Overwhelming anxiety about clinical

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I was hoping for some words of encouragement. I am in 4th semester (graduate this December) of an ADN program. This semester I am On a cardiac floor. Tomorrow is my first clinical of the semester and my anxiety is so unbelievably high I want to cry. I feel like I don't know ANYTHING for being in 4th semester. I have never started an IV or even changed IV fluids, never inserted a foley cath or NG tube. I have barely given any injections. I have only had up to 2 patients at a time. I feel embarrassed that I haven't done more. I am so scared about tomorrow and I don't really know why. This semester is the first semester that we aren't permitted to do prep work prior to caring for patients, we will just begin when report begins. I am so scared about finishing my assessment and giving meds that I might not even be familiar with and doing it on time. I am scared that I will be asked to do something that I should

probably already know how to do but haven't done and how mortifying it will be to admit I haven't done said skill. Please give me some

positive advice as I could really use some

support.

It's easier said than done, but take a deep breath, and try and let go of your anxiety. It will cause you to make mistakes, seem unconfident and really won't serve you for this semester. I don't know where you are supposed to be or what skills you should have mastered at this point, but you won't master them overnight, I suggest making a detailed learning plan of what skills, knowledge etc you lack and detail how you're going to overcome it.

Review common meds given in the floor, common skills done from your notes. Once you're on the floor, review the hospital policies. Study on your off time the pathophysiology of common diagnoses you will see and potential complications.

Even if you can't do prep work, you should be able to arrive early which will give you a chance to review the kardex/chart/ labs/ meds. When I was a new grad, I habitually showed up 20min early so I could review things on my own time. It helped me feel more prepared for my shot and gave me a chance to research things I was uncertain about.

I started my final preceptorship having only cared for two patients and was able to care for 4 by the end (4 is considered full load for us).

You can do this; all is not lost. It will take work and commitment. ask questions, seek new skills. And let's say, absolutely worst case scenario, you don't pass, it will only give you more time to be a more safe, more competent nurse. There is no shame in asking for more time if you don't feel safe to take care of your patients.

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