Murphy's Law

  1. This is just a general venting session but I've bottled it up for about 3 weeks now and it's driving me crazy!

    Most of my nursing experience is in correctional nursing, and the last 5 years in administration. So my skills are rusty at best but I'm willing to learn and try!

    I have Bsn classes with a DON of a small local hospital about 15 miles from where I live. I have a full time job but it's just not paying the bills. So I asked this DON if she needed any PRN help. She asked me if I had any ER experience, she really needed help in ER. I said no but I was willing to give it a try if someone would show me the ropes.

    Well, I started working two 12 hour shifts a week at this ER. (as I said , it is a very small hospital and they usually only staff one nurse in the ER at night). I got three shifts of orientation and I was on my own.

    The ER is staffed with rent-a-docs for the most part. Also mostly foreign. They are all fairly good Doc's though. I told the physicians right from the get go that I was not an ER nurse and to just bear with me while I was learning.

    I had worked by myself for about 6 weeks and had no problems. The ambulance service works out of the hospital and those paramedics really know their cardiac stuff ( which is my downfall and one of my ER fears!) So if I needed help in that area they were always in the building to assist.

    As I said, I had worked about 6 weeks and had seen a little of everything, was still not completely sure of myself but getting more confident each shift.

    Until one night I had one of those nights where everything I touched turned to mush or went wrong. I couldn't do the simplist thing like get the EKG machine to turn on, had to ask the paramedic. Couldn't get the neb. trt. tubing to connect right for a mask, had to ask the paramedic. A teenage girl came in with classic kidney infection symptoms ( flank pain, painful urination) I was all set just to give her some bactrim and send her on her way but these Doc's always have to go to extremes. He ordered all kinds of lab work, including a pregnancy test, and a KUB. Also had to start an IV on her. ( luckily that was one thing during the shift I did right, got it on the first stick!)I drew blood work and then the xray tech took her for the KUB.

    The xrays were done quickly and the tech brought them for the doc to review. The Dr. asked if the pregnancy test was back yet and my stomach went in my throat. I had sent her for the xray not knowing if she was pregnant or not. ( I didn't see the need for pregnancy test in the first place) Of course I got raked over the coals for that. (I'll for sure never do it again!)We kept waiting and waiting for the pregnancy results. I called the lab and the tech said they usually took a fairly long time. The Dr. asked if she did a urine or serum test. I had inadvertantly marked serum on the req. when he had written urine and that's why it was taking so long. I could tell he was getting more irritated with me by the minute.

    The next pt. was ordered Demerol for pain. I grabbed the tubex and started to draw it up and just in a nick of time noticed I had grabbed morphine instead of Demerol. No one observed that mistake, just me, and I caught it in time, thank God!

    The next pt was an elderly, disoriented woman from a nursing home who had fallen and had a lac. on back of her head. Her blood pressure was bottoming out so I immediately got IV stuff to get it going. She had those little rolling spider veins and I tried twice but each one blew. Rather than keep sticking her unneccessarily, I called the paramedic to try and of course he got it on the first stick. Tried to hook her up to the millineum monitor and couldn't get it to work right or register at intervals.

    It was going from bad to worse, I was beside myself!

    The night was finally over and I beat myself up all the way home. About 4pm that day, right after I had woken up, the DON called me and said that they had had several complaints about me last night .The caregiver that was with the nursing home lady said I acted like I didn't know what I was doing, I had trouble starting the IV ( doesn't everyone sometimes, that's why I asked for help!) and I didn't wear gloves when I checked the lac on her head. I didn't wear gloves, but I didn't mall my hands all over the lac. I just raised her head up to see where the cut was. The DON also said another pt. complained but didn't elaborate. But the main thing was, the Dr. complained and wanted me written up.

    She said she wasn't going to do that, but she was going to move me to the floor so I could get some more experience starting IV's and hanging cardiac drips, etc.If I still wanted to work the ER I could work a daychift as the second nurse. :angryfire I did not take offense to this except for the fact that it was just one bad night! And she didn't even offer to hear my side of the story, or what happened or anything. She just took what everyone else said as the gospel and that was that. I didn't think much of her as a supervisor after that. As I said I've been in administration for about 5 years and one thing I've learned, you always get both sides and all the facts before you start placing blame and making decisions.

    This really took the wind out of my sails and I felt inadequte for days and days. But I went ahead and worked the floor and kept my mouth shut because I really need the xtra paycheck.

    Sorry this was so long, but as I said I've been holding it in for a while and needed to get al the details out. Thanks for listening!
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  2. 7 Comments

  3. by   Tweety
    I appreciate hearing you vent.

    This person doesn't sound much like a supervisor at all. But you are stuck with her/him.

    Shake it off. Start new and fresh in a new day with a positive attitude. Give yourself a break, be kind to yourself. Admit your shortcomings, look where you can improve and realize you are a great nurse!!! You live and you learn. I've learned many a tough lesson through my mistakes.

    Is that enough of a pep talk? I can't tell you how many times I've had to pick myself up by my bootstraps and move on and give myself a pep talk like that.

    Sometimes we have a bad day and things just crumble down around us. My manager whenever someone new has a bad day she will put them back on orientation, or drop their patient load. I've talked to her a time or two about that. "You have to expect new people are going to have bad days at first, don't bump them aside or backwards. Allow us to have our bad days!".
  4. by   Energizer Bunny
    Wow...not a nurse yet, but that just sounds like a horrible night. I'm sorry it was so rough on you. I also agree that the supervisor should have at least listened to your side of the story!!! Did you have something personal going on that maybe was subconsciously bothering you, do you think? Or do you think it was just an "off" night? I'm just curious about that...don't feel like you have to answer if you don't want to.
  5. by   Stitchie
    Dixiecup, been there too! I just started in the ED after 7 miserable months on the floor; I had six weeks of orientation on the day shift when I was actually hired for PM's -- it's as stupid a way to train a new person as possible.

    We've all had bad days. We also have our great days. ED nursing, I've learned, is a completely different animal. Species, even.

    If the docs are hesitant/unsure/intimidated it will change the way they are willing to work with you, too. But what I've noticed from many managers along the way is that the staff they have come to know are the ones they listen to unless you are assertive in telling your side of the story. In my case it's only gotten me an insincere 'uh huh' and not much else.

    It will get better for you; hang in there and allow yourself to make mistakes. We all do and the ED is a tough place to start, no matter how small.

    You will develop your routines and habits eventually and think of things in the ED you would never have thought of in your previous jobs -- like urine hCG screening every female 10-50. That was a tough one for me too -- even when they way they are not sexually active or a virgin or whatever, it still has to be there, even when I don't see the need for it, either. Even veteran nurses still make this mistake that I've seen and we just have to shake it off as best we can.

    Good luck. Stick with it.
  6. by   SCRN1
    I'm sorry all that happened to you...especially in one night. I think if they'd given you a decent orientation, you all would have been able to avoid at least some of that. Like you said, she wasn't being very fair by not hearing your side.
  7. by   renerian
    OH gosh that sounds like a horrible night...........

    Hugs,

    renerian
  8. by   CHATSDALE
    i guess everybody has rough times just make it the best learning exper you can and go on from there....might be a blessing in disguise maybe you will like the floor and if you go back to er make yourself a mental check list and hopefully these night will be few and far between.....good luck
  9. by   Dixiedi
    Quote from Dixiecup
    This is just a general venting session but I've bottled it up for about 3 weeks now and it's driving me crazy!

    Most of my nursing experience is in correctional nursing, and the last 5 years in administration. So my skills are rusty at best but I'm willing to learn and try!

    I have Bsn classes with a DON of a small local hospital about 15 miles from where I live. I have a full time job but it's just not paying the bills. So I asked this DON if she needed any PRN help. She asked me if I had any ER experience, she really needed help in ER. I said no but I was willing to give it a try if someone would show me the ropes.

    Well, I started working two 12 hour shifts a week at this ER. (as I said , it is a very small hospital and they usually only staff one nurse in the ER at night). I got three shifts of orientation and I was on my own.

    The ER is staffed with rent-a-docs for the most part. Also mostly foreign. They are all fairly good Doc's though. I told the physicians right from the get go that I was not an ER nurse and to just bear with me while I was learning.

    I had worked by myself for about 6 weeks and had no problems. The ambulance service works out of the hospital and those paramedics really know their cardiac stuff ( which is my downfall and one of my ER fears!) So if I needed help in that area they were always in the building to assist.

    As I said, I had worked about 6 weeks and had seen a little of everything, was still not completely sure of myself but getting more confident each shift.

    Until one night I had one of those nights where everything I touched turned to mush or went wrong. I couldn't do the simplist thing like get the EKG machine to turn on, had to ask the paramedic. Couldn't get the neb. trt. tubing to connect right for a mask, had to ask the paramedic. A teenage girl came in with classic kidney infection symptoms ( flank pain, painful urination) I was all set just to give her some bactrim and send her on her way but these Doc's always have to go to extremes. He ordered all kinds of lab work, including a pregnancy test, and a KUB. Also had to start an IV on her. ( luckily that was one thing during the shift I did right, got it on the first stick!)I drew blood work and then the xray tech took her for the KUB.

    The xrays were done quickly and the tech brought them for the doc to review. The Dr. asked if the pregnancy test was back yet and my stomach went in my throat. I had sent her for the xray not knowing if she was pregnant or not. ( I didn't see the need for pregnancy test in the first place) Of course I got raked over the coals for that. (I'll for sure never do it again!)We kept waiting and waiting for the pregnancy results. I called the lab and the tech said they usually took a fairly long time. The Dr. asked if she did a urine or serum test. I had inadvertantly marked serum on the req. when he had written urine and that's why it was taking so long. I could tell he was getting more irritated with me by the minute.

    The next pt. was ordered Demerol for pain. I grabbed the tubex and started to draw it up and just in a nick of time noticed I had grabbed morphine instead of Demerol. No one observed that mistake, just me, and I caught it in time, thank God!

    The next pt was an elderly, disoriented woman from a nursing home who had fallen and had a lac. on back of her head. Her blood pressure was bottoming out so I immediately got IV stuff to get it going. She had those little rolling spider veins and I tried twice but each one blew. Rather than keep sticking her unneccessarily, I called the paramedic to try and of course he got it on the first stick. Tried to hook her up to the millineum monitor and couldn't get it to work right or register at intervals.

    It was going from bad to worse, I was beside myself!

    The night was finally over and I beat myself up all the way home. About 4pm that day, right after I had woken up, the DON called me and said that they had had several complaints about me last night .The caregiver that was with the nursing home lady said I acted like I didn't know what I was doing, I had trouble starting the IV ( doesn't everyone sometimes, that's why I asked for help!) and I didn't wear gloves when I checked the lac on her head. I didn't wear gloves, but I didn't mall my hands all over the lac. I just raised her head up to see where the cut was. The DON also said another pt. complained but didn't elaborate. But the main thing was, the Dr. complained and wanted me written up.

    She said she wasn't going to do that, but she was going to move me to the floor so I could get some more experience starting IV's and hanging cardiac drips, etc.If I still wanted to work the ER I could work a daychift as the second nurse. :angryfire I did not take offense to this except for the fact that it was just one bad night! And she didn't even offer to hear my side of the story, or what happened or anything. She just took what everyone else said as the gospel and that was that. I didn't think much of her as a supervisor after that. As I said I've been in administration for about 5 years and one thing I've learned, you always get both sides and all the facts before you start placing blame and making decisions.

    This really took the wind out of my sails and I felt inadequte for days and days. But I went ahead and worked the floor and kept my mouth shut because I really need the xtra paycheck.

    Sorry this was so long, but as I said I've been holding it in for a while and needed to get al the details out. Thanks for listening!
    Ok, I know this is not your case, but maybe, just maybe youwill see the humor and just in it and when the heck, I can share the gloating with you.
    I work regularly on 2 different home care cases. One of them has only been home from the hospital for a couple of months. During these two months my agency wsa deciding who owuld be the promary. Me or a nurse that had worked with hte family for some years (the sister had a similar accident some 8 years ago and still got 12 hr rehab nursing care everyday.)
    Anyway. They chose the other nurse to be the primary on this case. OK, not a problem for me. I really didn't have the extra hours available to devote to the responsibilities. At the same time it kind of hurt my feelings because this kid and I are really working together so well and SHE took most of my regularly scheduled hours because it was more convenient for her. Ticked me off!
    OK... here's the good part!
    I rarely have any problems at all getting this kid to do his ROM or transfer or bath or whatever. He never shows the least bit of agression - common post TBI out of frustration. he bit her! he bit her hard! hehehe
    There is justice!
    By the way... I got my hours back.

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