Am I a bad nurse?

Ruby Vee, BSN · Feb 3, 2017

I need more feedback. I'm not sure how to ask for it though. Patients seem to like me and I get along with my coworkers. But lately I've noticed that the people who follow me aren't so happy to see me...I've made a few mistakes and I have learned from all of them. I've only been on my own since December. I had a med error, one of my surgical patients got a hematoma, I held a heart med due to parameters in the med order and the next day the guy had to go back to icu, and one time I had an order for fluids at 150 but somehow they got set to 125. And I just realized that I had hung a secondary (no primary fluids ordered, I just put some ns to 5ml/hr) and didn't cut it off so the Pt is still on 5 ml/hr even though it's not ordered. How many mistakes is usual for a nurse to make the first few months? I've only been spoken to about two of them. I realize I make them after I leave work. How can I ask my manager and coworkers for better feedback?

The best way to ask for feedback is to be direct. "I'm new and I'm trying to improve my practice. If you find anything I've left undone or something I could improve upon, could you please let me know when I come back tomorrow?" Brace yourself -- you may be faced with a long list of nitpicky complaints. You may be tempted to dismiss them. Don't.

You want a reputation for receiving feedback gracefully. Most people have a tough time delivering negative feedback. They don't want a confrontation or don't want to hurt anyone's feelings, so they just avoid the whole thing entirely. Until something happens that they cannot avoid, and they have to go to the manager. You want them to be comfortable coming to YOU with complaints. It's up to you to make them feel comfortable complaining about you. It seems that you've already figured that out, so you're way ahead of the game.

Newbies (and I'm talking the nurse with 25 years of experience that just took a job on the opposite coast as well as new grads) make mistakes. I'm used to doing the I & O THIS way, but new hospital does it THAT way -- and if I'm stressed or in a hurry, I forget and do it the way I'm used to doing it. Everyone makes mistakes. You made a med error, and I'm hoping that you notified everyone who needed to know and then set about to mitigate the damage to the patient. When you held the heart medication, did you discuss it with the provider? Holding the med is just the first step -- you then need to talk to the provider so they can decide if the dose was too high or too frequent or not the right med for that patient, if the med is interacting with another med that just got started or if the patient's condition is changing so they're not tolerating the med anymore. And 25cc/hour of fluid is a mistake, but in the greater scheme of things (unless it was a vasoactive drip or a heparin drip) probably isn't that big of a deal. However if you're frequently making that sort of error, people will take notice and they won't be that happy to see you coming.

Ideally, you want the feedback to come from your colleagues before it gets to your manager. Try to identify an experienced nurse who is direct (or crusty or blunt or honest or who "tells it like it is") and get them on your side. ASK them for feedback, then make sure you listen to the advice and implement it. Follow up with them to see if you're doing better. It's possible that you may not get much feedback at first, but if you persist in asking for it, you may get more honest feedback.

Please don't despair if you get a TON of negative feedback. When we're new, we make more mistakes. And some of the feedback may not be about actual mistakes but about areas in which you can improve your practice. Even if you don't like the delivery, try to extract the nuggets and use them.

I think you're showing a lot of courage to be asking the question, and I'm sure that your coworkers will notice that. Good luck. It's going to be difficult, but you can do it!

Workitinurfava, BSN, RN · Feb 4, 2017

Don't be scared to ask for help, know who to ask and don't be so hard on yourself when you make small mistakes. My preceptor forgot to pass her 9 am medications while she was training me but she quickly passed them at 11 am.