I am now about 4-5 months in working at a LTC/Rehab center and have found that I am having a lot of difficulty with VERY high pressure, distractions, and stress during shift.
Recently, I have made a few errors which was due to me rushing. Luckily, neither of the errors caused any patient harm but it definitely harmed my confidence and is completely embarrassing.
I would also like to mention, I feel like some added stress has been put on the Nurses of my shift since our 3-11 Supervisor got promoted to a Unit Manager. No one filled her place and so we don't have that additional, VERY awesome person that steps in and helps with admissions, d/c's, and all the other things that can go wrong or just simply happen! A lot of it ends up falling on the lap of whoever the RN is - as they are considered the Supervisor of the whole building. 99% of the time, that's me!
I try to utilize my resources. I write down who the on-call Nurse is for anything that has to be reported, or that I need to ask a question about but there have been some shifts that have gone absolutely haywire and I cracked under the pressure and made errors.
I think I have realized one thing I've got to start doing is a self-assessment. I am so focused on ensuring all my patients are cared for, and that everything is done within a reasonable time that I neglect to realize I might need to step outside for a 3-5minute mental break since I don't take my breaks at all (as many of us Nurses do lol.)
I would love for any type of advice that can be offered from new and seasoned nurses alike. I'd also like to mention I have depression and anxiety that I have been treated with for about ten years now. So, I think that my anxiety may also come into play when things start to get really hectic. Sorry for the long post!!!
Breathe. You're doing just fine.
It's my guess that you've researched your errors. My advice would be to research them more. You aren't quite confident, but you don't feel incompetent.
Researching improvable moments will help a lot with your confidence. For example, if you made a minor error with heparin, researching heparin and heparin protocols to the point where you can educate others will not only help you feel more confident, but improve your practice.
We are not our mistakes, unless we allow ourselves to be defined negatively by them. I always took satisfaction in turning inadequacy into expertise.
When I worked in LTC, I didn't take a real lunch, but I would occasionally go into a med room, close my eyes, breathe, and consider why I was there. I found it simultaneously relaxing and motivational.
Thank you, Ninja!
And I love your name by the way. I think I may be depending too much on my superiors to teach me and I realize that there is only so much that they will do or can do. (Like a write up or have me take a certain CEU.)
One issue I have thought of is... we don't have access to our policies and protocols like I assume most hospitals do if I am remembering correctly?
Instead, if we are unsure we are suppose to call the on call nurse or who ever is a supervisor there... but while I am for that I really wish I had access to the policies and protocols on our laptops. That way if I wanted to review something I can just quickly search and read.
But I have been doing a lot of reading on my own including stress reduction. I even bought a book (please work lol.)
I will also do that too during my shift... no one is ever in our med room as only nurses have the key and we only go in there for things in the fridge or omnicell. I think I can allow myself maybe at least 15 minutes away from the floor and drink down a protein drink.
One thing I do when I start to feel overwhelmed is literally stop everything where I am, no matter what I am doing, sitting, standing or walking. I close my eyes, take a deep breath & tell myself "one thing at a time". Then I take 30-60 seconds just to refocus my priorities. I also try to always schedule in my meal; there are very few things that can't wait an extra 30 minutes while I recharge.
Thank you, RainMom!
I read your post when I finally sat down to take a breather for a few minutes... I did literally what you suggested and it is amazing how a few minutes of pep-talk and recollection helps!
Now... I am still struggling with fitting in a 30 minute meal. Then again the only nurses who I see take a lunch are supervisors lol so maybe it's not me and the workload?
I have a cheat sheet of sorts that I use every day. It has the basic tasks I need to get done that never change (assessments, blood glucose, ted hose, etc) and I add to it as needed. I use it to jot down notes as I work through my shift and cross things off as I go. I call it my brain.
It really helps with time management and with eliminating errors because things are in black and white. The trick is finding a system that works for you.
Deep breaths and a quick drink of water are also your friend.
I was doing the same but we are now required to use our shift change report sheets and turn them in... but I guess I could always use both
I definitely do find getting a chance to glance through mar/tar really helps
In order to take care of others, you need to take care of yourself! I have been in your shoes and it does get better! Take your lunch break (many places do not pay you for your lunch break, FYI), I like to walk outside if the wether is ok or do some simple yoga/stretching in the break room, read a book, meditate etc. When I'm most overwhelmed or scared, I give my self 2 seconds to feel the anxiety then take a deep breath and move forward with the task at hand.
Keep up the good work
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