Simulation Exam help

[tsm007]

Alright folks, back here for help again. I don't know what to do. I am in a non-traditional program so it complicates things. I am doing very well in the didactic portion of nursing school, but struggling very much with the clinical labs. We do not get a lot of lab time as compared to other schools and many of the skills have to be practiced at home independently. We do get a very good hospital clinical experience, but the labs are seriously lacking. Anyhow, I have failed 2 simulation exams now. This has set me back on graduation considerably and I now cannot fail another simulation exam or I am out the program. My primary problem is anxiety during the simulation exams. They are timed and it's causing me massive anxiety during the test. I do not get nervous around actual patients and do fine in the hospital setting, but the timing factor is making me a huge mess. I have already talked to my doctor about the underlying anxiety and have meds that I have just started taking for anxiety (probably shouldn't post that public, but oh well it is what it is and I'm tired of anxiety holding me back in life). Anyhow, what I need help with is figuring out how to tackle these simulation exams. I am trying to figure out how to practice and prepare for them better at home (and use my lab time most efficiently). I seem to not be able to think once anything deviates from what I think is going to happen. Once I'm calm and away from the scenario I usually can think the whole thing through clearly. I would seriously hire a private nursing tutor to help me, but it looks like all the resources out there are for people who have trouble with writing, math, or answering NCLEX questions. I do well in all of those areas. I just can't seem to apply what I know during the simulation exams. It's not even not knowing how to do the skills that is the problem really either. It's just staying calm and mistakes like calling the doctor without having all my facts together first. I'm making a lot of organization type mistakes. I think practicing lots of different random scenarios would help, but I don't know how to find them or where to look for help like this.

I am so very frustrated. I really think I will make a good nurse and honestly just getting tired of the nursing instructor weeding students out attitude versus really truly wanting to see their students succeed. It is wearing on me. I am discouraged. (I wanted to add that I was in a traditional nursing program 10 years ago, but did not complete it due to life issues - my kids were younger and it just wasn't working. I did not run into any of these problems during clinical labs and was at the top of my class then. So this is just very, very frustrating for me going from being at the top of my class to on the verge of being flunked out.) Any tips or ideas or even just encouragement would be really appreciated. If anyone knows any private tutors I'd be game for that as well.

[Shelby, BSN, RN]

Practice a lot. When you go to the lab, have a mock test or simulation. It would be best if an instructor could watch you do the demonstration and you both pretend it was a real test for you, but if that can't happen then see if a classmate can pretend to be the instructor. I have had other students watch me and tell me if they think I do something wrong. I have also watched others, and watched the teacher observe other students' demonstrations. This helps to not only know what to expect and puts some stress on you while you are practicing (which actually helps alleviate some stress and nervousness during the real test because you have done this before) but it also helps you to anticipate what things the teacher may ask you and how to react during the test.

In the real world you will be under stress, especially when you are caring for a patient that suddenly experiences a serious problem and you must react fast and correctly to help him/her. I'm sure you know this, but that's why it is so important to master these stressful simulations now and why your instructor (hopefully!) asks you questions and maybe throws you a curve ball.

One guess as to why you may be experiencing anxiety now is because you maybe realize how important this is and you don't want to mess this up. I wonder if you talk to your instructor and explain your anxieties and why you may be feeling this way, if she might take a calmer approach when testing you. Stick with the meds, especially if they work for you. There is nothing embarassing about that.

Good Luck!!