How do you get over a bad day at work? I know this probably comes with time, which is why I struggle with it being a new nurse... But I came home and I can't do ANYTHING else but dwell on work. Honestly, my day could have been worse, but it feels like the worst day I've had yet at my first job as a nurse. I have had this job for a little over 4 months, and have been by myself for a few weeks after a 16 week orientation.
I work at an outpatient cancer center as an infusions nurse. It's the job I wanted and I've never had a day where I've left crying or cried during the day, or wanted to quit or anything. I love it and 90% of the time I feel very competent and like I am doing a good job and am taking excellent care of my patients and I feel satisfied. But lately we have been so busy it has been overwhelming. I show up with 2-4 more patients than I am "supposed" to have in a day, and labwork is overlooked for being ordered, patient's schedules are not completed so I have to find the time to do that during my shift, pre medications are ordered incorrectly, or there are NO drug orders at all from the doctors. Paperwork for new patients is not complete... or we haven't gotten consent... the list goes on. Some days I spend more time fixing things that went wrong, or doing other people's jobs than I do actually doing my job.
Today all that could go wrong seemed to go wrong. After I was finally catching up on my day, trying to chart... my patient who had been receiving chemo for the last 3 hours (thankfully not a vesicant) was ready for their next chemo drug. I had been assessing her IV about every 30 minutes because she was a tough stick (and I did not start her IV, someone else did, so I always check more often with people with troublesome veins and when I wasn't the one that started the IV). I always got blood return and the site was never red or swollen and the patient never complained of pain. I did assess the IV 30 minutes prior to the chemo infusion finishing. Then, at the end, it's red and puffy. The patient said she had no clue and it didn't hurt at all. So that was about an hour of extra documentation and she had to be stuck 4 more times for a different IV to give her 2nd chemo drug. Clearly, even though I was getting blood return, toward the end of the infusion the catheter somehow got partially out of the vein. Even after noticing the redness and minor swelling, we got excellent blood return. The patient will be fine and even though I did "nothing wrong" I feel like I failed this patient. She was completely sweet about it but I am a perfectionist and the fact that anything went wrong with someone under my care... haunts me. If I thought something was wrong with the IV, I would have taken it out, but I saw no signs of any problem. I just worried because she has such difficult veins, so I was constantly checking on it... which is not uncommon, since a lot of our patients have really, really awful veins. And now, I just feel so defeated and terrified, since I DO give so many vesicants and we check for blood return to verify that we are in the vein to prevent extravasation... how can I even be sure that blood return means anything after today?