8 months as a nurse and I am failing miserably

[RN119]

Hello fellow nurses,

I am a new nurse and I made a big mistake last night... my DNR CC patient who I have (probably had) an awesome rapport with her and her family.. had some labs that I just forgot to check.. well she had hgb of 6.1... 6.1! how could I miss this??

so the nurse who I gave report to (who is never nice to me but that is not the point) was of course bitter towards me and rightly so.. doctor of course was furious and rightly so.. 7 hours after the fact... and close to midnight we are getting units of blood and consents signed

I work on a floor of sharks... I can't speak to them about this... I of course began crying pretty much on the spot (I really hate working with women for this reason) .. why does it always feel like when you oversee something, you are all alone?

I am just putting this out there... I realize that most of the people who read this will be women and I hope you know what I mean when I made the women comment above..

I am working so hard to keep all my patient information together here.. I know that 4 patients for me is more than enough to manage... I am in AWE of the night shift who sometimes take on 6.. let alone a charge nurse who has a whole floor to contend with.. and I thought I was making progress but this whole situation is making me take a long hard look at the decision I made... yes we all make mistakes but this???

I am being super vulnerable .. I have been up all night, I am one raw nerve here

I do not want to go back for fear of all kinds of judgement.. legal, the family, co workers... all of it.

If you have read this far, thanks for letting me vent this... If you are judging me... don't blame you but know I can't get any lower than I feel right now.

What do I hope to gain by this? tell me I 'll get better with time .. tell me I am full of sh...and just give it up? I don't know.. just hurting here

[applewhitern, BSN, RN]

I agree with everybody else~ did the lab call this "critical value" to anyone? Not saying this is the lab's fault by any means, but usually they call criticals to a nurse, and write that nurse's name on it, before they scan it on the computer.

[westieluv]

If the low hgb caused the patient to be short of breath, then getting blood could be considered a comfort measure, I have seen it done.

OP, please don't beat yourself up, this kind of stuff happens, and like everyone said, why was the lab tech asleep at the wheel and didn't notify you of this critical value? Also, even if the blood was considered a comfort measure, if the patient was comfortable enough without it not to draw attention or seem uncomfortable, then how did you fail her?

Ignore the mean nurses who pounce on your every mistake, people like this are unhappy and insecure and want to make someone else feel as badly as they do, don't stoop to their level. A happy, kind, person would have offered you comforting words and tried to make you feel better. These are the kind of people that are worth cultivating as friends.

The title of your thread concerns me. You missed a lab value on a DNRCC patient and you are "failing miserably"? Wow, then most, if not all, of the nurses that I have ever worked with, including myself, have been "failing miserably" at some point in our careers!

Chin up and believe in yourself. You CAN do this!:)

[amoLucia]

applewhitern said:

I agree with everybody else~ did the lab call this "critical value" to anyone? Not saying this is the lab's fault by any means, but usually they call criticals to a nurse, and write that nurse's name on it, before they scan it on the computer.

Just what I was thinking...

So maybe the some of the burden of the discrepancy lies elsewhere.

[Kaltia]

Breathe, patient is okay, right? breathe again. Recheck your hospital's critical value requirements. This should have been a critical value called in by the lab and there should be documentation from the lab and your floor relating to it. Like the others said, this is a system failure not a you failure. Charge nurse should have caught it too.

secondly, don't cry if you have to step out for a minute, do so. There are some people who you can never make happy. that's okay. You've learned from the mistake that's what matters.

Fact of life-doctors will find something to yell about, often with cause. You cannot afford to doubt yourself because of it, even if there's a mistake, you have to be able to move into fix it mode. yes it hurts the first few times but it gets better and you learn with time how to separate the feelings, instead of collapsing.

I'm am also an RN of eight months. As long as the patient is okay, let it go. Learn from it, but don't hold on to it. I guarantee you that every nurse who yelled at you has made a similar mistake somewhere along the way. No one is perfect, so don't let them try and come off that way. (hugs)

[brandy1017, ASN, RN]

Hopefully the patient is ok and they were able to get the blood up and find the source of the bleeding. Did the patient have a cath and they were bleeding? Most likely retroperitoneal or you would have seen the bleeding or hematoma at the site! Unfortunately sometimes labs get missed while juggling multiple patients. I don't understand why lab didn't call. It seems like that would be considered a critical lab and they should have reported it to you! So not entirely your fault. Mistakes happen, just do your best to stay organized and keep a record to remind yourself of when to check labs and pass meds.

[ausrnurse]

Honestly, I don't know any nurse who at some point has forgotten to check bloods, and when they did, they found something seriously wrong. So. Two things: like others have said, the lab should have phoned through a critical value, and; it is not only the nurses' responsibility to check bloods. The doctor ordered them, they should be following them up AS WELL. He has no right to be "furious" about it - it's his job too. The other nurse needs to remember nursing is 24hr care and deal with hanging blood without complaining. I cannot stand it when the next shift comes on and whines and moans about having one extra job to do on their shift.

[The_Optimist]

No, you are not failing miserably; you "failed" at the one thing.And that can also be debated. The ball was dropped somewhere along the line. We won't go into discussing whether or not the patient should have received the blood or not, right now it is about you.

I am very grateful that your patient DNR or not, made it through, that could have been pinned on you.

Try not to let your coworkers get to you and they will, if you let them. If you are able in future, try and hold your tears in and let it out in private so you don't give ammunition to your coworkers.

There are some great pieces of advice from people on here.Hang tight...you will come through this.

[Meriwhen, ASN, BSN, MSN, RN]

~*Stargazer*~ said:

Maybe the patient isn't on Comfort Care, but has a POLST with Comfort Measures Only. This would refer to end of life, and if the patient isn't at end of life, or if they are still able to communicate and make decisions, they can certainly receive a blood transfusion.

That was my thought. The fact that they are DNR doesn't necessarily mean "Do No Treat."

Mom To 4 said:

OK, deep breath! Did you learn an important lesson from this? If yes then forgive yourself because you are human. Now take what you have learned and move forward.

Rule #1 Do not cry on the floor ever! No matter how upset you are or need to cry. Find a bathroom or wait until you get to your car. If these women are vicious then know sharks smell blood. Don't be the cryer!

Rule #2 If you start crying see rule #1. You have to toughen up. Remember, you aren't there for friends. You are there for the 2 Ps: patients and pay check!

I don't cry... I curse.

[amoLucia]

Quote

I don't cry... I curse.

Not verbally, just a good old fashioned witch-y kind, twitching my nose!

[VANurse2010]

Ok, it is RIDICULOUS that your hospital doesn't have the lab call a value like that directly to the nurse. Yes, you have some culpability here but it's as much as system problem in my opinion.

[caddywompus]

I work with sharks too. It is hard, especially when you are new. I can't say anything about this that hasn't already been said, but I must say this- for the love of God people stop doing this ... all the time. Sorry, I'm a grammar nerd. Those three little dots are overused and improperly used ALL THE TIME. A period ends a sentence. An ellipsis indicates an omission. Sorry, rant over.

https://www.thefreedictionary.com/ellipsis

Hang in there. The first year of nursing is the hardest. You're still learning. Keep your head up ?