8 months as a nurse and I am failing miserably

Nurses New Nurse

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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

Listen, the first year as a nurse is the hardest, especially when you work with sharks, like you do. I did my first year in surgical telemetry/ICU step-down, and there were many days when I went home crying. Once, a surgeon screamed at me over the phone and told mehe never wanted me near his patients....

I had moments when all I thought was, "Why on earth did I ever think that I could handle this? I can't do this!"

But I got through it, and am now about to enter my 11th year as an RN. Believe me, if you stick to it, and really try, you CAN succeed. If there is anyone on your floor who you feel like you could talk to, it would help immensely, but just keep going. Talk about it if you can, and learn from the mistakes of others. We all make them, and sometimes they are more serious than others. Thankfully, it sounds like your patient was okay, you just got very shaken up. Those moments when we realize the gravity of our responsibilities as nurses can be so hard. Please do not lose hope!! Everyone (even those sharks you work with) started out new at some point. None of us came into this field knowing it all. You can do it, with all the hard work you've already invested. Good Luck!!

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OP, just because you missed a lab does not mean you are failing. You missed something. We've all done it, and anyone who tells you otherwise is lying.

As others have stated, the first year is the hardest. Pick yourself up from this, learn from it, and move on. You're doing fine.

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Specializes in Oncology.

*hugs*

As I have told our newbies, the other shift is always going to feel like you should have done more. I've worked both day and night shift on my floor, and I can say from experience that they do have more time to breathe for two obvious reasons: less admits and less incoming orders. Their shifts are much more predictable. I ended up being bored on night shift because of this and less conversation with the patients. But anyway, because our night shift has time to breathe, they can catch mistakes and have time to talk about them for hours on end in the nurses station and send an email to a manager, etc. I found myself catching much more when I worked nights. So as a day shift nurse, I can relate to coming back the next day and being chewed out for something. As sad as it is to say, you do just learn to toughen up after awhile because it doesn't stop. Even when you've admitted two patients, been charge, given 7/8 runs of potassium, changed three central line dressings and their respective tubing with sterile technique, and transfused two units of RBC, someone is going to be put out and ask why you didn't give the 8th potassium run. :p

You're doing fine. Give yourself time - I promise about a year off orientation, you start to feel much better. Your relationships are more established, you understand the culture of your unit, and you feel more confident in your skills. When I first started working, I couldn't hit the broad side of a barn when it came to IVs. Now I'm doing a lot better and I enjoy trying - I by far get more than I miss these days. Time does make a huge difference in this profession.

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Specializes in Clinical Research, Outpt Women's Health.

You are human. You will make mistakes. I bet you will never make that one again.

You just have to say "i messed up" and move on. Know what you will do differently in the future. A lot worse mistakes have been made by much more experienced nurses.

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If the patient is DNR and CMO/CCO why is the patient getting transfused? I'm not sure the blame for the failure should be entirely yours either. Was the Hb part of routine laboratory work or did it come from an ABG? In the case of the former the lab really should have called you to alert you to the critical value and in the case of the latter the RT or the blood gas lab should have called.

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Specializes in ICU.

You will definitely get better!

What time are routine labs done at your facility, and can you run around like a chicken with your head chopped off and get everything else done before labs result? This is my game plan. Labs are usually drawn at 4 AM - and I kick some serious butt getting everything else done before 5 AM rolls around so I can devote the rest of my morning to correcting abnormal labs. Even that plan doesn't always work. Just the other day lab didn't get any of the tests done until after 0600 and called a critical glucose in the 20s on one of my patients at 0615. I D50W'd him and fixed it. By this point it is about 6:30 and I checked his other labs, saw a potassium of 3.1, notified pharmacy, and started the first k-rider. AM shift arrived while I was still hanging the k-rider, and I walk out to give report, and AM shift asks, "Did you notice that his hemoglobin was 7.1?" :banghead: Sometimes it happens to even the best prepared people! I only got notification on the glucose because it was the only one that met the definition of critical, but hey, at least I got the ball rolling on one of the two other abnormals.

It really does ruin your day when you walk out the door after the following shift catches you in a mistake! I spent the whole rest of the day in a horrible mood about not catching that hemoglobin, but it happens. I know lab doesn't call for everything. I would look up what your facility's definition of a critical hemoglobin is so that you can take action if necessary, but the truth is that not all abnormal labs that need to be fixed are going to earn you a phone call, and if you are counting on that phone call you are going to mess up! Chin up, though, and I bet you will always check your labs now. At least make it a practice to check labs two hours before your shift ends, so you have time to at least start fixing whatever the problem is before you leave.

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Ruby Vee said:
Dictionaries define misogyny as 'hatred of women' and as "hatred, dislike, or mistrust of women". Dictionaries don't state that this hatred, mistrust or dislike of female MUST come from a male. Many women -- many women on this site, in fact -- meet the definition of misogynists. From your statement, you are one of them. It is your OPINION that women are "quick to tear each other down more so than their male counterparts, sadly". The fact that this is your opinion does not make it the truth.

The fact that the opposite is your opinion does not make it the truth.

1 Votes
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
caddywompus said:

Come on, people. Don't be offended.

Yes, it also can indicate a pause, however, too many pauses in writing annoy the reader and make the writer appear to lack confidence, which, in this situation is understandable.

Really? Lack confidence...interesting. I would never have thought that of myself. I have had many things said about me but a lack of confidence isn't one of them.:roflmao:

1 Votes
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
The_Optimist said:
Caddywompus missed the class on "ellipsis" LOL. (You should tell us how you came by your username sometime :yes:).

But you're right, there are some cases of abuse. Like this one, totally off the mark:bag:.

I did that on purpose, I was being sarcastic and I should not have been. My bad. I apologize.

However...

We need to return to the topic...this nurse is upset about a mistake they made...if we wish to discuss my, or anyone elses, grammar please start another thread.

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Specializes in Gerontology RN-BC and FNP MSN student.

I wonder if OP has checked back yet? She will probably get a great laugh at the rabbit trails...elipsis' and misogyny.

My experience that really stuck with me and has always kept me on top of any diagnostic lab or test...was when I had a mobile CXR done on a patient in LTC. It came back with apparent opacities consistent with bleeding. I immediately called the NP and we shipped her out. Her lungs were filling up with blood, she would have most definitely died on us. The reason we got the CXR is because her WBCs came back elevated. So this stuck with me...that if I wasnt OCD about checking our fax machine for labs...and being on top of them , I would have bigger problems that I didn't want.

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Some of you take a simple comment about a pet peeve and just go too far. We all have pet peeves. I voiced one of mine. Is it not time to let it go? Yes, I have a degree in English. It happened along the nursing road when I wasn't sure what I wanted to do. Sometimes I'm still not sure. The comment about ellipses being overused and making a writer appear to lack confidence comes from something I learned in a writing class. I have also read it in a few writing instructional books. It's not relevant here and I was not trying to offend anyone. As for the name Caddywompus, it's a slang term for bent/askew/slightly off. It's been spelled different ways- catywompus, cattywompus, cadywompus, and more. Thanks for asking. Cool word, isn't it?

Here is how I first heard it. "Can you help me reposition xyz? She's all caddywompus in the bed." I said, "She's all what?" Then she explained. Since then it has been my favorite word. :D

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Thank you all for your support... to answer a couple of the posts here... DNR CC do get blood apparently so they do not bleed out. This is what the doctor wanted... and our lab ... do not even get me started... they do not call on all the labs.. but they can be guaranteed to call us on elevated BUN/Creatinine levels on HDU patients... I AM NOT saying this is all the labs fault but dang it that was pretty freaking low. Again.. thank you so much for your comments...

I have been out of work since that night due to jury duty... believe you me I was STALKING the lab results..

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