To be f*cking terrified 😢

[Aortagggghhhh]

Posting as I’m sitting here terrified and would really appreciate if anyone has been in a similar situation. I’m a student and we have practicals, skill based-labs with real people and placements.

We have recently started seeing real people and I’m not doing well at all. I have been getting close to 100% in my exams and if anyone asked me any clinical based questions I would be able to answer them correctly, but when it comes to actually being with a patient I just fall to pieces and can’t do it. I’m absolutely rubbish at it and it’s so humiliating and I feel completely utterly useless.

I start off ok but then the panic starts and I feel my chest go in knots and I get a lump in my throat and cant talk. My mind goes blank and I feel myself sweating and panicking, then the tears start. Im so useless at my own degree and I just can’t do it. I can make small talk usually and my parents have always said I can talk the hind legs off a donkey but I just can’t do it when it’s in this setting😢

I’m being supervised at all times by my mentor/supervisor who would step in if I made any clinical mistakes so I’m not worried about getting it wrong, and I’m not expected to diagnose or treat or do anything at this stage, it’s just purely to get us familiar with seeing and interacting with patients. But I can’t even do that right. We carry out some basic tests but everything is checked by our mentor.

Im terrified of doing this class again. How do I toughen up and get better at this?😢💔

Also, if you fuck it up, you fuck it up (which I'm sure you won't). You will be able to resit. We all learn from our mistakes, and that isn't necessarily a bad thing. I failed my driving test twice and I'm so glad I did. I failed multiple exams at uni, and I'm so glad I did. It gave me the opportunity to reflect, learn and get there.

Beta blockers worked wonders for me

Big hugs 🤗
Some great comments here!
I wish you all the best.
(Ps like someone else here I really struggled with some work stuff from a confidence perspective - I had a session with a coach who did a personality test Myers Briggs with me. It didn’t solve the issue but even now 5/6 years on, I’ll revisit my personality type and it just gives me some reassurance that I’m not rubbish, we are all individuals with different strengths and weaknesses!)
Ps I’d rather have care provided by someone who is focused and knows their stuff but perhaps struggles with confidence/interactions than someone who doesn’t know their stuff but is personable!

Try beta blockers, they could help. But I think mainly you should be honest with your tutors.
I would say that I'm very competent at work, except for when being observed/being signed off for competencies. Things I can do with my eyes closed are suddenly full of mistakes.
Even with driving tests, walking is an issue.
Don't feel bad, it's absolutely nothing to do with how good you are. It's nerves, plain and simple.
I promise you it will get easier, just don't be too hard on yourself. Take care.

Hi, I'm a 3rd year student doing a degree which involves 50% placement and I struggle a lot with anxiety. I struggled so much to start with but it does get easier which I know is difficult to believe. Is it not knowing what to say/how to phrase things you struggle with? Could you speak to your mentor and ask to observe some interactions first to get an idea? To start with i would introduce myself and my supervisor would say I was going to do the taking bp etc whilst they made small talk/answered questions and it gave me a chance to speak when I felt comfortable and build up my confidence. I often stumble over my words when anxious but now I jusy make a bit of a joke about how they'll have to give a moment to get my words/work out how to talk. Everyday gets slightly easier, I definitely had setbacks, and days where I jusy couldn't do it, but I've now somehow done two years of it so it is possible! Good luck!

You need to act for a little bit. Deep breath and you pretend you are comfortable and confident. It will start to feel normal quickly. The people you see are unlikely to know you are nervous but if they can tell, they'll understand. Being anxious just shows you care. A very quick and barely noticeable way to calm down is to circle your thumb in the palm of your same hand, like you were doing "round and round the garden, like a teddy bear". If you are still worried in a few weeks, talk to your tutor, you won't be the first one to feel like this

I know it might seem random, but I found taking probiotics really helped my anxiety, it’s worth a try. Anxiety is normal but when your feeling overwhelmed it may have an underlying cause separate to the issue of the time.

*Opposite hand unless you've got very bendy thumbs

Sorry you are feeling this way. I would see this as a learning curve. Try and think if you were in the patients chair… how would you like the interaction to go? What would be important to you if you were the patient? Try not to overthink it. Most people just need a friendly, listening ear. Think what would be important to you and go with that instinct. I have a feeling you may be overthinking all of this. And that’s said with kindness. I hope your mentor is helpful?

Fake it till you make it :) Even with 20+ years of clinical experience, I still regularly get anxious (probably more so these last 2 years!!).

Could you arrange your own placement, away from uni, just to get some experience observing a clinical setting? I know I wouldn’t mind having a student tagging along to gain some confidence.

@randomname2 's idea of observing is a good one. Medical consultations are quite structured so you can learn certain moves. You could also pay attention to the speaker's delivery, intonation and speed of speech that makes them sound authoritative and professional, their body language and how they respond to people. I learnt a lot from doing observing other lecturers and it gave me confidence even though it wasn't really "me" speaking.

As a professional in a specialised field (and sitting on a process standards panel) my advice is for you to change career before you find yourself up for malpractice, which, in your case, could be severe.

There are plenty of opportunities to side-slip into a related field that doesn’t involve the intensity of that face-to-face consultation but where your academic excellence can still be put to gold use.

Humans are great at self sabotage, all of us, so you're not alone. You could tell yourself lots of positive affirmations- you've got this, you know this, you are going to do a great job today - quite American but it dies overtime work to create self-belief/reduce anxiety.

I'd recommend trying zen meditation. It is the laziest of all forms of meditation cos you do absolutely nothing. I mean don't scratch, don't think about breathing, if a thought floats into your mind push it out. 10minutes is all you need and that peacefulness lasts for hours.

If meditation isn't your thing could you practice with friends? This can help cos when you see a patient you can morph a friend into their body and create the illusion you're talking to your friend. The other way to do this is by using neuro linguistic processing. I've been using it inadvertently for years so I could present at conferences and manage difficult conversations. It really works, but takes practice like everything.

Good luck you sound like an ideal medic.

My advice to you especially if you've been DBS checked is to volunteer.

You need practise being around patients who are needing your care in a variety of settings. It will become second nature very soon.

Are you in a hospital setting already? Can you ask your supervisor?

Beta-blockers for the physical anxiety symptoms in the moment, CBT to help for the future.

@ArchibaldsDaddy not everyone who goes to university does so because they are arrogant and entitled. Some people like to learn, do well and follow their dreams, regardless of remuneration. I very much doubt this individual will end up with a malpractice suit against them. They care too much.

Just a fist-bump. I hated placement; hated it. The number of things I ha to think about paralysed me.

I got through it somehow. I made charts of the time I had left on placement to get through. I counted the days, counted the hours at times. Proper written reflection helped a lot; once I got through writing down how much I hated it and put some structure on my thoughts, I started to see some positives and to be able to put some perspective in place.

As soon as I qualified and I wasn't being watched any more, things got so so much easier. I've been doing my job for 10 years now. I'm really not terrible at it.

Are you sure you’re in the right career path for you

It’s ok to switch. Hope you can get proper advice from people who are advising you.

@ArchibaldsDaddy

As a professional in a specialised field (and sitting on a process standards panel) my advice is for you to change career before you find yourself up for malpractice, which, in your case, could be severe.

There are plenty of opportunities to side-slip into a related field that doesn’t involve the intensity of that face-to-face consultation but where your academic excellence can still be put to gold use.

today's most bizarre comment

Write yourself a script. Something like;

[Smile] Hello, I'm aortaagh and I'm here to help find out how we can help you. I'm going to do a couple of tests and if you're not sure about anything, please ask me anything you like.

Now, can you tell me about why you're here today?

Once you have the introduction almost automatic, it's easier to get into the bit you know in your head. They relax more because you're smiling and friendly and start explaining, you get onto the asking questions and taking blood pressure, etc, and it becomes familiar and comfortable.

Only if you think doctors who have a meltdown when they have to speak to patients are a good idea.

I’ve been part of panels that’ve struck off several professionals who just weren’t suited to what they were doing but ploughed on anyway. It’s a disaster for all concerned.

But perhaps you’d welcome your DD or DS being diagnosed by a doctor in a panic the next time you’re in A and E, or at the GP’s for something you’re deeply concerned about.

The people you are seeing may be even more nervous than you - try to push all your focus onto them and helping them feel relaxed and at ease.

Practise, practise, practise. Role play to start grab mates, family members and run through scenario's. No harm in working out a narrative on how you greet a patient, ask them questions.
Try cbt techniques to focus on confidence.

Talk to you tutor, they may be helpful or rubbish. Talk to other members of staff and ask for tips or techniques they use. Most people Iv met in the NHS are happy to help anyone who wants to learn to be better.
Def worse trying rescue remedy or even short term meds.
Would it help to write things down in your patient interactions.

@ArchibaldsDaddy

Only if you think doctors who have a meltdown when they have to speak to patients are a good idea.

I’ve been part of panels that’ve struck off several professionals who just weren’t suited to what they were doing but ploughed on anyway. It’s a disaster for all concerned.

But perhaps you’d welcome your DD or DS being diagnosed by a doctor in a panic the next time you’re in A and E, or at the GP’s for something you’re deeply concerned about.

But there's a difference between ploughing on and a student not yet having the skills or taught to deal with patient interactions, it doesn't come naturally to everyone in the beginning. It may come with training or it may not but op wont know until she settles in to her role and gets further support/training.

@ArchibaldsDaddy

Only if you think doctors who have a meltdown when they have to speak to patients are a good idea.

I’ve been part of panels that’ve struck off several professionals who just weren’t suited to what they were doing but ploughed on anyway. It’s a disaster for all concerned.

But perhaps you’d welcome your DD or DS being diagnosed by a doctor in a panic the next time you’re in A and E, or at the GP’s for something you’re deeply concerned about.

I'm fine with nervous students. They have to learn somehow- and it's not them who have ever caused issues in my experience, it's the supremely confident ones who are so absorbed in their own greatness that they haven't noticed the smoking gun of a lifethreatening condition.