Struggling in 2nd semester

Ruby Vee, BSN · Mar 10, 2018

Hi all, I feel like I need to vent a little bit and maybe get some advice from you guys.
I'm currently in an LVN program 2nd semester, planning on bridging over to 3rd semester RN when I'm done.
Right now we just started our med surg rotation. I've had 3 clinical days on the floor so far. One 12 hour shift and two 4 hour shifts. I feel like it's so overwhelming and fast paced for me. We have one patient where we do total care for them and are assigned a nurse to kind of follow and help them out. What I'm struggling with the most is looking at the big picture with my patient. It takes me so long to look at the chart because usually they have a long history, meds. I try to look at everything including their labs and try to figure out why some components are low or high and comparing it to their history or primary diagnosis to put 2 and 2 together. I also take a lot of time looking at their meds trying to figure out why they're taking it. I feel like I spend so much time on the computer that I miss out on what my nurse does. I want to know everything about my patient so I can give a good report to my instructor and also be able to give meds. We can't do that unless we tell our instructor all about the med and the key things about the patient. My instructor already chewed me out for missing some things on the chart about my last patient when I thought I looked at all of it and also for not knowing some things she asked me from 1st semester. She said it was unacceptable and I have some serious studying to do. I'm trying so hard not to fall behind. I feel like I'm forgetting the basics from 1st semester. Everything is just piling up with learning new things and trying to retain what I learned and applying it to clinical and I'm getting so overwhelmed that I'm questioning about becoming a nurse. My instructor is so strict on us and expects so much. I feel like I'm not meeting her expectations and I feel like I might get dropped for being unsafe or negligent. Is this a normal feeling? Because at this point I'm really questioning if nursing is for me. I can't imagine what it'd be like 3rd and 4th semester because I hear it only gets harder.
At the same time I WANT to become a nurse. Whenever I do something for my patient to make them comfortable, it's SO gratifying and I feel amazing. But on the other hand I feel like I'm not smart enough to become one. Is this also a normal feeling?

For starters, it's pretty normal to feel this way. I did, and I've been a nurse successfully for 40 years so if that's any indication, you're right on track!

There's a lot to learn in nursing, and you've correctly identified that you must apply the new things you're learning to the clinical situation AND build upon the things you've learned last semester. My question for you is, did you spend the time last semester LEARNING and thoroughly UNDERSTANDING the material, or did you just memorize answers to likely test questions? The test is whether or not you could explain the material to someone in terms that they could understand -- your 16 year old daughter/cousin/sister/neighbor? Could you explain the anatomy or physiology or chemistry to the point that you could make a complete novice understand it? If you can, then you probably understand it enough to build upon it for the next semester or for your career. If not, then you need to study a little more. I didn't learn that until my third or fourth semester.

Once you thoroughly understand the material, then building upon it becomes a whole lot easier. The more of a framework you build, the more facts will stick to it. I'm not sure this is making sense to you, but hopefully it will lead to an "AHA!" moment for you.

One other suggestion is to ask the nurse you're working with what are the most important aspects of this patient's care and why. You'll still be doing your own research, working through the chart and learning as much as you can about each patient, but the nurse you're working with might be able to help narrow your focus a bit so you're focusing on the right aspects of the patient's current situation. For instance, you still have to think about your patient's history of high blood pressure and Type II diabetes, but if they've just had major surgery the immediate problems may be bleeding, pulmonary toilet and ambulation.

I hope this helps.

mantidqueen1 · Mar 12, 2018

I think feeling overwhelmed is pretty normal. I just finished my ASN, and what I found helpful was arriving at clinical early, getting my assignment, and then looking up patient history and medications. So that I wouldn't get in the nurse's way, if they needed a computer, I made sure I had my pocket med-surg book and drug guide.

I felt more confident and less put on the spot when I had that prep time. When does your clinical instructor do assignments? Can you go early? Even now, working on an acute medicine floor, I come in at least 1/2 an hour early. So do several other nurses, and having a good report sheet helps as well.

MiladyMalarkey, ASN, BSN · Mar 14, 2018

I've nothing valuable to add other than I find second semester a bear as well. They really start pushing us to critically think & at times seeing the bigger picture is a challenge. Hang in there.