SRNA struggling with clinical

Nursing Students SRNA

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I just finished my first semester of an integrated masters program. While I don't have straight A's, I feel comfortable with my grades. I've been struggling with clinical and am hoping for some words of wisdom to help me improve/survive. We finished our first 3 months of clinical (2 days per week) and will be starting clinical evaluations two weeks from now. I feel childish for saying all of this, especially since my classmates all seem so confidant.

I don't know what's happened to me since starting clinical. I was a strong ICU nurse prior to this. I have never been the typical type A ICU nurse. I have always had anxiety with new people. It never was a problem while on the job, but now I feel I've psyched myself out. It doesn't show on my face. Instead I just freeze up. Once I step foot into the clinical site, it's as if I forget how to be a nurse.

I was a preceptor/charge and now have trouble with decision making/jumping in without being told. I still rely heavily on preceptors. I was a go-to for IVs and now I'm about 50%. I'm only about 40% after 30 intubation attempts and my technique doesn't seem to have improved at all. Focusing so much on what the staff thinks of me and a fear of mistakes is causing me to screw up even more. Even though it is frustrating dealing with various techniques of different preceptors, it's not their fault. Compared to my classmates, I lucked out with my clinical site. They've all been great. Instead of telling me to suck it up, they've actually pulled me aside to try and talk through it. I'm the only one to blame for my performance.

I've done many things to help but have only noticed a slight improvement in my clinical performance. Seeing a therapist/starting propranolol has helped with the anxiety/fear of failure. Talking through each step of the cases while driving to/from clinical helps to keep me on track intraop. I always ask to review what went well/bad with the preceptor at the end of the day. I go over their advice in my head, but can't seem to follow through in the moment. I do feel I can identify my own weaknesses pretty well, but can't improve them. I've gone through many forums on here/reddit/head of the bed podcast.

The preceptors say I'm doing fine. I feel the complete opposite. No preceptor or instructor will give me a timeline of expectations. I don't know where I'm supposed to be at this point. I don't know when I'm expected to stop relying on the preceptors. I've heard and read that many students go through trial by fire and it seems to work. At this point, I am 100% certain that wouldn't work for me and that I would fail without the frequent help from the preceptor. I know I need to be better.

Sorry for the rambling post and thanks for getting through all of that.

Give yourself a break. If you knew you to do anesthesia already, you would not be in school. You have been in clinical for 2 days a week, for 2 months?!?! Chill out. Seriously. Take a deep breath and chill. 30 intubations?!?!? That is a very small number. Maybe you are not right for the profession, but one just cannot say that yet. Things usually settle down quite nicely when you start going to clinical 4 days a week.

P.S. Yes, yes, the confident classmates are all full of ***. Nobody is money after 3 months of 2 days a week. I am usually a hard *** with you guys on this site, but please, come on, give yourself a break.

Specializes in Nurse Anesthesia.

JV2000

Just my two cents as I have been where you are. The best words of wisdom I got in the beginning of my training was “You can teach a monkey skills.” Not to minimize the importance of being proficient in various skills needed in this profession, but they are acquired over time. Of equal importance is knowledge. Keep your nose in the books and pick the brains of the providers you are with. When I first started clinical I felt like a clumsy, awkward, idiot. However, I kept going back for more, I kept reading, I kept asking to be involved even if just to watch. Overtime perseverance pays off.

Another piece of advice is to try not to be in your own head so much. Remember that if you struggle with an airway the patient will be OK because there is someone to help right next to you. It does get better and things do get easier.

Specializes in DNAP CRNA APRN.

Battle on and never quit! You got this!

Sincerely,

Linda

On 2/19/2020 at 8:50 AM, BigPappaCRNA said:

Give yourself a break. If you knew you to do anesthesia already, you would not be in school. You have been in clinical for 2 days a week, for 2 months?!?! Chill out. Seriously. Take a deep breath and chill. 30 intubations?!?!? That is a very small number. Maybe you are not right for the profession, but one just cannot say that yet. Things usually settle down quite nicely when you start going to clinical 4 days a week.

P.S. Yes, yes, the confident classmates are all full of ***. Nobody is money after 3 months of 2 days a week. I am usually a hard *** with you guys on this site, but please, come on, give yourself a break.

Yes INDEED!  BigPappa has hit the nail on the head.  Chill out and drink some beer and breath.  Breath...  Offer your classmates an enema because they are full of ****.  When people aren't confident they feel the need to act like they never struggle...they lie.

-Clinical 2 days a week is nothing.  You often forget what you learned the next time you are in clinical.  Also, this is your first semester.  You need at least 100 intubations to feel comfortable.  Once you are in clinical more regularly, you will begin to put things together. 

-You have a good point about nerves and performance, they definitely play a major role.  Mike Tyson said everyone has a game plan until they get hit in the face.  That being said, yes you still have some skills as an ICU nurse, but anesthesia is a COMPLETELY different discipline.  There are so many things like timing, flow, etc that you cannot learn in the classroom.  Try learning some breathing techniques to relax before stressful procedures.  As someone mentioned the Emcrit episode is awesome.  

-So timeline of where you are at: You are I'm sure further along now and hopefully putting things together.  Just relax and know that everyone has struffles just keep getting better everyday

JV2000,

Reading your post was exactly what I needed to read. This is exactly where I am right now. Did things get better for you?

CCRNtoCRNA19 said:

JV2000,

Reading your post was exactly what I needed to read. This is exactly where I am right now. Did things get better for you?

Did things get better for you?

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