2 day suspension HELP NEED ADVICE

Nurses New Nurse

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Hello, I am a new nurse working at a nursing home and this is my first nursing job and i have been working since July 2014 and today I got suspended. The patient I was taking care of was very sick to begin with. He was previously in the hospital for acute renal failure. The patient was 99 years old with acute renal failure and for the past week and a half the patient hasn't been eating well. He refused to eat for a good 3 days tried to encourage him fluids, but still refused. He was on aspiration precaution. He is DNR and DNH. On this very day I worked it was my 6th day working straight taking care of 30 patients by myself with 4 CNA's. I checked vitals 5 pm and the bp: 130/38 p:49. I don't know why I should of reported the pulse right away. Around 8: 30pm i rechecked the vitals and BP dropped to 74/50 P:44. I reported this to the supervisor and the doctor. I got suspended because I failed to report my first assessment right away. I wrote the order for the IV around 9 PM and the IV wasn't started till 11 PM. I am not IV certified so I asked my supervisor to come start the IV once i got the order and she came around 10 PM. It took about an hour to start it because the veins kept busting. That very night the patient died. The patient's family and the nurse practitioner and the doctor knew that patient didn't have much time too. I just need some advice. I don't know what to do, i just feel very discourage and its making me rethink of being a nurse. I worked so hard for my RN license and Im so scared that my license will be revoked. I don't know if I should continue with this job or if i should quit before I get terminated. Mind you this 3 days before (thanksgiving) my uncle had a massive heart attack and is still in the ICU and still hasn't woken up. I just need some guidance on what my next step should be.

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Take a big breath. Okay, take another one. You made a mistake. Sorry to hear about your uncle and the horrible nurse/patient ratio. That being said, it was a mistake, no excuses. More concerning to me than the bradycardia is the wide pulse pressure...means the dyostlic BP wasn't enough to fill the coronary arteries.

It was a mistake and not the first one you'll make as a nurse. You are NOT going to lose your nursing license, especially because you are a new nurse.

Read up as much as you can on vital signs and how they reflect what is going on inside the body, because you are going to be able to explain what you have learned.

25 years ago, after 3 months as a nurse, I gave a patient 10x the ordered dose of Valium. Never made that mistake again! Good luck to you.

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Thanks for the advice, I appreciate it. Im just worried that after this suspension.. the next mistake i do will lead to termination and that scares me especially since I would feel it would be hard to find another job with only 5 months experience

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I don't know what the job market is like where you live, but 30 patients as the only nurse is terrifying and intimidating to me with 25 years' experience. Have you looked into other practice areas where you would have support as a new nurse? Maybe OR or PEDs? Or a large hospital med/surg unit? Clinic setting? Graduating from school is only the beginning of your training, and the best program or the best student isn't enough to qualify anyone with the responsibility you have on your shoulders.

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So, how did everything work out?

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At most, I would have rechecked a 49 pulse in a half hour -- and THAT would've depended on his baseline VSs. A lot of people on beta blockers go below 55 and stay there and are fine.

One question; do you have 'reportable' vital sign parameters? Like "Notify MD if P

I'd never work for an employer THAT punitive. I'd quit. I'm worth a lot more than that, and so are you. Even as a brand new nurse. I hate to see you personalize this and wonder if ALL of nursing is like this -- it isn't, I promise.

You might look back on this as a blessing in disguise, if you decide to take your toys elsewhere.

Besides, if they'll suspend you for THAT, and terminate you completely for another similar oversight/mistake, you do not want THAT on your resume' or even on your mind! If you can avoid that experience, please do. It's really not that hard core in other facilities, employees are treated with much more respect and dignity elsewhere.

This really wasn't YOU, even the mistake, for a 99 y/o with multisystem failure.

Your take away from this is to check orders for vital sign parameters (what to report to MD or RN). Also, a stable pt will have stable vital signs, they won't waver around much. A 49 pulse may be no big deal if the baseline is 55, but if his typical baseline is in the 80's, it WOULD DEFINITELY be an indicator of him going south. All this comes with experience, and part of the hidden blessing is stuff like this. We all learn something the hard way, no matter how vigilant we are. Part of maturing as a nurse is to get perspective. Some mistakes are bigger than others, and you are human.

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Actually the day after my suspension, I got a job offer on a telemetry unit at well known Hospital. That was just a sign from God. Things work out in weird ways and the very next day I resigned from the nursing home job. Im going to take in this experience and learn from it. Im so thankful that I have a better opportunity at a teaching hospital. Thanks again for the advice

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Specializes in Family Nurse Practitioner.
Actually the day after my suspension, I got a job offer on a telemetry unit at well known Hospital. That was just a sign from God. Things work out in weird ways and the very next day I resigned from the nursing home job. Im going to take in this experience and learn from it. Im so thankful that I have a better opportunity at a teaching hospital. Thanks again for the advice

Wonderful! Great how this all worked out.

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This patient died because he was 99 with organ failure, not because of anything you did or didn't do. Nursing homes tend to be ridiculously punitive w/o the education and support to back up the attitude. Have you tried to find something acute care? It's not the manna from God, but it's usually better.

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I am also a new nurse and was suspended due to stolen meds. I had 36 pts that day and one had just accused someone the week before of sexual assault of male nurse so no male nurses could care for him. I feel your pain and glad you left your job and started some where else. I also had upwards 30+ pts and admissions where we also add meds into computer, assessment and file paperwork etc... I am currently going to proceed other employment also. I fear my license and it feels silly to put off other pts and their meds and needs for an admission that takes hours plus the fear I will be in trouble and will need to clock out due to my timing (I don't clock out). New pts have left facility b/c their meds hadn't arrived at the facility in a timely manner. But it's ok to make our other residents wait an extra 1-2 hours for their meds while I admit a new pt? Hugs to you! Hope your new job refreshes you in why you became a nurse!!

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Specializes in HH, Peds, Rehab, Clinical.

Why wasn't the facility properly staffed with an rn who could have started an IV in a timely manner?

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Specializes in HH, Peds, Rehab, Clinical.

Oh, and am I the only one slightly curious about how someone's veins continually "bust open" during IV attempts? Surely this is not a term you were taught in nursing school, op

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