When it's time to trade mannequins and simulations for real patients, even the most confident student nurse can get a case of the jitters.

Many RNs-to-be worry not only about acing their clinical skills but also about getting along with patients and hospital personnel. "I tell students who are [starting their clinical education] that they really know more than they think they do, and that they actually can do the things they were trained to do," says Susan Bankston, a senior at the University of Texas (UT) School of Nursing at Houston.

Try these tips to overcome your anxiety:

Realize You're Normal

Even experienced nurses were once nervous students. "Every nurse starts out in exactly the same place feeling the exact same way," says Donna Cardillo, RN, a career coach and author of Your First Year as a Nurse. She recommends asking more advanced students how far they've come since their first patient encounters and meeting with fellow students to vent and share experiences. "This gives you the sense that everybody has to go through it and makes you more comfortable," she says.

Be Conscientious

Careful preparation may not completely banish your nervousness, but it will keep you busy so you won't have time to stew. Perfect each skill in the clinical lab before attempting it in the hospital, says Gwen Sherwood, PhD, RN, FAAN, professor and executive associate dean at the UT School of Nursing at Houston.

Do your homework the night before meeting patients so you're familiar with their care. If you're shy, practice what you plan to say when entering a room, Sherwood advises. Bankston recommends getting plenty of rest the night before your clinical debut and allowing yourself ample time to get to the facility you'll be working at.

Act Professionally

The basic rules of any workplace apply to students gaining hospital experience. Be friendly, make eye contact, and introduce yourself to patients and other health professionals, Cardillo recommends. Don't expect all nurses to be talkative or helpful; they may be overburdened and stressed from staffing shortages or other difficulties.

"Take the initiative to help," she suggests. "Offer to get supplies or turn a patient. If you're friendly and helpful, people will want to be friendly and helpful to you."

Other healthcare professionals will come to appreciate an eager student. "If you're willing to do some of the dirty work that will alleviate their workloads, they'll love you," Bankston says.

Lean on Others

Acting professionally also means asking for help when you need it. Many students are relieved to learn that they'll have a great deal of supervision and provide very little care independently during their first semester of clinicals. "There are lots of checks and balances in the care process, including the clinical instructor and other nurses," Sherwood says. Clinical instructor styles may range from motherly to tough, Cardillo says, but all are there to answer questions and help shape you into a capable nurse.

Show You Care

The nursing school adage of "the patient doesn't care how much you know, the patient wants to know how much you care" is generally true, Bankston says. Although Bankston fumbled the first few times she took a temperature or blood pressure, patients were usually tolerant. "Patients want to know that someone cares about them and is listening to them," she says. Cardillo adds that patients also expect a student nurse to be as courteous and respectful of their privacy as any other nurse.

Persevere

A little queasiness is normal when nursing students begin working with real flesh and blood. "I've gotten emails from students saying, ‘I thought I was going to throw up when I was doing a certain skill. Does that mean I shouldn't be a nurse?'" Cardillo says. "Most nurses get over their queasiness or learn to work around it."

However, do try to downplay your skittishness if possible. "You don't want to look too nervous in front of patients, because it will make them jumpy," says Fay Bower, RN, DNSc, FAAN, chair of the Holy Names University Department of Nursing in Oakland. "Some skills are scarier than others, but once you've done it a few times, you'll be pretty good at it."