Am I Incompetent?

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I am looking for reassurance, the truth, and insight on how to deal with something that happened and has been happening for awhile. I have been an LPN on an acute care/general internal medicine unit since June 2011. I am a fairly new grad finishing school in april 2011. I have always felt stupid at work. Always feel like i dont know what im doing and am missing the fine detail. I have never had a complaint about my work and people seem to enjoy working with me until today. I am one of those people who goes to work as a big ball of sunshine. I dont see the point in being a ***** when your day is tough is just brings everybody down.

Our manager is never around so many problems Do not get addressed and she doesn't want to hear any negativity (direct quote) and we consistently run understaffed. I had 2 patients which needed constant observation and was denied due to budget cuts although the night staff was approved. Days are when they are awake! Hello! .. So my day was off to a fine start when there's a man urinating on the floor in front of me and a delirious lady crying out for her non existent puppy rubbing her arms and legs raw from her agitation in restraints. I piped up and said how i felt like this was staff abuse and that i needed the extra help and the charge nurse looked at me and said "you'll have to talk to the manager" who wasn't there today. She didn't care to get me help at all! And another nurse was snooty and said "i dont understand why people complain that were short staffed just suck it up and learn how to do your job" while meanwhile im standing next to her. I felt like a baby sparrow being eaten by the big **** hawk.

Knowing this nurse if it were her assignment all hell would be broken loose and she would be complaining+++. And heres me, a person who never complains, getting **** on by people who i thought cared about me. This is the beginning of the day..... After my horrific day of changing beds over and over and mopping urine of the floor and chasing naked people down the hall i am forced to go to an in service which i have had no preparation for. I go in, watch a little 5 minute video in enteral feedings and am asked a number of questions by a clinical nurse educator. One being on aspirating stomach content to determine how well someone is tolerating their tube feeding. i knew nothing of this and if i did it was in school almost 2 years ago.

Well some of these questions i was unable to answer and found myself completely lost and the 2 Educators made me feel like i was THIS small. Like an idiot and seemed worried about me not understanding the questions. I got a pass by the skin of my teeth. I left feeling inferior and incompetent and saw that some of my other co workers scored 100%. Here i am with my embarrassing 80%. I want to crawl in a hole and hide after burning my mrsa infested scrubs and never return to work again. :( am i overreacting!? Nursing has made me a paranoid anxious mess.

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Specializes in Trauma Surgical ICU.

Sounds like a bad day made worse with the in-service.. You have never had a pt on TF, have you ever check residual?? These are basic but understandable if you have never dealt with it.. Check your facility for a P&P re this topic, it should help you. I would not let this one example make you feel incompetent though. You still passed, take every victory no matter how small :)

Oh and I have done nights for years.. people don't sleep all night :) That sweet lil old lady that was so nice turns into a monster at night, more confused, trys to hit, bite etc.. While nights are slower you still have the same pt care to do, assessments, meds and deal with "issues" with less.

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I deal with TF all the time! Have just never checked residuals because i have never had a patient with complications!

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Specializes in Trauma Surgical ICU.

Residual checks should be q4h or what ever your policy states. Checking for residuals is done to make sure the pt is tolerating TF.. Too much TF = the pt is not tolerating/digesting the TF and can cause aspiration into the lungs, abd distention etc.. We stop all TF's if they have a residual of over 250 then recheck 4 hours later, if they have digested we will restart the TF at a slower rate and gradually increase back to goal.. But that is our policy and you will need to go by what your policy states.

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I just researched and learned that this is our policy too. How did i not know this :( now i feel like a complete and utter failure. I can't believe i've been nursing 20 months and have never done this once. Wow......

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To be honest. I have never seem anybody do this... I have completley overlooked this all together. I feel lucky to have not had any TF complications and that i know this now. But im sure the clinical nurse educator feels that i am quite the retard

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Specializes in Trauma Surgical ICU.

Sorry but I have to ask, do you check placement if the pt has a NG tube? Maybe reading through your P&P manual will help.. Skim over the things you see on your floor..

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Don't ever say that your incompetent. That is the job of clinical educators, to make sure you are doing your job properly.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
To be honest. I have never seem anybody do this... I have completley overlooked this all together. I feel lucky to have not had any TF complications and that i know this now. But im sure the clinical nurse educator feels that i am quite the retard
That last word is a harsh word. Personally I don't like it...but I don't like it when I hear someone calling someone stupid either.

It is difficult to know what to do all the time. Most facilities have it somewhere on the kardex, treatment sheet, MAR, or care plan about checking for residuals. Your educator is also responsible for ensuring that the policies are being followed. If you have not done something before ...google it. If not at work then when you get home. We all have those days when we feel that maybe a job in the food service industry might have been a better choice.

Although the in service was a pain.....you learned something valuable that will keep your patients safer!

It was still a good day.:)

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Yes i do know how to check the placement of an NG tube.

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It has been minute since I worked in a nursing home or hospital but most places that I have worked usually have it documented on the MAR ( checking tube for residual). Whether they have complications or not the residual should be checked. I only say this because you can ask a patient the entire shift if they are okay and they will deny any complications but when the next shift comes on they will state I haven't been feeling good all day. I've seen too many patients do this. Check your facility's policy or protocol regarding tube feelings. You will be okay. No one is perfect!

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when some people get the same assignment you can be the incompetent nurse where as for them it was a "bad assignment".

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