Stupid mistakes!!!! - page 3
I feel so bad today. The past two nights I have worked in the ED and have been so nervous! On Monday night we had a lady to come in with an acute MI. The doctor ordered 50mg of Demerol with 25mg of... Read More
Sep 29, '08Do not let this get you down. I do not know a nurse that has not made a mistake. The important thing is you learn from it. Think of it as this is how you become a better nurse. This is how you gain and experience. If the worse thing you do is not label syringes, consider yourself lucky.
Oct 7, '08I've been a nurse for 8 plus years and a couple weeks ago I gave phenergan undiluted two times in the shift into one hand IV heplock and in one left ac IV site. Both times I worried about infiltration but it wasn't until the second time that my brain clicked to remember that this might be a vesicant. It's an old drug and apparently I'm a little late to realize the latest rule is to dilute it. For a number of reasons I missed this getting into my head and last week I made the mistake. After figuring it out, having the md look at it and the patient being discharged and following up with risk management, I'm wondering, what next, can't stop thinking about it. The patient's left hand was red at the time and apparently CT had tried to inject contrast after the initial dose of contrast. The patient got the phenergan just before CT and all I noticed was on the flush, the IVS leaked slightly and the patient seemed to experience some discomfort, but denied more than that. I hear it takes 2 weeks to develop a problem. The two weeks will be up in about three days. Feel depressed about it and I'm expecting to hear more about it. If not in the two week period, maybe later after the patient has had 3/4 surgies to fix her hand or goes septic or something. I've looked up nurses and lawsuits and wish now I'd read more stories about mistakes so I could learn from other people's mistakes to engrave frequent mistakes in my brain so as to be extra alert when it comes to high risk situations. I also wish I knew more about legal documentation and more about how people lose their nursing license, to avoid those errors as well. It turns out pharmacy had also neglected to place warnings in the pyxis and on the MAR. From what I've read and heard, it seems the nurse often takes the brunt of the lawsuits, for reasons I can only speculate at. Hopefully, I'm wrong about that. One theory is that someone has to be blamed so soceity can believe it's taken care of with that one person. But it's not, everybody makes mistakes, dumb mistakes too. I really think a couple of classes inshould be devoted to these topics and how to cope with them because being new grad is very scary at times and so is continuing in the field after you've made a mistake/two/three. Most seem to manage with a certain amount of denial, humor etc. because there's simply no way to know it all until you've been through at least some of it. Believing you have a right to be there is half the battle. I believe the medical field is becoming more and more regulated and delineated and there will be more and more lawsuits until no one wants to go into it anymore. Then one day, someone will realize criminalizing certain errors has it's own rebound effect, because an imperfect nurse with the heart and courage to do it with all she can is better than no nurse at all.
Oct 7, '08Quote from Dawn_M_74I feel exactly the same way. I love this thread, it reminds me I am not the only one. LOL!My Gosh how I relate to this post!
I am a new nurse (just graduated in May; passed NCLEX in July) & I feel so dumb 99% of the time. I feel like I don't know what to do during certain situations (like when a pt asks me about certain medical procedures/tests or brand new meds that I haven't heard of & forgot to look up before I take the med to the pt) & that I just don't have enough time to get everything done during my shift (7a-7p). I'm very fortunate that the floor I'm on now has lots of supportive RNs/LPNs who know that I'm a brand new nurse & they really go out of their way to help me out. I can ask just about any of them anything so I'm very blessed.
I know it's gonna take at least a year before I start to feel comfortable as a nurse....I just try to remember that fact whenever I feel overwhelmed &/or dumb(which is most of the time).
Oct 8, '08
Oct 9, '08Here's the thing... My primary preceptor caught several potential med errors in my first couple of weeks of orientation so now she's super nervous /careful when I give meds to anyone (by rights, I know)... I, too, am cautious ;-) I perform assessments well, interpret labs, educate pts, etc -- it's just the meds.
Last week, on my 4th week of orientation, I hung vanco without checking to see if a trough was ordered and/or drawn (day nurse said she *thought* she ordered it... I got busy and *ass*umed that she did and I hung the vanco right after the lab should've come... anyway, I ordered the vanco to be done prior to the next dose on my shift and THANK GOD it was in a therapeutic range; otherwise, I would have "had the wrath" of the infectious disease doc per my preceptor. The whole time this was happening, my preceptor did not gently remind me about checking for the order or if the lab was drawn... (I think *I'd* do that).
I am not sure what to do -- on the one hand preceptor says I'm just like any other new grad and doing fine; on the other hand, I get her wrath for stuff that I feel like she could help me avoid. While I definately won't make the almost misses / mistakes again, I feel like my job is on the line.
The unit has a brand new NM and apparently she's pretty harsh (to be nice). She had the day charge nurse call to set up an appt 48 hrs from the call for a 30 day eval (on day 6o!). I stayed late that next shift, she caught me in the hall and we had a spur-of-the-moment meeting. It was all about how I needed to improve, but without specifics; she said she'd check w/ my preceptor and Nurse Educator for some.
I am 5 weeks into my job and I feel like ****. I feel like people on the unit are on witch hunts for the "weakest links" and I'm one of 'em. I've heard countless times from people on this board and other places that I need to "stick it out" on my first unit, but I'm worried about getting fired. I feel like I should quit before this happens.
I don't feel safe to divulge this information / ask for suggestions from anyone on the unit -- I'm new to the unit and to the state (RN educator noted that and appreciated that fact).
The hospital is for-profit -- could the NM be worried about profits and trying to find reasons to cull staff? Please help!! Feel free to PM me ;-) .
Oct 18, '08Quote from jessnurse06I know this is an old post, but it so sounds like what I feel like a lot. I don't think you sound like a loser at all. I think you sound like "I" sound inside my head...and it's a bad habit to get into, this calling yourself names. I've been catching myself doing it and I am stopping it. Of course, this poster has been a nurse for two years now...I bet if she posted now she'd really feel so much better than she did back then!I really identify with this post. I just got my license a month ago, I am so hard on myself when I make a mistake like not writing a order down in the TAR which I do before I really screw anything up or talking to a Dr and why I do this I don't know, I forget to grab the MAR. Thank goodness the facility Dr is nice & understanding most of the time. When I ask this one nurse on my shift a question she looks at me like an idiot. Mostly all the nurses I work with are very helpful. I was going end the shift last week & never come back, because I feel like an incompetent fool, my ADON threatened me with a fleets. She told me to get over this it's going to take a least a year before I feel comfortable in these new nurse shoes. She tells me I expect perfection from myself, and I'm not going to get it so knock it off. I know my stuff but in clinicals there was always an instructor there, I did my first foley & this is stupid but I kinda freaked when I had to set it all up, it doesn't come together like the one in the lab supplies we bought. Man I feel like a loser, & most people reading this will think so too.
Oct 18, '08Just wanted to share my "learining" experience for the week.....when you are getting an admit make sure the room is clean before you tell them to bring the patient up.....otherwise they will be waiting in the hallway......
Oct 18, '08I have made a similar mishap that has only consumed and wasted my time. I had to give Heparin and Dilaudid and I drew both up in a normal 3 ml syringe then couldn't remember which I drew up in which! Not only that but I forgot to put a subcut syringe on the one with the heparin so I had to waste both. Felt pretty stupid. It happens though and the good part to remember is your recognize your mistake and don't get lazy and give them anyways.
Oct 18, '08Quote from Sully, RNJust wanted to share my "learining" experience for the week.....when you are getting an admit make sure the room is clean before you tell them to bring the patient up.....otherwise they will be waiting in the hallway......
Hah, sometimes this can't be avoided though with the rate they give you admissions!
Oct 18, '08Quote from Sully, RNI see this one happen at our facility several times a year. So, here's what happened last time this same thing occured. ER had just wheeled a sweet oler lady ( with demetia ) up to our floor. So as she was waiting while we scrammble to clean the room she looked into the room next to her and very loudly shouts, " I see that man's ass!" I could hear somebody in another room laughing, and the door to that man's room closed real quickly. That sweet woman was such a character, she entertained us for 4 days and we were so sorry to see her go.:chuckleJust wanted to share my "learining" experience for the week.....when you are getting an admit make sure the room is clean before you tell them to bring the patient up.....otherwise they will be waiting in the hallway......
Oct 18, '08Quote from jessnurse06I really identify with this post. I just got my license a month ago, I am so hard on myself when I make a mistake like not writing a order down in the TAR which I do before I really screw anything up or talking to a Dr and why I do this I don't know, I forget to grab the MAR. Thank goodness the facility Dr is nice & understanding most of the time. When I ask this one nurse on my shift a question she looks at me like an idiot. Mostly all the nurses I work with are very helpful. I was going end the shift last week & never come back, because I feel like an incompetent fool, my ADON threatened me with a fleets. She told me to get over this it's going to take a least a year before I feel comfortable in these new nurse shoes. She tells me I expect perfection from myself, and I'm not going to get it so knock it off. I know my stuff but in clinicals there was always an instructor there, I did my first foley & this is stupid but I kinda freaked when I had to set it all up, it doesn't come together like the one in the lab supplies we bought. Man I feel like a loser, & most people reading this will think so too.
No, not at all, it took me 40 min. 2 put in a foley a couple of nights ago.
Oct 21, '08As far as the "witch hunt" goes, I remember my first nursing job. It was actually pre-strike at this big teaching hospital and I remember missing giving this rescue drug, leucovorin (oncology unit), which basically rescues the body from the chemo previously administered so there is no organ damage. I simply did not know what the drug was and was not cued up to it's importance among all the other very important million tasks I had to do and somehow missed it in my overwhelmed state. When you're new, I think you have a harder time prioritizing because your brain isn't sure when to freak out and when not to freak out, so it's freaking out all the time (I found this very tiring as well, the anxiety is very draining in and of itself). When my preceptor discovered I'd missed the drug she said I should've known what it was and how important it is because the importance had been written somewhere in my orientation booklet (ok my orientation booklet was about a 1/2 foot deep of new information). I remember feeling terriable, fessing up to the pharmacists with a shaking voice, and the doctor (some big whig dude pioneering some blood brain barrier treatements) and feeling like the loser of my generation. I made a couple more errors (not so serious) and after reporting myself dutifully, was brought into the nurse managers office and two other nurses followed and shut the door. They looked very worried and anxious and this worried me and made me even more anxious than I already was. My manager told me no more med errors would be allowed and that I was on probation.
I went home and thought about it for a couple days and unlike my usual tenacious self, I called them up and told them I was resigning. I didn't have another job (also unlike my usual behavior), but by the next month I got a new job that wasn't nights or 12 hour shifts, but an evening shift 8 hour job at a hospital in town that at the time seemed less flashy, but much more welcoming and interestingly enough, is now a magnet hospital. I was actually told in my interview at the new hospital that "nurses eat their young" and that that was probably what was about to happen to me. The new job was still hard, no doubt, but everyone was so much more supportive and more kind and nurturing and guess what? I learned more. I have since heard that "it takes a village to raise a child" often referring to a new nurse as well. If you get the feeling they're trying to eat you alive, you may be right. Don't be afraid to look for a better learning environment. I may have been able to tough out the other job, but it wouldn't have been anywhere near as supportive and helpful as the second job I found. I think that it really pays to do your own personal studying, if for no one else, it's good for the patients and your own confidence and well being at work. Knowledge is power. But put a limit on it, you can only do learn so much, so fast and you are only one person. I wish I had done that very thing more because over the years all that self teaching adds up to a lot better patient care. I would also highly recommend 8 hour shifts for the new grad, evenings in fact. It makes the shock more gentle on the body and the mind and the heart when it's already being challenged with a plethora of new information and skills and crotchety old nurses that are injured by their own painful experiences. Once you've gotten past that first 6 months or year or so, things get easier. Get enough exercise and beauty in your life. I remember becoming very depressed after taking care a many dying cancer patients and becoming obsessed with death. I joined this mountain climbing club and on my days off starting going outside a lot and I remember a lot of the depression lifted and I think it was the beauty of the forest that was very healing as well as having a mental break from things so serious. The concept of "art saves lives" , I found, rings so, so true.
Anyway, just trying to encourage a little, remembering my own painful new experience.
Oct 21, '08I can totally relate to what you said about feeling stupid. I started working on a OBGYN unit (which includes L&D, Postpartum, and Nursey) in a small community hospital and it seems like every day I work I do something wrong, and there is no positive feedback. It feels like my orientation so far has been very disjointed (we have been very busy) and everything is different from any clinical I had in nursing school, e.g. all the nurses notes are computerized and the MARs on paper only.
Today was the worst --I couldn't insert a foley (again, haven't been able to since I started working) and then I left the keys to the narcotic cabinet on the counter by the cabinet instead of putting them back in my pocket, and didn't remember before it was time to pass them off to night shift. True, I've never been anywhere else that used keys rather than a code or fingerprint but still, I've been upset since I left work. I feel like a total failure and can't figure out what's going on (why I keep screwing up)