Recent clinical has me fearful of real world nursing


I'm graduating in May and after clinicals my instructor has me truly doubting myself and my ability to work in med-surge for the first time since I began nursing school. He is a good instructor and very well liked. He was pushing me hard to answer questions, but I was having trouble prioritizing what my role for the day is with a particular patient or patients after his questioning me for 35 mins on various issues. I know I need to think along these lines, but had such a difficult time giving him report on my only 2 patients in an organized manner. He asked me to begin at the head (HEENT) and move down system by system i.e. nuero, pulmonary, cardiac, GI, GU, etc. and was not allowed to skip to any system that wasn't next, like bowel sounds and abdominal tenderness before I explained any and all from systems above. I kept freezing up badly and saying "um,um" with him looking straight at me saying, "come on what's next?" over and over :wideyed: and I'm typically fairly confident, but not anymore. He said I was good at the technical side of disease processes and my patient's symptoms, but that I'm not connecting those with what my priority care for my patient is individually for the day. I left feeling completely deflated after that experience and am wondering if working med-surge is really for me now, like I previously thought. For the most part I enjoy working with med-surge patients for the most and have never seen myself working as any other type of nurse except for perhaps, nursery, IMU or SICU with are still similar scopes of practice. I am also having issues with organizing my report notes, what I should write and how to write it, when I take report, along with a big fear of how I'm going to properly and adequately care for a full patient load when I begin working in the real world in a few months. I rarely cry over anything involving school, but I cried when I was trying to explain to my husband my newly found worries and anxiety. What can I do to become better at taking and giving report and exploring what field of nursing will truly be a good fit for me?

nurseprnRN, BSN, RN

2 Articles; 5,114 Posts

You are a student, you are in school to learn those things, your clinical rotation is to help you learn to put them into practice, and your instructor is doing exactly what he should be doing, pushing you to think of what you need to be prepared and organized. You, however, are not -- you are freezing up. This is not a knowledge deficit, this is a risk for disturbed personal identity diagnosis (risk for the inability to maintain an integrated and complete perception of self), with the risk factors of social role change and change in stages of growth (student to grad, li'l ol' you to real nurse) (page 283, NANDA-I 2012-2014)..

You aren't expected to start your last rotation with everything in place. Why would a school bother with a last semester if you were all set to go at the end of the next-to-last one? :) This semester is what you are here for.

So, while you are falling apart and thinking maybe you are a total failure and life as you planned it is over, you should be thanking your lucky stars that your instructor cares enough to be pushing you, because he knows you can do it. He is being your nurse. You can do this, you know.

My friend Esme has some great "brains sheets" that will help you with your organization, and I am sure she'll pitch in with them in a bit. ::calling Esme, come in, Esme! Earth people need you! ::

The more you do it, the better you'll get at it. One day you'll be tooling along through report and suddenly realize that you did just fine. Really. You will. Deep breath.

Esme12, ASN, BSN, RN

4 Articles; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 43 years experience.

You need a good brain sheet to keep you are a few.

doc.gif mtpmedsurg.doc

doc.gif 1 patient float.doc‎

doc.gif 5 pt. shift.doc‎

doc.gif finalgraduateshiftreport.doc‎

doc.gif horshiftsheet.doc‎

doc.gif report sheet.doc‎

doc.gif day sheet 2 doc.doc

critical thinking flow sheet for nursing students

student clinical report sheet for one patient

i made some for nursing students and some other an members have made these for others.....adapt them way you want. i hope they help


31 Posts

Esme 12...

Just printed your documents.... thank-you for your time in making them, and for sharing.

I think they are going to be helpful. :yes: