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    Hello I'm new around here so hope you don't mind me barging in to ask for some advice.

    I'm a student paeds nurse, in my final year and due to qualify at the end of this month. I've been at uni for almost four and a half years as I had a lot of time off sick with a heart problem, and am really struggling with placement at the moment. I'm not a very self-confident person at the best of times; I'm quiet and shy, and I really feel that all the time off has just knocked my confidence even more.

    I'm on my final managment placement now, and have had all my clinical skills signed off, but am having a really hard time with the management side of it. I just don't feel able to manage a ward, and it's beginning to make me wonder whether I am capable of being a nurse. I really enjoy being with the patients and their families, but I hate being in charge of people and telling them what to do, and just feel like all the nurses on my ward think I am absolutely useless. I still have five managment skills to get signed off, and I know I need to just bite the bullet and get on with it, but every time I go in there all prepared to manage the ward, I just end up getting self-conscious and embarrassed and making a complete mess of it. I'm running out of time to get it done now and am getting worried that at this rate I won't qualify at all.

    I think another part of it is that it has been hard to mantain my enthusiasm with so many interruptions because of my health, especially as all my friends qualified over a year ago; I think I just feel a bit left behind, and I've been here so long now I can't really imagine ever qualifying!

    God I've rambled on for ages. Thankyou if you've managed to make it to the end of this. Not even sure what kind of advice I'm after really; maybe just some reassurance that other people have felt like this?

    Thankyou in advance for any replies
    Ashford xxx

    Im only a second year, so my management skills are still developing, however i'm going to pass on some advice a very good nurse gave me!

    1. You don't 'tell' people to do, you suggest it and let them think it was there idea! Ie if i wanted a patient to do excercises following a TKR, i wouldn't tell them to do it. I'd remind them, and suggest ways to make it easier, or drop it into 'well if you did some excercises you may find your less stiff in the morning'.

    2. Make a plan for your day. At the end of handover, and for each patient (say you have 12, 6 in each bay) you seperate the back of your sheet, or a plain piece of paper into 3, one columns for A bay, another for B bay and a third for 'URGENT'. I then put the patients bed numbers down the side and seperate the 3 boxes into 2, one for Am jobs and one for Pm jobs. I'd tend to leave the PM jobs empty, unless a patient has a test booked, or something like that at a certain time. I'd then write down, in the am column all the jobs that need to be done between 7.30am-12pm, in adult nursing these are things like bloods, washes, morning and lunch drugs, maybe a wound change if its a quick one or anything that has been handed over. I'd then liase with the HCA's i'm working with, and delegate tasks- such as do you want to take this bay, or can you spend more time with x patient, they need extra help. Then at around 10am, when ward round starts and most of the patients should be washed and before obs start, we'd have a mini meeting and catch up, maybe they'd pass info to myself or my mentor about what has been done, anything they may noticed (aka patient a may be worried about her husband) obviously i'd expect things like SOB or chest pain to be reported ASAP to nurse in charge!

    However does that make sense, you plan your jobs, have a mini meeting with those that work with you, even a quick minute natter at the station, and then catch up halfway, update, tick of jobs that have been done and you can also start planning your afternoon. I must point out this VERY rarely goes to plan and something always goes wrong, but it has helped me focus on my day and manage time wisely

    3. Always ask questions- ask and you won't recieve. Find a response, and go and make sure you understand by doing reading etc!

    4. Realise it's ok to feel underconfident! It is OK!! We all feel it now and again, however you have to accept how you feel now and deal with it. It's not going to be long till you're qualified. Speak to your mentor, express concerns and develop an action plan together for the rest of your placement

    and finally

    5. If it all goes balls up, go in the linen cupboard, have 3 bangs of your head against a wall, have a silent scream and walk out with a smile on your face!
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