"Performance" Anxiety?

[cherubhipster]

Hi Friends!

The count down continues..I am starting school in just over a month. I can't wait!

I have a question. I've never been one of those people to have test anxiety...I've always been very good at managing my study time, getting my work done early, and I've never been one to flip through the notebook, panicing, moments before the exam. When I imagine the academic part of my nursing student days, I feel pretty confident. I feel ready, and I know I can do it.

But then there are the clinicals. I imagine having to perform nursing procedures, about having to actually stick patients with IVs with a hovering professor or maybe even a group of classmates or critical, seasoned nurses, or bandage the patient, or anything, and I start to feel really nervous. I feel like I have performance anxiety!

As a side note, I haven't had any healthcare jobs before, not even small scale ones. I am essentially entering the nursing profession cold! Part of me knows it's crazy, but the rest of me doesn't care. i have decided that I am going to do this- wether or not I should go to school is not the issue.

I was talking to my friends about this- they think that I am just experiencing a "fear of failure", the idea being that I am about to do something new and, "like most people" they say to me, I am nervous about doing something that I have no experience in.

I just want to know if anybody can relate to this fear from before they started school, and what happened once they started clinicals. Does the anxiety go away once you get the hang of it? Am I just having pre-nurse jitters?

Thanks.:redpinkhe

[lemonaidangel]

I felt the same way before I started school! My first day of clinicals were the worst. I had no previous medical experience, and all of my book knowledge flew right out of my head as soon as we walked into the building. My mind was completely blank. I had no idea even where to begin. I almost started crying, I felt so stupid. But I was blessed with an AMAZING clinical instructor. She was so sweet. She patted me on the back and practically held my hand as we walked into my patient's room. And then she gave me her stethoscope from her neck and said, "Why don't we start with vital signs and go from there." The rest of the day went much more smoothly after that. As a senior, I laugh looking back at how scared I was that day. Doing vitals and assessments and basic care are nothing! But back then, they were a huge deal. My clinical instructor will never know just how much her small gesture of kindness helped. I will always love that woman for that.

I have good news for you, clinicals do get better! It's scary at first, but you just need to take a deep breath and remember what you know. If all else fails, start with vitals and go from there. Once you fall into a pattern of doing things, it won't seem so overwhelming anymore. The butterflies in the stomach go away. My best advice is don't be afraid to ask questions, and don't be too proud to admit that you need help. You aren't expected to know everything, that's why you have an instructor on the floor at all times to help you out.

[cherubhipster]

I felt the same way before I started school! My first day of clinicals were the worst. I had no previous medical experience, and all of my book knowledge flew right out of my head as soon as we walked into the building. My mind was completely blank. I had no idea even where to begin. I almost started crying, I felt so stupid. But I was blessed with an AMAZING clinical instructor. She was so sweet. She patted me on the back and practically held my hand as we walked into my patient's room. And then she gave me her stethoscope from her neck and said, "Why don't we start with vital signs and go from there." The rest of the day went much more smoothly after that. As a senior, I laugh looking back at how scared I was that day. Doing vitals and assessments and basic care are nothing! But back then, they were a huge deal. My clinical instructor will never know just how much her small gesture of kindness helped. I will always love that woman for that.

I have good news for you, clinicals do get better! It's scary at first, but you just need to take a deep breath and remember what you know. If all else fails, start with vitals and go from there. Once you fall into a pattern of doing things, it won't seem so overwhelming anymore. The butterflies in the stomach go away. My best advice is don't be afraid to ask questions, and don't be too proud to admit that you need help. You aren't expected to know everything, that's why you have an instructor on the floor at all times to help you out.

Wow thanks so much for that post. I feel a lot better already. I'll have to remind myself of your story when I start getting nervous. I hope I laugh at myself one day too!

[locolorenzo22, BSN, RN]

Ahhh...yes. The joy of clinicals....what other way would they force you to be able to do things. I was NOT a CNA through my 1st semester...and I felt clueless, clumsy, and nearly failed out my first week!

The reason? I took a diabetic client away from breakfast...because we were told that upon getting to the wing we needed to assess our clients in their rooms...."in private". So I took that to mean right away....hence it was 9AM and he hadn't had breakfast yet....also during my assessment, the staff RN came in with a powdered drink (fiber supp) from MAR....and asked me if I could make sure he drank it once I was done....so I did. Guess that was giving meds without checking with the instructor....so I had to fill out a "plan of correction"....and watched my P's and Q's the entire time!

Here are my own tips for clinicals:

1. (see above) NEVER give meds without checking with your instructor first!

2. Never do anything you aren't sure of...not being a CNA first (Being "cold") it may take you more time to do that.

3. Get to know someone in the group who will help you...and never be above lending a hand. You are NEVER above helping change a bed.

4. Make sure you take time to be friendly, professional, etc. You could be having the day from heck...but your patient would never know.

5. Welcome to the joyful and stressful journey known as nursing school!

[maliat]

Just finished my 2nd year, going into my 3rd year of nursing school. Still get nervous all the time, but at least I've learned how to sleep the night before clinicals. All I can say is try to project some confidence, especially for your patients. If you don't know, don't be afraid to ask. It's always the silliest thing you need to ask, like where is the juice and can my patient have some. And always help each other. Not only your classmates, but the nurses and nurse aides on your floor.

Malia

[mrosev14]

Cherub, I am right there with you. I start in a month and am scared out of my mind. Just like you I am a great student, never fret before tests. I don't even bring my notes to school on test days. I just go into class and spit out everything I've learned; however, I am scared sh*tless about nursing school.

I am afraid that I wont be able to do it. I feel like i have a million people counting on me to be awesome at it and I am so scared. My Mom is a nurse and I have spent a million hours in the hospital shadowing a peds cardiology attending, but we actually have to do procedures not just watch and absorb. Ah!!

[Jules A, MSN]

I was similar to you and the good news is that most of the people that failed were due to not passing the written exams. You will start slow with vital signs, bed baths etc. Your confidence will increase as your skill set increases. Hopefully your instructors will be supportive. I was lucky and loved all of mine except one, and despite not really liking her I learned so much under her instruction. Take a deep breath, do not let them know you are anxious underneath and just do your thing. You will be fine!

[mrosev14]

Thanks Jules. What are some of the written exams on?

[Jules A, MSN]

Thanks Jules. What are some of the written exams on?

Just the stuff from our classroom lectures such as systems, disease processes etc. At my program even if you passed clinicals if your classroom average wasn't above 78% you were history. Staying on top of the material is very important.

Good luck.

[momandstudent]

This fear will soon pass...Unlike you, I did have experience in the healthcare field. I worked as a CNA (for 5 yrs.) and a PCA (for developmentally disabled so I was used to dispensing meds and checking glucose) ten years prior to starting nursing school. Up until the first day of clinicals, I was sure of myself and had no jitters what so ever. I walked into the LTC facility the first day and was even afraid to transfer someone to the toilet. Like someone else posted, I began small with the vitals and watching the staff (of course helping where needed). The second day of clinicals was soooo much better. I knew I could do this and I was more than willing to jump in. Then came the first injection (SQ and on a human). Everything that I had learned went running out of my head:bugeyes:. I was shaking and injected the insulin slowly (at least the pt. was very understanding and told me that she had to be my guinea pig otherwise I would never learn). As we walked out of the room, my CI told me that I would eventually get over the fear and it is ok to be afraid when doing the skills for the 1st time. The next week I had to do 2 more SQs and they went awesome. My CI asked if I wanted to do the first IM out of our group of students and I was all over it. We went to the 3rd floor and when the floor nurse brought the pt. to her room I chickened out. There was ABSOLUTELY no meat on her and I was not about to stick bone on my first IM. Another student opted to take a chance at it and did great. My CI told me she understood why I rejected the "offer" and when she found another IM to be given on a bigger pt., she would offer it to me. I never did get the chance and I start Med-Surg next so I am now experiencing those same jitters AGAIN!!!:bugeyes:

[mrosev14]

Just the stuff from our classroom lectures such as systems, disease processes etc. At my program even if you passed clinicals if your classroom average wasn't above 78% you were history. Staying on top of the material is very important.

Good luck.

Thanks. It is the same at my school. Anything below a 78% is failing...see ya later.

[WVlpn2b]

I'm so happy to see this thread! I'm scared out of my mind -- actually even posted a thread about it yesterday.

I start in a month, "cold" as well. I have a CNA license as a requirement for the LPN program I was going to go into before I applied and was accepted to the RN program, but I've never used it. At the very least, though, some of the more basic procedures won't be entirely unfamiliar to me. But I have enormous anxiety about approaching patients and being watched by my instructors.

I hope we can all look back in a couple of years and see how far we've come! Hopefully, that anxiety means we'll be extra-good nurses! Good luck, everybody.