I got an "unsat", now what?

  1. I am in 4th semester and I pulled my first "unsat" last week. I deserved it and I learned from it and I won't make it again. I forgot to recheck an abnormal temp. I know better. The patient was off the floor for a couple of hours and when the patient came back I was busy and I just plain forgot. That said, now what do I do about the big, huge knot that has formed in my stomach at the thought of getting another unsat? So many of my classmates have resorted to antianxiety meds this semester. Our stress level has been building, but I always thought I could handle it. Now I am not so sure. What about the 10,000 other mistakes I could make while I am not repeating this one? My instructor is great and I know that she is fair. I know that clinicals are a learning experience and that we all have to learn. I also know that if we make a mistake, we unsat, and if we unsat 3 times in any one behavior, we are gone. I have so little actual experience and now I am terrified that I will screw up and get kicked out. (Before anyone says it, yes, I am most concerned for the welfare of the patients, I just am not addressing that issue right now.) Someone please help me get prespective and get back on track.
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  2. 10 Comments

  3. by   babynurselsa
    First....Take a deep breath. Part of the learning process is making mistakes and learning from the. I bet that one is indelibly etched in your brain, right?
    Nursing school is very stressful. You are obviously doing a good job since you have made it to 4th semester without previous problems. Hang in there, you can do it.
  4. by   Daytonite
    Quote from lindy777
    the patient was off the floor for a couple of hours and when the patient came back i was busy and i just plain forgot. . .someone please help me get perspective and get back on track.
    what you do is sit down and plan out how to prevent something like this from happening again. you already have the reason you made the mistake figured out: the patient was gone, you got busy doing something else and you forgot about it. now, what strategies can you take to prevent something like this from happening again?

    i have to tell you that something like this happens frequently to all nurses. nothing ever goes as planned on a nursing unit. interruptions happen all the time to distract us from what we are doing. i learned early on that i needed to find a way to get back on course. when you are an employee, you don't just get a bunch of unsats--you get bad evaluations and possibly fired for forgetting to do enough important things. usually, you remember them as you're driving home!

    what i did was learn to make my report sheet work for me. anything that i absolutely knew i needed to follow up on, like take another temp on someone, i put in red some where by the patient's name on my report sheet and then circled it about 10 times with the red ink so it stood out and i wouldn't miss it. i checked my report sheet often to see that i was getting things done or to refresh my memory.

    another suggestion would be to make a list of things you need to do before you finish your time on the clinical floor. then, you just add "take patient x's temperature again" to the list. they're called to do lists:

    http://www.ehow.com/how_3812_make-list.html - how to make a todo list
  5. by   jov
    Quote from lindy777
    So many of my classmates have resorted to antianxiety meds this semester.
    first of all, I would like to say using antianxiety meds is a poor choice to deal with long term pressure like nursing school. Your classmates would be better off if they could use other stress management techniques, such as positive re-framing, taking breaks, exercise, eating, meditation, massage, etc.

    I know that clinicals are a learning experience and that we all have to learn.
    nursing is a learning experience too. No one comes out of nursing school equipped to be a nurse. You will continue to make mistakes like this, and hopefully learn from them as well. I hope you can relax a little bit. It's never so good as we have it now in nursing school, 1 or 2 patients, very little responsibility (relatively) and almost all the time in the world to look up the disease or syndrome your patient had. Let's enjoy the good stuff!
    Last edit by jov on Oct 15, '06
  6. by   firstyearstudent
    4th semester? Is it ADN? I unsat in your last semester sounds pretty good to me. It's all a matter of perspective...
  7. by   firstyearstudent
    Quote from daytonite
    what you do is sit down and plan out how to prevent something like this from happening again. you already have the reason you made the mistake figured out: the patient was gone, you got busy doing something else and you forgot about it. now, what strategies can you take to prevent something like this from happening again?

    i have to tell you that something like this happens frequently to all nurses. nothing ever goes as planned on a nursing unit. interruptions happen all the time to distract us from what we are doing. i learned early on that i needed to find a way to get back on course. when you are an employee, you don't just get a bunch of unsats--you get bad evaluations and possibly fired for forgetting to do enough important things. usually, you remember them as you're driving home!

    what i did was learn to make my report sheet work for me. anything that i absolutely knew i needed to follow up on, like take another temp on someone, i put in red some where by the patient's name on my report sheet and then circled it about 10 times with the red ink so it stood out and i wouldn't miss it. i checked my report sheet often to see that i was getting things done or to refresh my memory.

    another suggestion would be to make a list of things you need to do before you finish your time on the clinical floor. then, you just add "take patient x's temperature again" to the list. they're called to do lists:

    http://www.ehow.com/how_3812_make-list.html - how to make a todo list
    this is great advice! last week i turned off my patient's iv pump (running an antibiotic) because it had air in the line and i couldn't get it out. then i got distracted and went to lunch! ugh, i felt so terrible when i came back 20 minutes later. it was not a big deal in this instance -- but it could have been. how could i have forgotten? i remember thinking as i was going to lunch, there's something i forgot to do...

    why did this happen? i didn't write it down on my little list. the patient is on isolation and we've been getting into trouble for taking things into isolation rooms. from now on i leave my "to do" sheet and pen on the iso cart and that will be the first thing i revisit when i leave the room!
  8. by   truern
    I'm a walking "to do" list

    I write things I have to remember to do on my arm...I found out the hard way that my hand was NOT the place to write anything important :uhoh21:

    Mind you...I only have one or two things written at any one time..hehe
  9. by   lindy777
    Thanks guys. We were introduced to report sheets just last week and I haven't gotten the hang of it yet, but I will this week for sure. I knew I could count on someone out there to point me in the right direction.

    Yes, I am in an ADN program, so if I can make it through this semester I will have just one left.

    I know I am human and I will make mistakes. I don't want to make the one that hurts a patient. I don't want to make any of them, and I don't want to lay awake at night because I fear getting kicked out of my program. I know that tension feeds on itself, so if I can just calm down and do my job, everything should be alright.
  10. by   s.carter
    IMO, so dont jump on me. as a student, you will make a mistake every day. thats part of learning. the truth of the matter is that every single student makes a mistake every clinical day that he/she could unsat for. the instructor just doesent see all of them. how many times have you thought ,oops I forgot to... well keep your head up and pay attention to the enviornment and you wil succeed
  11. by   wish2bRN
    You are getting some great advice! One little bit I might add that I've started doing, is before I leave a patient's room, I start at one corner and go clockwise around the room looking at everything...the IV, the O2, the tables, the sharps box, the foley bags, etc. and of course the patient, mentally checking off that everything is in order before I walk out. You can do this pretty quickly and it's saved my b_tt a few times! I actually do it when I go in as well. I'm a little OCD.....
  12. by   nurse4theplanet
    Quote from lindy777
    I am in 4th semester and I pulled my first "unsat" last week...
    ...I also know that if we make a mistake, we unsat, and if we unsat 3 times in any one behavior, we are gone. .
    I think you are over-reacting. You have done a satisfactory job thus far, or you would not have made it to fourth semester!

    If this is your first unsat in four semesters, odds are you are not going to get another two unsats within this same semester...as long as you don't let this get you worked up to the point that you can't function.

    You are being too hard on yourself. You need to take a step back and put everything in perspective. You have received some great advice so far!

    You will be a :mortarboard: in no time!

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