores. She told me to find someone who is getting a score that I want and do whatever they're doing, lol, but not to be too hard myself because this is nursing school (which I felt was kind of a jedi mind trick because she's the gate-keeper). I sort of feel, however, that my grade this semester is somewhat predictive of my grade in second semester. I.e., if I get a B this semester, a B will be the max grade I can get next semester. We flunk out at less than 75% and that scares me.

[sjalv]

For what it's worth, your grade in 1st semester does not determine your grade in the following semesters. My grades so far, from 1st to 4th, are/were: B, C, B, A. Of course the semester isn't even halfway over yet, but my point is I was nowhere near an A in 2nd semester and now in my final semester, I have a pretty solid 95, which shocks even me. Life events and how you handle stress will greatly affect how well you do in school. Of course, the course content and your motivation to conquer it have a lot to do with things as well. I would simply suggest not to get worked up about anything until you have a reason to, like when you need an 85 on the final to pass the semester.

A little bit of anxiety is good. No one "coasts" through nursing school. But being hard on yourself and constantly worrying will only bring you down.

[pht15]

Evidently at my school, this semester's clinical performance determines next semester's clinical placement. I really would rather not be in the remedial group. Terribly insecure about this prospect and would like to know what I should do to avoid doing poorly in clinical.

[elizabethhRN]

My first semester of nursing school now seems like a blur, but I was not at all confident, and really looking back on it now, all I can remember was being overwhelmed. That first semester always seems to be the toughest because honestly nothing prepares you for it, and that's okay! Trust the process- you will be amazed at what you know and what you are able to do by the time you graduate. Don't be so hard on yourself