Help me not fail
October 6, 2011 4:21 AM   Subscribe

I'm in nursing school and feel like I'm drowning. Help?

I, like many mefites, have gone back to school to pursue a second degree in nursing. I am 25 years old, have a bachelor's in an unrelated subject, and all of my work experience has been in restaurants and hospital kitchens. I wanted to go into nursing because I really enjoyed working in the hospital environment, I studied gerentology and interned for a local agency on aging (and loved it), and I like working closely with people.

This is an associate's program. After the first year I get my LPN. Then, I need to reapply for the second year (which has about 2/3 the number of spots than the first year) for my RN. I will be up against more than just the people in my class, including older graduates who didn't get in the first (couple) times around.

The program was competitive to get into in the first place because it's cheap and has a high NCLEX pass rate and job placement rate. Everyone in my class is so dedicated. I've been in school for five weeks and I'm working my tail off. I have gotten a 97 to 100 on every test and the teachers have told me that if I keep it up I should have no problem getting into the second year.

However, I feel at a disadvantage because almost everyone in my class worked as a CNA (nursing assistant) before coming to the program. We had our first clinical day this week in a local nursing home. We were each assigned one resident. It was SO, SO hard. I've never really been hands-on in a work environment so far and there are so many things to keep track of. I felt so out of my element and incompetent. All of the studying I had done went out the window. My teacher had to remind me of the most basic things - hand hygiene, wheelchair locks, patient privacy - things that are probably second nature to CNAs but I have never really given much thought to. I was so embarrassed and tense the entire time. I also couldn't bother the LNA or RN because the LNA yelled at me when I got there (not relevant, I think I was just unlucky in that respect. I will get a nicer one next week) so I was basically alone all day with a completely dependent alzheimers patient. I came home, burst into tears, and then slept and woke up incredibly sore.

Now I feel like I am burning out. There is just so much to learn and I feel like I iwll never get there. My relationships are suffering because I monday through friday I have class from 7-2, take a break till 4, study 4-7, then I go for a long run, eat dinner, study some more, and go to bed. Every. single. day. On the weekends I need to work and I spend my non-work hours studying.

But this week I feel like I'm cracking. I have a test today and I barely studied for it! I just feel so tired and overwhelmed. I blew off studying yesterday to get a massage and I was so tense, so afterwards I came home, went for a walk and then fell asleep.

I really, really, really want to succeed. I was one of those people in college who put everything off until the last minute, then managed a B. I'm proud of myself for staying on top of my work so far but I'm not sure how long I can make this last. Help?
posted by pintapicasso to Education (17 answers total) 6 users marked this as a favorite
Best answer: I am a nurse and I can assure you that it is very difficult to one on one a patient with dementia. I think you are being much too hard on yourself. Yes, the students with experience as CNAs know how to make mitered corners, operate wheelchairs and pull the privacy curtain. Well, maybe not the privacy curtain, that can be a big failing, being too comfortable with other people's bodies we forget the niceties of privacy. ( this is a joke) And handwashing? We have signs up all over my hospital reminding us to wash our hands! So lighten up on yourself. The bed and body work is easily learned.

What isn't is the commitment to education, self improvement and the ability to take care of yourself so you can take care of others. The massage, the walk, and the sleep. BRILLIANT.

Forgive me if I am trying to read between the lines, but perhaps you are overwhelmed with worry that you didn't enjoy every single moment of your first clinical. The first patient I ever took care of as a student had a dreadful end stage cancer. The patient was totally unresponsive. So any ideas that I had about bonding and having a meaningful nurse - patient relationship my "first time" went right out of the window.

While bathing my patient, my instructor and I turned her to her left side, and she died. Lots of extra experience that I didn't think was necessary for my first day. At the end of it all, my instructor said, "Well that went fine, but next time don't be a soap floater". ( leave the soap in the wash basin.) I went home and cried for it seemed like hours.

You are totally new to this. It is not always fun. It is not always interesting, and frequently doesn't smell very good.

It is still the best job I have ever had and even better I feel most days it is the calling I have always wanted it to be.
posted by moonlily at 5:10 AM on October 6, 2011 [7 favorites]

Best answer: First, it sounds like you are over thinking the experience thing. While other may have experience as a CNA emptying bedpans and taking BPs, you have life experience and a bachelor's degree in a different area. Cut yourself some slack! You've only had your first clinical!

Do you have post clinical meetings? We did, and it helped to discuss how our day went, how we were treated and what we learned.

It was hard for me to realize, at first, that what you are taught in the book is not always what you do in life. For example, my first clinical I had a patient with a vaginal fistuala. For whatever reason, (I don't remember why) I didn't have access to her chart the night before so this was news to me the day of clinicals, (maybe there was a last minute change in patients?). I kept trying to clean her, only for more stool to come out. My instructor came in the room to help me, and said "we're giving her a bath while she sits on the bedside commode"! I was confused--we "hadn't studied" a bedside commode bath! While I laugh thinking back about it, I didn't at the time.

Focus at the task at hand. Study. Know that care plans are a bitch but a necessary evil of all nursing programs and are actually helpful. Try not to focus on the things you cannot change. While I understand you are stressed about keeping in the program, the best thing you can do to ensure that you stay in is to keep your studies up.

Nursing is a very hard profession. I had an injury awhile back and will be transitioning out of direct patient care. FWIW--I am back working on my BA in business to help me be more marketable. Feel free to MeMail me if you have concerns I haven't addressed or further questions.

Best of luck on your journey!
posted by 6:1 at 5:10 AM on October 6, 2011 [1 favorite]

Consider taking out loans so you can rest on the weekends. You need at least one day of rest to keep up with such a demanding program.

You can do it!
posted by yarly at 5:11 AM on October 6, 2011 [3 favorites]

Best answer: You are going to be fine. I am a registered nurse. I did a 2-year associates degree program for my RN and then went on for my BSN.

So, a lot of people in your class are CNAs. You can't compare yourself to them. Please do not worry about this. Not everyone is a CNA in your class and what happened with the WC lock and the hand washing is completely normal. When you are confronted with your first patient it can be overwhelming. You are learning and your instructors are aware of this. Now you know to think about patient safety, privacy, hand washing, etc.

I can remember my first clinicals in the nursing home. It was stressful and I can laugh now. I remember I was pouring a liquid food supplement down a PEG tube. Every time I would finish a can I would throw the can in a trash can that was a few feet away. With each throw it made a rude, loud clanking noise. The instructor was standing right next to me. She was nice and didn't say anything. I was so green and so nervous that I was just making these baskets with Ensure cans. Not so bad but not so professional either. This is a very minor example of a "mistake". I have made real mistakes -- violated a sterile field, hung blood incorrectly (not the wrong type) and got blood everywhere (looked like a murder scene), and so many more.

Yes, school is demanding but you can do it. Your critical thinking skills will improve. You will learn to zero in on what is important. Right now you are bombarded with information and theory. It's easy to get hung up on complicated things and forget the basic things. Go easy on yourself and do not give up.

Good luck!
posted by Fairchild at 5:30 AM on October 6, 2011 [1 favorite]

You need to schedule some fun time in your schedule. And no, you're not going to fail your exams and ruin your career as a result.
posted by koahiatamadl at 5:32 AM on October 6, 2011

I have a full time career and am in law school 4 nights a week. So, while not a nursing student, I understand the stress and the constant go-go-go. One thing I have founnd is that following my "fun" rule is helpful. I get to do one "fun" (dinner w friends, a movie w friends, etc) a weekend. I have to do one fun thing, and I only get one. Even when I'd rather use that time for sleeping, once I've had that nonschool-nonwork contact, I'm a much happier person, better able to cope generally. Also, definitely continue the running that always keeps me saner. Finally, it's ok for other things to drop. Sometimes I buy more socks/underwear bc laundry is so not happening.
Oh! One more-find a friend who doesn't mind you constantly bitching, and vent!
posted by atomicstone at 6:13 AM on October 6, 2011 [1 favorite]

Best answer: Hey, another non-nurse here, but I've worked with lots of nursing (and other health professions) students and I've done the working-two-jobs-in-school-full-time thing.

First, nursing school is hard! That is why you're finding it hard. You are maybe struggling more with the face-to-face patient stuff while some of your classmates are probably having more trouble with the academic side. That's the way it works - there are lots of aspects of nursing and different people have more to learn about different subjects.

You seem to be spending a lot of time studying - are you sure it's not overkill? Are you studying efficiently? If you're getting 100s, maybe you could still get 100s with a little less studying. I've noticed that some health sciences students have a tendency to get competitive about how much they study - not saying this is you, just saying it happens. Maybe try taking one afternoon off a week from studying. Just tell yourself "It's Thursday, Thursday is my no-study day." Work, especially amorphous work like studying, expands to fill the time you allot for it.

Second, as far as taking care of yourself goes, try to get organized as much as possible in your personal life. For me, one thing I did when I was working and going to school was stocking up before the beginning of the semester on toilet paper, nonperishable food, shampoo, medications - anything I knew that I was likely to need in the upcoming 3-4 months, so that I didn't have to worry about it when I was busy doing other things. It was like I was going on an expedition. And I cut myself a lot of slack about laundry, cooking, etc.

I wish I had done something like atomicstone's "fun" rule - I let a lot of friendships lapse during that period and I regret it.
posted by mskyle at 6:54 AM on October 6, 2011 [1 favorite]

Best answer: First of all, take it a little easy on yourself about your first clinical experience. It was your FIRST experience, and all those details will come more easily as you accumulate more experience. The clinical environment can be overwhelming (even if you are strong on the book learnin'). When I was training to be an EMT, my initial clinical experiences left me almost frozen and I struggled to use all the knowledge and skills I accumulated in the classroom. But that gets better.

Now that you've taken a test without such intensive studying, see how your grade comes out. You may be overstudying - do you really need all the hours and hours of studying to get high A's? Maybe you can dial back a little and still be successful - just study from 4-7 and take the rest of the evening off. Or study three nights a week and take the other two off.

Self-care is very important for nurses. Sounds like you have good practices and instincts here. Keep it up!
posted by jeoc at 6:56 AM on October 6, 2011

Oh, another thing: is it possible to get yourself a low-key evening job instead of the weekend job? Having a full day off makes a huge difference in my mental well-being. I know this is not exactly the best time to be switching jobs, but it could help.
posted by mskyle at 6:57 AM on October 6, 2011

My ex had a job as a nigh security guard when he was in grad school and it was perfect--lots of study time, plus he got to take a walk every hour. The pay sucked but he was essentially being paid to study, so it didn't matter.

It sounds like your first clinical went exactly the way it was supposed to go, frankly. Nobody expects you to know these things the first day--the reason you're there is to learn them. And everybody's nervous and freaked out when they first start. Hang in there, OP--you're smart and you'll figure all this stuff out.
posted by WorkingMyWayHome at 8:39 AM on October 6, 2011

Best answer: Hey, I'm about a year ahead of you in an almost identical program. It gets better!

I had never done one-on-one work with patients before I started my first clinical rotation, which was also in the geriatric setting. I was so freaked out! I remember my instructor easing us in by having us sit at the breakfast table and assist patients who were blind and with dementia in eating breakfast, and I felt like I had no idea what I was doing. Helping them get out of bed the next morning was nervewracking. I'm really thankful for my classmates who HAD worked as CNAs, and the important skills and shortcuts they were able to share with me, and the same goes for my instructor. I learned a hell of a lot in those first 10 weeks of patient care, and it's really helped me as I've gone on to do care in more independent settings.

As far as school/life/work balance goes, I'm kind of in a similar boat. I'm still working 40 hours a week, and I do my classes and clinics during the evening/weekend. I've been a champ for the last year, but the toll it's taken on me, socially and emotionally, is starting to catch up with me now. I'm having to reconsider being able to have so many balls in the air at once, and I will definitely be cutting back to 20 hours per week next semester (when I'll be doing my preceptorship/internship). Take care of yourself. You can only do what you can do.

Feel free to PM me with any questions or for moral support.
posted by scarykarrey at 10:46 AM on October 6, 2011

Best answer: "I felt so out of my element and incompetent."

This is how EVERYONE feels on their first day of clinicals. The scary thing about nursing school is you can be a brainiac and do well on your exams and theory classes, but the hands-on stuff is where the rubber meets the road in nursing care and it just takes a lot of practice to get used to. I'm not exaggerating when I say that I was wide awake almost every night before my clinicals for at least half of each new semester before I finally got into a rhythm where I felt like I wasn't so overly stressed by the thought of going in in the morning to the hospital. Just about when I got used to that particular rotation on that particular unit, the semester would be over and I'd be on to a new, stressful rotation. :P I never got to love clinicals, honestly, though I graduated top of my class and was well-liked by all my teachers and clinical leaders, and I felt a lot of doubt about my ability to be an RN until I finally got a job where I was finally learning the real ins and outs of being a nurse in real life. It was very hard, because there were a lot of my peers who loved clinicals, loved the experience... I was shaking and mortified when I gave my first bedbath and it took me forever to get done, while others jumped in like they'd been washing up naked old demented patients their whole lives. Some people are just naturally more adventurous than others, that's all.

What I'm trying to say is, don't discourage yourself by basing stuff on your one clinical day, especially if you're doing well in classes. Focus your energy on time management, the basics of your nursing care like having compassion for your patients and giving them dignity, and when you're in class, pay attention because you're going to use all that theory and microbiology and A+P when you've moved beyond doing basics like bedbaths and stuff. The hands-on care of a patient isn't something you can learn from a class.. it's sometimes embarrassing and uncomfortable and it just takes practice.

Most importantly, in regards to the overwhelming stress factor of the workload (and believe me, I've been there) - school doesn't last forever. These first few classes and clinicals are meant to weed out the people who (unlike you) don't put in the study time and who aren't serious about the nature of the profession they're working towards. As WorkingMyWayHome said, that's exactly how first days of clinicals go. Someday you'll be signing your name with an "RN" at the end and taking care of some tanking patient and you'll marvel at how far you've gotten and how all those little things that seemed so hard in the beginning have become second nature to you. :)
posted by takoukla at 10:56 AM on October 6, 2011 [1 favorite]

Hey, just wanted to put in my two cents! I'm in my second semester of Nursing school and absolutely understand where you are coming from. I took a CNA class before getting into my RN nursing program, but haven't yet been able to get a job as one, so I have only school clinicals as experience. The first day of clinicals for this program was nerve wracking for me! I felt so unsure of myself that I wasn't even sure I was giving someone a bed bath properly. I still feel unsure of myself, and likely will for some time, but that's something that I've started to come to terms with. It's ok to ask questions and to go over how to do something before actually performing it on a patient.

With all that said, your nursing skills and ability to maintain a safe environment for the patient are a top priority - even more so than getting high grades on your tests. You should ask your teacher if they have any open lab times so you can practice various procedures. If not, practice on someone at home! Go through everything from walking in the door, introducing yourself, verifying the patient's identity, washing your hands, explaining the procedure, etc... The more you do those basic things that you feel unsure of or keep forgetting, the better you will get at them!

Something else I've learned in my nursing classes is that more studying of the text book does not necessarily equal better grades. Much of nursing is about taking what you have learned and applying it to new situations. Basic concepts are the foundation - as long as you know them, you can figure out the answer by process of elimination.

Good luck, and remember that the best answer to any question is one that puts the patient's safety as a top priority.
posted by pontouf at 3:23 PM on October 6, 2011

Best answer: Oh pintapicasso, don't worry! I remember 2 years ago nearly to the day when I walked into my first clinical and felt like I would never make it. I was like you, in a 2nd-career nursing program where about half my classmates had worked as CNAs, and I felt so out of my element in the hands-on stuff. A lot of people are saying "that's how your first clinical is supposed to feel," but honestly, that's how MOST of your clinicals are supposed to feel. If you get comfortable with everything, then you're not still learning new things! Luckily there will be no shortage of things to learn, even once you graduate and pass your NCLEX and get a job. I've been working as an RN since February and I still have days when I feel like I don't know anything. But then if I really sit back and think about all the things I know now, compared to when I started this job, or goodness, compared to my time in clinicals, it's amazing.

You sound like you're used to doing well at things, so it's probably hard to feel like you're not immediately good at this stuff. At least that's how I felt, especially since I was doing so well in the classroom part of my nursing classes. Part of it is that studying for skills isn't the same as studying facts -- no matter how well you memorize the steps of putting in a foley or whatever, you're not going to be good at it until you've actually done it in real life a bunch of times. But the thing is, nobody expects you to be good at this stuff yet! You're there to learn, not to already be perfect, so don't beat yourself up when you feel unsure or make mistakes. The number 1 thing I learned in nursing school is to give up feeling embarrassed when I don't know something, and ask somebody so I can learn it right. Faking your way through won't do you any favors even if you can get away with it, and it certainly isn't good for your patients either.

As for the burn-out feeling: (a) it's normal! and (b) you have to find ways to take care of yourself. Keep up with the exercise, and the sleep. Let your studies slide a bit to get some social time -- friendships are important! As you get to know your classmates, group study sessions can be a good way to split the difference of social time while learning. And don't forget, this isn't forever. You will make it through this program, and things will get easier -- on graduation day, you will be amazed at how fast it all flew by!

Good luck, and feel free to MeMail me if you want to talk or vent or ask questions!
posted by vytae at 4:16 PM on October 6, 2011

Another RN here, echoing what my sisters/brothers have already said - it gets better. I'm 15 hours short of a BA in finance - I thought I'd spend my career in banking, so nursing was my second career too. :-)

Less than 2/3 of those in class with you now will finish. The experienced aides who are willing and eager to teach you and help you are the aides and CNAs/LPNs who will end up with the RN license. The rest are there from jealousy. They think the RN's job is somehow 'easier', that once they can sign 'RN' after their name that they will never again have to empty bedpans or give baths or clean up someone who crapped all over themselves five minutes after they changed the linen. They will be sorely disappointed.

Listen, I started nursing school when I was 24, when my first child was an entire eight weeks old. (No, that's not a typo - eight. weeks. old.) I had my daughter during my psychiatric rotation, took three weeks maternity leave, and finished nine months later, on time, with my class.

My husband was a marketing rep for a large, multinational oil company, which meant that he had mandatory overnight travel, out of town, three nights a week. And they were always the nights before clinical. I got up at 0400, ate breakfast and got ready for school myself, and got my two children in diapers up and to preschool/daycare by 0600. I spent 0630-1530 on the floor, then went home to change clothes (never wear your clinical clothing anywhere but straight to the clinical setting and then straight home!). I picked up the aforementioned children, played with/fed/bathed/put to bed said children until 2000 or 2030, studied or prepped care plans (don't get me started on the damn care plans) until 2300, then did it all over again the next day.

If I can do that at your age, you can do it too. Really. You can. It will help, though, if you back away from wanting to get the A+ and settle for the A or even the B. I'm like you in that respect too - I'm a National Merit Scholar, so I know what it's like to get and expect those grades. It's a matter of priorities; for me, extra time with my family was more important than the difference between scoring 85% or 92% on an exam.

I've been where you are. While I didn't love every single second of nursing school - anyone who says they did is a liar - it was worth it, and I can't imagine my life any other way. :-)
posted by lambchop1 at 4:32 PM on October 6, 2011 [1 favorite]

The experienced aides who are willing and eager to teach you and help you are the aides and CNAs/LPNs who will end up with the RN license. The rest are there from jealousy. They think the RN's job is somehow 'easier', that once they can sign 'RN' after their name that they will never again have to empty bedpans or give baths or clean up someone who crapped all over themselves five minutes after they changed the linen. They will be sorely disappointed.

I couldn't agree more!
posted by 6:1 at 11:28 PM on October 6, 2011

Response by poster: I marked a lot of best answers. It was SO COMFORTING to read those. Thank you very, very much.
posted by pintapicasso at 2:14 PM on October 7, 2011

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