What do we do with an "Imperfect" nurse? - page 3

Me, that is? I seem to make mistakes ! Nothing that has ever caused any injury, harm, or negative outcome for a patient. I remember well the 10U of regular insulin that looked like 100 of... Read More

  1. by   psnurse
    I agree, Norbert needs to become intimately familiar with the patient group he will work with as agency staff. This will probably require a staff position with a good orientation.

    I would not suggest that he quit, but a regrouping seems in order.
  2. by   thisnurse
    fiesty, double checking insulin and heparin used to be required at our hospitals here but is no longer. was a good system too. i guess it was too time consuming.
  3. by   kaycee
    I also applaud Nobert for asking for help and advice. He sounds like a very caring and compassionate nurse, that as psnurse said may need some redirection. I only suggest as I said before that maybe a consistent job in a facility would be helpful. Agency nursing isn't for everyone. I know it is not for me.
    I hope your doing ok Norbert and know that our suggestions are meant to help. Please let us know how you are doing.
  4. by   thisnurse
    mc,
    my instructor was with another student. you cant lay blame on her. i was second year...it was MY mistake, i knew enough to know it was a high dose but didnt question it until AFTER administering it. that was my fault not hers.
    it is no longer required we get a double check on insulin and heparin. it hasnt been for years.
    i always get a double check on heparin now. ALWAYS.. ive not made any mistakes and im going to keep it that way.
    i now work with so many diabetics i dont think i need the double check on insulin. i know the usual doses and when something seems strange i question it. i do the five rights and i check and double check.

    you cant be niave enough to think that nurses arent making med errors out there and not reporting them.
  5. by   funnynurse
    Perhaps you would be more comfortable in another setting where you don't have to worry about making med errors.....preadmission testing, casemanagement...... also the preop holding may be a good placement for you(yes, you will still administer meds but very few) I would look into other areas fast before you lose your liscence! (I am sure you busted your but to obtain it and don't wish to lose it) Also I know we have time constraints put on us, but remember the 5 rights and your policy and procedure manuals. No nurse out there is perfect and we all have probably made some mistake(be it med error or order error)
    Be glad noone was hurt and move on, try not to beat yourself up about it, just find ways to fix the problem so they don't continue. Please don't leave nursing, we need you!
  6. by   LilgirlRN
    Sounds like you are traveling nurse, agency nurse ( I only read a few of the posts, you may explain yourself better later). I think it would be hard to know what to do in each facility and I myself would rely heavily on the regular staff. Remember there are no stupid question, only stupid answers and we learn by making mistakes or by watching others make mistakes Maybe you need glasses?
  7. by   mcl4
    Originally posted by thisnurse
    mc,
    my instructor was with another student. you cant lay blame on her. i was second year...it was MY mistake, i knew enough to know it was a high dose but didnt question it until AFTER administering it. that was my fault not hers.
    it is no longer required we get a double check on insulin and heparin. it hasnt been for years.
    i always get a double check on heparin now. ALWAYS.. ive not made any mistakes and im going to keep it that way.
    i now work with so many diabetics i dont think i need the double check on insulin. i know the usual doses and when something seems strange i question it. i do the five rights and i check and double check.

    you cant be niave enough to think that nurses arent making med errors out there and not reporting them.


    As a student nurses, instructors are responsible for their student's actions no matter what level of clinincal rotation they are in. The fact is a two year nursing student nurse still needs supervision. I would not be happy with a student that took it upon themself to work this independently and subsequently make an error.

    I would say most medication errors are found by other shifts and they report them. This nurse was written up by other staff after they found his errors since he appears unaware he made them.
  8. by   mcl4
    Originally posted by thisnurse
    fiesty, double checking insulin and heparin used to be required at our hospitals here but is no longer. was a good system too. i guess it was too time consuming.

    Policy or no policy, it takes a small amount of time to have a nurse double check your insulin or heparin. We double check medication math calculation also.
  9. by   mcl4
    Originally posted by LilgirlRN
    Sounds like you are traveling nurse, agency nurse ( I only read a few of the posts, you may explain yourself better later). I think it would be hard to know what to do in each facility and I myself would rely heavily on the regular staff. Remember there are no stupid question, only stupid answers and we learn by making mistakes or by watching others make mistakes Maybe you need glasses?


    My experience has been that agency nurses are expected to come into a hospital or long term care facility with experience and be flexible enough to handle many situations without a lot of supervision. Not everyone can do this.
  10. by   RNKitty
    The other bonus to getting out of agency and finding a "home" where you can orient is that you can establish a trust with your coworkers. Then you can find mentors. Mentors and a consistant work environment definitely improve experience level and self-esteem and confidence! Good luck!
  11. by   Pete495
    Dear Worrier,

    I've made my share of mistakes in nursing, but the biggest thing that you can worry about is Medications. It should always be custom to you to double and triple check your MAR for medication dosage. I know nurses in a unit I worked in that are Great nurses with copious years of experience who always check their medications 2 to 3 times. It's almost a must because it is easy to make errors when you give out so many medications per day.

    Nurses are Health care Professionals. Everyone expects us to be perfect, but it's just not the case. Many managers and supervisors come down hard because of the perceived cost of mistakes against patients. It's understandable, yet hard to believe since no one on earth is expected to be so perfect. Our managers give the perception that nurses are perfect and this is why they come down hard.

    Even agency nurses should be given orientations if that is what you are doing. Don't settle for anything less. Also, you need to become more aware of each hospital's protocols if you are going to continue doing nursing. This is a difficult job esp. if you jump from hospital to hospital. it's easy to confuse them. But don't worry too much, and enjoy your patients. Maybe seek out a place you are comfortable with for a permanent position, and still do some agency work on the side. It's a good way to get experience. Good Luck!

    Pete
  12. by   EXOTIC NURSE
    I agree with most of the posters on the board that he was brave and also he recognizes his mistakes but the thought I am mainly supporting is I feel the poster should get out of agency nursing and work in a hospital on a specific unit first and get some good experience then progress to agency nursing. It does not have to be a med surg floor it could be any unit that you feel comfortable in the nursing atmosphere. I personally do not like the med surg units I work on a tele unit, but I feel comfortable there and I am going to try and explore the ICU or even ER units at one point but I just did not feel comfortable in those areas as yet.
  13. by   Cubby
    Thank God you admit your mistakes. The big problem comes from nurses who don't or won't admit their mistakes. As long as you know you need to learn more there isn't a problem in my eyes.
    God be with you. Things will get better for you.

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