The 'what ifs'

Nurses General Nursing

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I know this is a pre-nursing rant, but I'm posting it here as I was hoping to get more experienced replies. If this is wrong, I won't be upset if it gets moved. I apologize that it is a bit long.

I'm not a Nurse, nor am I in a Nursing Program just yet. I'm at the tail end of my pre-reqs before I can petition to go on the wait-list for the program.

I'm not one of those who feel that Nursing is a 'calling', but it is one of many things I was interested in when deciding a new career direction. I will admit that I was drinking the marketing kool-aid when I first started this journey. Through allnurses (and other follow-up research) I seem to have thankfully gotten a dose of reality in regards to what the career is really like, and what's in store for me. That said, I'm still interested and excited about becoming a nurse. :)

Most of the time I am pretty confident about myself into the career. I'm generally hard-working, reasonably intelligent and at times personable. However, I do have some concerns. I doubt I'm alone in this, but sometimes I have some serious self-doubt about whether or not I'm doing the right thing. I'm doing well in school and my grades are great, and all that, but...

1) I'm afraid I've been forgetting everything. I grasp the concepts of everything just fine, but even in the several months since I've finished A&P 1 and 2, I know I've lost some knowledge. I doubt anyone is going to ever pull me into a broom closet and force me to recite the steps of cellular respiration, nor will I have to fear getting swirlies if I can't describe the entire blood clotting process forwards and backwards. (I hope).

Some of this knowledge has got to be more than just 'background knowledge'. When I read over it all again it comes back, sure. But it never feels like it's a full-time resident of my knowledge, like many other non-essential, non-day to day things are. I don't know how much of this I will need to have with me at any given time.

2) I'm afraid I'll be incompetent. That a patient will crash right in front of me, and I won't know what to do. Or worse, I'll do the wrong thing- take it from a "a critical situation" to "welp, they're dead now". Or I'll make some other grave mistake, or just 'blow it' in the worst way possible. Locally we repeatedly hear about the Nurse that mixed up orders of magnitude when calculating an IV drip and killed the patient. Orders of magnitude is actually something I catch myself making mistakes on sometimes in electronics. Therefore I always double and triple check them and have always caught it. But what if?

I'll admit that I can be a little absent-minded at times. Usually I'm good at focusing and being precise when it matters, and allowing my mind to wander a little when doing non-critical monotonous tasks. My current job requires 100% accuracy 100% of the time. So far so good in almost seven years. It sounds like Nursing allows *NO* time to let the mind wander. So what if? What if?

3) My self-esteem isn't stellar. I'm aware of it, I'm working on it and making progress. However, I've heard so many rantings here on allnurses where the patients yell at you all day, the patient's families yell at you all day, the doctors yell at you, fellow nurses yell at you and the management and administration yell at you. I know this is a site of ranting and the negativity is concentrated, but sometimes it sounds like everyone has it out for you.

This is either going to make me or break me. I try to maintain that it only matters if it matters. That is, if the patient is yelling at me, but I know I've done nothing wrong, and all my co-workers also know I've done nothing wrong, it won't affect me at all. Otherwise, hopefully I can develop some quick and effective coping skills, as well as the ability to confidently back my actions and myself up if necessary. I don't at all intend to screw off all day or half-orifice anything. However, mistakes and conflict over mistakes do happen. See #2.

4) What if I hate it? What if I can't find a job, 12 to 18 months goes by and I'm no longer hireable? Well, I guess that's the danger with anything. Don't know till you try.

If I were to be honest with myself, I guess that reassurance is what I'm looking for by posting this. However, the thing that allnurses really, really excels at is giving you honesty. Maybe another honest dose of reality is what I really need.

So tell me. Have you all been here before? Have you seen this before in other students or new grads? Are these fears normal? Founded or unfounded?

Thanks for any and all replies. The good, the bad and the ugly. Lay it on me. :cautious:

mofomeat,

Based on my experience these are my thoughts:

It is normal to feel anxious before starting nursing school. I did, and I think so did most people in my class.

As far as forgetting A&P, I wouldn't worry. You will be studying the pathophysiology of different diseases/medical problems. Also, before clinical we researched our patients and had to complete clinical prep sheets where we explained the pathophysiology of our patients' conditions. There were several semesters between my taking anatomy and starting nursing school and at least two or more between physiology and starting nursing school. It wasn't a problem. You will be able to review anything you need to once nursing school starts.

I wouldn't worry too much at this point about being incompetent when giving patient care. Nursing school is a very structured program. Before you go to the hospital you will have researched your patients and practiced skills that you will be performing in clinical in the lab. You will have your instructor supervising you in clinical, especially in the beginning. And there will be your patient's nurse and all the rest of the nursing staff too to ask questions of when you need help. You will be taught how to respond to concerning changes in your patient's condition. You will have the 5 rights of giving medications drilled in to you. You won't be left on your own. If you pay attention to what you are taught, study conscientiously, and before clinical research your patients, their medications, and the clinical skills you will be performing thoroughly, you should be prepared. I found that nursing school forced me to be very focused. Practicing safely is critical, and nursing school teaches you how to do that by making you very focused. But you are right that there is no room to be inattentive when you are caring for patients.

My experience with the nursing staff, patients, families and doctors as a student was primarily positive. The vast majority of patients and their families were a pleasure to take care of. Most of the nursing staff were considerate of students. The negative interactions you describe that you have read about here will for the most part not happen to you as a student. There will be some negativity, but as a student you will not experience many of the situations you would experience as a working nurse. Be conscientious, ethical, respectful, well-prepared, hard working and helpful. Keep a good attitude. Be willing to listen. Be receptive to criticism.

What if you hate it? You probably will at times. I did. As far as finding a job, there are no guarantees. But if you do well in nursing school and in clinicals you may make contacts with other nurses/managers that could help you with finding a job when you graduate. Some people in my program worked as paramedics/techs/aides throughout the program and found their first nursing job with their current employer.

I hope this is helpful. I went through an ADN program, and then bridged in to a BSN. Good luck.

Thanks Susie2310. Your response makes me feel a bit better.

Ever other occupation I've ever worked has been something where I'm basically thrown into the fire and it's up to me to figure out how to survive. I don't know how much of this happens to new grads in this field, but I've never previously been in an occupation where other people can die. At least not directly.

Destroy hundreds of thousands of dollars worth of equipment? Sure. Incur multi-billion dollar lawsuits? Sure. Death as a direct result? No.

Specializes in Med Surg.

You will forget things. There's only so much memory in our processors. :) Wherever you end up working, you'll most likely see similar patients/disease processes. Eventually you'll realize that you know so much more than you think you do. I also found that much of what I learned in pre reqs and nursing school made so much more sense once I became a working nurse. The pieces just fell into place when I could actually see what until then had been a theoretical concept.

Until you've been a nurse for a while, you'll only be semi-competent. This isn't to be mean, but it's just a fact. It's like learning anything new--it takes time and practice. Until you become more competent and confident, you'll rely on your more experienced coworkers. The first time I had a patient crash on me, after putting O2 on my patient, I hollered out for help and had 3 much more experienced nurses in the room in seconds. They didn't take over, but supported me and guided me in what to do. It's essential to have good teamwork on any unit, but even more so when you're new.

I actually don't see a lot of abuse by patients, families, doctors, and coworkers. Maybe I live in an incredibly nice part of the country, but I really think you get back what you give. If you act professionally and politely, you'll get that in return. I've only had a couple of patients who were nasty and they had addiction/mental health issues. It wasn't anything personal, it was their disease. Yes, that was tough, but you just can't take that kind of thing personally and you'll learn not to. Our doctors are great to work with; the more you work with them, you learn how they like to communicate and they learn they can trust and work with you. That just comes with time

Finally, what if you go through this and hate nursing? Change jobs or careers. Nursing was a second career for me, so I've been through the whole career change process. It's scary, but doable. If it's possible, you might look into becoming a CNA, so you get a good view of patient care.

Thanks Susie2310. Your response makes me feel a bit better.

Ever other occupation I've ever worked has been something where I'm basically thrown into the fire and it's up to me to figure out how to survive. I don't know how much of this happens to new grads in this field, but I've never previously been in an occupation where other people can die. At least not directly.

Destroy hundreds of thousands of dollars worth of equipment? Sure. Incur multi-billion dollar lawsuits? Sure. Death as a direct result? No.

Mofomeat, You said that you are at the tail end of your pre-reqs. I am guessing that you will have a wait of possibly a few semesters before nursing school starts, once you apply. Perhaps it would be an idea to volunteer at a hospital on a med-surg unit to get an idea of how you really feel about nursing. I am thinking from reading your post that you sound very unsure about your decision to go in to nursing, although only you know how you feel. There are areas of nursing such as doctors' offices where the patient population is more stable, and the stress (and the pay) is less because the responsibility is less. Before you commit to the strenuous training nursing school involves, perhaps it would be an idea to try to find out if you truly want to commit to that training, before you spend a lot of money and time. Nursing school is stressful, very time consuming, often expensive, and can make a lot of demands on one's family, and there are no guarantees of jobs at the end of all that.

Nurses do have responsibility for peoples lives. You will be trained in nursing school to provide safe care. You will be taught safeguards. But yes, errors happen.

New grads today as I understand it face varying levels of support and orientation as beginning nurses. Other threads on this forum discuss new grad orientation/training and what to look for for the best experience.

I was wondering if perhaps talking to a career counselor might be beneficial. Perhaps he/she could help resolve some of your concerns.

I do wish you all the best with whatever choices you make.

Perhaps it would be an idea to volunteer at a hospital on a med-surg unit to get an idea of how you really feel about nursing.

After next semester, I can test for a CNA license. I was planning on working or volunteering as a CNA (as a second job) during the time I'm on the waitlist (it averages 2 years at my school).

1) Honestly, my lowest grade in college was anatomy. I think I barely scraped by with a B-. I was very nervous that I wouldn't be able to pass any of my nursing classes, which I actually wound up excelling in. Anatomy and nursing classes are very different. Anatomy is mostly memorizing. While there is some memorizing in nursing classes, it's about critically thinking (you will grow to hate this phrase) and problem solving. Don't worry about not remembering all the intricate details, trust me! If you're learning about congestive heart failure and are having a tough time remembering what pumps what where, go back into your anatomy books and take the 10 minutes to relearn the basics. You'll be fine.

2) You will have this fear for a long time. Listen, if something starts to go wrong, grab your friends. Even if you notice something or have a question, a nurse gave me a really great bit of advice: never be the only one that knows a piece of information. I am always talking it out with doctors and other nurses..."hey my patients breathing looks different from before, what do you think?" Tell a coworker, tell your charge nurse. Everyone should be there to help the patients. You are not going to be totally alone.

3) Neither is mine. Do I get yelled at occasionally? Yup! When I was a student nurse a patient actually made me cry! You have to learn to let it roll off you like water on duck feathers. It's never fun, but it gets easier to deal with. This is another place where your friends will come in handy, "That patient just told me to get off my lazy *** and get him his ice cream. Seriously!" (in a vent-safe zone of course :saint:)

4) I doubt it will take 12-18 months for you to get a job if you are actively applying. You can't be picky at first. If you hate your first job, get the experience on your resume and then move on. Surely you've heard about all the different options that us nurses have :)

Good luck!

I have been a nurse for five years now and here's what I know so far:

1) Its okay to cry. I cried one night inside the med room infront of my colleagues. I was charge nurse and had a full load of busy patients!

2) If a patient yells at you, do not take it personally. Its easier said than done, but their problems make my problems seem minute. Put yourself in their shoes.

3) Always be kinder than necessary. If you make a mistake, a patient is more likely to forgive you if you were kind to them.

4) Leave your personal problems at home. No one wants to work with someone who comes in to work already in a bad mood.

5) Offer help if you're not swamped. Teamwork makes the dream work!

6) Always look up things if you're unsure of them whether it be a medication, procedure, diagnosis, etc. More knowledge, more power!

7) Professionalism even when a doctor is yelling at you. Work with each other, not against each other.

8) Find ways to de-stress. Its a very stressful profession but very rewarding once you find your niche.

Good luck!

Based on your writing style, and your critical, organized assessment outlining your concerns, you'll have no trouble. Trust me on that.

But is this (nursing) what you really want to do? Listen to that little inner voice.

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