SIM lab left me frazzled and worried

[heartsgal, ADN, RN]

I'll be graduating from an ADN program in 11 weeks and I had my Simulation lab rotation this week (in lieu of clinical, that's how my school does it). While I am grateful for the safety aspect that SIM lab affords me to make mistakes on a mannequin and not a real patient, I find that I get so much more nervous and flustered during the scenarios than I do with an actual patient.There is pyxis(similar but not real thing) machine that has some drugs in it, but others have to be pulled from an old fashioned drug cart. The lab director and instructor does a great job and is super nice so I don't know why I become so nervous. I could not remember how to calculate flow rate for 50 ml bags to be infused in 30 minutes and felt like an idiot when she asked me what the rate should be for the IVPB's. I did catch some things I was supposed to, like I couldn't run both IVPB's (incompatible drugs) with separate flush bags in a CVC line because my SIM patient had a high BUN level and pulmonary edema and was on 2 diuretics and she told me, "awesome job". Nevertheless I now have this overwhelming fear and feel very inadequate to fully care for 5-6 patients at a time, in 4 months time after I pass NCLEX and begin working. I am normally much more confident in my abilities to provide adequate patient care and have always loved my clinical days when I'm working and caring for real patients as opposed to SIM, but now I'm so fearful and truly worried about "real world nursing". What I can do to be better prepared?

[HouTx, BSN, MSN, EdD]

Trust your instructor. If she said you did an "awesome job", then you are on track with the skills and knowledge expectations for this point in your education. We all get nervous when someone's looking over our shoulders. Heck, I once took an ACLS (written) exam with a very experienced, board certified critical care nurse... she was so nervous she wrote her maiden name on the exam despite the fact that she had been married 30 years at that point. Yep, she flashed right back to her student days - LOL.

All employers know that new grads have to have a transition period in their first job - moving them from student to novice nurse. Your first employer will have processes in place to help you with this. It may be a formal program for new grads or a customized extended orientation with an expert preceptor.

Take a deep breath. Focus on the job at hand and try to stop fretting about the future. It's going to be fine.

[rubato, ASN, RN]

So far, I have never left SIM without feeling like a complete moron. Then, we all go out in the hall and I find out we all feel like complete morons. It's ok! Don't worry.

So far, I have forgotten how to hang an IV (which I can do all day long), have forgotten that I can't recap a used insulin syringe, have neglected to check if there were new orders from the doc on the chart (gave the wrong meds due to this) and have almost given my wrong name when introducing myself (caught myself at the last sec).

It's a good learning environment. You need to learn somewhere right?

[SurroDoula]

SIM labs always leave me feeling frazzled and dumb, lol. There is something about it being an artificial environment that just doesn't work for me. And the robotic patients are creepy...

[heartsgal, ADN, RN]

Thank you for your encouragement, I appreciate it. It instills some of my lost confidence to hear that it's not just me that feels grossly inadequate after SIM lab.

[2bNurseCai]

Don't feel so bad! I had one last week (I'm in my first year) and when my sim patient's O2 sats went down, I panicked and forgot what to do next! Mind drew a total blank!

That said, sims are a great teaching experience! Focus on what you did well :)

[Pure One]

Quote

Trust your instructor. If she said you did an "awesome job", then you are on track with the skills and knowledge expectations for this point in your education. We all get nervous when someone's looking over our shoulders. Heck, I once took an ACLS (written) exam with a very experienced, board certified critical care nurse... she was so nervous she wrote her maiden name on the exam despite the fact that she had been married 30 years at that point. Yep, she flashed right back to her student days - LOL.

All employers know that new grads have to have a transition period in their first job - moving them from student to novice nurse. Your first employer will have processes in place to help you with this. It may be a formal program for new grads or a customized extended orientation with an expert preceptor.

Take a deep breath. Focus on the job at hand and try to stop fretting about the future. It's going to be fine.

Thanks for that- aim worried that I will only ever be able to care for one pt

How do you juggle : the getting OOB fall risk with the dizzy one you just put on the pot, and the decompensating HF, the new post op that needs 15 min vitals, a scared pre op, and a reg patient with normal needs?

Now that I am almost done aim wondering if I can really do the job.

[Esme12, ASN, BSN, RN]

Pure One said:

Thanks for that- aim worried that I will only ever be able to care for one pt

How do you juggle : the getting OOB fall risk with the dizzy one you just put on the pot, and the decompensating HF, the new post op that needs 15 min vitals, a scared pre op, and a reg patient with normal needs?

Now that I am almost done aim wondering if I can really do the job.

Don't back yourself into a corner. It will come...it takes time...at least a year to even feel like you aren't going to throw up on your way to and from work with anxiety....you are normal!!! and you ask for help. Allow yourself to be new...give yourself a chance.....

((HUGS))

[gaonsi]

I volunteer for my alma maters sim labs. We purposely bring up the wrong meds from "pharmacy" have the doctor have an attitude, make the house md an idiot and make the patient whine and complain in the worst way. Not because we want students to feel stupid, but so we can really assess how well they do under an unreasonable amount of stress and pressure. Some students knock it out of the park. Others don't do as well. But the important thing is that when we debrief, they see what they did wrong, and how to improve on it. I'm sure if your instructor said awesome job, you did a great job. I always finish by saying " Be confident in what you know. Because if you think of all the interventions you do know, by the time you're stumped, your coworkers who have more experience should hopefully be at the bedside helping you. "

[rumwynnieRN]

My second to last semester, I hated sim lab. We were pretty nervous throughout the whole thing, and our argument to our instructors was the set up for the scenarios wasn't real. It was so different from what we were accustomed in clinical that when simulation came, it was a bit, "Um...but...we get the lab values from the computer, we don't call the lab? And if that was the case, shouldn't the number to lab responsible be NEAR THE PHONE!?"

It didn't help that our teacher was a bit intimidating, and if she was having a bad day, she totally took it out on us. I will say that simulation left this on me -- I'll be doubly paranoid when I give narcotics (long story).