Performance Anxiety

Nurses General Nursing


Hi everyone,

This is the first time that I've posted something, so I'm a little nervous. I just found this website yesterday, and was so into it, that I was reading the posts for 2 hours. I have a problem with anxiety when I have to perform skills in front of the clinical instructor. I know how to do them, practice them over and over again, but I still have difficulty. Does anyone struggle with this problem, and if so, what helps you? Thanks in advance for any input you can give me.


jnette, ASN, EMT-I

4,388 Posts

Specializes in Hemodialysis, Home Health.

Hi debsuztx !

And WELCOME to the BB !!! :D

As to your question... what I do when I'm nervous with someone looking over my shoulder is PRETEND. I just block evryone out but my patient. I PRETEND I'm the only one there with that patient and that I have been doing this for years... if you're confident with your skills, then just do what you really WOULD do for that patient, and forget that anyone is there with you, watching. Act as if you are doing exactly what you really would do for that pt.

Another thing that works is to (again) PRETEND that the person with you is a "student" and that you are his/her preceptor. You are showing this student the correct procedure to follow.. you want to make sure the student gets it right.

That's what I did, anyway. Worked for me ! ;)

Wish you the best, and look fwd. to hearing more from you ! :)

Specializes in Med-Surg.

I have the same problem with certain instructors. There are some that can make you feel comfortable in the room doing skills, and others that make you feel like you are going to shatter into a million pieces. My current instructor makes me majorly nervous when I do even simple things that we have been doing for months now (like hanging IV piggybacks). She hasn't had anyone in my group before so we have to "prove" our skills to her--which I have no problem with, but she has certain nitpicky things she expects us to do in front of her each and every time, and it's hard to remember all of them. One of my classmates got fussed at because the drip chamber on her IV tubing was only 1/3 full instead of 1/2 full. She expects us to ask the patient about allergies every time we give a medication--I can only imagine what the patient thinks when we have already asked them that several times the day before--about the exact same medications.

I'm not really sure what to tell you to make it better...try to have confidence in your ability for sure. It seems like they eat it up when they sense you are uncomfortable.


626 Posts

Specializes in Med-Surg, Long Term Care.

Hi and welcome! So glad you got over your fear of posting; I felt the same way here at first. I also can relate to your performance anxiety and struggled with it in nursing school. When we had our skills labs, I found it most stressful to perform in front of, not only my instructor, but also my classmates. Also, it's more difficult if you perceive your instructor to be hyper-critical or impatient. (I had a couple of those... :rolleyes: )

You're already doing what I was going to suggest first: knowing the skills and practicing them on your own, over and over again. Once you build confidence by successfully doing more and more hands-on skills, you'll probably feel less self-conscious. Try as best you can to focus completely on the procedure you're doing and try to forget yourself. It's something you have to learn and sometimes, do a good acting job to portray and instill confidence when you're performing procedures in front of patients and family members. I still fight some performance anxiety when we have to perform skills and answer questions from our clinical educators for our yearly evaluations where I work.

The only other thing I could suggest is leveling with your instructor that you're struggling with performance anxiety and ask her/him if they could give you any suggestions for overcoming it. You are new at this and everyone had to start somewhere-- including your instructors; try not to be so hard on yourself, too. That adds pressure you don't need. (Believe me, I needed this advice-- and still do! But easier said than done, I know.)

Katnip, RN

2,904 Posts

I did. And the other day rd year surgical resident asked me to please show the proper way to do a wet to dry dressing for his (&^* new residents and med students. Now there's an audience for you.

Anyway, when I'm under pressure like that, I've learned to focus only on what you're doing. Stop before hand, run through what you know, supplies you need, and the process you need to perform. Block out the fact that there's anyone else in the room. (With practice, it's easier than it sounds).

When you're practicing, have another student watch you. Then watch them. Critique each other. Support each other.

Just keep in mind, while you're performing the procedure that you DO know how to do it. And remember to breathe.

Nrs. LaLa-Land

116 Posts

That's a great idea jnette........I'm going to do that when I have my skills test in 2 weeks!


586 Posts

Brings back memories of performance anxiety during school. I had it all the way through school and feel comfortable now learning new procedures. Part of it is just becoming more familiar with the hardware needed to performing the procedure, be it IV tubings or dressing changes. It can be confusing. Then, some instructors really expect you to know the procedures before clinical, and honestly I think in some schools this may be unrealistic. The school I went to didn't have adequate and had very outdated stuff. It seems now when I am unfamiliar with a procedure, I ask a nurse that I know is friendly to watch me once or twice. This is what works for me.

Tweety, BSN, RN

33,493 Posts

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Hi. No advice, except that each and every time you get through it gets better.

It helped me to focus on one thing at a time, to concentrate fully on what was in front of me right at that moment. "Right now I'm just sitting here breathing and chatting with the patient. Now I'm opening my sterile field...I can do this".

Good luck and hang in there.


37 Posts

I find that getting to know the instructor helps. I am generally reallllly nervous in front of people I don't know, and less so in front of those I DO know. I know it may not be always be posssible, but if you can, try to build up a nice rapport with the instructor, make chit chat at appropriate times, etc.


543 Posts

Specializes in home health, LTC, assisted living.

Okay, I can really relate to you, I have this also, and this is what works for me ........ NEVER let them think you do not know what you are doing, explain yourself all through the skill, and what your next step is and why, etc, they love it. Also I have told the instructor at the start that I am nervous, then they know, and usually are more understanding! good luck!


720 Posts

Specializes in CCU/CVU/ICU.

Pefomance anxiety? Shoot...I'm the king of that!

(i really want to run with this one! ;) )


I think your anxiety will ease as you become more experienced...and more confident.

In the mean-time, the big thing to remember is that we're all human and make mistakes. So, don't 'sweat-it' if you do. If you can honestly/authentically carry that 'attitude' with you before and during your 'preformances', they'll be less intimidating.

.....but thats eay for me to say! ;)


42 Posts

I remember those days! In my first clinical semester my instructor was an old army nurse and I was scared to death of her. I failed bedmaking. I was so humiliated! I learned quickly that appearing confident helped me maintain my composure and I could actually think my way through situations and use good judgement.

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