Starting my 5th Level Preceptorship, and I'm Terrified of Doing Everything Wrong...

SilverOwl · May 18, 2013

aweldon001 I am not a nurse yet, but I am currently a Licensed Vet Tech, and we share many similar responsibilities -- with many similar pressures and expectations. It sounds to me like you are psyching yourself out!!! Take your instructors' positive comments to heart and focus on the things you KNOW you are good at. I remember being terrified I was going to kill a patient and feeling like a total fake when I first started out, but I built my confidence by realizing there were some things I was great at, and others I just needed to learn by DOING. I was top of my class in my Vet Tech school, and awesome at placing IV catheters and intubation, but radiographs terrified me!! With time, and slowly building experience, I gained a lot of confidence :)

You absolutely cannot put yourself down mentally and then expect to be confident!! You'll be OK :laugh:

aweldon001 · May 18, 2013

SilverOwl, as soon as I read the words, "psyching yourself out," I took it to heart. I've had an instructor tell me these exact words before!! You're right though. I need to focus on the positive and go with that. It's so much harder to say I'm going to do it than actually doing it, but I will try. That's how I feel all the time. I worry I will hurt a patient or do something wrong. I feel like there's a written policy/procedure for EVERYTHING, and I worry I won't follow one correctly. It's always a constant worry for me. I'm the same as you though! I'm great at IV's, so maybe I will focus on that when I start freaking out. Thank you for responding and building up my confidence a bit! It means a lot! :)

SoldierNurse22, BSN, RN · May 19, 2013

aweldon,

I remember very clearly the anxiety you're describing. BREATHE DEEPLY!! You are not the only one!

Let me tell you something as a preceptor--we don't expect you to know everything. In fact, I don't usually expect my preceptees to know anything for the exact reasons you're describing. We're humans. We get nervous, we get flustered, and when we're put in an unfamiliar situation, it's hard to think fast.

So my suggestion to you is to let your preceptor know how you feel. Tell him/her that you want lots of explanations and what you're comfortable/ not comfortable with. That is the only way you will start to feel better. It takes time and experience--LOTS of experience--to feel comfortable as a nurse. I didn't really feel like I had my sea legs until I was a year--a full year--into my first job.

The weight of the world isn't on your shoulders! This is not you flying solo--it's an opportunity to learn. You sound like you're very enthusiatic, which would be all I needed to see if I were your preceptor. I don't care if my preceptees have it down or if they follow me like ducklings--as long as their attitude is right, I love working with them and teaching whatever I can.

A lot of nursing isn't common sense. It's a 6th sense really that you develop over time along with your assessment/critical thinking skills. That education that's going to keep you from feeling stupid and inadequate? Part 1 is waiting in your 5th level preceptorship. Give yourself a break, be honest with your preceptor, and get ready to learn a lot!

stephanie. · May 19, 2013

Practice makes perfect. Work on the things you struggle with until you know them like the back of your hand.

aweldon001 · May 19, 2013

Oh man, I feel like after reading your reply, I was literally able to breathe and relax these tense muscles in my neck! I wish you knew how much it means to me to read this. It it like a weight is being lifted off my shoulders.

I do worry about not even knowing how to get through some of the simplest tasks, but I'm hoping my preceptor will be as understanding and kind as you. I seriously hope that my preceptor will keep what you said in mind. I want to learn and I want to be able to appear confident and intelligent, but I feel like I'm faking it most of the time. It's hard to think fast like you said, and being put on the spot is the worst!

I will definitely take your advice and tell my preceptor exactly how I feel. I will be sure to touch base on all the things you mentioned. It definitely makes me feel better that experience is the key, because even though I've been in clinical, I've only got to do a few procedures at best. I feel like if I can get in there and do everything over and over that I will catch on and feel better. This makes me nervous to think my first year will be like this as well, but I'm going to try as hard as I can.

I feel so much better after reading this. I felt like my preceptor was going to expect me to know every little thing about everything and I've been having mini-panic attacks over it! Learning is good, it's what I WANT out of this. I'm extremely positive and friendly, so I hope this will help.

Wow...just thank you.....thank you so much, SoldierNurse22. I will look at my preceptorship as PART 1. I love that. I will do everything you said and take it to heart. Thank you so VERY much!!!!! :)

aweldon001 · May 19, 2013

I think after reading these past few comments, that I'm starting to realize that experience and practice are key to easing my stress. I will take your advice. Thank you so much, Stephanie.

KelRN215, BSN, RN · May 19, 2013

This is why you have an experienced nurse as a preceptor. I have precepted senior nursing students and I didn't expect them to come in knowing everything or even anything. I expected them to pay attention, to learn and to progress over the course of the semester.

What specifically do you find difficult about IVP meds? Figure out what the problem is and then you can figure out how to fix it.

SoldierNurse22, BSN, RN · May 19, 2013

I do worry about not even knowing how to get through some of the simplest tasks...

Neither did I. Neither did any of us, actually! People can be born with an inclination toward nursing, but you don't come out of the womb spiking IV bags and programming pumps. It's a process and it's learned at individual rates. The big thing to remember is that you don't have to learn it all right now.

I want to learn and I want to be able to appear confident and intelligent, but I feel like I'm faking it most of the time. Again, that's the name of the game. Don't pretend you know what you don't know of course, but if you have to feign confidence, that's not a bad idea. If you don't know something, tell your patient as much, but tell them you'll find out for them. That maintains rapport and also will teach you not only the info, but how to find it, which is key! If you are put on the spot, do your best and learn from it. Those people who are really confident and unflappable? They got that way by being put on the spot over and over and eventually, they figured out how to deal with it.

It definitely makes me feel better that experience is the key, because even though I've been in clinical, I've only got to do a few procedures at best. I feel like if I can get in there and do everything over and over that I will catch on and feel better. This makes me nervous to think my first year will be like this as well, but I'm going to try as hard as I can. Clinical is really good for getting familiarized with things, but most of the time, you don't learn all you need to know by any means in clinical. When you get your first job, you'll be precepted there, too. I was precepted for 3 months before I was able to fly solo. I felt very comfortable by the time I was on my own and I knew I could ask my coworkers for help if I needed it. That's the mark of a good workplace--that teamwork.

Unfortunately, your first job is always going to be a little nerve-wracking. There is just so much to learn that you can't be taught in school, and can't be taught, PERIOD. Give yourself permission to take your time and go through this process just like all of us have! You'll be better able to perform if you keep this in mind and stay calm.

Wanna know a secret? I STILL haven't inserted foley! I've been a nurse for 2.5 years. When I get my chance, though, I will be asking another nurse for an assist, you betcha!

I felt like my preceptor was going to expect me to know every little thing about everything and I've been having mini-panic attacks over it! When I started oncology, I had a preceptor like that. When she asked me questions I didn't know the answer to (specific details of chemotherapy drugs that I had literally just been taught about), I told her I didn't know, but I'd find out. That is all you can do. If you really find that you and your preceptor are having issues, talk to your clinical leader / manager (once you're working).

Learning is good, it's what I WANT out of this. I'm extremely positive and friendly, so I hope this will help.That will absolutely help. That's all I ask of my preceptees and patients like that personality type.

I will look at my preceptorship as PART 1. I love that. I will do everything you said and take it to heart. Your life as a nurse will be one big learning experience. Things are constantly changing and improving (hopefully) in medicine, and just to maintain your license, you'll have to complete continuing education credits in order to stay current in practice.

There was this time when I was a brand new nurse working alone--this was probably in my first week on my own--that I had a patient who needed Tylenol, but he couldn't tolerate PO meds. I chatted with the doc and then talked with the pharmacy and found out that they made Tylenol in IV form. The older nurses had never heard of such a thing. They didn't believe it until they saw it. As I was setting up the infusion, I had half of my coworkers filtering through the room to marvel at it. The point of this story is that you can be a nurse for 30 years and still have something to learn!

Thank you so VERY much!!!!! You're quite welcome! Feel free to PM me with any questions or anything I can help you with. I really enjoyed precepting and I love students who are eager to learn.

aweldon001 · May 19, 2013

You're right. I think I'm trying to shoulder it all and it's freaking me out. I want my preceptor to at least think I have a brain between my ears, lol. I will definitely be paying attention and be ready to learn like you mentioned. I also hope I can write everything down he/she tells me.

Well, just a few weeks ago I had to push Protonix, so I had to reconstitute it with 10 mL of NS, and I didn't know if I was supposed to push air into the vial of NS before withdrawing and I struggled getting all of the mixed Protonix out of the vial when I was withdrawing it into my syringe. I just felt like an idiot. I've learned about all of these things in school but when I'm doing it with my hands I just get nervous and forget what I'm supposed to do. =/ I will definitely be going over reconstitution and pushing IVP meds before going to clinical though. Thank you.

aweldon001 · May 19, 2013

Well, that's a relief for sure!! Haha. I actually struggled programming a pump a few weeks ago and I got so flustered and felt so dumb! After doing it a few times though, I did start to catch on and that felt immensely better! Seeing you say I don't have to know it ALL right NOW is a relief too. I don't know how you guys store all of that information in your head, but I hope I can get there one day too!

I definitely feign confidence, though I don't know how good I am at it! I'll keep this tactic in mind when I'm interacting with my patients. I have also caught myself worrying about telling my patient something wrong, but telling them I will find out for them works best and like you said, it helps me learn it too! I really hate being put on the spot, it gives me the nervous sweats! BUT, if it's what I have to do in order to be that confident nurse, then I'll be ready for it.

Getting familiar with things is the perfect explanation for what I've done in clinical. Oh wow, I'm glad to know that I'll be precepted at my first job too! Wow, that's great. I was thinking it was just 5th level and them BAM, bye, you're thrown out there to be a nurse. Phew! That's relieving! I hope I have that awesome unit culture as well. I hear it's hard to get integrated into a unit when you're new. I just hope that I can make it through. I am stressed about the new job craziness. I hear that "nurses eat their young." I'm hoping to avoid that experience. I will definitely try to do that. I'll give myself time to figure things out so that I can better understand what's going on. Stay calm. Good motto to live by when being a nurse, I'm sure.

Oh wow! Hearing that has made me feel even better! I guess we won't always get the opportunity to do EVERYTHING, but I like what you said. When you do get that chance, ask for help and take it! I will for sure be doing that! :)

I hope my preceptor doesn't do that. I guess I'll find out more on Thursday and Friday. I WILL do that though, I had to do the same in clinical with my instructors. If I didn't know, I would just tell them that I didn't know, but that I would find out and let THEM know. It always worked and impressed my instructors. Good strategy! Hopefully I don't have any problems, but if I do, I will definitely let my clinical instructors know!

I'm glad to know that my personality will help. I've also been known to be a pushover though and my instructor tried to beat it into my head that some CNA's will eat me alive. Hopefully I can grow out of this. I just figure that if I'm there to help and be open to everyone, that everyone will like me. I guess I'll see how that works out for me....

I love learning, so I think this will work out for me. I hope to be an L&D nurse, so hopefully I can find a job in that after I graduate. I will look into taking continuing education courses before I find a job too because I hear it helps you get hired.

I fear being alone as a new nurse, haha. That's an awesome story though. Perfect example of patient advocate, right? I love that. So I guess I'll never know EVERYTHING at any given time. There's always something new to learn. Awesome.

Thanks for the offer for me to PM you. I may just take you up on that, especially after meeting my preceptor and seeing how it goes. I hope my preceptor is just like you! Thanks again for everything, SoldierNurse22!!! :up:

KelRN215, BSN, RN · May 19, 2013

You're right. I think I'm trying to shoulder it all and it's freaking me out. I want my preceptor to at least think I have a brain between my ears, lol. I will definitely be paying attention and be ready to learn like you mentioned. I also hope I can write everything down he/she tells me.
Well, just a few weeks ago I had to push Protonix, so I had to reconstitute it with 10 mL of NS, and I didn't know if I was supposed to push air into the vial of NS before withdrawing and I struggled getting all of the mixed Protonix out of the vial when I was withdrawing it into my syringe. I just felt like an idiot. I've learned about all of these things in school but when I'm doing it with my hands I just get nervous and forget what I'm supposed to do. =/ I will definitely be going over reconstitution and pushing IVP meds before going to clinical though. Thank you.

Is your instructor or the nurse caring for the patient with you when you are doing these things? If not, they should be. You don't have a license and there needs to be someone supervising you with medications. If you're not sure of something, ASK! Whether or not to inject air into a vial before withdrawing is a matter of preference. Some will tell you it's easier to withdraw the medication from the vial if you first inject air, but it's not wrong to not do it. Remember that there is often more than one acceptable way to do things. Where I have seen nursing students really get themselves in trouble is when they don't ask questions they know they should. Your instructors and preceptors know you don't know everything and expect you to ask questions... students who don't ask questions worry me a lot more than the ones who ask a lot.