When does it get better?

[RNBuggers]

I know this topic has been exhausted, and I have probably read every post related to it. But I think I just need to get it off my chest and talk with nurses outside of work. I am a brand new nurse and I have been off orientation for one week. I have made two errors (thankfully ended up being minor). On orientation I flushed a hemodialysis line. I thought it was just another line I could use, I had never heard of not being able to use them so I didn't think to ask. All the proper steps were taken and the patient was fine. I will definitely never ever do that again! Next on my first night off orientation, I was extremely overwhelmed (obviously)! I had a patient on an amiodarone drip and pca, another with a pca, and one with an insulin drip. I made a slight error with the insulin. I miss understood the order that if the patient went out of goal that they needed to be checked every hour again. I thought it was after two checks of being out of goal that it needed to go to every hour. The patient was fine and I only missed one check and realized the error. everyone told me it was totally fine and that I learned from it! My manager was even really cool about it when I told her. I just feel so bad about these mistakes still. I dread going into work every night and I hate this feeling. I am so scared about everything I don't know and that I will really hurt someone. I know that it takes about a year to feel comfortable, but how soon does the fear go away? I can hardly take it anymore. We are a very stressful unit with patients that should be in the icu and we have a 5:1 ratio. Does anyone have any loving advice for this anxious and scared new nurse?

[Tenebrae, BSN, RN]

The very first time I did a solo male catheter change. I was so nervous that I focused on getting the old one out and the new one in as quickly as possible that I didnt give the lignocaine a chance to work and should have gently rotated the catheter prior to removal.... As a result the poor patient was in a great deal of pain. I had nightmares about it for a solid week. Its certainly not a mistake I will ever make again.

I think we are our own worst critics. Look on this as a learning opportunity and stop beating yourself up over it (which I know is much easier said than done) self flagellation achieves nothing

[kaylee.]

I can't believe they gave you two high risk drips and two pca pumps on your first night alone!

where i was as a new grad, cardiac stepdown, they started with a light load, and started assigning high risk pts gradually.

how many insulin and amio gtts have you cared for with the preceptor? the team you had would be a crazy night for any nurse!

This is irresponsible on their part. so dont feel bad about how you handled the shift! And dont be afraid to tell the charge if you dont feel safe with such a case load. They will respect you for knowing your limits and asserting them so you can practice safely.

I have been doing this for a year + now, and i still ask for help--ALOT.

It gets better, i swear, but the mistakes will still pop up. The HD flushing is one of those, and while you cant unflush it, you wont even have to worry about doing it twice, bc you will see another hd line, and will get a flashback of the first one, and you will take pause.

Most likely, it will be like seeing a hot pan after burning your hand for the first time. you will have a reflex to double check.

And if you dont, just practice pausing with EVERY new thing.

The first year is a challenge, but it gradually eases, so stay positive and keep learning!

[VANurse2010]

Personally, I don't think an insulin drip is really appropriate for a floor with 5:1 ratio, especially not paired with someone on amiodarone. Doesn't sound like an appropriate new grad assignment, OP's mistakes aside.

[RNBuggers]

Thank you for the reponses, they have really helped. I have talked to other new nurses on our unit and they also have concerns. We have lost a few new grads in the last couple months. Which makes me realize I'm not alone in feeling like this. My second week of orientation did go better in a way. I didn't make any mistakes that I am aware of. But I did get another insulin drip, a heparin drip, one very high acuity patient, one patient started having chest pain, and I got an admit. I asked for a lot of help and I feel as though I handled it well. I was very overwhelmed and felt like bawling the entire shift but I got through it. There is talk about turning our unit into progressive care. Meaning it will be a strictly what our specialty is (I will not say what it is to protect the facility and myself). We will be 4:1 ratio if the changes are made. I will wait to see what the decision about it is next month and if there are no changes made I think that I will look for another job.

[PCnurse88]

I'm in my 8th month at my current job and I've made my fair share of mistakes, including one with a heparin drip. Luckily I thought it seemed to be going way too fast almost immediately after I programmed it and asked someone to double check.

But the good thing that came out of this? I'll never make that mistake again because now I know what I did wrong.

[LVHI_RN]

I'm sorry you're feeling like this. It really is a tough feeling! We are all human. Mistakes happen. We just have to stop, think about it, learn from it, move on, and don't make the mistake again. Always ask questions, any question. Ask ask ask. Don't hesitate. What's the worst thing that can happen? Getting yelled at. I rather get yelled at for asking a "stupid" question, then just assume and make a mistake endangering someone's life right?

You're new. Don't be too hard on yourself. Prepare for your day well. Have a good brain sheet.

As for the feeling of being comfortable, idk. I'm still feeling the same way and wondering the same thing. One day at a time. Good luck!

[RNBuggers]

Thank you for the response. Our charge rn talked to the managers about the new graduates getting too difficult of assignments. Hopefully they take that into consideration. I am asking a lot of questions. But I still feel so stupid. I was involved in an error, not all of my fault but partly. A patient was given expired lipids. Another nurse hung tpn for me because I was insanely busy. She thought I had put the lipids in the room and scanned them, but I had not. It was from another night when another nurse did not hang them properly and they did not infuse. I did not notice until late that the patient should not have gotten those lipids. The patient is doing fine from what I know. I feel so horrible about it. And so inadequate. It was a horrible busy and stressful night. I had also scanned a heparin injection for another patient and realized I didn't have carpujet to administer it. I went to go get one and got distracted and never gave the heparin. And didn't realize it until it was time for the next injection. I know that is a very minor mistake and they patient was healthy and going home. But I still feel so stupid! Are these too many mistakes?? I feel like all I do is mess up. I'm sorry to keep whining on here, but it does help to receive input from experienced nurses.

[plinytheRN]

This reminds me so much of my first experience as a new grad on a medical telemetry floor! Same stress, very sick patients with 5-6 patient ratios on day shift... It's rough, but you will get it, have faith in yourself and keep trying. I eventually did get a little bit more comfortable.

[RNBuggers]

A little over a month off orientation now. And it is better :). Thank you for putting up with my whining! I still feel extremely nervous going to work, but the dread is almost gone! I think having our lead talk to the manger helped. I feel as though my assignments now are more balanced with the other nurses. Some nights I actually feel like I did a good job !