RN lacking confidence and assertiveness

Nurses New Nurse

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Hi everyone! So I just passed my one year mark of being an RN, and although I feel as though I have made progress, and am getting into the groove of things, I feel like I am still lacking a lot of nurse qualities. My first nine months I worked in a LTC facility caring for up to 30 patients... it was very overwhelming, hard to learn in a setting like this, I received little to no support from colleagues, and it was just overall not a good experience. I left and am currently at a sub-acute rehab facility. I like it there much better, but am still having a lot of doubt and anxiety about my abilities as a nurse. Tomorrow is my first day off orientation, and I will be on my own. I am very comfortable with passing medications, administering treatments, putting in orders, and the basic skills that nurses do. What I have severe/crazy anxiety about is critical thinking, communicating with doctors and NPs, expressing concerns with them, and fearing they will ask me questions and I'll look at them dumbfounded. Don't get me wrong, a lot of the doctors who work at my facility, are very welcoming and easy to approach, but I still get scared. I know that the more I put myself in scary, uncomfortable situations, the faster I will get used to it, and become more confident in doing it. Yes I know people say critical thinking takes time, but I feel as though I should SOMEWHAT feel a bit more comfortable talking to doctors, etc. I am afraid to sound and look like an idiot, and I feel as though I literally know nothing related to nursing. I am so consumed with my busy, daily tasks, that I may easily overlook important things. I am usually able to determine if something is wrong with my patient, but it's the actions after that, that I freeze up with. What is causing the problem? What warrants a call to the doctor? Am I overreacting over something that isn't important? My mind goes into overdrive. This is one of my biggest struggles. I'm hoping as I get more and more experience under my belt, I will become more comfortable, but it's a serious lack of self-esteem that is bringing me down, and doubting my abilities. Some days I tell myself I am not cut out to be a nurse, which makes me even more upset because I know I am capable.  Does anyone have any advice for me? People say fake it until you make it, but it's easier said than done! 

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Specializes in Critical Care; Cardiac; Professional Development.

Have you heard of SBAR? Use that framework when calling providers. Situation, Background, Assessment, Recommendations

Situation:  Dr. Soandso, your patient Mrs. Gillespie in Room 303 has a BP of 201/99.

Background: She has gotten her regular dose of Norvasc at 8 this morning and I gave her PRN hydralazine about 30 minutes ago.

Assessment: Her BP remains elevated at 189/101. She has no chest pain but does admit a bit of a headache. Her telemetry readout is NSR.

Recommendations:  I was wondering if you would like another dose of hydralazine or for me to give her something stronger to bring her BP down and help with her headache.

 

SBAR takes the emotion out of it. If a doc rattles off a question at you in the hallway, its FINE to say "I don't remember off the top of my head. Let me look it up for you". And then do that. 

As far as critical thinking, it really does develop over time. Most start to see it around year 2. 

 

 

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Specializes in sub-acute/rehab; acute psych.
8 hours ago, Nurse SMS said:

Have you heard of SBAR? Use that framework when calling providers. Situation, Background, Assessment, Recommendations

Situation:  Dr. Soandso, your patient Mrs. Gillespie in Room 303 has a BP of 201/99.

Background: She has gotten her regular dose of Norvasc at 8 this morning and I gave her PRN hydralazine about 30 minutes ago.

Assessment: Her BP remains elevated at 189/101. She has no chest pain but does admit a bit of a headache. Her telemetry readout is NSR and she denies any chest pain.

Recommendations:  I was wondering if you would like another dose of hydralazine or for me to give her something stronger to bring her BP down and help with her headache.

 

SBAR takes the emotion out of it. If a doc rattles off a question at you in the hallway, its FINE to say "I don't remember off the top of my head. Let me look it up for you". And then do that. 

As far as critical thinking, it really does develop over time. Most start to see it around year 2. 

 

 

This! For me I try to predict what they will ask and have the answers ready. 

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Specializes in LTC, Vent/ Trach.

I'm in a super similar position because I started out part time 11-7 at a SNF and then went to sub-acute vent/trach after six months. I'm still per diem at both places but I'm not sure what the next step should be because I'm not super confident in my clinical skills like managing tubes/ central lines and inserting catheters. I'm currently not able to work full-time probably for the next six months or so but when I can IDK what the best position would be to apply for where I could build and practice those skills more regularly without  having to deal with the hustle and bustle of a hospital floor. 

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