Being too hard on yourself

[walkingthecow]

I am a new nurse--I have been working at my first job (LTAC ICU) for about 7-8 months now. I made a minor (?) mistake at work and it is weighing on me.

The last shift I worked I was caring for a patient that had high gastric residuals--pt vomited on previous shift and tube feed was turned off. On my shift I pulled off 200mL, next check residual was only 30mL so I decided to try starting tube feed again. I passed this on in report.

Well, when I woke up (I work nights) I had a voice mail from that nurse saying that the GI doctor was irritated because I didn't chart the residuals or when I restarted the tube feed, and she was just calling to remind me it is important to chart things like that etc...Now this nurse was my preceptor when I was on orientation, so I don't think there was anything wrong with her calling me about it, nor do I think she was trying to be ugly. I know I charted when I started the tube feed, and yes I did forget to chart the residual (part of this is because how we chart residuals is weird in our EMR and I will be looking up policy the next time I work).

But it has just been on my mind. I feel like I will never be good enough. And I am tired of this culture of "the doctor is mad at you" or "doctor so and so will chew you out so you have to be careful"...I don't know if this is just my facility or if it is like that everywhere, but can't we just all treat each other like professionals??

I also am wondering when my coworkers will start to trust my knowledge...it seems like it still frequently happens that a coworker will help me turn a pt or something, and feel like they have to make a comment like "with all this weeping edema you need to be sure to put chux under the pt's arms" (when chux are already under their arms...) "oh be sure to do oral care on that orally intubated pt"...I am trying hard to just say "ok" instead of "I know that!!!" I know I still have a lot to learn but I'm not brand new!

When I was in school I was in the top of my class, did leadership stuff, etc. And it has been the same in previous jobs I've had... I am typically good at what I do and have been a well-trusted employee. I know it will take time, but dang...

I would have posted this in first year as a nurse but I wanted to get perspectives from nurses with more experience too. Any wisdom would be appreciated...how long did it take for your coworkers to stop treating you like the new guy? Do I have to look forward to May/June when we hire another crop of new grads?

[pookyp, LPN]

I think they are just trying to help you. I hear on this site many times about nurses eating their young. Now I see this situation where a nurse is giving pointers and reminding you of tasks to be helpful, and there's still complaints!

Don't feel discouraged! You're still new! You'll get the hang of things! :)

[txredheadnurse, BSN, RN]

It takes time, a lot of time, to trust your co workers fully, to know they can pull their share consistently. Nonetheless checking in with each other and serving as a back up checklist is necessary to help everyone not miss things. I view it as a healthy interdependent team model.

I don't think any of yours are out to get you but rather trying to ensure you remember all the details that go into documentation and bedside care. I also think you are feeling insecure still and that might be making you perceive their guidance as nagging or lack of trust.

[OCNRN63, RN]

If it makes you feel any better, I've been a nurse for almost 30 years, and I still fight with low self-esteem. I've always gotten good evaluations from my supervisors, but the little voice in my head constantly rebuts positive feedback.

Have you tried to keep a journal and writing down all the things you did well on your shift? For example, "I did a complicated dressing without needing any help," or, "I placed an IV in a patient who is a notoriously hard stick." You get the idea. Another thing you could try is to wear a rubber band on your wrist, then whenever you start having those negative thoughts, snap it, then replace the negative thought with something positive.

You are new. It takes time to get organized; to understand what you need to do and why you need to do it; and, feel like a competent professional.

You will get there. It sounds like you have some supportive co-workers; be glad for that! Eventually, you won't be the NKOTB. For now, don't pressure yourself to run before you can walk.

[LakeEmerald]

Walking,

It hurts to hear that you have done ONE thing wrong today when you have done 100 things right all day long. It stings and it has happened to us all. However, the reason you were told is so you don't make the same mistake again, not because you are a bad nurse. It sounds like the message was delivered respectfully and in the long run, helps you be a better nurse.

You also do need to stop being so hard on yourself. The whole "the doctor is mad at you" and "that dr will chew you out" happens where I work and in lots of other places with certain drs. The trick is to step back and analyze the situation objectively:

a) Could you have done something better? If yes, chalk it up as a learning experience and do it the better way the next time. b) Was the person unnecessarily a jerk when they said it? If yes, then really - who is the jerk here? Not you! That's when you put up a barrier and don't let the hurt in! There are weiners in the world after all, in all professions, but they don't have to ruin YOUR life!

If a dr has time to be mad at you, he/she desperately needs a life! Where I work, 97% of the docs are great and 3% can be weiners at various times. Learn to say "meh" and move on.

Regarding coworkers, take the chip off and let the helpers help. If they didn't care they would let you fail, and that is worse. And yes, as time goes by and you become more experienced, you may find yourself looking at a green nurse with less experience and offering unsolicited advice because you CARE, not because they aren't good enough. I hope you can ease up on yourself. Best wishes to you! :)