the pretension and the tension

I had a practical exam today. I prepared and I felt prepared but for some reason I can't exactly say I did particularly well.

The things that went wrong (they are quite comical really):

1. My patient began to cry out in pain in the middle of my exam. Great, just great. "I have a tummyyyyyyyyyyyyyyyyyy aaaaaaaaaaaaaaaaaaaache! AJMA! AJMA!" Now, she did this just this morning and I told her she has had an operation and to have some patience and that it will go in time. Nope. She screams during my exam. I end up looking bad because she does this during a procedure. I felt stupid repeating what I already said this morning and lost points because I did not communicate with my patient.

2. I am now incredibly nervous and answer almost every question thrown at me incorrectly, not because the answer is beyond me but because I can't stop thinking what a loser I am for losing points when it came to patient communication, especially when I know chatting and blabbing is basically what I do best.

3. I am taken to the treatment room in order to show them how to prime an IV set. They told me that I dont have to talk if I don't want to while performing this act. I did it perfectly...at least I think I did. So that was fine. I also set the drop rate and that was fine.

4. Time to administer drugs. I think, yeay, time to redeem myself, I studied these. I open the chart and find out they changed all this patient's drugs from intravenous to oral tablets. Fuck. I get confused and panic and get pissed off. I know how to give the drugs and all the procedures ect... I thought I knew all the side effects too but I was hardly asked any. Instead I was asked stuff about diseases which I didn't know...well, I did know them but at that point I was dying inside. I was asked questions about a disease my patient didn't have. I was asked questions about clinical procedures on the ward which were apparentally carried out incorrectly by qualified nurses therefore I said them incorrectly thinking they were right.

5. My patient pipes up saying she is to be discharged and I am asked about her discharge planning. I did not know she was going to be discharged so I did not know her discharge plan. At the end of the exam, a staff nurse tells me she was not going to be discharged until tomorrow.

6. When giving the patient's history I could not figure out whether the patient had cancerous polyps or not...but then I remembered she did but I still lost points because I said I wasn't sure.

7. I also happened to wear ugly shoes and that didn't help.

When I re-read all these things I can't help but think what a disasterous human being I am. I was totally prepared but I still managed to fuck everything up.

Alot of people tell me I am clever and a great nurse, but when I see or do certain things I can't help but think that it is all false pretense. Quoting American Beauty, in order to be successful, one must portray an image of success. Well, I'm sorry but the image just isn't enough. I know what it takes to be successful...it isn't the image, it isn't the hardwork...its luck. And to hardworkers like me, its really quite heartbreaking.

But, to see the good in the bad, I did pass, so I guess the examiners saw something in me. I don't know what, but maybe it was a certain je ne sais quoi.

Honestly, it all makes me very, very tired. 1 year to go. I hope it goes by quickly. The stress is going to make my tiny brain inch its way out of my ears.