How do you get over your new RN boo boos (mistakes)

[love-d-OR]

The last two days at work where colonised with mistakes. I timed a medication wrongly, forgot to to give a med (totally did not see it in the MAR!) and forgot to label my TF. I had two though critical pairs and before the night nurse left that morning she told me "you will be busy, this is a though pair" Well she must have jinxed it for me because I was busy, to the point where I felt as though I was checking off tasks instead of actually nursing my patients.

Anyway, since I got home I have been feeling down. I feel stupid and incompetent, although I know I am not perfect I expect more from me so it is hard to just 'learn and move on.' I want to be a competent nurse, and I know it takes time. But for how long? I guess I had a totally different expectation of myself at this point in my career (about 1.5 months off orientation), and now that reality has set in, it is hard to swallow it down. Plus, I feel like I am being evaluated and probably judged as a bad nurse for my mistakes ( I know, Im a little paranoid. But I have heard many nurses gossip and I don't want to be labeled). I have to go back in to work tomorrow and I am feeling a little insecure of my nursing abilities.

How do you pick up from something like this? Experienced nurses, do you remember your first mistakes and how you overcame them? New nurses, are you in the same boat, are my overanalysing myself?

[my_purpose]

I'm still in nursing school and not a nurse yet, but I am a Patient Care Intern and I'm a little bummed. Last night on the unit, I was doing my rounds of vitals and a nurse asked me to glucose test her patient in a specific room. I said the name of the patient's room that I thought it was. So as I proceed down the hall, I looked at the name on the placard and not the room number. I proceeded to go in to the room to do the test. I was just about the scan the patient armband that was on the supply cart and one of the nurses, that I formerly liked, told me that that particular patient wasn't due for a glucose test yet. I responded, isn't this room, ____?

So I'm thinking, oh shoot!!! I could have made a mistake. Shame on me. First mistake was not getting the name of the patient and just the number, and the second thing was not getting the cardex from the nurse so that I would able to check the patient's information against that information. I am all about taking responsibility for my mistakes, although I do hope not to make many. So, I test the correct patient, then go back to tell the nurse the reading. The nurse, the I formerly liked, says in fron of everyone in the nurses station, 'You did test the right patient right, in ___ room?" Then the rest of the night, she was on me like a hawk, wondering what I was doing going into patients rooms. It was ridiculous.

I allowed that incident to throw me off for the rest of the night. I was so embarrassed. Then I started the think about how I should have done this the correct way and is this how we treat each other? I'm still a student and it should have been a learning experience. Wow!!!

I don't want this to get back to my manager without having my side of the story told. She I email my manager (I work nights) and explain the situation and where I went wrong and how I would never make this same mistake again? I thought about doing this, but I'm not officially glucose certified, I don't take the course until next week for the hospital. I don't want to make the situation worse by saying that I was glucose testing. Or should I just leave it alone. I have been beating myself up about this all day and it feels good to get it out. Thanks everyone in advance!!!

[dudette10, MSN, RN]

I went in with her am meds and crushed them. I diluted them and pushed them through what they said was basically a PEG tube. The charge nurse was outside the room and apparently knew what they told me in report, that the meds went through the tube. As soon as she heard me coming to the door, she came in and wanted to know how I gave the meds. When I told her, she called the doc and complained.

This really chaps my hide. You mean the charge nurse knew you thought it was a tube into the stomach from the way it was described to you, she knew that you would probably push the meds through the temp tube, and when you confirmed what she already knew, THEN she said something?

That is pure evil to you AND the patient.

[dudette10, MSN, RN]

I'm a year in now, and I put my mistakes in perspective or reframe or figure out a way to prevent it from happening again, if it is reasonable to do so. This isn't giving myself excuses, but I do it as a way to not become consumed with the mistake. A couple of examples:

Night nurses have to put in their own orders b/c we don't have a unit secretary. I put in all the orders for my admission, except for three particular labs all related to the same body system. Last night I went in and had the same patient, and I saw my mistake and that the doc had to write a NOW order for the labs when he made his rounds. I was mad at myself. To avoid getting thrown off for the rest of the shift, I reframed it. The labs were not related to the reason to patient was admitted (like cardiac enzymes for chest pain) but for a secondary complaint as a rule out/rule in thing, the labs came back normal, and the labs did in fact get done.

I had picked up a day shift. A patient with a GI bleed and chronic cardiac issues had a "no aspirin/no anticoag" order at admission less than 24 hours prior. The cardio comes in and, you guessed it, writes for 81 mg of aspirin daily. I gave the aspirin. As soon as I walked back to the station, I thought, "OH ****!" I should have known better. I wasn't thinking. I should have held it and called the cardio to explain the situation. But nope, I blindly followed the order. Then, I called him, and he said to just d/c it, and she shouldn't have problems with such a low dose. The doc's response put it in perspective for me.

I accidently underdosed a patient who needed more than one of the same pill/vial (discovered the error myself later in the shift). I fixed that mistake for the future by using my highlighter at the beginning of shift if more than one vial/pill needs to be used to give the full dose.

I almost gave Dilaudid to a patient who was allergic to morphine. I got the order for pain, transcribed the order, faxed it, and was getting ready to pull it from the Pyxis. Pharmacy called to tell me about the contraindication. I learned to 1) be more vigilant about allergies and 2) NEVER bypass pharmacy on orders. I could not put that one in perspective or reframe it. I just thanked my lucky stars.

[Heartbrokennurse]

Uhg, bad day here too. Been a nurse a few years. I was trying to help out and answer a call light (pt pump beeping) for another RN. The picc heparin was running in looked funny (out far) and I was not sure of the patient's norm I IV pump said occluded. The trainee walked in and I told her I stopped the medication/bc of the picc condition. She said it was norm/used as central line. It looked like she was going to do sitecare. I walked out and explained to the trainee's nurse that I stopped the medication and the trainee was going to do sitecare. She was charting/half-listening to me. At the end of the day . . the charge/trainee nurse were discussing the patient's heparin being off for 4 hours. I overheard and said; I stopped that, remember I told you before. I said sometimes I feel like you don't listen to me. She heard me say the PICC looked funny but not that I has stopped the heparin. She told me that I overreact sometimes so she disregards me at times. I feel terrible. I am upset this happened to the patient and that I had to do with it; but I told two people who did not listen to me I wonder? How do you do PICC site care/care for a patient for 4 hrs and not notice the med is not running? boo, bad day. I feel terrible about it. We all make mistakes. Does not matter your age.