Let's start by saying I've been shy and "insecure" my whole life. Refused public speaking projects in high school was I was too afraid to order my own food at a restaurant until I my freshman year in college. Flash foward 5 years and I'm an RN in ICU for 1.5 years and I've definitely come a LONG way with self confidence and being "sure" of myself but I still have so many moments of self doubt. I'm a little OCD in my practice and if one little thing goes wrong during a shift or everything isn't perfect... Let's just say I'm very hard on myself. I go over it in my head over and over to think what I could have done better or different. Similar situations could happen to my coworkers and they don't even seem phased.
Does anyone else experience this? Is it a new nurse thing? I'm learning to be not so hard on myself and relax but I'm finding it difficult sometimes.
Thank you so much for all of your replies. I'm glad I am not alone. The anxiety is not necessarily getting in the way of doing my job...but it kicks in after my shift is over and I'm going over the night in my head. My original post was prompted by an incident with a physician my assessment. (And as he later found out..My correct assessment) but his questioning immediately shut me down... Self doubt instantly creeping up on me. I am already insecure and I realize speaking up in my position is entirely necessary I still sometimes find it difficult to do... But I do it. I work on this every day. I may seek out counseling to help me with this.
The bit about 'shutting down', and instantly doubting yourself and wondering if you are actually incompetent is something that experience will iron out. For instance, in this experience, you didn't need to rake yourself over the coals at all, your assessment was correct. In a nutshell, you can add a notch to your belt, your confidence in your assessment skills is VALID.
Too often new-ish nurses, or those who struggle with confidence, see things in black and white. Like, "I'm either a great nurse OR I'm a pathetic excuse for a nurse" when the truth is, we are in all the areas in between. We move between the extremes of black and white all the time, over the course of a single shift. I've caught an early symptom of sepsis and saved a patient from a stint in ICU, and another patient missed an error on the MAR. So which am I, an idiot or a skilled clinician ? Both? Or somewhere moving around in between?
You can get yourself, with some practice and deliberation, to a place where it is perfectly OK to be wrong, or make an error in judgment. You won't enjoy the sensation but the automatic response to missing a call won't be "I suck!" A person striving to be proficient is always seeking to improve and be a receptive learner. A person stuck in (pretending) to be all that and a bag of chips is not receptive to learning more. Neither is a nurse drooping in self-recrimination going to be receptive to learning new things. Both extremes are unrealistic.
So if you find yourself bouncing between extremes, there IS a problem, but not with your abilities necessarily. It is with your thinking. In cognitive science, bouncing between extremes is called 'catastrophic thinking'. It is self-defeating besides being untrue. What IS true? That sometimes you rock the stage and others you have something new to learn. You and everyone else.
Thinking in extremes is a habit. Yes it is, just not one you hear about much. Your upbringing or temperament might make you vulnerable to this habit, but habits can be broken. This one should be, for the sake of your job satisfaction. Ask me how I know, OK? I was literally plagued in my first several years. I got better evals than I expected every single time. It's like I couldn't even notice my positives for how much the negatives floored me and preoccupied me.
So when a staff or physician cries 'you did that wrong!' you can PRACTICE a new way to think about that. Really, it's a simple statement. "Wrong" is just . . . not right. "Wrong" isn't "you suck!" So you proactively ask, "What was wrong about my assessment?" in a polite-toned voice, and then you listen to why you were 'wrong'. Then, you evaluate the situation. You might need more information, or it might be obvious you WERE wrong, or the other person is wrong. Still, there's no shutting down, just staying alert and being fine with yourself. You are no paragon of nursing superiority, no one is, and no one honestly expects it.
I didn't get comfy with being wrong over night, it takes practice. It takes examining yourself, and how you talk to yourself. We all carry loads of unquestioned assumptions than can cause one person to be uber defensive when they even suspect they are being criticized. That person is thinking "If someone questions me, they must think I'm stupid." That's called mind reading. That's that person's OWN internal voice, not the person questioning them. Make sense?
It's good to be a bit on the OCD side, the anxious to not make mistakes side. This can be done without shutting down or spending your hours after work bullying yourself with negative self talk :) I've done it, mostly, there are exceptions. It's good news that it really is not 'other people' dragging you down, it's your own thoughts doing it. Then you have control, if it's just 'you'.
Gooselady, BSN, RN
601 Posts
The bit about 'shutting down', and instantly doubting yourself and wondering if you are actually incompetent is something that experience will iron out. For instance, in this experience, you didn't need to rake yourself over the coals at all, your assessment was correct. In a nutshell, you can add a notch to your belt, your confidence in your assessment skills is VALID.
Too often new-ish nurses, or those who struggle with confidence, see things in black and white. Like, "I'm either a great nurse OR I'm a pathetic excuse for a nurse"
when the truth is, we are in all the areas in between. We move between the extremes of black and white all the time, over the course of a single shift. I've caught an early symptom of sepsis and saved a patient from a stint in ICU, and another patient missed an error on the MAR. So which am I, an idiot or a skilled clinician 
? Both? Or somewhere moving around in between?
You can get yourself, with some practice and deliberation, to a place where it is perfectly OK to be wrong, or make an error in judgment. You won't enjoy the sensation but the automatic response to missing a call won't be "I suck!" A person striving to be proficient is always seeking to improve and be a receptive learner. A person stuck in (pretending) to be all that and a bag of chips is not receptive to learning more. Neither is a nurse drooping in self-recrimination going to be receptive to learning new things. Both extremes are unrealistic.
So if you find yourself bouncing between extremes, there IS a problem, but not with your abilities necessarily. It is with your thinking. In cognitive science, bouncing between extremes is called 'catastrophic thinking'. It is self-defeating besides being untrue. What IS true? That sometimes you rock the stage and others you have something new to learn. You and everyone else.
Thinking in extremes is a habit. Yes it is, just not one you hear about much. Your upbringing or temperament might make you vulnerable to this habit, but habits can be broken. This one should be, for the sake of your job satisfaction. Ask me how I know, OK? I was literally plagued in my first several years. I got better evals than I expected every single time. It's like I couldn't even notice my positives for how much the negatives floored me and preoccupied me.
So when a staff or physician cries 'you did that wrong!' you can PRACTICE a new way to think about that. Really, it's a simple statement. "Wrong" is just . . . not right. "Wrong" isn't "you suck!" So you proactively ask, "What was wrong about my assessment?" in a polite-toned voice, and then you listen to why you were 'wrong'. Then, you evaluate the situation. You might need more information, or it might be obvious you WERE wrong, or the other person is wrong. Still, there's no shutting down, just staying alert and being fine with yourself. You are no paragon of nursing superiority, no one is, and no one honestly expects it.
I didn't get comfy with being wrong over night, it takes practice. It takes examining yourself, and how you talk to yourself. We all carry loads of unquestioned assumptions than can cause one person to be uber defensive when they even suspect they are being criticized. That person is thinking "If someone questions me, they must think I'm stupid." That's called mind reading. That's that person's OWN internal voice, not the person questioning them. Make sense?
It's good to be a bit on the OCD side, the anxious to not make mistakes side. This can be done without shutting down or spending your hours after work bullying yourself with negative self talk :) I've done it, mostly, there are exceptions. It's good news that it really is not 'other people' dragging you down, it's your own thoughts doing it. Then you have control, if it's just 'you'.