Mistakes, overwhelmed, new grad

  1. Hi I just wanted some tips and advice.
    So I'm a newly graduate and started my nursing job In November! So far so good I am really enjoying myself, however 3 months in and I've made silly medication errors and that has completely knocked my confidence. On top of that I was on a night shift not long ago and was asked to move to another ward as there were no patients on my unit! I was allocated 15 patients for the whole night, and ended up not realizing my patient could potentially be deteriorating (aki, oedema, catheter but no urine draining) obs were stable but he was on lots of fluids but was not passing urine! Anyway I didn't escalate until the morning ( guided by the nurse in charge). I just keep thinking as a student or text book I would've picked this up straight away, escalated it to the doctors etc. I'm so overwhelmed, ended up crying & apologizing to the NIC for my mishaps& on my journey home that morning!! I just don't know what's going on with me, it's just one thing after another knocking my confidence and even making me think whether or not I'm capable to be a nurse is this normal? Any tips on ways to overcome these situations and not be too harsh on myself?
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    About Welshy101

    Joined: Jan '18; Posts: 3; Likes: 3
    Specialty: 1 year(s) of experience

    7 Comments

  3. by   Lil Nel
    Where are you working? You were responsible for 15 patients? Can you provide a few more details?
  4. by   Welshy101
    I normally work on coronary care, but due to having no inpatients I was moved to care of the elderly ward. Yes I was responsible for 15 patients bare in mind that this is a completely new hospital, still getting to the the policies etc and first graduate job!
    Last edit by Welshy101 on Jan 13
  5. by   Lil Nel
    First of all, forgive yourself for making these mistakes. You are new, and are expected to make mistakes, not perform like a seasoned nurse.

    But do try and learn from these situations. You didn't specify the medication errors, but always double, and if necessary, triple check your medications against the MAR. Double check your IV rates before walking away from the IV pump.

    I am sure you won't make this particular mistake again.

    When I was still on orientation, I had a patient with liver cancer who was very, very sick. I foolishly listened to my preceptor, a nurse with under two years of experience, who told me to allow the patient to sleep, rather than conduct my usual neuro check.

    Later in the shift, the patient was found, by the techs, to have left-sided weakness. A call was made to the MD, as this patient most likely had suffered a stroke at some point. We couldn't give a time of last wellness, because I listened to my preceptor, and allowed the patient to sleep, rather than undergo neuro check.

    My lesson learned: Don't always listen to your preceptor. Follow your gut.

    After that, I didn't care if all my patients were sleeping, they were going to wake up, tell me their name, dob, squeeze my hands, etc.

    Each mistake is a learning experience. And nursing is a profession in which you never stop learning.

    Believe me when I tell you that I understand all too well that feeling of being completely overwhelmed. And who wouldn't feel overwhelmed being in a new environment with 15 patients.

    Are there experienced nurses you can turn to for advice when you have questions or feel overwhelmed?

    Do your best not to cry at work. What you are feeling is normal. When you feel overwhelmed, take in a deep breathe and let it out. I learned this in yoga. It slows things down and helps you think clearly.

    Again, you are normal. You will get past these feelings.

    Good luck!
  6. by   OkGo1
    New grad year is tough! I am at the same stage as you currently and here are a couple of things I have learned.
    ALWAYS be your own advocate when patients are being allocated, and never take more/higher acuity than you can handle. This in turn is advocating for your patients to ensure that you are always providing safe care. You must be able to stand up for yourself and take a load that you feel comfortable to handle. If you feel that you have been given too much, or a patient is outside your scope, speak up! Patient safety is always the priority.

    Ask questions, all the time. Look things up. General rule: if you have a patient that you are unfamiliar with their condition/care/medication regieme & you don't have time to adequately study their notes/read up sufficiently on policies/protocols, than your load is too heavy, and your practice will be unsafe.

    ALWAYS double check everything. if it's a double sign, don't count on your colleague to check that it's the right drug - sometimes they sign mindlessly! YOU take responsibility and must always be conscious of every drug/fluid you give.

    Lastly, as said above you need to forgive yourself for mistakes made. Learn from them, improve your practice and move on. Don't dwell on it. Don't let it get you down! Take a couple of days off and do something you really enjoy - it's so important to look after your mental health in nursing, but especially during grad year. All the best!
  7. by   OrganizedChaos
    15:1 is tough for a new grad. It will get better, I promise you.
  8. by   Munch
    15 patients in an acute care hospital is tough(you said hospital and working with heart patients usually so I assume you are working acute care). If I could give one piece of advice to a new grad it would be to be vigilant(bordering neurotic) about medications..double, triple, quadruple check even until you are comfortable with medications, dosage and route of administration. These things are so important. A few years back when I first started the job I am working now we had a new grad on the floor that had a patient on dilaudid 4mgs PO and she gave the patient the Dilaudid 4mgs but gave it IV. 4mgs PO Dilaudid is equivalent to 1mg IV so you guessed it the patient needed narcan. Thank goodness the patient survived but it scared me into being neurotic about checking medications.

    You will get the hang of it though it just takes time. Remember you are brand new and mistakes will be made. Just use it as a learning experience.
  9. by   Welshy101
    Thank you all for your reassurance and advice! Will hopefully take it on board!!

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