Skills Checkoffs and Anxiety

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I have just completed my first semester and have had a few weeks to reflect on my strengths and weaknesses. My biggest problem this semester was skills testing. I would prepare for hours in open lab and have the skill down pat, but come testing time my hands would shake and my heart would pound in my ears, my voice was shaky- it was impossible to hide my anxiety from the professor evaluating me.

This caused two problems for me: 1. The days leading up to skills testing were so wrought with anxiety that I couldn't accomplish much or concentrate on anything. 2. I failed 3/4 of my tests on the first attempt. I did manage to pass them all on the second attempt.

I am prone to anxiety and take an SSRI daily- My anxiety is very well managed except the time surrounding these skills tests- I told my doctor about the situation and he offered to up my daily dose of medication. I am afraid to monkey with my dose as it works for me 95% of the time and it was not easy getting to this point where my anxiety was managed to this degree.

I am wondering if anyone has good anxiety reduction techniques for these situations. The only thing I can think of is more preparation for testing.

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In our school there are usually professors available during practice time so have you tried maybe getting a professor to watch you a few times before the actual test, or set up an individual appointment with your professor to get feedback before the test? That might help.

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I do not like being watched and graded. Although my anxiety is not that severe, what I did was just pretend they weren't there. I actually just completely blocked them out of my head and talked to the "patient" explaining what I was doing every step.

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Thanks futurenurse- There are teachers available during open lab and I did go through the testing with them and did well prior to actual testing- BUT I think I need to do it over and over and over again so that I know it inside out, upside-down and sideways. That should help.

Thanks for the suggestion loveneverdies- I'm going to try to do that.

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I don't really have any advice to give you, but I just want you to know that you are not alone and I think that is completely normal. I was always SO prepared for check offs, and no matter how much I practiced I would ALWAYS freak out a little bit. My hands and voice were shaky and my instructors would always comment about how nervous I was. I would also get nervous when we'd do sim labs. Every single semester of nursing school I would feel just as nervous and anxious. To this day as an RN I STILL get nervous when we have skills check offs for work or my preceptor is watching me do my assessment or give meds. I HATE having people watch me! I think it's just performance anxiety - you and me and most people in nursing school probably have pretty type A personalities and we want everything we do to be perfect (or at least as close to perfect as possible). I realized I put a lot of pressure on myself to do everything perfect, and I think that is what increases my anxiety in those type of situations.

I also take an SSRI for general anxiety problems, and I've found that it doesn't really have much effect on situations like that. I might feel generally less anxious about the situation, but my hands still shake and my preceptors say that I look nervous.

It definitely sucks and I wish I were more relaxed, but as a new RN I know I have to get over it and just jump into situations that I know will probably make me a little anxious or I'll never learn anything. And that's what I do. Don't get me wrong - I still feel SUPER anxious - but I try to fake some kind of confidence, trust that I know more than I think I know, and go with the flow. You'll probably always feel the way you do during check offs during nursing school, but try not to let it hold you back from learning opportunities in clinical.

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Specializes in L&D, infusion, urology.

Are you working with a professional to work on coping techniques? You'll learn some when you take psych as well, but it can help to be the patient sometimes! :)

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RunBabyRun- For decades I have been seeing a therapist, on and off and have developed some coping skills. I tried deep breathing techniques before testing I think it did help before one of the tests but not much before the others for some reason. I am going to talk to my advisor before next semester and see what she says also I may see our psych professor- I know that nursing requires that we help patients through times of extreme anxiety- so we'll see what shehas to say (she already taught us guided imagery and progressive relaxation- I have tried these with little success- but the deep breathing has helped in other situations.

MH82- thank you for your post! It was very comforting to me! You sound just like me!

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