Not sure whether to continue

[m.laine]

Hi everyone, I'm hoping I could get some advice or more opinions on what I can do at this point. I'm in an RPN program in Ontario (a two year program similar to the associate's degree in the States) and this past spring was my second semester. I failed my clinical because I made medication errors. I had a chance to repeat my clinical this summer so that I could go back normally in the fall but this past week I made another med error. I had medications to give at 0800 which were all through a g-tube. My instructor walked me through giving them because I'd never done it before. I had a medication also due at 1000 which I didn't have written down on my sheet. When I came back the next day I saw that my primary nurse had signed for it although he had not asked me about it the previous day.

The last time I made errors I made up a learning plan which had strategies such as getting more sleep and reading carefully so as to avoid mistakes. Obviously my strategies didn't work. I do have anxiety issues and last semester I was taking lorazepam but this semester I've switched to propranolol as it also stops my hands from shaking from anxiety.

I talked with my instructor who talked with the clinical coordinator. My clinical instructor phoned me last night and said that I could continue with the program I would just need to make another learning plan with better strategies. She also gave me the option of transferring some of my credits to our PSW (our version of CNA) program. She mentioned that if I took this option maybe I could work as a PSW for a few years to build up confidence as I am very shy and then take an RPN program part-time later on.

I'm confused as to what to do now. I like nursing, I want to be a nurse but I'm worried about continuing. Lately, I haven't felt like I'm smart enough to be a nurse even though my instructor says my knowledge is fine, it's just my anxiety. I'm worried that even if I did manage to pass this semester that I won't be okay for next semester when I will have more patients probably on a surgical floor, which is much busier than I am used to (right now I'm on a rehab floor). All of my mistakes so far have been caught before they've gotten to the the patient but I'm worried I'll make a mistake that won't be caught and will seriously injure someone...or worse.

I'm very unsure at what to do now. Whether I should go into the PSW program or whether I should continue. Maybe I just don't have the common sense that it takes to be a nurse? I'm not sure if I did continue what strategies I could come up with that I haven't tried already.

Edit: I"m sorry if this is so long.

[RunBabyRN]

First, ((hugs)). It sounds like this is really weighing on you!

Next, I don't think that your errors are related to your intelligence. You didn't say anything about how you're doing in your other courses, but from what you posted, it doesn't sound like they're a struggle. If that's the case, I don't think that the knowledge is the issue. It sounds like your instructor isn't concerned about that part.

I firmly believe that most nursing students would benefit from a year or two of CNA work. Once you've worked hands-on with patients, especially in such intimate ways as performing ADLs with patients who are so vulnerable, you can get past the "Oh my God I have to touch people" thing that so many people struggle with, and you can just focus on what you need to learn. My past healthcare experience served me very well when I started nursing school, and I am so grateful I didn't have the anxiety MANY of my classmates experienced. I know one that cried every day on the way to clinicals, another who threw up a few times beforehand. I'm sure there were more! You're not alone in your clinical anxiety, but when it leads to errors, then yes, that's problematic. Taking some time to get comfortable with patient care, then progressing back into nursing school when you're read is something you really might consider.

It sounds like your instructor(s) is on your side, and wants you to succeed. Coordinate with her for input and go from there.

One thing that I've found helps, as far as planning out my day goes, is watching what multiple nurses do. Several nurses I worked with had their own "brain sheets" they'd created, and I'd ask for a copy. I found that using a multi-colored pen to color coordinate the info is REALLY helpful. I'll take report in blue, create red boxes for things I need to get done with times next to them, write down misc stuff during my shift in black, and underline or write anything I need to pass on to the next nurse in green. I've found that this works very well for me, and keeps me on track.

I hope you find what works for you! :) Best of luck, whichever plan you take!

[chickpea7]

Do not give up. Come up with another learning plan, like your instructor suggested, and go from there. I don't think you should transfer into the PSW program unless you have no other option. You want to be a nurse, so keep trying! You said it's not your knowledge that's the problem, it's your anxiety. With that in mind you should also try to come up with some strategies to lessen your anxiety, if at all possible.