I'm afraid that I'm a bad nurse. - page 3
Hello All: I am a relatively new nurse (practicing 8 months). At the time I started my first job, I entered with the excitement and enthusiasm that accompanies most new endeavors. Although... Read More
0Mar 22, '11 by R*Star*RNYou will always feel like your are forgetting something.
When I started in acute care I had a check-list of things that I needed to complete for each patient. Assessments, VS, I+O, charting. If someone needed to have their foley removed I wrote it down. Dressing changed? Wrote that down.
Crossing things off my list really helped me manage my time, and I wasn't constantly second-guessing if I had done something or not done something.
After a while the list got burned into the back of my eyeballs and while I still write down non-routine things, every item on that list is mentally crossed off by the end of the shift. And if it's something like a qday dressing change that I didn't get to -- well that is why we have nurses working 24 hours a day. Once in a while you'll have days where there just isn't enough time to get that one extra thing completed before the next shift comes on.
It takes a while, probably a bit longer than 8 months, but once you have the routine things streamlined you will find time to spend with your patients. An assessment is a really great time to talk with your patient, find out about them, plan their day. I usually spend at least 15-20 minutes with each patient during their first assessment (my patient load is 3 - 4).
And of course my organization recommends hourly rounding. You may already be doing this, but you will find that hourly rounding really decreases the use of call lights and bed-wetting emergencies. When you check on the patient ask them "Do you need to use the bathroom? Do you have pain? Are you hungry or thirsty? Is there anything else I can get for you while I'm here? I'll be back in approximately one hour".
I agree with the above poster that the ICU can be more stressful than floor nursing. While I don't steadily work in the ICU, I sometimes float there. Of course I take some of the less critical patients but I get to see everything that goes on. They have more codes than any other unit which can be stressful and of course dealing with the family can be tricky at times.
1Apr 6, '14 by morninglandWow, I relate to this so much. It took me two years to finally reach the understanding that I am not a bad nurse, in fact I am a good one by a reasonable standard.
I may not be considered a stellar nurse by everyone - I miss meds from time to time and my charting is not always spot on, but I provide safe care and I am compassionate towards my patients needs.
I have learned that, your confidence is the only thing that will make you appear better than you are. If you walk on a floor and act like you are awesome, people will pick up on that and encourage you. If you are timid, people will follow up with making you feel incompetent.
It is all BS.
Humility in health care is a good thing. Even the Hippocratic oath commands doctors to never shy away from saying "I don't know". But this is not how we were taught. Nursing school teaches you it is dangerous to ask questions. How many of us have heard "you should know that"?
I was targeted on my first floor and constantly told I was a bad nurse and I was going to "kill someone one day". Finally I had enough and told them I would quit if they didn't stop. They agreed (cause they were despret for nurses) and backed off.
A couple days later, I noticed my pt was showing cognitive changes so I informed the doctor and literally RAN her down to get a CT. Since I actually talk with my patients, I knew something was wrong.
When I got back, my manager chided me because the patient was "probably faking" cause she didn't want to go home.
Turns out the pt was having a hemorrhagic stroke. If that patient was under my managers care, she would have died but may have lived because I was her nurse. That was very eye opening.
Another time a nurse reported me to management because I ran an abx ivpb w/o spiking it. The manager said, "yes we can fill out a med error report but first I have one for you to sign for the same mistake".
So understand, that people's view of your skills is only subjective to what they see for a brief moment of your practice. Only you can truly know if you are a good or bad nurse.
If you truly, do unto others as you would have them do unto you: it is almost impossible to be a bad nurse, even if time management is your week area for now.
The reality is, we are not set up to succeed in this profession. We are understaffed and over worked. You will make mistakes and you will feel like a bad nurse sometimes, but that doesn't make it so.
You need to just do the best you can and wash your hands of it at the end if the day. You simply aren't paid enough to deal with that stress and liability.Last edit by morningland on Apr 6, '14
2Apr 7, '14 by Ruby VeeMaybe you are a bad nurse; on the other hand, maybe you're just new. We don't work with you so we can't know if you're a good nurse or not. But at eight months, you would be doing well to be an "on the way to becoming competent nurse." That feeling of dread you describe, the feeling that you might be missing something . . . it never completely goes away. But with experience, you'll find that it sits WAYYYY in the back of your mind and when it does pop up, you really ARE missing something. With experience, you'll know when to listen to that little voice. Right now, the voice is overactive. Check and double check, but don't drive yourself crazy.
Five patients on Med/Surg can be busy, but at 8 months, any assignment will be busy. Perhaps Med/Surg isn't your niche, but it's darned good training. A competent Med/Surg nurse will find it far easier to transfer to another position and pick things up more easily. You, however, are not competent yet. That takes at least two years. Please don't put pressure on yourself to become a great nurse before you've had the time to learn the job, learn the profession and become competent.
You WILL miss things; you will make mistakes. You're human, after all, and no human is perfect. The fact that you're worried about it speaks well of you. Just hang in there. It gets easier. With eight months of Med/Surg under your belt, you're well on the way. One day you'll find that it just "clicks." And that day you may find that you like Med/Surg. Or at least you'll be very clear what you do like and don't like about it.
Hang in there!
0Apr 8, '14 by anon456I have about 1 shift out of 4 when I feel like I've really connected with a patient or family, taken the time to talk to them about their feelings or educated them. Usually it's the ones who need education before going home, so that time is allotted into the patient assignments.
To the others, I tell myself they are in here mostly to get treated for the medical condition. I am not ever going to see them again, I am not their friend.
That does NOT mean I don't deeply care about my patients, because I do. Every one of them. I try to make a 5 minute conversation count for something towards their confidence in the hospital or making them feel like we care about them. I have good "listening ears" to try to draw out the information that's important to the hospital stay.
The bigger satisfaction is seeing that my nursing care (the medically related interventions) is helping them to get better or be more comfortable. Not letting their pain get out of control, propping them up so they can breathe better, alerting the docs if something is getting worse, being able to quickly act on an emergent situation.Last edit by anon456 on Apr 8, '14 : Reason: adding