Almost 2 years in and still making mistakes

TriciaJ, RN · Jun 28, 2020

Two years is really not enough time to achieve infallibility. Maybe three, or four or never.

My thoughts? How many patients do you typically have to care for? How sick are they? What kind of support do you get from coworkers, aides, charge nurse? I'm suspecting your unit might be mildly toxic around the edges.

You bring a situation to your charge nurse and she blows it off. Then your incoming coworker throws a fit. FYI, anything odd happening during or immediately after administration of blood products should just be treated as a transfusion reaction until someone (like the doctor) says otherwise. But if you were in a supportive environment, someone would have been available to advise you of that, without a lot of drama.

It seems to me you are taking accountability for your errors which is a good sign. I do think the lack of support on your unit is undermining your confidence. How much do you like that unit? Is it worth looking around to see what else is out there? You now have two years of experience; you're in a position to start considering options.

Good luck.

**canoehead, BSN, RN** · Jun 28, 2020

I've got thirty years in and the lab just called to say I ordered an STD panel wrong. You won't become perfect, and the person you reported to...she isn't perfect either. I get so tired of the rudeness when pointing out mistakes. If someone makes a mistake you have to assume they intended to do it right, and be nice about it. They will do better next time if they aren't humiliated. Nursing as a profession has a huge issue with this.

dontbetachy90, BSN, RN · Jun 29, 2020

In the grand scheme of things, two years is still pretty "fresh." From what you have described here, it sounds like your co-workers may be a little hard on each other, and also sounds like you could potentially be a little hard on yourself.

In a demanding job such as acute care nursing, "forgetting" small tasks should not be marked as "mistakes" unless you are forgetting something major or putting patient safety at risk. Going on 6 years as nurse myself, and I cannot count the times I have almost forgotten about a lab re-draw after replacement. It happens! My advice for newer grads who struggle to remember is to make a "to-do list" for each patient and write everything down, every single time... IF this is something you are concerned about rather than just a few isolated incidents.

Do you have "nurse buddies" on your unit you feel comfortable running information by? My coworkers and I often turn "problems" into group discussions, constantly running ideas by one another as if just to say, "hey, this is what I think, do you agree? What am I missing?" If you're not in an environment where that kind of thing is the norm, it may not be the most supportive environment. Personally I don't know that I could do a job this tough without the support of my coworkers. I also find some nurses in report cannot get through without making the offgoing nurse feel guilty about SOMETHING -- again, unless it's a BIG issue or something you really had no excuse not to do, brush it off, it sounds like a "them" problem more than a "you" problem. There seems to be a problem with toxic and problematic people in our career field, but I think you would find those kinds of people ANYWHERE!!

It sounds like you are concerned about your performance and that you care about your patients and want to do your best -- that is wonderful, and the rest will get easier with time! Use your downtime to really think about each patient's plan of care, what has been done, and what still needs completed, well before shift change. I personally catch a lot of little "things" this way, by carving out time for each patient to really look at the BIGGER picture.

And one last thing, if you can't count on your charge nurse to give sound advice, call a physician (for instance, in the case of the questionable transfusion reaction). Better to be safe than relying on someone who seems disinterested.

Hang in there! Sounds to me like you're doing just fine! If you disagree, ask for feedback from your leadership, or other nurses you trust.

caliotter3 · Jun 29, 2020

You can be on the job for 43 years and on your last day prior to your retirement, make an error. Humans are not perfect. Because you make an error does not make you negligent or uncaring. Negligent or uncaring comes into focus when you don’t try to prevent errors the next day.

speedynurse, ADN, BSN, RN, EMT-P · Jun 29, 2020

17 hours ago, Newbie_Newbie_New said:
Hi, everyone. I just want a bit of a reality check. I have been an RN for nearly 2 years. I made it through the time where I felt I was unable to do my job. I feel I can do my job, but sometimes I make stupid mistakes. Last night I didn't order a calcium replacement for a patient when I should have. It was not life threatening, just got distracted. This morning I also transfused platelets and about 25 minutes after, the patient's lower lids got swollen. I had never seen that kind of reaction before. Got vitals, made sure he was stable and then spoke with my charge nurse who was pretty disinterested and advised I give eye drops.
Day shift showed up. The nurse I gave swollen lower eyelid patient to seemed upset with me for not having treated it as a transfusion reaction. Again, neither of the transfusion reactions I have seen looked like this. We did handoff at bedside and then she just walked away from me without a word. It feels horrible. And I feel like this kind of behavior occurs often when I am handing off.
The nurses I hand off to seem to go out of their way to point out how they might have done things, or use sarcasm to express judgment of how I cared for the patient.
I also sometimes walk into a situation where there is something left for me to do. For a very long time, I have felt that it was because the person I am receiving report from didn't have time to in their day to address whatever it is they are passing onto me. I just don't feel that same understanding...and is it because I am making mistakes? Even when they are honest ones like what may have been a mild transfusion reaction to platelets....
I'm just not sure how to feel confident about the care I give when I get a lot of negativity from all around.
Thoughts?

Can I be honest about my perception of your post? First, nurses make mistakes....6 months in....a year in....10 years in....etc. It happens to even the most cautious, careful, most intelligent and capable nurse. Mistakes are not necessarily OK all the time, but they do happen and sometimes, it is hard to even prevent those mistakes.

Second - this honestly sounds more like an environmental issue. It seems like your team is less than supportive which can make you feel much worse about yourself. I know I started out with a team that was really amazing to me as a new grad - even when I made mistakes, they somehow dealt with it very well and did not contribute to further destroying my confidence level. However, I have been in other jobs where they were very nit-picky about everything and I felt unsure of myself and almost anxious throughout the shift. Have you ever thought of shadowing another department or asking nurse friends about their departments to see if you can find a place with better, more supportive teamwork?

Newbie_Newbie_New · Jun 29, 2020

Thank you everyone for your responses. It has helped frame this situation differently for me. I appreciate your time and hope you are all doing well!

Kooky Korky, BSN, RN · Jul 5, 2020

On 6/28/2020 at 3:27 AM, TriciaJ said:
Two years is really not enough time to achieve infallibility. Maybe three, or four or never.
My thoughts? How many patients do you typically have to care for? How sick are they? What kind of support do you get from coworkers, aides, charge nurse? I'm suspecting your unit might be mildly toxic around the edges.
You bring a situation to your charge nurse and she blows it off. Then your incoming coworker throws a fit. FYI, anything odd happening during or immediately after administration of blood products should just be treated as a transfusion reaction until someone (like the doctor) says otherwise. But if you were in a supportive environment, someone would have been available to advise you of that, without a lot of drama.
It seems to me you are taking accountability for your errors which is a good sign. I do think the lack of support on your unit is undermining your confidence. How much do you like that unit? Is it worth looking around to see what else is out there? You now have two years of experience; you're in a position to start considering options.
Good luck.

I agree with this.

Also, OP, how is the swollen eyelid pt? I think I would have at least notified the doctor, especially if I felt like my Charge didn't take me seriously enough or I was uneasy with her/his answer to my concern.

You are encountering a very common problem in Nursing - working with a bunch of ***es. Not mincing words here.

Your Charge is either distracted or disinterested. Your peers are quick to anger, have no interest in conferring with you and figuring out a problem together so you will be able to learn and then do better next time. (If there really was a need to treat the swelling - who knows).

Best of luck to you. Go on to greatness. Keep having an attitude of "Nursing is 24/7. Not all staff have that attitude. And some will take advantage of you. In time, you will know which end is up with each of your peers.

Newbie_Newbie_New · Jul 5, 2020

Thanks again for everyone who responded. I just got a new job because I felt that it was likely my unit had an attitude issue. I totally believe that I have a lot to learn. I just need a different environment to help me be the nurse I want to be. Your perspectives helped me feel more confident about my decision to leave.

Thank you!

gowiththeflow_RN · Sep 17, 2020

I mean, I would've notified the MD and wouldn't have even bothered with the charge RN. the MD probably would've ordered some benadryl for the patient and continued the transfusion. sounds like it was pretty benign, but better safe than sorry. that nurse shouldn't have treated you that way.

Been there,done that, ASN, RN · Sep 17, 2020

Swollen eyelids during a blood product transfusion is a major reaction. Stop running to mama charge nurse.. and handle it yourself. Follow protocol and notify the MD! You are not taking responsibility for your practice.