Struggling during second semester, need some advice

HouTx, BSN, MSN, EdD · Feb 25, 2015

You already know you're a perfectionist. You're going to become very anxious if you are not 100% prepared and able to demonstrate your skills flawlessly. You know that you're not one of those lucky devils that can ad lib or recover smoothly from a mis-step. There is only one way to get where you need to be. PRACTICE PRACTICE PRACTICE -- repeat as often as necessary.

You need to take up residence in the sim lab - practice each 'checkoff' skill until you can do it blindfolded with one hand (just joking). For things like SBAR, It's is also possible to co-opt some 'volunteers' such as family and friends... they can monitor the checklist and let you know if you miss a step. You could even record yourself & run it back to check yourself off. Your ability & confidence will grow with each practice session.

If it's any comfort, nurses with your level of perfectionism are very well suited for interventional areas such as OR, GI lab, Cath lab, etc. They don't cut corners. Every patient gets exactly the same prep and level of attention. This makes for excellent clinical outcomes.

nurseprnRN, BSN, RN · Feb 25, 2015

Also, and I know this sounds kinda New-Agey, you have to start talking to yourself better. Or stop listening to yourself, whichever is easier for you. Or both.

1) When you go into lab to get that practice time, tell yourself, "I have nothing to worry about here. It's SimMan, he doesn't care. I will be fine." Then proceed, focusing on what you're doing, not worrying about what you're feeling, and do what you came there to do.

OR

2) When you go into lab to get that practice time and you notice your brain starting to remind you about how you always screw up by...blahblahblah ..., stop short and tell it to shut the heck up. Then proceed with what you came there to do.

This will take you a little time to learn. The key is to do it IMMEDIATELY, as soon as you notice it happening. After a few tries, you'll notice it sooner and sooner, and shut it up faster and faster, which will get it out of your way.

One or the other, or both, will help you. Let us know what happens.

empatheticRN · Feb 25, 2015

I never really do this, but here goes, sorry in advance if I sound rambly...
I'm a nursing student in my second semester. I made the Dean's list my first semester, got As and Bs on all my material, etc etc. Nothing to worry about. This time around... well, I still feel comfortable in lectures and did well in my psych clinical, but here's the thing: I keep failing the check-offs. Check-offs that are worth a huge portion of my grade. I got a 0/10 on my foley (yeah, I know), which I later remediated with a perfect score. The second one I just did today, it was the hand-off/ISBAR one, and I just... froze during it like I have never frozen before. We were supposed to do two procedures before hand-off and I couldn't even get through one. It was awful.
I went home and just fell apart. I feel humiliated. Like I have no place being around patients at all. It brings on this weird existential dread; if I freak out during these check-offs, will I be reliable when someone codes? What good am I really? I was diagnosed with OCD as a kid, so I'm already more prone to anxiety than the average person, and... I just don't know how to control this. When I get too anxious, it's like I can't control my own brain, and I end up looking completely moronic and incompetent.
I know this post is a little all over the place, and again I'm sorry for that. I guess I could just use some advice, maybe some similar stories, obstacles like this you've overcome, etc. Just something I can use to pull myself back together and ease my fears before I remediate /this/ one as well.

I understand completely. I used to be a nervous wreck in skills too. I'd get really anxious. Practice in the skills lab is really helpful. Practice at home , watch skills video and memorize step by step instructions on the particular skills.

empatheticRN · Feb 25, 2015

I understand completely. I used to be a nervous wreck in skills too. I'd get really anxious. Practice in the skills lab is really helpful. Practice at home , watch skills video and memorize step by step instructions on the particular skills. Also I had a similar experience with a foley catheter insertion at clinicals. My instructor told me I'd failed clinicals. When I asked I her what I did wrong, she said, "I almost contaminated my skill" Almost? She sent me for dinner and I refused. I confronted her about contaminating and almost contaminating. I was determined to let her have it that day. I know I'm an anxious person and certainly know when I've done a lousy job but that was so unfair. In nursing when you can yap your way through anything, everyone will love you. So try your hardest to pretend that you are not anxious. Also if you are not yet a nursing assistant, try getting a job as one so that you will be more at ease with the patients and nurses that are kind enough can show you some skills. All the best.

Shakrashi · Mar 3, 2015

I retook it a few days ago and passed. :)

I really appreciate the comments here, especially what HouTx wrote about perfectionism in the workplace... Makes me feel like I might not be as out of place as I feel haha. Thank you all so much, I'll definitely be taking your advice with me from now on.