[Curiosity77]

I'm on a practicum right now, and feeling really insecure and stupid. My concentration and memory are not what they used to be. This morning i was with a supervisor who asked me a question, and it was a bit of a trick question. I answered wrong, and he said you fail, right in front of the patient. I'm in this practicum to refresh my skills because i graduated 3 years ago, but have been away from practice a lot since graduation due to mental health problems and other circumstances. My work wants me to take on more responsibilities, and when i told them that i don't feel able to, they set up this practicum. I really don't want my job to change, i don't want more responsibilities because that comes with more stress and more homework and reading to stay current. I was really unwell during my last year of training (i'm an NP), and i managed to graduate, but i don't feel like i learned things as well as i could have. I only practice to my level of competency, but i don't want to be pushed to do more, and i just want this practicum to end because i feel so scrutinized. I think about going back to being an RN, because it is less responsibility and stress, but i really like the work i have been doing up until this point. I guess this doesn't really have much to do with bipolar, except that my illness has interfered with my training and made me take time off work. I wish i had never trained to be an NP because now going back would feel like failure, but i'm just treading water here. Everyone i work with says i'm doing great, but it is causing me a lot of anxiety.

Just venting.

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[BipolaRNurse]

I was in a similar situation until last Friday, when I was "released from my trial service" as a state nursing home surveyor. I tried SO HARD to read and remember everything and to work with the incredibly complicated computer system, but as soon as I'd get out there to actually do the job, I'd forget everything. I had trainers with me every. single. step. of the way, and while I was trying to do my job they were walking behind me and assessing my every move.

Needless to say, being so closely scrutinized---and receiving almost nothing but criticism---made the experience excruciating for me, and I failed out of the training program. I am not one bit sorry about it. It just wasn't a good fit. But it still pisses me off that because of my bipolar and the meds I take to control it, I can't memorize things like I used to, and of course being nervous and anxious made everything worse.

I think that may be where you're at right now, except you like what you're doing and people are telling you you're doing fine. Only you can decide whether the end result is worth the scrutiny; personally, I'd hate to see you give up being an NP because I think you can relate to your patients better than the average practitioner. Besides, you and I both know that life as an RN isn't easy either, in fact we have a LOT of responsibility and almost no authority.

Don't give up---and if you do, at least make sure you do it for the right reasons.

[Curiosity77]

You're right BP nurse, being an RN is hard too, but at least then my role was understood and respected. Where I live NPs are pretty new, and I constantly have to explain myself and prove my value to doctors, RNs, and patients. It's really hard, especially on days like today when my self esteem is low and my anxiety is high. Plus when I was an RN I felt like an expert, and I was really good at my job. Now I feel like a novice, and mediocre at my job. Maybe my performance would have gotten worse with time because my bipolar has gotten worse, and I have more cognitive symptoms now. But I think about what my life was like when I was an RN, and I just want to turn back the clock and tell my younger self not to go back to school. When I was an RN I wasn't even on meds, and my life was pretty good, with a little bit of cycling, and only one major episode. Things got really unstable for me during my NP program, and I haven't been totally well since. So that's 3 years of mostly anxiety and depression, and being on a lot of medication. I really want my old life back, but it's gone forever. When I was an RN I was married, owned a condo, and had a lot of friends. I don't have any of those things now. All I have is my career, and even that is causing me stress. I just want to give up, but I'm too scared to try to do something else, so I'm paralyzed.

[BipolaRNurse]

That's kind of how things went for me too. I started going downhill 3-4 years ago and gradually began losing pieces of me to this illness, although I didn't know I had it at the time. Finally about 2 1/2 years ago, the strain became too much and I think that's when I tipped over, because I remember being basically out of my mind until I got to a psychiatrist and was put on medication early in 2012.

The cognitive stuff is what alarms me most, because although the losses seem to be leveling off, I am considerably limited as to what I can do with a memory that's like Swiss cheese. That's why I got out of clinical nursing.....couldn't handle it physically OR mentally. Maybe I can manage home health or something where it's 1:1 with one patient at a time. I don't know. I'm scared to try.....I'm about ready to become a barista or work in a factory again.