new nurse needs advice, worries a lot

[cbear5]

hi there,

I qualified last year as a RN and worked in orthopaedic female trauma for 8 months part time, since then I have secured a permanent full time post within a general surgical ward which I love. I have however, been sick with worry at times on my days off worrying over things I should, could have done.. The other day I discharged a patient who was admitted with abdo pain, diarrhoea and vomiting - she was in for the night and had no further episode of vomiting or diarrhoea from her admission and her pain was decreasing. She attended for ultra sound the following day and the results were unremarkable, the junior doctor was happy for her to go home so I discharged her with a letter and pain relief. I am looking back now and wondering if I should have been more thorough with this patients discharge, as she also had positive urinalysis results. I am now worrying if her problem reoccurs it will be my fault for discharging her?? Just looking for some advice / reassurance from any nurses out there.

thanks,

a worried nurse

[anon456, BSN, RN]

What you are going through is completely normal. When you are a good nurse you worry about this kind of thing. :-) As you get more experienced with the types of patients on your unit, things will become more intuitive and less cognitive. I mean you will still use your brain every single day, and it will become tired, but you will be efficient enough to be able to focus on the unusual or important things and the other stuff will come second nature.

Also, while it's important to go over things on the way home (and call the manager if you forgot to chart or pass something on at report-- I have done this plenty of times), you have to learn to turn your brain off and get back to your own life so you can maintain your mental health.

[cbear5]

What you are going through is completely normal. When you are a good nurse you worry about this kind of thing. :-) As you get more experienced with the types of patients on your unit, things will become more intuitive and less cognitive. I mean you will still use your brain every single day, and it will become tired, but you will be efficient enough to be able to focus on the unusual or important things and the other stuff will come second nature.

Thank you so much for your reply. I do hope this worrying becomes more bearable, it's comforting knowing that this is normal. What do you think with regards to this patients being discharged under me? If there were any issues would it be put down to me? Am I over thinking this? If the doctor was happy with the patients ultrasound results then it should be ok right??

[nurseprnRN, BSN, RN]

If he's so happy with the ultrasound that he completely neglects to pay attention to the Homan's sign you've picked up, then no, it's not ok if you just let the patient leave. We are the patient's last safety check, but thankfully, most medical care is competent. :)