Feeling Overwhelmed & Incompetent

[newgradpedsnurse]

Hey everyone.. So I'm currently in my third week of night shift, second week off of orientation - and I can't help but feel like I am constantly making stupid mistakes. I worked last night and had two patients who would be NPO after midnight. One of them had been complaining of a terrible headache all day and had been getting Percocet whenever he could. I gave him his 930pm dose and around 11 he was asking for more but would not be due until 130am. After speaking to the residents about what to do for him, they advised me to have him try to hold out until 130am. At 130, he asked for the med and I gave it to him, completely forgetting he was NPO!! Then at 615, one of my other patients desatted to 68% from a coughing fit and everyone was rushing to her bedside, and my headache patient was asking for more pain meds. This time I was preoccupied with my more emergent patient so I quickly gave him his Percocet like an idiot again and rushed to my second patient. At her bedside, I felt completely incompetent. Luckily I knew enough to call the residents to come for help but when one of the picu nurses who happened to be on our floor that might came I. The room and completely took over the scene, I felt like a complete idiot. And to make the situation worse, when I gave report to the day shift nurse who pointed out that I stupidly gave Percocet to an NPO patient, I just wanted to go home and cry.

It was my third night in a row, and I was exhausted, but I know that is no excuse. Luckily the patient I gave the meds to wasn't scheduled for the OR until that evening, but that was pure luck. Everyone at work is telling me I'm doing okay and that we all make mistakes, especially as a newbie, but I can't help but feel like I leave work after every shift with at least one mistake. Luckily I feel like the big things I am able to pick up on, but it's hear little things that most people assume is common sense that I seem to miss.

I don't know what to do and I can't help but think that maybe this isn't for me if I can't seem to pick up on these very obvious things. These "little mistakes" could potentially become life threatening, and if that were to happen I would never forgive myself.

[nurse__joy]

Hey! New grad here w/ about six months of experience. I usually give all my morning meds and just tell my patients to take them with a small sip of water if they're NPO per procedure. The general surgeons at my hospital are fine with this and usually will write "okay to give PO meds with small sips of water on morning of surgery". Now, I will withhold certain meds (such as xarelto, PO diabetes meds, etc.) or if I'm unsure about giving a certain med before surgery/procedure, I'll ask my coworkers about it. I've never gotten in trouble or yelled at for doing this, and the other nurses on my unit do the same thing.

Better to control pain, blood sugar, BP, etc. before a procedure than to let it go uncontrolled because the pt was NPO. At least that's my view.

[KimberlyRN89, BSN, RN]

Hey! New grad here w/ about six months of experience. I usually give all my morning meds and just tell my patients to take them with a small sip of water if they're NPO per procedure. The general surgeons at my hospital are fine with this and usually will write "okay to give PO meds with small sips of water on morning of surgery". Now, I will withhold certain meds (such as xarelto, PO diabetes meds, etc.) or if I'm unsure about giving a certain med before surgery/procedure, I'll ask my coworkers about it. I've never gotten in trouble or yelled at for doing this, and the other nurses on my unit do the same thing.

Better to control pain, blood sugar, BP, etc. before a procedure than to let it go uncontrolled because the pt was NPO. At least that's my view.

I agree. New RN here with 5 months experience on a busy med-surg floor, and like you mentioned I will either ask my more experienced co-workers or I even call the OR to make sure giving a med pre-op is okay. Don't beat yourself up OP. Like it's been said, the first year is hard on all new nurses.