S. O. S.

  1. For the first time since I started nursing (I graduated last June) I feel really discouraged with myself. It all started last week. I made a med error. I was waiting and waiting for a now order to come from pharmacy...also waiting for the chart to come back from the unit secretaries...I gave the med iI "thought" was prescribed and low and behold it was the wrong dosage. Called the doc...no adverse effects...felt really stupid and humiliated. ( I mean the three med checks are basic and I ALWAYS do them. I don't know why I didn't think to just wait and do it properly I had an IV site that was looking bad and leaking and I was to hang Vancomyacin. I was uncomfortable with Vanco going into that vein so had the CCU nurse come and try to start him (he had a reputation of being a very hard start and I am relatively new so I deferred to her) She tried twice and could not get it and said "His veins are shot...they are all scarred" So I called the doc and got one of his ATB's PO and took a telephone order to hold the vanco. When the night crew came on there was a cracker jack RN who had served in the army and low and behold he started it..."Yeah". It was the end of my shift so I left. The next morning I get a call wondering why the vanco order read "hold" and why the orders where never noted....I assumed the night nurse would have handled things. ALSO that same night I had a lady who passed away (expected) This was my first death so I cleaned the body, comforted the family, called the mortuary and asked my charge what else to do. She said I had to fill out this paper which I did and the morturary guy came and picked up the body. Then I got a call from the supervisor...I did not contact the doctor... BIG MISTAKE! It may sound silly but I really did not know I was suppose to call him. In twenty-twenty hindsight it makes a lot of sense. (Now I am feeling really stupid and humiliated.) THEN LAST NIGHT...my first night back ...everything smooth...after report the night charge came out and said "That sliding scale insulin report should have been "BLAH BLAH BLAH" Dr. so and so has terrible handwriting...I know because we discussed it with Days , they had a question too. This insulin dose seemed a little off for the BS (that should have been a red flag right there ) but I double checked it with another RN as is our policy and I also asked the patient about it and she said "That's right - my doctor and I are right on top of my diabetes" No clarification order had been written even thought there had been questions but the bottom line is that I SHOULD HAVE QUESTIONED IT...again, no harm came to the patient. At peak her BS was still 130. Again 20-20 hindsight...I was lulled by this patient's very hands-on management of her diabetes and the fact that the order looked clear to me. So, I filled out an UNUSUAL OCCURANCE report AGAIN. The second in as many days. I know I am a new nurse. I expect to have a growth curve but I FEEL SO DOWN and am beginning to wonder If I lack judgement. I did very well in school and had excellent recommendations and a very positive preceptorship and now I feel like I will be considered incompetent...or maybe I should find some other area of nursing that doesn't have so much stress. PLEASE....sister and brother nurses.... I need perspective.
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  2. 55 Comments

  3. by   hapeewendy
    *hugs* although these "mistakes" or "lack of judgement" are important to note and learn from
    do not beat yourself up over it!!!

    every nurse has made a mistake, its the whole "human factor" none of us are machines! and those who come down hard upon you for making an error should examine their own practice carefully before judging.

    the important things to remember here are that
    a. your patients were not harmed terribly from
    your error
    b. you learned from what happened, I sincerly doubt that you will repeat what happened again right?

    honestly, give yourself a little break here, I'm not advocating making mistakes by any means , I'm just saying that you need to press forward, move ahead, and be the great nurse to your patients that *YOU* know you are/can be!

    let this be a learning experience, take it for what it is, do not let it reflect on you personally, its hard to do that I know, but nursing is a learning curve in itself and never stops!

    keep the faith, and keep at it , if you really feel like your judgement is in question, seek out the help of your more experienced co workers, and whenever in completed doubt after doing that, contact the dr involved with respect to the orders that dont seem too clear.....the dr may feel "hassled" and sigh a lot on the phone, but at least you have the peace of mind that you clarified what was going on!!!
    if you have a good supervisor or experienced co worker that you feel comfortable talking to, go to them when youre feeling this way, nursing isnt always about dragging one another down, many nurses are very supportive etc!
  4. by   Zhakrin
    Take alot of pride that you reported and took responsiblity for your actions properly, and that no one was really hurt.

    I have heard horror stories about nurses and Dr who tried to cover up their mistakes with total disregard for their pt saftey.

    As you said you are still new and it take years to become a "clinical Master" and perfection is beyond the realm of any person.

    Take alittle time to refocus yourself and assess if your errors were caused by knowledge gaps in policy or practice, if so correct this.

    If not, continue to practice reveiwing mentally concepts of practce and policy.

    I am new myself and this is what I would do.

    Good-luck
  5. by   Brownms46
    Dear (((((((((((((((shavsha))))))))))),

    I'm so very sorry that you're in such despair. Lord.... I remember the med error I made as a new nurse. The pt. had no adverse effects from it...but I felt lower than low...for not using the 3 R's! I found my own error....and could have slapped myself silly!!! I informed the charge nurse...called the dr., and wrote the incident report. I felt whatever he screamed at me....couldn't be worse than what I was screaming in my head to myself! But for some reason ....pity...too sleepy...or whatever...he didnt! But I FELT he should have.

    But you know....I never made that mistake again. I agree with hapeewendy. Don't let this take away your confidence in yourself and your abilites. No one is beyond making a mistake. We hope that we don't cause any harm to those we care for....but in reality...it could happen to anyone....not just a new nurse.

    Pick yourself up...dust yourself off...and keep striving. You only truely fail when you allows your mistakes to become stumbling blocks to your success! NEVER GIVE UP ON YOURSELF!
    Last edit by Brownms46 on Feb 27, '02
  6. by   kyjule
    Been there....Done that!!! Try not to beat yourself up too much..Its all a learning experience. Hang in there jules
  7. by   NicuGal
    Man...I hate when my day goes like that, heck, my week! We all have times like that when not one damn thing goes right and you feel like you left a huge ole mess at the end. Don't worry, things always right themselves...try not to dwell on it and move on!
  8. by   shavsha
    =============THANK YOU====================
    Your encouragement means so much. You are right, I will most likely not make these exact mistakes again. I feel better already.
  9. by   lever5
    Your team members should have helped you with the death paperwork and routien. I always look at a peer and ask, "Have I done everything", then we go over it. Even in a charge position you need help sometimes. The biggest lesson you need to learn is not to trust another nurse when they say they know what the dr meant. If the dr was not clear enough in his orders for everyone to understand, he needs to be called and the orders written out as "clarified" if this is not done , you do it yourself. And you are right, the next nurse should have signed off an order that was on the chart if you did not. That is the supportive and right thing to do. And you will find that a person with no veins will pop up one a few hours later. With experience you will learn to wait if you can't find anything. Go back at the end of your shift and look again. The bottom line is there is always some supernurse that can get a vien on anything. But, if the iv access is that bad, the person needs a central line. Sounds like your teammates have not been to supportive. I still need support at this time and I have been a nurse for 11 years. It is too bad you can not depend on them to do the right thing and take care of these things. They should have called for clarification on that order. And you should have said, "You know i'm going to have to call for clarification." Especially now you can say, "Remember what happened last time that I didn't call." Remember never to do anything without seeing the order. If you are asked to take a verbal order, (Bad thing), but you do run into situations where it is necessary. Badger, bug, bother the Dr. until it is written, or ask if you can write it yourself. Maybe it is better to write it yourself. And remember it is never your mistake alone. We are all responsible for the things that happen on a unit. That is why we are a team. You will get to be there for the next new nurse.
  10. by   Zhakrin
    100 percent Lever. You said it.
  11. by   mattcastens
    When I was in school, an instructor put med errors into perspective this way...

    - Assume that on a regular shift on the floor you have 4 patients.
    - On the average, each patient will have 8 meds per shift (4x8=32).

    - If you work 0.8 (average for a nurse), you work 4 shifts per week (32x4=128).
    - 50 weeks in a work-year (128x50=6400).
    - Assuming a first-career nurse working until retirement, career span of 43 years (6400x43=275,200)

    In effect, you have on average 275,200 chances for a med error during the course of your career, and that doesn't even take into account "bad hair days", or sleep deprivation. If you don't make a med error at some point, you have acheived god-like skills.

    Don't worry about it. Fill out the report, have a stiff drink (after work, please), and move on.
  12. by   nursedawn67
    shavsha, Do NOT let this get you down and discouraged!! It happens to the best of us. Learn from the experience, I know I did with things that have happened to me. And I learned how to overcome things that have plagued me, I know that sometimes with all things we have to remember I forget something, I carry sticky notes with me and my 24 hour report and I write everything I have done down on my 24 hour sheet and things I need to do on the sticky notes. I have sticky notes everywhere, but I remember what I needed to do. I tell you what I feel nursing school does not in anyway prepare you for what actually nurses do, and I also feel there is no way to teach everything, otherwise we would be in school as long as a med student is! Hang tough and vent to us anytime! That's what friends are for!!


  13. by   P_RN
    Gosh, there is nothing left to say! This has been a great thread. Shavsha, it gets better. Next time YOU will be the one giving the hugs and support.

    P
  14. by   RNforLongTime
    I think that I can safely say that every nurse has made at least ONE med error in her/his career. If someone says they have never made one, then I believe that they are either GOD or are lying! Not that I am trying to make it sound like no big deal. Shavsa, don't beat yourself up over it. Move on and take it as a learning experience! {{{{{{Shavsa}}}}}}

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