Frustrated Grad Student

button2cute · Oct 7, 2005

Hello all,
I am new here and looking for a little encouragement. I am 5 months away for finishing FNP program. Problem is that I am severely lacking confidence. I have a great deal of experience (18 years ER nurse), and a GPA of 3.86, but am having difficulty transitioning into the role of primary care giver. I do a mean assessment, but then my brain shuts off. After 3 months of clinical, I still feel the need to go present my findings to the attending, and let them finish the case. Any suggestions on how to get past this and become more independent? Mid term clinical eval in one week; I gotta get movin. I know I know what to do, but I seem to spend a lot of energy worrying about if I am doing it the same as the attending. Is this normal? Does it pass? How can I progress from this point? HELP! Ready to give up.

Hello,Peglu

What is going on? It sounds like you have the case of the nerves and graduation blues. Listen to me, get a grip and relax. Take a deep breath and slowly exhale about ten times. Close your eyes and do ten neck rolls to each side. Stretch your your body for twenty minutes and make sure you have a good stretch as well.

Okay, Take each step one at a time. Do not worry what is next and what you had completed. Just concentrate on the step you are performing and the patient. You have the ability to complete the task in the amount of time given. When you are stuck just remember you have resources that will be helpful to resolve your issues. Use your resources wisely and efficently for your cofusing issues. Go to the resources and present the problem, the labs for the problem, the dx, and the plan for the problem and your resources will be able to guide you through it. You have to learn to practice independently due to the fact the skills you had obtain as a nurse and through your clinical practices. If you feel that you need to have more clinical experience my suggestion if apply to a residence program or go to a teaching hospital or find a family practitiioner to assist you in your lack of skills and self-esteem.

In addition, when you enter a practice, they will train you according to their style.

You need to understand eveeryone feels some type of nervousness, fearful of missing something, questioning what did they do by choosing this career and most of all, knowing they are liable for their patient's care. If anyone tells you that do not get the case of the nerves near the time of graduation and/or after graduation - they are not being truthful at all. Now, if you see several of brown spots on their pants than you have it good cause they just crap their pants. It is a joke, laugh...ha ha ha ha.

You will do fine and you can always get addition clinical time if you need too. That is why I am a for residence programs for me and to give me the extra time to sharpen my skills and confidence.

You need to finish up strong, with a strong positive attitude and lots of self-esteem and pass any exam prior to graduation. Stop worrying about tomorrow and yesterday, and concentrate on today matters and everything will fall into place. Also, you have what it takes to get into the program and to make it through the program. Do not waste the money and knowledge due to the case of nerves. Just finish up, set goals each day at clinical and build up it each clinical time. Oh, watch "House" their are characters on the show that question their abilities as well as doing a review of their career and self. Therefore, jump back into the saddle and ride off into the sunset.

Start the goal of independence, today and present your case in a timely fashion to your clinical instructor and listen as they explain the numerous of options for you.

Good Luck,

Buttons

cgfnp · Oct 7, 2005

Hello all,
I am new here and looking for a little encouragement. I am 5 months away for finishing FNP program. Problem is that I am severely lacking confidence. I have a great deal of experience (18 years ER nurse), and a GPA of 3.86, but am having difficulty transitioning into the role of primary care giver. I do a mean assessment, but then my brain shuts off. After 3 months of clinical, I still feel the need to go present my findings to the attending, and let them finish the case. Any suggestions on how to get past this and become more independent? Mid term clinical eval in one week; I gotta get movin. I know I know what to do, but I seem to spend a lot of energy worrying about if I am doing it the same as the attending. Is this normal? Does it pass? How can I progress from this point? HELP! Ready to give up.

Don't worry. That fear will keep you honest and make you one of the good ones. It's the ones that don't have that fear that don't double check the PDR even for a simple med they've written a hundred times that will end up hurting someone.

You will get comfortable. Don't expect that from school, ESPECIALLY NP school. Don't be surprised that you can't practice medicine independently after writing a few papers about what Nightengale thought about hand washing.

lalaxton · Oct 7, 2005

Remember that you also have 18 years of experience behind you! Where there not times in the ER that you had to make a decision for yourself? or you knew exactly what the patient needed, went ahead and did it and told the MD about it later to get the order? Give yourself some credit and yes, relax! I remember feeling exactly like you did until I reminded myself that I had alot of experience in critical thinking before I ever went back to school.....If your strength is assessment that's half the battle, you probably know intuitively what needs to be done, trust yourself!!

We are all sending strength your way, you already have the knowledge!

Editorial Team / Admin · Oct 8, 2005

Hello all,
I am new here and looking for a little encouragement. I am 5 months away for finishing FNP program. Problem is that I am severely lacking confidence. I have a great deal of experience (18 years ER nurse), and a GPA of 3.86, but am having difficulty transitioning into the role of primary care giver. I do a mean assessment, but then my brain shuts off. After 3 months of clinical, I still feel the need to go present my findings to the attending, and let them finish the case. Any suggestions on how to get past this and become more independent? Mid term clinical eval in one week; I gotta get movin. I know I know what to do, but I seem to spend a lot of energy worrying about if I am doing it the same as the attending. Is this normal? Does it pass? How can I progress from this point? HELP! Ready to give up.

Hello, Peglu,:Melody:

I recognize this feeling. Brings back memories. I was an OB-GYN NP for a few years before going to the FNP program. Prior to graduation, I was most unsure if I could really do this or not. In fact, I remember having a panic attack just thinking about the responsibility.

Then, a physician asked me, "Siri, when you do that awesome assessment and then get my opinion, do you realize that you are right on? I can tell you that you have a great eye for this and you will do wonderfully."

Those words were needed in a time when I thought that I had made a very huge mistake transitioning to FNP.

You already know that you have the skill to assess. I am sure you already know the dx. And, you know the tx. Just go with your instincts. Never, ever be arrogant enough to proceed if you are in question, however. And, I am sure you will not. You will learn much about yourself and your abilities after graduation.

Hang in there and do not let the fear cripple you.

Editorial Team / Admin · Oct 8, 2005

Don't worry. That fear will keep you honest and make you one of the good ones. It's the ones that don't have that fear that don't double check the PDR even for a simple med they've written a hundred times that will end up hurting someone.
You will get comfortable. Don't expect that from school, ESPECIALLY NP school. Don't be surprised that you can't practice medicine independently after writing a few papers about what Nightengale thought about hand washing.

Excellent insight, cgfnp.:Melody:

catch33er · Oct 8, 2005

Peglu -

I know just how you feel... I graduated August of 2004, and even at the end of my program I was still presenting every single patient. I've been in my first FNP job for six months now, and it has taken me quite a while to get the confidence to stop doing that.

You say your brain shuts off, but I'm sure it doesn't - sounds like you're doing your thinking out loud when you present to your preceptor. I find that I still do the same thing with my complex cases, and I find that I do know the answers to my own questions!

You are at a tough part of the learning, and you will get through it. The easy stuff - allergies, colds, strep throat, will start getting much easier and you'll feel less need for help. It really does happen. I didn't believe it ever would, but it does.

Best of luck and keep at it! It's a wonderful feeling to really be out there practicing...

catch

Peglu · Oct 8, 2005

Hello, Peglu,:Melody:
I recognize this feeling. Brings back memories. I was an OB-GYN NP for a few years before going to the FNP program. Prior to graduation, I was most unsure if I could really do this or not. In fact, I remember having a panic attack just thinking about the responsibility.
Then, a physician asked me, "Siri, when you do that awesome assessment and then get my opinion, do you realize that you are right on? I can tell you that you have a great eye for this and you will do wonderfully."
Those words were needed in a time when I thought that I had made a very huge mistake transitioning to FNP.
You already know that you have the skill to assess. I am sure you already know the dx. And, you know the tx. Just go with your instincts. Never, ever be arrogant enough to proceed if you are in question, however. And, I am sure you will not. You will learn much about yourself and your abilities after graduation.
Hang in there and do not let the fear cripple you.

Thanks for the encouragement! It is comforting in itself to hear that this fear and insecurity is not unique to me. And you are right, I do know this stuff. And, I know that this is really what I want to do, however long it takes.

Peglu · Oct 8, 2005

Thanks for the encouragement and for letting me know that I am not alone. It's comforting to know that others have gone through the same thing and have come through it okay. Somehow, that makes me feel more confident that this will pass with time and more patient contact. Thanks again for your support.