advice desperately needed

[EAWM,RN]

I have finally joined all nurses after reading many helpful blogs and rants of nurses in similiar situations. I now need some advice, criticism or general info and and all are greatly appreciated.

I graduated August 09 and went directly into an ICU setting, there wasn't a new grad program but was placed with a preceptor for about 4 months (3 days a week). My preceptor was awesome but to my disappointment there were no classes or structured inservices. In this ICU it isnt super acute like the med center but does focus on hearts and neuro (cabg and cranis) etc.. I have always been incredibly confident in my abilities, graduated at the top of my class, was a very good surg/ er tech for total of 10 years prior to Nursing, recieved multiple glowing recommendations from prev employers as such. So.... to get to the meat....

I have made quite a few mistakes in my first few months in the ICU. Those being: 1.had a cabg/resp distress, that was beligerent and upset he wasnt getting certain meds go AMA walk to front door I caught up with him and had him sign papers gave him discharge instuctions HOWEVER....I failed to take out his central line! ouch biggee, he showed up at our CV surgeons ofc at his 4 week check up with it. 2. Contaiminated blood culture bottles x2, lab said showed staph which doesnt grow unless skin not cleaned enough or site touched prior to stick. 3. During a TEE with cardioversion sedation was given and called back to doc, a month later wont sign the order bc states he called for a different dosage than order written for by me.

THERE YOU HAVE IT IN A NUTSHELL. My question is, Is this common to have mistakes like this as a new grad? Is the incredible stupidity or does it all take a bit to come together? It just seems the acute situations im fine in, but some of the basic or no brainer crap bites me in the butt. Should I step down and work in a different situation and then come back to ICU or press on? Im throughly confused and want to be a great nurse but when confronted by my manager Its like he's putting me down and I begin to question myself and my choices. Once he simply told me "pull your head outa your ass" Did anyone have this type situation and how did you pull through it?

[missbutton]

EAWM, I would move this post over to the critical care forums so an experienced CCU nurse might answer you. I just don't know enough. Good luck.

[jmgrn65, RN]

First, the guy that left AMA you cant do anything about, he obviously didn't give you time to think about it. If you had remembered after he left sometimes homecare will go out and remove them.

Blood cultures sometimes get contaminated, that is a normal mistake you have learned from it and probably wont make it again.

I am not clear on the sedation part, so what I will say, we have a read back policy, when a doc gives you an order you read it back, it then say yes or no when you sign the order you sign it T.O. Read back N.Nurse RN/Dr. Smiley

Hope this helps, it takes at least a year to be comfortable in any position in nursing and sometimes longer depending on the specialites. Dont' sweat over them, they are learning opprotunities

[fiveofpeep]

I think the guy with the CL several weeks out AMA is hysterical. Maybe I just have a sick sense of humor though I can totally see myself doing that--being all freaked out by my patient booking it. I bet the head nurse had an aneurysm contemplating how that would affect their central line infection stats.

Im a new grad in critical care too and Im on my own now and I am just learning that you have to get used to making mistakes and feeling dumb regularly. I dont think your mistakes are so bad.

Want to hear some of mine?

accidental self extubation in a restrained patient, given NPH in a patient who was NPO, didnt call about an INR that was mildly elevated, totally jacked up an NIH SS form for TPA patient, forgot to get an order to continue some drips a new patient arrived with, wrote down morphine order qh ATC instead of PRN (luckily I caught this when I was reviewing the order), forgetting to call RT when I have a pt who needs a vent in the room or when we are going to CT and I need him to bag em...Im sure there are more that Im forgetting.

I feel really bad when I remember my mistakes, but I try to remind myself, no one died, no one got hurt (thank God), and I tried my best. Its more important that you learn from your mistakes than you beat yourself up for them.

Just remember you are doing the best you can and you will make mistakes, and that's normal...everyone does.

[EAWM,RN]

Thank you for the great replies. Im trying to take it all in stride. I think as well as all nurses are im a perfectionist, want instant gratification and hate making any mistakes even though inevitable.

Peep of five.. that is awesome. stuff happens right?