6 C’ing my way through Nursing – Competence

I say competence but really I mean incompetence. That’s how I feel today. I feel pretty pants.

Yesterday was entirely different. Yesterday I attended a COPD simulation session at my Trust and actually did pretty well – I managed to remember hellomyname is….I did my ABCDE assessments and incorporated all of my 6Cs into my care. I even managed to squeeze a brief intervention in there and encourage smoking cessation to my ‘patient’. I was pretty chuffed. Yesterday I went home from placement thinking that I could really do this nursing thing. After all my doubts and tribulations, I believed in myself. Yesterday I felt pretty competent.

Today however I feel the opposite.

Today, I took our a cannula for a patient who I knew was going home. Said patient proceeded to leave the ward without their discharge documentation and take out medication. She wasn’t my patient, I was just trying to do the nurses looking after her a favour and take it out so they had less to do. I don’t know if the patient took the removal of the cannula as a sign that she could go home. I don’t know if its my fault. I don’t know if that makes me incompetent but it feels that way.

Today, I took a shivering patient’s temperature (36.8), just like I always do, by holding one of those fancy infrared thermometers against their forehead and said patient proceeded to then spike a temperature (37.9) half hour later. The patient’s partner told the nurse in charge I had held the thermometer about 2 feet away from the patient. I’m sure that these thermometers do not work at a distance, and I’m even more sure that it wouldn’t have recorded a normal body temperature at all held so far away. But still, I don’t know if it was my fault. I don’t know if I did something wrong. I don’t know if that makes me incompetent but it feels that way.

Today, I also had my mid-placement review. All my competencies signed off except one. I should be happy I suppose. That leaves me the next 3.5 weeks to focus on one competency. Care of an acutely ill patient. The only problem is that it is not getting signed off not on the basis I haven’t been involved, but on the basis that the placement area itself doesn’t really care for acutely ill patients (elective day case) and therefore I’m unlike to experience it in the next 3 weeks. There was no attempt to get me to explain how I could care for such a patient. There was no attempt to run through my COPD simulation yesterday which covered exactly that. I had no chance to explain all my previous acute placement, for example A&E, which have given me more experience in acutely ill patients that almost any other areas of care. I know that I have the knowledge I need for the level that I’m at. I just feel like I won’t be given the chance to prove it. don’t know what it all means, but it doesn’t feel great. It makes me feel incompetent.

I wonder if competence and confidence are always so closely linked that it is near impossible to seperate them. I wonder if today I have lost my confidence and that’s why I feel so incompetent. Or I wonder if I really am not as competent as I think and my ego has taken a bit of a hit. I really don’t know.

But is confidence always a good thing? I don’t know if I would rather have days like today when I sit back and really reflect in my own competence and doubt or always be confident and self-assured.

I have met nurses and students who are super confident, who do not accept any form of critique and who appear slapdash, but they come across as always knowing what they are doing. Is that better or worse than having occasional self doubt? I think the answer, as with anything, is that everything should be in moderation. The good comes with the bad and vice versa. I just wish the lows didn’t have such a demoralising impact on me. It’s a vicious circle isn’t it? I’m not sure where I am in this bo – but today I really feel like I’m in the ‘Need Help’ Category.

I hope next week will be better, I hope that I will be able to feel confident and competent again.