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Nurses New Nurse

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So I am a fairly new nurse still (just passed my 9th month in my first job) and I've made several dumb mistakes along the way. Insulin given incorrectly once during orientation, narcs given too soon after a c-section once shortly after orientation, and not clamping an abx PB after it was done and the bag exploded... oops. Like i said, really really stupid errors but I haven't hurt anyone, never been written up, and I've never made the same mistake twice.

However, last week was bad. I was about an hour from the end of my shift and got a new GYN pt from PACU. She came up in the middle of a blood transfusion - her starting count before surgery was only 7.5 - and with two other completely dry lines. I hurried to get fluids going again before her veins collapsed and then stopped the blood as it was done by the end of my assessment/charting.

She was due for another unit, and as I hadn't hung blood since my orientation ended several months ago, I asked a seasoned nursed to come in with me as a refresher and back up. Bear in mind, we're the only two nurses on the floor at the end of an incredibly busy shift. No excuse, but fact.

So we primed the line with saline and went through all the motions and hung the bag with the same tubing - first mistake, as it was due to expire at 2330 and we were hanging this 2hr infusion at 2215. Stupid, but we didn't think beyond "It's not bad now." Spiked the blood and we started it at a rate of 100 - second mistake, as our hospital has a policy that we can only start at 75 for the first 15min. (We actually were trying to find said policy at change of shift but our hospital recently changed the website and we were lost.)

Got all the 15min signs - everything good - and ran down the hall to stop a pt trying to get out of bed w/o assistance, etc. Got them taken care of and it was change of shift time. Went back to the GYN room with oncoming nurse to clear the PCA pump and discovered a pink NS bag, though the line was red as well. Clamped off the saline and gave report, the patient is sitting up in bed laughing and chatting with us during. Realized at the end of report that the tubing expired in twenty minutes and we pitched everything then - over half a unit not given. We called the doc and got a repeat order, and the replacement unit was hung about twenty minutes later.

I completely understand that this was a big mistake, and shouldn't have happened if I'd been paying attention. My educator spoke to me about it and said I'd have to probably repeat my "education" on blood and get signed off - I'm all for it, I need the refresher. The other nurse that hung the blood with me is getting similar help. One of the dayshift nurses when she heard about it asked me point-blank why I didn't just "lie and say the tubing was new" but it honestly didn't occur to me. I'm not a liar by nature and I do my very best for each patient every night, so of course I'm gonna tell the truth.

My question is that now, the entire unit is gossiping behind my back that I "hung blood wrong and almost killed a patient" and am "definitely going to get fired." They think I'm a danger and completely incompetent. I've worked several shifts since this incident so I'm not entirely afraid of being fired (wouldn't they have stopped me working?), but this horrible backtalking is dealing a severe blow to my confidence. I understand my error was bad and that even though we were having a night from hell I shouldn't have missed it - and believe me it won't happen again, but I don't think the patient's life was ever in danger. Am I wrong? Am I just not cut out for this, as they're making me believe? The past 9 months on this unit have completely drained me. Any advice or help is much appreciated.

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Specializes in Critical Care, Education.

I can certainly understand why you are feeling down. Just when you feel like you're becoming more comfortable, you got hit with another 'newbie' whammy.

It doesn't really matter what co-workers are saying about you. It's important that the people that matter (your boss, clinical educator, etc) know the truth. You're learning from your mistakes, just like we all do. That's actually the only way to develop expertise. If you talk to any 'experienced' nurse, s/he will be have a lot of very interesting stories that are probably much worse than yours. Heck, I once made 15 med errors in a single hour .... brand new nurse, functioning as the "med nurse" on an ortho-trauma day shift. I didn't really grasp the significance of the green ink (back in the day, loooong before computer based charting) so I gave everyone dalmane at 9AM. Yeppers... 15 med errors & a humiliating conversation with the highly amused Chief Resident. I also have several blood admin stories, including one in which a co-worker ended up reenacting the pivotal scene from the move Carrie... but I'll save those for another time.

It's hard, but try to just ignore the gossip squad and don't contribute to their chatter. Eventually, their attention will turn to something else to entertain their tiny minds - it always does.

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Specializes in POST PARTUM/NURSERY/L&D/WOMENS SERVICES.

OMG!!!

I get so angry when people sit and talk about other peoples mistakes...good lord, we have all made a few in our lives...

I guarantee you at least half of the nurses you work with would have made the same mistakes as you did...but I bet they wont admit it...I know EVERYTIME I have to hang blood I pull the policy and my second nurse and I look like dumb and dumber as we attempt to prime the lines and prepare to give it...DO NOT feel bad...

Mistakes are good to make...they teach us what not to do...you will never make the same mistake twice, and you are all the wiser for it...

You already know the work place can sometimes feel like the lions den or a shark tank...you have to grow really thick skin...and just let the mill run dry...you could take the opportunity to tell everyone about your mistake, that way rather than the inaccurate details of a rumor, you can ensure that its only facts that are being spread...somehow when its factual people don't want to talk about it...its not as juicy...

And to lighten the mood let me tell you about the big boo boo I made,

In my 10 years of being a nurse, I have always spiked the IV bag in my hand and then hung the bag and primed the line...Im pretty short, so that kinda stems from IV poles sometimes being a bit to high for me...anyway...I started working in this new LD unit, and this nurse would hang the bag, and spike it while there...and you know when you pull off the cover it doesn't come out until you spike it...well genius me sees her do this , and I think...hmm how cool...I wonder if there is like a shut of valve inside the bag...so I hang a bag of LR on a laboring patient and put the pit bag up too so that I can spike it when she delivers....she delivers...and I leave the lr bag hanging, pull the spike out to spike the pit, and OMG LR is spraying all over the room like an out of control garden hose...AHAHAHAHA!!...As soon as I realized what I had done, I was like oops...but the other nurses were calling me a moron and a dingbat and a tard and talking so bad about me...understand I have ALWAYS changed a bag in my hand, so I assumed when it was in the upright position there was a shut off valve....

I apologized to the patient, who was laughing so hard she could barely breathe...it WAS funny....and when I left the room and the nurses were dissing me I just let it roll off...

I don't work there anymore, but I tell my story all the time to students...its funny, it breaks the ice, it really happened...and IT WILL NEVER HAPPEN AGAIN!!!

You are always learning....the minute you stop, its time to move on....

Take care!!

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Specializes in ICU, Postpartum, Onc, PACU.

People will talk crap no matter what. If you hadn't done this "thing", it would be something else. It's hard to deal with when you're not new, but it happened to me about 5 years into my first job and what was worse, it wasn't even work related AND a couple family members (who also worked there at the time) believed the BS as well.

I don't know how blood tubing expired if they'd used a Y-set and the first unit was spiked with the set as soon as it was taken out of the package, but maybe I missed something. Good for you for not lying. THAT would have been a truly bad thing because once you're pegged as a liar, things don't go well.

xo

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Specializes in Private Duty Pediatrics.
OMG!!!

And to lighten the mood let me tell you about the big boo boo I made,

In my 10 years of being a nurse, I have always spiked the IV bag in my hand and then hung the bag and primed the line...Im pretty short, so that kinda stems from IV poles sometimes being a bit to high for me...anyway...I started working in this new LD unit, and this nurse would hang the bag, and spike it while there...and you know when you pull off the cover it doesn't come out until you spike it...well genius me sees her do this , and I think...hmm how cool...I wonder if there is like a shut of valve inside the bag...so I hang a bag of LR on a laboring patient and put the pit bag up too so that I can spike it when she delivers....she delivers...and I leave the lr bag hanging, pull the spike out to spike the pit, and OMG LR is spraying all over the room like an out of control garden hose...AHAHAHAHA!!...As soon as I realized what I had done, I was like oops...but the other nurses were calling me a moron and a dingbat and a tard and talking so bad about me...understand I have ALWAYS changed a bag in my hand, so I assumed when it was in the upright position there was a shut off valve....

I apologized to the patient, who was laughing so hard she could barely breathe...it WAS funny....and when I left the room and the nurses were dissing me I just let it roll off...

I don't work there anymore, but I tell my story all the time to students...its funny, it breaks the ice, it really happened...and IT WILL NEVER HAPPEN AGAIN!!!

You are always learning....the minute you stop, its time to move on....

Take care!!

I did that, too, because I was used to glass bottles that resealed themselves when the spike was removed. Boy, was I surprised! :eek:

You know how to learn from your mistakes, and, Believe me! We all make `em.

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Specializes in kids.

Follow your instinct. Don't ever lie!

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"Just so we are all abundantly clear, and because I really hate gossip, I overlooked changing out blood TUBING with a new bag of blood. Lesson learned. Thankfully, it caused no harm to the patient. Period. End of story. Now can we get on with our day???"

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Yes, we ALL have made mistakes, and no one should be talking behind your back. However, I am surprised you haven't been written up. You are making mistakes that shouldn't be happening. Incorrectly given insulin, or untimely use of narcotic drugs in a post op patient is a big deal. Perhaps you should get in the habit of reviewing the 5rights of med administration. Right drug, right time, right dose, right time, right patient. I am not clear on why your blood tubing was expiring so soon, bu I believe you could have replaced the tubing without ditching the blood. Wasteful.and expensive, not to.mention a delay in the patient getting the blood she needed. I have never worked anywhete that 2 nurses have to.check.and hang blood. Seems you could use some review on your hospital's policies and procedures. If you intend to remain in nursing, you need to.identify your strengths and weaknesses, and take action to.improve the weaknesses. Good Luck!

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Specializes in ICU.
Yes, we ALL have made mistakes, and no one should be talking behind your back. However, I am surprised you haven't been written up. You are making mistakes that shouldn't be happening. Incorrectly given insulin, or untimely use of narcotic drugs in a post op patient is a big deal. Perhaps you should get in the habit of reviewing the 5rights of med administration. Right drug, right time, right dose, right time, right patient. I am not clear on why your blood tubing was expiring so soon, bu I believe you could have replaced the tubing without ditching the blood. Wasteful.and expensive, not to.mention a delay in the patient getting the blood she needed. I have never worked anywhete that 2 nurses have to.check.and hang blood. Seems you could use some review on your hospital's policies and procedures. If you intend to remain in nursing, you need to.identify your strengths and weaknesses, and take action to.improve the weaknesses. Good Luck!

To the PP, are you even a nurse? If you truly believe that you've never made a mistake, then you are either not being truthful or terrifyingly unaware. Out of curiosity, where have you worked that doesn't require two RN checks prior to blood administration? Are these places accredited by the Joint Commission?

Mistakes happen. The OP was admirable for her honesty, transparency, ability to self-reflect and desire to better her/his practice. Those strengths will take her/him far in nursing. I find it concerning that you feel need to pick apart all of the things that OP has already recognized as shortcomings and taken action to address. No decent hospital/facility is going to fire a new nurse for forgetting to change blood tubing and telling on herself for it…

OP, don't stress. You sound like someone who really wants to excel. Don't let the chatter stop you from taking great care of your patients and continuing to be transparent in your practice. I learn new things every day and have had my share of face-palm moments. We will never get further nursing as a profession if we don't have the ability to see our practice as a work in progress.

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Yes, I am a nurse. 40 some years. My comment about blood was a misprint (yes, I make mistakes too) and should have reflected what you said. We ALWAYS had to have 2 RNs to.hang blood. I have made med errors as well, but I always admitted them, and wrote . Myself up if I noted the error. A couple of times, someone else wrote me up. I am saying some 6 errors in 9 months seems excessive, and a need for additional focus and staff support until she is more reliable. In court, no one cares that you were only a nurse for 9 months, or that the shift was craziness when the errors occurred. She needs to protect her patients, her hospital and herself.

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Everyone makes mistakes! It's too bad that it's being gossiped about, instead of others trying to help you learn.

The first time I have IV Phenergan, It was 34 mins past when my 12 hour shift was supposed to end. We were in the middle of giving report when the patient complained of severe nausea. Instead of the small dose they were supposed to get, I gave the whole vial. I didn't realize my mistake until I returned that night for my next shift. The day nurse said, 'I don't know how much Phenergan you gave the patient. But they slept all day!'. That's when I realized that I had probably given too much. Directly after report, I went and checked the dosage and, sure enough, I'd given the patient to much. Luckily, the only adverse affect was sleepiness.

Another time, in the middle of the night, I went in and hung a patient's IV antibiotic. I triple checked everything, right patient, right dose, right time, right med, the IV pump was programmed correctly.

I went back in when the antibiotic was done. I was standing in a puddle of liquid. Turns out, I'd dime so much checking that I'd forgotten to hook the IV line to the patient. The antibiotic had been running into the floor for an hour!

I never made this mistakes again!

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Sarose61--I am willing to bet you are that one in a break room whispering about people. She is a new nurse. She is aware she made mistakes and is open to being checked off again, etc. You have made mistakes, we all have. "IF YOU WANT TO CONTINUE BEING A NURSE." Seriously? Get off that high horse.

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