Struggling NP student

[lvICU]

I am in my final semester of NP school and I am having a hard time. It is not the work load but the clinical experience that I am having major difficulties staying focused. I have 9 years of RN experience and I really thought that I wanted my NP but I truly feel like this isn't clicking. For example, I have to force myself to go to clinical because it just makes me miserable. I chose to do a hospitalist type clinical and we rotate to different services of the hospital and with each rotation I have gotten more and more anxiety. This has gotten so bad that I have actually been trying to come up with excuses not to go to clinical.

I just don't know if this level of anxiety is normal. I feel like I am losing my mind and I am scared to death to even think about being a new grad NP. I am at a loss for where to go from here. Do I just tough out this last semester and muddle through with the hopes that this will all get better with time and experience? If anyone felt like this during NP school, I would love to hear about how you handled the situation and how you are doing now.

[nurseaig, ASN, BSN, MSN, NP]

Don't give up.

[anxiety]

I am in my final semester of NP school and I am having a hard time. It is not the work load but the clinical experience that I am having major difficulties staying focused. I have 9 years of RN experience and I really thought that I wanted my NP but I truly feel like this isn't clicking. For example, I have to force myself to go to clinical because it just makes me miserable. I chose to do a hospitalist type clinical and we rotate to different services of the hospital and with each rotation I have gotten more and more anxiety. This has gotten so bad that I have actually been trying to come up with excuses not to go to clinical.

I just don't know if this level of anxiety is normal. I feel like I am losing my mind and I am scared to death to even think about being a new grad NP. I am at a loss for where to go from here. Do I just tough out this last semester and muddle through with the hopes that this will all get better with time and experience? If anyone felt like this during NP school, I would love to hear about how you handled the situation and how you are doing now.[/oquote]

I am starting my final semester tomorrow....I am freaking out. Now, I don't have as much experience being a nurse (4 years) but I think it is normal for no matter how many years you have had because np roles are different. I almost feel like working at a doctors office as a nurse would have better prepared me to be an fnp than being a staff nurse at the hospital! (Is that weird?)

Anyway, I had a little over a month off and I feel like I have forgotten everything that I have learned. Like you, I have tried think of reasons not to go to clinical. Once, I actually called in sick because I couldn't bare the thought of going. I tried meds for depression and beta blockers and they didn't work for my anxiety. I think I might ask my doctor for a prn xanax script or something.

I honestly think I do best with preceptors/instructors are the most important predictor of how I feel. I didn't feel extremely comfortable with my clinical preceptors the first semester of clinical. I just worried if I didn't use the correct term or performed something incorrectly I would fail. Basically, I couldn't learn with them and honestly with the exception on one of the three that semester there was no reason for why I should have felt that way. The other was just an evil person (fortunately I was only scheduled the last half of that semester with her or I would have probably quit).

Last semester, I loved my preceptors and my clinical instructor so I didn't hate going as much. Sure I still was counting down my hours everyday in anticipation of the end of the semester but it wasn't like I despised going. They were really positive and when I was wrong they corrected me in a good way.

Unfortunately, one of those preceptors that I didn't very comfortable with (not the evil one though) will be my clinical instructor this semester (so basically the person that decides if I pass or not). I am afraid if I am not 100% all the time I will fail. I just spoke to my boss about going prn at work because I'm flipping out about needing to be perfect so much than I need all my spare time to use it to study/etc... I hope that will work but I have serious motivation problems because I have been distracted by wedding planning. I can't stop looking as wedding stuff.

I just keep telling myself....less than 4 months...I worried in undergrad too and everything was fine then. My instructor said I was right on track so really I don't see any reason for why that should change. Hopefully it won't. Anyway, I just want to let you know that I am right there with you. Hang in there! I wouldn't think they would have let you get this far if you were doing bad!

[mammac5]

I hear you what you're saying, completely!

I was a wreck because my first preceptor was NUTTY as a fruitcake - totally blew my confidence and set me back. I pretty much live in anxiety-ville anyway and I just gritted my teeth to get through it with her. I made sure my professors knew all along the way how things were going; when I got a less-than-fabulous evaluation from her it was not a surprise to her and they appreciated that.

Things did get better along the way with other sites. I think you'll surprise yourself when you go back to your original site and have a chance to see how far you've actually come - hopefully your preceptor will notice that and have some encouraging words for you as well.

The wedding planning is a distraction, but you already know that. Stop trying to get done and try instead to enjoy the process. As you point out, it's only 4 months - try not to rush it. For me it came down to forcing myself to STOP thinking about myself and focus instead on the patient. I honestly felt so self-conscious that I would be concerned about what I was doing, what I looked like, if I was saying something stupid, etc. and I had to STOP it so I could focus on the patient. Then it started to get fun!

[burnedoutRNinSC]

I feel for you. I feel the way you do a lot of times myself. I'm an FNP student, and my school makes us look for people willing to precept us on our own. The anxiety of that process is very similar to keeping up with class room work and our final research project. Oh wait... Yes there is my family, bills, job, and spouse who stays at home with our newborn. Just when you think life can't get anymore stressful, here come the babies. I recently joined crossfit in my community. It has been a life saver. I reap more mental strength than physical. Since I started I have been able to taper my dose of anxiety meds.

[WKShadowNP, DNP, APRN]

I don't know if we're thinking of the same thing but I'm kinda getting what you mean about "freezing up" on rounds based on my experience as a hospital-based NP and seeing NP students go through our service month per month. Is it feeling intimidated about presenting your patient's case to an audience of attendings, NP's, and residents? Or being afraid you'll get put on a spot with a question you couldn't answer? As nurses, we have a different style of presenting our patients during shift report to each other and we seem to get stuck on that mode, even after we we reach a point when we are already transitioning into a provider role. Don't feel bad, we all have to break these "old habits" and eventually we end up being good at talking the "physician" lingo (for lack of a better word).

This! This is exactly why I searched for this thread and wanted to talk to someone about it. The SOAP method seems so simple on paper, but it really is a paradigm shift and alternate way of organizing it in my head to get it out to present to my preceptor. Today was better but the past three days were a mess. He'd keep interrupting me because I'd lose focus or be talking about assessment too soon.

Let me keep reading to see if there are more tips I can gain and then I'll post more questions.