emmalou*

^ this. If you listen to nothing else on here, listen to this. Most of us have concentrated on the 'doing' tasks, which are important obviously, but qualities which are as important are empathy, kindness and active listening. Nursing students and new nurses tend to concentrate on the physical and you forget that is a person in the bed there, with a mum, dad, husband, wife, kids, friends in their life. Best advice I've read on here, from the best kind of person, someone who was a patient.

Hi, I replied to your post last year. Congratulations on making it to 2nd year! Good for you. Did you receive any feedback on your last 2 clinical placements? It would be a good place to start, by thinking about what you need to work on still and working towards those goals you discussed with your facilitators. I guess I am just going to reiterate the advice I gave you last year which is to continue being enthusiastic and proactive as that is a good way to be. Don't do anything outside of your 2nd year nursing student capabilities Ask questions in appropriate situations. For example, in the middle of an emergency situation - not a good idea. In the middle of a routine procedure - it's ok to ask a couple of pertinent questions. After all the fuss has died down and during routine nursing duties - even better Take notes Have a plan in place before you start, of procedures you want to observe, skills you want to learn, questions you might want to ask Utilise your facilitator during the placement Stick close to your preceptor to learn the routine and time management Recognise that you are not always going to please everybody. By being polite, friendly, professional you know you are doing the best you can, if some nurses are still unhappy with dealing with students this is their problem Give appropriate, professional feedback to your facilitator about your placement Learn from your mistakes Avoid judgmental perceptions about nursing students like bottom feeders etc, if that is what you think, that's how you'll come across, believe me when I say you will need to be strong to deal with all the challenging behaviour that comes your way. Think of nursing students as learning, not stupid which is sometimes what you get called Sometimes it is a good idea to keep your head down - I can tell you when or whatever but you need to develop those skills of perception and understanding non verbal cues which is so important to being a nurse - this will happen over time I get the feeling you need a bit of reassurance still and I'm happy to give it but honestly, what you need to do is reflect on your past experience, be honest with your shortcomings and all you still need to learn, and recognise that this is an ongoing process.

Being ex RN of a couple of years, but having visited here over the past 10 years (I lost my account so had to make a new one in 2006) Allnurses didn't make my physical skills better but improved my knowledge. It also helps knowing there are other people going through the same thing you are when times are difficult. I think it helps to talk things out with people, some on the other side of the world :redpinkhe, which can put things into perspective. I would have loved for this site to exist when I was at uni then started as a new nurse! But then I graduated in 1996 so no internet then.

I guess the reason nursing is so scrutinised is because, a) the perception by so many people of nursing being altruistic; and b) the fact that nurses see their clients more than any other health professional. To deal with people 8-12 hours a day, good or bad, is reason enough to expect that someone going into the job would be a people person. I'm not into the whole Florence Nightingale perception of nursing - in actual fact, I think people who are pragmatic, less emotional and straight shooters make very good nurses - however you still need to like and respect people for the most part. FYI - I hate that people think nurses are altruistic and endlessly kind - apart from being completely impossible to live up to, it usually means we miss out on pay rises or get paid less than other professionals; the perception being that we are somehow above needing money or practical life needs (kind of how people look at nuns or something).

I can see where the OP is coming from actually .. I mean I don't think everyone necessarily needs to say they want to help people in regard to their career, and certainly, being attracted to a job for security and decent pay is fair enough ... The fact is though, you really need to have a realistic perception of nursing and be someone who likes people to do the job well. You do need certain personality characteristics, morals and values to be a nurse (ideally). Just like you need to be a certain type of person to be a teacher, lawyer or social worker. Still, as long as people do their best, the end result is the same, whatever reason you went into it for. The worst thing I ever heard was someone in the public service saying she wanted to do nursing so she could become a drug company rep! Talk about selling out, not to mention the conflict of interest in using nursing as a springboard to drug rep. I was horrified by this and thankfully she never did it. That's an extreme case though.

The OP was obviously placed in a difficult situation - it had to be done by someone and there was nobody else around. Some of my thoughts on cleaning tasks ... Nurses should not be cleaning, full stop unless there's danger to a patient or anybody else. Nurses are not housekeeping staff or cleaners, nurses are health professionals. Frankly, it isn't about being too proud or thinking you're better than anyone, it just isn't our job. I consider personal hygiene cares to be a nurses job - while I am doing those cares I am building a rapport with my patients and doing a physical and psychosocial assessment of them, and I am helping them, which is a privilege - this is totally different to cleaning a floor or a room. I am sick of nurses being expected to do housekeeping or cleaning duties while other health professionals wouldn't do the same. Would anybody ask a doctor, social worker or physio to clean a room? No. Didn't think so. And yet those professionals are also caring for patients. I'm sick of people in the white collar, corporate sector saying things like "nurses are to posh to wash", and "university nurses won't do menial tasks" etc - well why should we? Would they? It's amazing to me how people will get on their high horse about this type of thing; it's clear to me nurses are not respected by so many people. The more nurses do this kind of thing, the more our colleagues and community will think that is what nurses do - clean. It is bad enough that other people don't know what nurses do as it is, it is bad enough that the invasive, responsible, sometimes harmful to our own health, highly skilled tasks we do are behind closed doors or curtains; imagine family members walking past a room and seeming a skilled nurse cleaning a room - that is unacceptable to me. I'm not saying I never cleaned a bed if necessary, or wiped up a contagious spill for infection control purposes, or got a cup of tea for a patient or family member who was upset - I never did these things often though and I stand by that. TBH, I've always thought nurses were their own worst enemies when it comes to promoting our profession.

I really felt for you reading that. It's very difficult to do your job well, particularly a task like administering medications, when you're anxious or stressed out with too high a workload. Anxiety is crippling. Even with day to day activities, much less work tasks. Nursing isn't for everybody. Hell, nursing is probably not for most people - most of us muddle through the day, doing our best, hoping we don't make an error - that didn't stop me going home at night, lying awake worrying I'd given the wrong dose, had forgotten something or had offended a patient somehow. I agree it's an occupation which sets people up for failure - if you're not 100% on the ball, confident, knowledgeable and skilled all the time, you run the risk of making errors - and really, who can say they're all that and a bag of chips every single day? You have learned many skills from nursing - use that to move into another area and be happy. In my current field, I see many unhappy people who hate their jobs, everyone has the right to like what they do most of the time. :heartbeat

I didn't see your previous question unfortunately - it sounds interesting. I'm not sure if this is what you mean, but I've observed a certain type of person with depression (and in fact chronic illness, psychological and physical overall), who use the illness to their advantage and appear to be complacent about having the condition. They might, for example, use the illness as an excuse not to work, or to not make an effort with relationships, or to deal with difficult or challenging situations, or when they behave badly or inappropriately and someone reacts to that, they might say something like "I'm depressed, I can't help it". They might also like talking about their condition constantly, drawing attention to themselves. Please don't misunderstand - I have a lot of empathy for people with chronic illness but I think most of us know people who might 'use' their medical condition to their advantage somewhat, manipulating others to get their own way at times. From the research I've read, personality type is significant in diagnosis of depression or anxiety - negative, depressive type personalities have a higher risk of being diagnosed with depression, and people who are highly strung tend to have a higher risk of being diagnosed with anxiety. That's not to say that other personality types can't become depressed, for example, but it's thought that some people have better coping skills in terms of depression diagnosis and can avoid a depression diagnosis, or recover quickly from it, in terms of a traumatic or sad event. While I think it's possible for people to use their condition to their own advantage, I think this might be more possible when the condition is mild or moderate, (not, for example, in severe depression). Also, I think rather than enjoying the depression, I think it could be that some people become used to it and even comfortable with it, and this is probably more likely in a manipulative and/or attention seeking personality type. Just my thoughts. Not sure if this is what you meant though so if I'm off the track completely I apologise!

I was terrible at time management when I was a new grad nurse - and yet time management hasn't been a problem in other non-clinical, healthcare jobs; in fact I've been dropped in the deep end in senior jobs and did quite well. My guess is, the pressure of having so much responsibility at a young age overwhelmed me psychologically and I probably couldn't cope at first. I mean, I did my tasks fairly well, but seemed always to be chasing my tail in those first few months. I copped a lot of flack for it too, and not much support so that didn't help, I basically thought I was a bad nurse for the first 2 years then realised I was pretty good, and stopped beating myself up. My feelings are that some people can hit the ground running and manage their time pretty much straight away and others, like me, needed a bit more time (that said, I think a lot of people come across as being more confident, whereas me - not so much). Time management is not something you can learn as others have said, its more instinctive. I just think I was one of those people who would have benefited from hospital training but when I left school, university education had taken over and I didn't have a choice. Regarding your student - maybe she needs more orientation time? How long has she been a nurse? What kind of ward is it? There are so many variables really. She sounds like a very promising new nurse, it would be a shame for this to hold her back when all she probably needs is time. Not everyone learns at the same rate. I agree with the others who've said chart as you go, and always be thinking of what you can be doing right now - maybe try shadowing her very closely to see exactly where the problem is and try to get this across.

I agree with the above. You made a mistake, and it wasn't a terrible mistake on the scheme of things. You will make mistakes over your nursing career and you will sometimes feel stupid . That is a reality of nursing. I can understand how you feel - the first time someone complains about you is awful, but you learn to take things on the chin after a while. Don't dwell on this - you did the right thing, took responsibility and apologised and that is the most important thing.

I tend to get sweaty hands when I'm nervous - I do have a general anxiety issue though. I don't know why, but it didn't pose much of a problem once I started nursing because you're so busy with getting all your work done, washing your hands between patients, having lots on your mind etc, it wasn't really a problem and TBH, most patients don't care, they feel too sick. Also in a situation like a code, for example, it wouldn't be abnormal to sweat, on hands or anywhere else. If someone was watching me perform a task my hands would start to get sweaty but then my problem is psychological rather than physical. I remember my hands being sweaty when I did my first CPR exam on the dummy and a friend just made a joke about it (it was quite warm in the room though and a few people looked a bit sweaty). I would explain to my tutors I was nervous and they seemed to be understanding most of the time. Don't let this stop you from doing the job you want to do - maybe have another assessment with your doctor to see exactly what is causing the problem (physical -v- psychological). Wearing gloves is an immediate solution, but just a warning - I also used to get dermatitis on my hands because of sweating and the gloves exacerbated that. Some people do sweat a lot on their hands and feet, it's more common than you realise and there is treatment available. Good luck with your studies.

Yes, thank you for sharing, I hope all goes well, waiting for test results can be an anxious time.

undergraduate nurses are considered a bit childish and not quite the real deal. A bit of a micky mouse degree if you will. virtually anyone can get into a nursing degree ( charles sturt university for example) and believe me - the RN's ive had to work with during the past years have been dodge dodge dodgy ! and embarrassing to say the least. Are you repeating what you've heard people say or what you think? Is this coming from nurses or other professionals? I don't agree with this - it strikes me as yet more endless criticism of university educated nurses -v- hospital trained nurses, something I've been hearing (and tiring of) for around 15 years or so, since I completed my nursing degree. One of the things I disliked the most about being a graduate nurse back in the 90s, and it certainly hasn't changed from what I've observed/heard, is that hospital and health systems expect graduate nurses to be fully experienced and skilled right from the minute they walk onto a ward. This isn't a realistic expectation in any occupation, much less nursing. Experienced nurses, whether they come from a hospital trained background or a university education, are often very dismissive and impatient with new nurses. I often think how self defeating this is, considering that new nurses are valuable to nursing and the health system, and with some patience, tolerance and education from seasoned nurses, will go on to become experienced nurses who hopefully stay in the system. Sadly, a lot of nurses leave, probably in a large part because the nursing culture is so negative. I see nursing as a part of a whole team - we work with allied health professionals, and doctors. Feeling like you're being told what to do, or are answering to other people is your perception, it's not necessarily the case. I've always felt equal to allied health staff, and the more experienced I became, I felt comfortable with medical officers as well. I was an RN for 14 years, tired of the shift work and the workplace politics, then completed my masters in rehabilitation counselling and changed my career. I can tell you from the experience of changing my career to a seemingly 'easier' occupation in terms of working hours and not being in the front line anymore that it is just as stressful and difficult at times, as nursing. I can also tell you, from rehabilitating workers back to the workplace who are from many other disciplines, that there are just as many issues in other career paths as nursing. Nursing is difficult, true, likely more difficult than some occupations. But the real problem is within nursing, the culture, and how nurses perceive themselves and their peers - often negatively. I think a lot of nurses walk around with a massive chip on their shoulder and expect people to pat them on the back for doing a good job. That doesn't happen in any occupation. It is up to you, and your peers, to increase the positive perception of nursing. How can nursing leaders do anything if you yourself have such a negative view of nursing?

Traditional medicine is flawed at times and is far from perfect but it is the only proven system we have of managing disease. Those grandmothers, ancestors etc who used 'home remedies' also had a much higher mortality rate than we do. Sorry, but I am not into so called 'natural medicine' - I agree that chiropractors and acupuncturists (for example) have their place, but frankly, traditional medicine is confrontational, which is why people prefer to seek alternative or natural medicine, it gives you responsibility for your medical condition and that's hard for people to take sometimes. Apologies to OP for going off topic.

I wasn't suggesting the OP was older or overweight, I was giving information. I also advised a physiotherapist if you read my original message - in Australia you need to get a referral from a doctor to go to a physio which is why I suggested the doctor. From the information I've read, knee pain is common in most people after 40, however women tend to have more issues with their knees.

haha, this reminded me of the Seinfeld episode where George tells everyone he's a marine biologist then comes across a beached whale ... :chuckle With me, I wanted to be a nurse from a young age and 2 things triggered it - firstly my grandmother dying of cancer; I remember feeling helpless that I couldn't do anything to help and wanted to be like the nurses who looked after her. I also remember going to a private hospital in the 80s to visit a sick relative when I was young and watching the nurses (who at the time were dressed in the traditional nurse's uniforms with caps) doing their work. Nurses fascinated me from a young age - I guess the mystery of what they did, the traditional uniforms like they used to wear in the movies and on TV shows, and the fact that they all seemed kind, competent and calm made me want to be like them. When I left school I had a gap year or 2 of work/travelling, then applied to nursing school - that was pretty much it really. Even though there isn't any mystery to it anymore, and I suppose reality hit me pretty quickly in terms of how challenging nursing was, I'm happy I achieved my goal.

Well you might want to talk to your doctor about getting a scan to see what the problem is, then see a physio for some exercises. Chronic knee pain in women is very common, particularly if you are getting older, are carrying a bit more weight than usual and/or are on your feet all day. I find if I haven't been exercising for a while, then get back into it, I might feel it in my knees for a couple of weeks then they're fine, but a medical assessment is always a good idea if this isn't normal for you.

What is the place and role of the student in the clinical environment? We are guests on the ward, there to learn and improve our skills as nurses. We need to be proactive, willing and excited whilst keeping out of the way and not stepping on any toes. I have found, very often, that there is nothing for students to do. Asking for things to do more than once in the hour is annoying for staff, and once all the patients have fresh water, their call bells answered to the best of your ability the old ladies are sick of talking to you, there's little left to do. When your facilitator rocks up for a visit, it's hard to look useful! I generally read all the patient charts, look up medications, diagnoses and treatments that I dont know/understand and make myself clearly available if anyone needs a hand. This concerns me. It is the role of your facilitator and the role of the unit and the nursing staff to educate and train you - yes, the student should be proactive and enthusiastic, but they are there to train you, that's the whole point of clinical practice. Given how busy the hospital and aged care environment is these days, I find it hard to understand why you wouldn't have a lot to do - I'm getting the feeling the staff and facilitators aren't doing their job. I'm not sure if your university does this, but your facilitator should be going over goals with you before the start of any prac - tasks and skills you would like to learn/need to learn while you are on that prac with appropriate time frames. You should also be having regular discussions with your facilitator (daily usually) on how things are going. Always remember to give positive and negative feedback (there's always both in any workplace realistically).

I agree you're being very hard on yourself, and am concerned you're possibly setting yourself up for failure which such strict guidelines. I'm not too comfortable myself with knowing my place, not getting comfortable and not speaking out of turn etc. The thing is, you're not a robot! And you're dealing with human beings so there are many variables you can't possibly take into account. Still, you need to do what you are comfortable with, and what you feel is best. You will find your way I have no doubt. It all gets easier when you start working and take on a more autonomous role. However facilitators often take a bad idea from seeing a student sitting at a desk. Can anyone help me out on this one? This can be difficult, particularly if you're in a unit which is not engaging or cooperative with students. If you're in a surgical unit, you might request to see some operations or procedures (with the patient's and surgeon's consent but this isn't usually a problem). Shadow your buddy nurse as much as possible to get to know the routine of different shifts and do as many tasks as possible within your role. If you find you're being buddied with casual staff instead of permanent staff - bring this up with your facilitator as feed-back! Remember students are assessing the workplace too - for potential jobs down the track. Good luck with it all - good luck particularly with the facilitator.

You managed her the way I would have. The thing I found the most difficult about aged care when I first started, was some of the relatives. Some people will try to use emotional blackmail to make you feel bad - don't take this on board! They might have their own issues or feelings of guilt placing their parent in managed care and this can have an effect on the way they communicate with the staff. One of the most common issues for older people are UTIs - the fact that the lady has dementia and isn't able to communicate makes it even harder to assess her. The good thing about her being in the ER is that they would have given her IV fluids and ABs which would have resolved the condition. You did the right thing.

Yikes you had it a bit tough girl. Despite that you sound very enthusiastic, eager to learn and seem to be taking the criticism you received to heart - I admire you for that. I'm Australian, and remember my clinicals back in the mid 90s. Seems like some things haven't changed unfortunately (the attitudes of the staff whose job it is to teach you for one and the hard nosed facilitators). It actually used to really get me down. Like others have said, the loud voice is only something you can change. Is it something that poses a problem while you're in your paid employment? I feel your confidence is probably rubbing people the wrong way. In my experience as a student and grad nurse it seems like you're expected to always keep your head down and never disagree with anyone. I don't think this is a good thing though. While I think you should be respectful to the staff and patients, I think questioning things and being genuinely confident in your ability are very good qualities. You will always come up against people, even experienced staff, who are not confident in their abilities, or who dislike their job or are burnt out who find this hard to deal with. One of my friends from uni was an enrolled nurse who was sometimes loud, opinionated, was very confident and could often be over bearing - she was a pain in the bum a lot of the time TBH but she was an excellent nurse. My feelings about personality is - you are who you are - to an extent anyway. That said, nursing is a lot about personality really - you have to build a rapport with staff and patients to give good, safe care. Behavioural qualities like effective listening, respect, compassion, empathy and tolerance are important. Your personality characteristics of being confident, maybe a bit loud will be difficult to control - it's who you are. I would hate to see you lose those qualities of what I perceive to be enthusiastic, hard working and taking things on the chin because I think those are very good qualities to be a nurse. Appearing meek, proactive and willing to learn without stepping on anyone's toes, getting in the way of the staff or stepping outside my role as a student Lowering the volume of my voice consistently Carrying myself as "a professional" - not a friend of the patient or the staff (and not an equal of the staff, either) As far as being meek - you don't seem like a meek person and anyway, that's not something a nurse should be. Remember you need to advocate for your patients and be tough when it comes to appropriate, safe treatment for your patients. Being proactive and willing to learn is definitely something you should continue to be, never lose that, no matter how long you are a nurse. You should also only work and learn in the boundaries of your student role. Stepping on anyone's toes or getting in the way - well you can try mate, and good luck to you, but realistically sometimes you will step on toes and get in the way, especially when you're learning and especially in the health field. That's life. The other 2 you've suggested are probably reasonable, in that not being equal means you are a student and there to learn. You are certainly equal in deserving just as much respect as anyone else though, never forget that. Good luck with the rest of uni and your career. :heartbeat

Like others have said, it's a tough job but well worth it on those good days. Honestly, any job is going to give you the $#@(& sometimes, particularly if you work in human service type occupations. I no longer work as a nurse, but was an RN for 14 years - I don't regret being a nurse at all. I feel it defines me, even now, and has made me a better person. Some jobs, like nursing, increase your knowledge, give you insight and perception, give you better communication skills and help you understand people better. What could be bad about that? I also think nursing could benefit from more males - if only for the fact that having a variety of genders, cultures etc makes us all try a bit harder to get along.

Eh??!!! Well the felonies were committed over about, oh 15 years or so? I'm sure most people have had similar injuries/medical issues .... No don't have any neuro problems. Yes mum, maybe I do need to slow down and plan ahead. Please understand, that being from a different culture (Aussie) that my style of writing might be different to yours and I was being tongue in cheek somewhat.

If you want to teach nursing students you really need well rounded experience, including acute hospital experience IMO. I had a couple of nursing tutors at uni who weren't very experienced (we called them textbook nurses) and they weren't very beneficial for our learning really .... it's not like we couldn't tell either, even at our level of knowledge. The best teachers were the ones who had the stories to tell (funny, sad, scary, confronting), and who were obviously experienced and comfortable when they taught us in the hospital setting as well as the lab setting. Sorry if that's not what you want to hear but I felt it was best to be honest!

That sounds like very rewarding work to me. There is always going to be someone who is critical of a person's job, whatever it is. If you like your job, be happy because there are a lot of people who hate what they do. Don't get drawn in to the discussions about pay either. I can never understand why people think it's ok to talk about money, it's a subject I'm never comfortable with and a lot of people use that to feel higher up on the food chain or whatever. That's their problem!