Yearling

Nurses New Nurse

Published

Hi, I have reached a very very low point in my first year of nursing. Things have been trucking along nicely for about 10 months with a med error here or a missed detail there. Nothing major but still mistakes due to inattention. I changed the way I handle my medications but I still made a mistake with a written script (HIPPA). Then I discharged a patient without completed orders, then recently I had. G tube rupture it's balloon at the end of shift, I reported this change to the oncoming shift but forgot to call GI to assess. All of these more minor mistakes triggered a conference with my supervisor and director to work me through this rough patch. I feel like the dumbest nurse right now.

I was was having a pretty great day today. I felt like I was on the ball. Then my ÜBER was helping me with a PICC when I told her the bio patch was good but when I had assessed the pt in the am I saw her PICC from the side and what I thought was the bio patch was actually the stat lock. So there was another discussion about attention to detail.

i don't know if I am cut out for this job. The finer details escape me. I'm pretty sure that I'll never look at a PICC from the side again but there are millions of other things that crop up daily. I want to be good at this but I don't know if I can.

Please, has anyone else fallen into this problem so late in the game? How did you overcome?

I wasn't a 'natural' with details like you mention, either, but I learned how to be.

The most unhelpful thing you can say is "I'm just terrible with details". You can't be and be a good nurse :) Needless to day I felt like a complete idiot for my first two years. Literally.

Making mistakes is human. Making the SAME mistakes over and over again is a kind of incompetency and needs to be addressed.

Is there a 'pattern' in the mistakes, besides being bad with details? Are you in too big of a hurry? Are you prioritizing your tasks appropriately?

For instance, your patient has CHF and renal failure. You aren't going to spend four minutes listening to bowel tones, considering all the other systems you have to check. You can walk in a patients room and SEE off the bat the person is eating and chatting with family, say hello to everyone, observe their coloring, breathing pattern while talking and eyeball their foley bag and then move to the more critical patient who needs you NOW. You have 'assessed' this patient in less than two minutes, enough to move to a sicker patient and leave fully assessing the CHFer for a bit later.

It's not so much a matter of 'too much detail' but HOW you prioritize the details. It could take you three or four minutes to do a hit and run mini-assessment, enough to get something on the chart. Check ABC's, IV line, foley draining, pumps need take very little time. Keep your mind on the task you are doing rather than all the other stuff you know you have to do.

A nondetail person is usually good at the big picture, eventually, with experience. Until then, prioritize. It's about the only thing you can do with a chaotic patient load.

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