Zana2, HouTx and Emmalou have said more useful stuff than I could think to say. I went back and checked out last year's comms. You got some t'riffic advice there, too. So, as requested, here goes again - apologies to the three above - you have probably already said it:
1. Remember the universe wasn't created in one semester. Slow down. If you run the whole time (from experience to experience) you won't really appreciate any but the most shocking/toe-stubbing moments. And, as you discovered last year, your metaphorical charging around upsets the locals.
2. Keep a small notebook in your pocket so that when you feel that almost uncontrollable urge to interrupt with your oh-so-important question you can consider stepping away and jotting it down for reflection/research and/or later clarification with an experienced nurse. This will depend on the situation and all those variables already identified. Learn how to exist in the moment without seeking validation from others that you exist.
3. You are the future of nursing. You are an important person. You are a valuable person. You are being given a huge privilege by very sick people and very hard working nurses - the opportunity to learn from others' experiences and to practice so that you can make mistakes safely. I applaud your desire to be as good as you can be. Regard this semester as an opportunity to hone your judgment skills.
I sense your fear that you will receive more criticism than praise - and that this is your personal valley of the shadows. You have a huge hunger for approval. If you are not careful, it will continue to be your undoing - in nursing, in life, in general... Learn to make a steady, quiet inviolable centre, Rachel. Learn it sooner rather than later - and spare yourself this continuing world of hurt. (Consider signing on with a private psychotherapist who can help you to build it).
People will not remember what we said. People will not remember what we did. People will remember how they felt when they were with us.
Sometimes the best we can be is quiet and present for someone else - learn how to be quiet, Rachel - so that you can really learn what's going on around you. If you can really learn what's going on and then respond appropriately, you will make the kind of difference that people remember because it mattered (and coincidentally, get the kind of recognition that you crave.)
When I was an oncology patient I felt very, very physically sick. Early on after my surgery, if my oncologist had stood at the end of my bed and said "You're cactus, babe." I would have said "Thank God." That's how physically sick I felt. There was a young nurse there who was assigned to look after me. She thought it was all about her. She had no idea that I even existed as more than a praise and gratitude machine for her. She spoke loudly, she moved loudly. Her keys rattled loudly. She smelled loud! She bristled with a sense of dramatic self-importance ("Look at me - I am Flo Nightingale reincarnated. And I am sexy - just like those gorgeous nurses on tv.")
If I had had the energy I would have told her to go away. If I hadn't been scared that the quality of my care would deteriorate even further, I would have told her to go away. I dreaded hearing her coming. She didn't notice that I was in pain and too sick to say so. She didn't notice that the sun was reflecting off a picture hanging on the wall right into my eyes and I was too sick to turn over without help. She didn't notice that my mouth was dry but I was too sick to sit up to take a drink. I told her I was lying in a puddle of urine and she was hugely irritated that I wanted her to change the sheet. I used the very last of my energy to ask her to wash her hands when she tried to change my SPC without doing so first. She stormed off in a huff and I didn't see her again - thank gawd!! I will never forget her - and I love to tell the story of her complete incompetence. She made me feel that I didn't matter; that I was a nuisance. She terrified me. If I ever see her again - I will happily tear her a new a-hole.
Good luck, Rachel. You can do it.