Not Cut Out to Be a Nurse?

[wanna_be]

I just finished my first year of a two-year BSN program. I also work at an outpatient health center as a clinic assistant, where I've been for almost two years. I am absolutely, 100% certain that nursing is what I want to do with my life, and from working with nurses and healthcare professionals for several years I know what I'm getting into.

I feel like the deeper I get into clinical rotation, and observe my peers, the less confidence I have in my ability to be a nurse. It's also reflected in my job. The NPs at my work have always seemed frustrated with me; I've always gotten great feedback from clinic managers about my performance, but the providers only point out things I do wrong, and I feel like I make a lot of little mistakes every time I work.

For example, today I had a patient with a preexisting condition who wanted to do a procedure. She told me a little bit about her condition and I went and found the NP to ask how she wanted me to proceed. She seemed annoyed that I had not already anticipated asking questions about the treatment and outcome of the condition (the patient was reticent to provide more information), and sent me back into the room. The second time I asked more in depth questions and requested she get records from her specialist, then reported back to the NP, who was now REALLY annoyed because I had not educated the patient about an alternative option if the NP decided she could not do the procedure.

It's always stuff like this--little things that add up: I didn't get a clean catch because the patient's symptoms didn't clue me in to a UTI; I didn't do a pregnancy test because the patient insisted she'd been consistent with condoms, even through her period was three months late.

I feel really incompetent all the time, and think my lack of confidence just fuels my mistakes. I never do anything to jeopardize patients--if anything, I'm overly cautious. No one has ever approached me directly about it, but whenever the NP asks, "why didn't you do this"? I imagine that my coworkers think I'm slow, stupid, incapable of doing my job...and fear for my future as a nurse. What if I'm just not able to think analytically? What if I'm not cut out to be a nurse because I can't think for myself? Does everyone struggle with little things like this, or am I a hopeless case?

[TriciaJ, RN]

I still think you're being expected to perform outside your scope. Sounds like they want to train someone off the street and have them function like an RN. They're expecting critical thinking skills that you have no way of having just yet. There's nothing like constant woulda-coulda-shoulda in a work place to undermine your confidence and decision-making skills.

On the plus side, if you can navigate that position and get good at it, it will stand you in good stead for when you are a nurse. Don't sell yourself short just yet. The fact that you think things through in the early stages, instead of "just diving right in" is not a bad thing. I think you're on the right track. Hang in there.

[wilsonra]

Hey, I have exactly the same problems you do. I'm a new grad. Recently just quit a job b/c I made little mistakes like yours and it made me question everything to be honest. But I learned a few things:

"Nurses eat their Young" is something I've heard about frequently while in and out of school. My experiences have led me to believe that its the expectations that people have of new nurses that really messes things up. People forget what its like to be new and afraid of everything!

Most RNs tell you to grow a tougher skin, and to a degree they're right. Just acknowledge that many RNs aren't great teachers.

What is really going to help you in your career is letting nursing envelope you in every sense. Always look at situations as if the person has something to teach you. I remember in anatomy class, I practiced daily and I worked hard at memorizing. That knowledge that I gained made me feel so confident. Its because I made it a lifestyle. With more knowledge, the confidence will come.

-Just remember that you are in charge of your education.

-Not all nurses are great teachers, so you will have to be the one to ask questions.

-Always be very clear and concise in your questions-many times I have asked vague questions only to get vague answers.

- not everyone has a knack for nursing (I know I don't!) compensate for that by asking questions and gaining knowledge.

I relate to you, really. I went through school hoping to cure my social anxiety. What really did it was taking risks. I'm still not the best at nursing, but I've grown from my experiences.

[wilsonra]

Do not delegate what you E.A.T.- evaluate, assess, teach. They're expecting you to act as an RN when you aren't licensed as one.

[wilsonra]

Thinking analytically comes with time. You didn't come out of the womb knowing how to walk and talk! Skills are something you build. Always look at it this way. And as far as the NP asking "why" - this is not helpful the either of you. First time mistakes should always be treated like a learning opportunity, especially with someone learning the ropes of nursing.

Whenever you make a mistake, try not to think of it like you're stupid and can't do anything. You'll make your mind your own worst enemy! Just say to yourself in your head, "I made a mistake and I will learn from it now." I think you need to work on some cognitive restructuring, you need to retrain your brain to perceive yourself more positively. This is the only difference between you and the girls you go to school with. Believe me, I've been there.

[la_chica_suerte85, BSN, RN]

Wait....hold up a second. You're a clinic assistant, right? I'm not sure what your job description entails but by now you should be familiar with the delegation portion of being an RN and you are being delegated things that are what an RN/LPN can do. You missed these things because they are not your responsibility. There are some clinical days where I am wondering if I'm ever going to remember all these working parts but I know with experience it will come. However, I also know not to be hard on myself because I'm a student and it's not my job to make sure the patient understands their procedure before signing consent and it's not my job to call the pharmacy to double check a med (these are things that RNs have attempted to delegate to me and my mates when in clinical). Sometimes you have to be careful with what you're being told to do. Once you have your license and you're practicing, you're going to feel a lot more confident because the license means you do have what it takes to be responsible as a critically-thinking nurse who has their own scope of practice according to their state (also, be familiar with what your Nurse Practice Act requires in your state and you won't have to be afraid if you're being to cautious or not).

Good luck! I'm sure you're going to make it out A-OK!