new nurse biggest mistakes

Ego, newnursitis is the biggest problem I have seen with new nurses.

Ugh! I'm remembering "many moons ago" as a new nurse in Psychiatry, a tired doc, asked me to "divert" him some ativan, or whatever the sleep med. was at the time. Dummy me *did it* and got counselled. I think I was just too new and wanted to fit in. Lesson learned: don't be a dope or a stooge, hold your head up, and be the best you can be. That was +/- 20 years ago and now I'm an APRN heading towards a DNP. Its been a great profession for me, I never minded going to work!

One thing that I learned early on is always take one last peek at my pts before giving report. Make sure they look clean, tubes/lines are where they're supposed to be...and give the room a quick once-over, too. Clean up the counter by putting away any items left out. Every nurse likes to walk into a tidy room and see a clean patient at the beginning of a shift. Sometimes *stuff* happens right before/during report, but then at least you'll know that when you looked at your pt 10 minutes ago he/she was fine. Plus, it will sometimes jog your memory of any little thing you were meaning to do and kept forgetting because you were pulled in 100 different directions. I've avoided some mistakes by donig this....NG out, IV out...the next nurse might not be able to get to the patient for a while, but believe me, she'd rather wait for report (or help you before getting report) while you're fixing something than walk into a disaster.
Along this line....in ICU....check your pts immediately after X-Ray comes (or go in with them & help if you can)...many times IVs have been d/c'd by XRay.

One of the things I learned is that no question is too stupid. If you don't know something ask!! NEVER assume things and ALWAYS listen to your gut instinct. Don't be afraid to ask the physician if you are unsure of an order, after all our patients are paying them for their services. Keep in mind that everyone was new at one point so use your resources...ask your co-workers if you can watch them do things that you haven't got experience with yet.

When you are able, help others! If you do your best to work as a team, coworkers will recognize this and subsequently help you out as well. I know there are some who are not easy people to work with, let alone help when you'd much rather grab a quick dinner break, but I think it's worth it. If nothing else, you'll make no enemies.
I wish you the best!
Jess

About 7 months into my nusring career I was doing peritoneal dialysis for the first time after orientation. I was working in the ICU and it was only once in a blue moon that we got a patient requiring this treatment. After reviwing the policy and procedure manual I preceded to start the treatment. Well, i should have asked for help because I was so nervous that instead of first draining the indwelling fluid I infused a whole other bag of dialysate into this poor woman's abdomen! To make matters worse, before I realized my mistake I had to transfer the patient. Thankfully the nurse I gave report to on the other unit picked up on this after the patient complained of severe abdominal pain and drained all 2000mL of fluid. The director of my department came to me a couple of hours later and when I realized what I had done, I was absolutely devestated. I wanted to leave nursing completely. I was horrified that I had caused someone to be in pain when i had entered the profession to alleviate other's pain. My director was very understanding and changed the policy in our unit so that dialysis nurses had to come to our unit to perform peritoneal dialysis because we did it so rarely.
Whenever you perform a procedure that you have never done before, consider asking a more experienced nurse to watch you so that they can offer assistance if necessary. Never perform a procedure that you don't feel comfortable doing! But if you do make a mistake (which you inevitably will, we all do!) just learn from it and move on. That's the best you can do.

At the end of your shift, review all the new orders during your shift and make sure each one was filled (lab tests ordered, new or changed medications on the mar correctly, etc.). Don't trust that the pharmacist/pharmacy filled the medication order correctly. I once had orders to start a patient on a new medication stat, and then receive the medication every 12 hours. I gave the stat dose of the medication, but then forgot (on a particularly hellish shift) to check before my shift ended to make sure that the pharmacy filled the q12h order. Well, the pharmacy screwed up and never put the q12h dose in the MAR. The nurses after me didn't realize the patient had been ordered the new medication. The patient ended up not getting the medication for 3 days before the doctor asked after her condition worsened, "isn't this patient getting this med?" Now before I leave, I double and triple check that new orders are filled correctly. Also, our manager now makes all nurses do a chart check at the end of each shift and it must be signed by two nurses. You would be surprised at how many times we find errors. I still feel horrible for my mistake.

I have a question. Does time take care of errors? I am completely serious about this... Often things are going along just fine for people and then suddenly.. oops.. they have a horrid night, forget a medication that they 'thought' they pulled, forget to turn up a drip.. etc.. I'm not sure how this happens to people other than they are running their butts off and mistakes occur.

Please advise 'kindly'.. thanks!

Peaceonearth I don't really understand your question - can you clarify?

Everyone has a bad shift every now and then - sometimes you're cruising along dine and then it all goes to hell in a hand basket within minutes: one patient pulls out their central line, another decides to finger paint (which is when you realise they're hypoxic), and a third decides that now is the perfect time to fall out of bed.

1. Make sure you understand the order.
2. PLEASE follow the 5 rights of medication administration.
3. Look it up. Don't depend on your co-workers to have all the answers including the incorrect ones.
4. If it looks funny, have someone else come look at it.
5. If you make an error, self report. Don't wait until someone else finds it. Also, if the error needs correction, it is better to do it sooner than later.
6. Just because your coworker has been a nurse for a thousand years does not mean that he/she knows what they are doing.