Help! How do I overcome my shyness/anxiety while examining patients?

[newbie girl]

Can anyone help me out?

I've just started my clinical rotations and I'm having trouble conducting examinations on patients. Whenever I have to examine someone I always get really really nervous. For some reason anything that is hands-on makes me like this. The situation gets worse if I have to examine a patient with people watching me, especially consultants. I get really nervous and start to blush and sweat. No matter what I do I can't fake confidence and I know I must look like a nervous wreck.

How do I get past this?? Has anyone else had anxiety like this before? What is the best way of dealing with a fear like this?

If anyone has any advice I'd really appreciate it!

Jess

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[jtlc2345]

Most of us get nervous, turn red and develop sweat patches when starting clinical medicine. The best advice is just to keep going, whether practicing on friends/family and examining real patients. Most people eventually get over it - it's all about adjusting and feeling comfortable in a new situation.

Jonathan

 

[turkeyjerky]

the best way to get over nervousness is to be well prepared. think about what you're gonna do before you do it. if there's a part of the exam you feel incompetent about, watch a video or read about it so you'll be able to (at least look like you) know what you're doing.

If it's any consolation, I don't think there's anyone who doesn't feel grossly incompetent at the beginning of third year.

 

[cpants]

The good news is that it will get easier. The more you do, the more confidence you will have. The bad news is that the only way you will get that confidence is by examining as many patients as possible. Rest assured that most of your patients have no idea what you are doing while examining them, and are in no way evaluating your exam. You could put your stethoscope on their forehead and tell them your are listening for brain sounds and they would believe you. You know what you are supposed to do, so do it. If you have any question regarding an exam finding, run it by a resident. Most of them will be glad to help out.

 

[Doctor Bob]

It's just like with public speaking... imagine that your patient is naked.

Wait... or are you supposed to imagine that you are naked... I can never remember.

Oh just imagine that everyone in the room is naked and that should make it easier.

 

[wAyRadikull]

I recently started my very first rotation in pediatrics. Examining newborns and kids is a whole other ball game. I was super nervous when I began because I didn't remember how to take a proper history or do a proper PE of an adult, let alone a newborn/peds patient.

However, after the first few days and doing H&P's on several patients, things got a hell of a lot easier, and now I'm fairly good at H&P's and presenting to attendings.

The key is to practice, practice, practice. Also, try and sit in on your residents and attendings doing PE's and historys so you can see how fluidly they move through the whole process.

 

[dantt]

xanax

 

[gulnosh]

propranolol!!

 

[PharmaTope]

It's just like with public speaking... imagine that your patient is naked.

Wait... or are you supposed to imagine that you are naked... I can never remember.

Oh just imagine that everyone in the room is naked and that should make it easier.

chaos orb!!!!!!!!!!!!!!!!!!!!!!!

 

[DocDanny]

I've just started my clinical rotations and I'm having trouble conducting examinations on patients. Whenever I have to examine someone I always get really really nervous. For some reason anything that is hands-on makes me like this. The situation gets worse if I have to examine a patient with people watching me, especially consultants. I get really nervous and start to blush and sweat. No matter what I do I can't fake confidence and I know I must look like a nervous wreck.

Like you just said, you've only started the rotations. They know that you have a lot to learn. They expect it. If you were doing extremely bad, they'd take you aside and tell you that you need to practice X or Y.

It's perfectly natural to get nervous doing these things. It's harder than it looks. You don't need to fake confidence. Nervousness will go away with time and practice. Then your confidence will be real.

Hope I helped, Jess!

 

[montessori2md]

In all seriousness, if by the end of your first rotation you still feel this way, you should call your school's counseling service and ask for help -they can teach you relaxation techniques, among other things. In the meanwhile, read up on treatments and strategies for anxiety/stage fright (up to date). Deep breaths. Ease up on the caffeine. Try to counteract that epi as best you can. Keep telling yourself it will get better, because it will.

 

[ZagDoc]

Eventually, you'll reach the point where it is your responsibility to perform the exam. Early on in the year, everything you do gets double checked so its easy to get nervous because it feels like your work is being checked. Its also natural to feel like you don't deserve to do things to patients that makes them uncomfortable when you don't even know what you're doing yet. Eventually you reach a point where no one is there to check your work anyone. "Hey, go see this patient in the ED and report back to me." "Go do a post-op check on Ms. Hanson and let me know if anything is abnormal." "Got a new patient on the floor admitted for r/o stroke, I'm getting hammer paged, you mind triaging them? I'll see them later."

I was nervous with the physical exam early in third year. But when it reaches the point where either YOU do it, or no one does it, well... I found I got over my nervousness pretty quick when I knew the information was important. It's normal to be nervous. Just make sure you are also competent, because eventually the onus falls on you to gather the necessary facts. You also get more comfortable with patients in the process.

 

[Doctor Bob]

chaos orb!!!!!!!!!!!!!!!!!!!!!!!

That fixes all your problems.

 

[cartoondoc]

Med school forces you to become a lot more outgoing. The more patients you see, the more you will get desensitized to your nervousness.