So I started my clinicals last week in a pediatric outpatient office.  My preceptor being the pediatrician whose office it is.  It has been quite an experience so far.  My nursing career has mainly consisted of adult critical care.  Being in a completely different setting then what I have done for the majority of my career has definitely put me into a culture shock.  It’s like being a brand new grad all over again.  Back again are the times you know the right answer when asked but it seems as though the wrong one seems to come out of your mouth or you get the “deer in headlights” look on your face.  Back again are the times I feel like I know absolutely nothing and in my brain is scrambling to recall that disease I vaguely remember going over in class.  Gone is the confidence I have when I’m working in an ICU titrating pressors, monitoring heart rhythms, and interpreting ABGs now that I’m facing a 5 year old with a cough and fever and the parent is looking to you to diagnose, treat, and give advice for what do for their child.  Now I remember what it was like 5 years ago stepping out onto the ER as a new grad thinking….did I learn anything in nursing school?  But as I pressed on…it came back to me, I learned new things and tricks of the trade.  It did get to the point where I knew what I was doing enough where I now precept new grads.  I have to keep telling myself in time I will get this, I will gain confidence, I will walk into the room with a screaming toddler and desperate parents with an understanding and know the right answer!