3rd semester- Feeling overwhelmed at clinical

amybethf · Mar 13, 2008

Hi everyone, I'm just reaching out for support. I am in my 3rd semester and feel lightyears away from being a real nurse. I do well on exams but feel like a total moron on the floor. This is my 2nd career and have had no prior pt care experience except for previous clinicals. I am currently feeling overwhelmed with the many nursing responsibilities, critical thinking skills which are lacking on my part at this point, understanding all aspects of the chart and taking care of the basic needs of the pt. I do my best to fake it so I have been getting by OK. I even have difficulty ascultating/differentiating heart and lung sounds! My classmates all seem to have a good grasp in clinical and seem ready for the challenges ahead.
Is this normal in the third semester? I feel like a complete poser and my confidence is shot. I really want to become a nurse but am scared witless the pieces are not going to fall into place as I thought they should by now. If anyone has been where I am and moved past these feelings, I could definitely use your help .

U have been very candid and I think you just need to slow down and think things thru. It is a matter of prioritization but it's not a race. It's totally normal to feel like you aren't up to par, you are a student and learning.

I am told by many nurses that it doesn't completely 'click' until you've made it thru your first year as an RN. So don't be too hard on your self. Talk to your instructor, get some feedback. If you were doing as bad a job as you say, your CI would have picked up on it!!!!

Best of wishes! :heartbeat:redbeathe

meggiepie24, BSN · Mar 15, 2008

I'm in my fourth semester of clinicals in a BSN program and I still have moments where I feel like I know nothing. What will help you right now is getting a job. I work at a local hospital (3500 employees, 500 beds) as a student nurse. You learn about different procedures, get to know the doctors, learn how to deal with politics/gossip, and how to get things done. If you can learn from so many things if you just ask. When I first started my job I would tell the charge nurse what I could do, and most looked for opportunities for me to practice skills.

suanna · Mar 15, 2008

The reason you feel lightyears away from understanding the process we call nursing is because you are lightyears away. Most students don't really have things fall into focus until thier senior year. Right now it's about basic skills and knowledge base. Trust me, the last 2 semesters it will be less overwhelming. If you gould get in a a couple of semesters you wouldn't have to go to school for 4+ years to get a BSN.

mimi13 · Mar 15, 2008

Thanks. I think I just need these words from you all reinforced. I know I'm not an idiot and manage to do well on my exams. All this seems to be lost when I'm at clinical though. I'm applying for an externship and hope that helps. Thanks for all your replys. mimi

pooshx2 · Mar 16, 2008

By all means, don't feel alone in this! I too thought many of my peers were so confident as that is what they give off in clinicals, then a student asked me a question that I thought to myself - she isn't really asking me that, it is scary she is this far along and doesn't know what that means, but guess what, she really had no clue! I am starting to feel that a lot of my peers in class are as you said "faking it" in clinicals. I am in 3rd semester now and was on ICU the other day and made to feel like I had no right to have a uniform on by the staff nurse I was with. During our postconference I told my clinical instructor what specific questions she was asking me about the meds, guess what? My CI told me this nurse is in a NP program at the moment and the types of questions she was asking me, while good questions, no where near what is expected of me to be able to answer. That made me feel much better. I think that if any nursing student tells you that they don't suffer from moments of self doubt, they are lying to themselves. I am applying for an externship for over my summer break between 3rd and 4th semester. My goal is to listen to as many hearts and lungs as possible and then have the nurse listen also and tell me if she agrees with what I think I heard. I work as a tech and get patient care exposure often, but still feel lacking many days in my "nurse" skills. Hope this helps you to know there are lots of us out there who are still able to admit "we're learning!" . Good luck!

~Erica :specs:

SmilesHeal101 · Mar 16, 2008

To mimi13

I totally understand what you are coming from. I feel the very same way about myself. Have you taken Intermediate Med-Surg?I heard that the is when the light bulb comes on. I will be taking that next. I am in my third semester as well. I think everything comes with time and most of all experience. I have a hard time differentiating between different sounds. Some people fake the feeling, and some people get things faster than others. I am a slow learner and I learn with hands on experience. Pretty soon you will be skipping around knowing your stuff. When you seek employment as a RN make sure they train you for 3 to 6 months before you start on the floor alone. I wish you the best! What school do you attend? I am in nursing school in Stockton, CA. :up:

mimi13 · Mar 16, 2008

Thanks to you and everyone who has responded. Reading your notes makes me feel much better. When I say I am in my 3rd semester, I am nervous because I will graduate after my fourth semester. I am almost done! I am in an associates, not a BSN program. I am in the process of applying for summer externship as well and hope that gives me a better inside view of the med surg routine. Right now, a few hours twice a week does not give me a good feel of what it is like being a nurse. I have no intention of quitting at this time but sometimes the self doubt gets the best of me. I should say it consumes me. Fortunately I have a great support system and a wondertful husband who helps to screw my head on tighter when I need it most.

Thanks again for taking the time to reassure me when I need it!

justme1972 · Mar 16, 2008

I do my best to fake it so I have been getting by OK. I even have difficulty ascultating/differentiating heart and lung sounds! My classmates all seem to have a good grasp in clinical and seem ready for the challenges ahead.

Before you beat yourself up, you didn't say that the clinical instructor has said anything to you.

Could it be that your other classmates have also mastered "faking it" and may feel just as lost as you?

You know how gossipy nursing school is...just study what you can, do your best, and that is all you can do.

ER-RN2009 · Mar 17, 2008

I will graduate in 7 weeks and let me tell you there are times when I wonder how in the hell I got to this point. Most of the time I feel really good about myself but boy there are times when I just have this deer in the headlights look...DUH... But I'm honest with myself in the fact that there are so many more things out there for me to learn. My real learning is coming in about 7 weeks when I get out there for real.. I'm ready!!!

Ms Kylee · Mar 19, 2008

Oh my gosh.. I was just going to post this same thread... last week was awful and I got my butt chewed out. Last night was the wound practicum, and I totally forgot how to put on my sterile gloves (never mind that I do this at work all of the time.) Tonight's clinical went well and I actually started to think last week was just a bad week, when the instructor pulled me aside and told me I "had to practice sterile gloving". Thing is, I KNOW how to do this. I'm so frustrated, I'm ready to quit.

Daytonite, BSN, RN · Mar 19, 2008

mimi13. . .when I was in nursing school 32 years ago we discussed this with our instructors and were flat out told by them in no uncertain terms to "fake it" in front of patients and to at the least try to look like we knew what we were doing. We were told that feeling unconfident was normal, but that we were not to let it show in front of the patients. We had talks about the "professional face" we needed to display. And, I can honestly tell you that over the years that I have worked as an RN there have been times when I have had a patient or two that stumped me from the start; I didn't know where to start with them for some reason or another; maybe they had a medical disease I had never heard of or a drug or treatment that was new and I had never done. I did my "professional face" to those patients treating them like any other and making them feel comfortable and, hopefully, confident that they were going to get good care. Meanwhile, at the nurses work station, believe me, I was panicking, looking up information on their disease, drugs or treatment. That is part of the nature of this profession sometimes. In the end, things never turn out to be as bad as they first seem to have been. There are patients, and then there is patience. It takes time to develop experience and confidence in this profession. Until then, "fake it" and just look like to you what you are doing. The great thing about nursing is that using good old-fashioned common sense will often get you, minimally, out of most jams. You don't have to confess to anyone that you don't know what you are doing. That can be your own secret. What you do is hit your books to look up information you didn't know in the privacy of your home later on at home--this way, no one knows your secret, do they? And, you looked like you knew what was going on all along until you finally found the answer. As you develop more confidence, you won't have trouble admitting when you don't know information about something and are seeking an answer, but at this stage in your learning it's sometimes more important to protect your ego. We all have gone through these uncertain feelings. Just keep putting one foot in front of the other, look up stuff you don't know, learn from your (and others) mistakes, but keep moving forward. Honestly, it's worse for the medical students--there are two doctors in my family and I've heard all the grim stories from them.I also want you to know that there were some things in my nursing practice that took me years to find the answers to. I never stopped looking for them. And, it was so great when I finally found the answers. Your instructors, supervisors and coworkers won't have all the solutions.