Bad Day During Pre-Grad Placement - need reassurance!

[Nugget]

Hi y'all:

I am a pre-grad nursing student (wahoo! Only 2 months to go!), doing my consolidation on a surgical floor (mostly ortho, but a lot of gen surg too). I've been there since January 20th.

Last night I worked my first night shift and I think it completely threw me off my game. I made a bunch of stupid stupid mistakes that, in retrospect, I realize that I would never do; however, I just didn't think.

I gave a pre-op on-call appendectomy pt. tylenol PO for a headache, then as soon as I left the room, I realized what a stupid move that was. Fessed up to my preceptor and she said it was no big deal.

I had my first pt. with NG suction, who was vomiting green bile and was receiving NaPO4 over 4 hours (her electrolytes were all out of whack, as I am sure you can imagine). The pt. was complaining of burping and horrendous stomach pain and had pantaloc ordered for 2200. I stopped the NaPO4 and hung the pantaloc (w/ a new secondary line). My preceptor (who is very nice and supportive, but probably thinks I am the bane of her existence now) had told me to hang the pantaloc when we were in the pt. room together and stupid me, I assumed she had noticed the NaPO4 was still running and wanted me to give the pantaloc asap because the patient was in agony. When I mentioned the NaPO4 hadn't finished, but I had hung the pantaloc, she told me to never stop any infusions until they're finished, no matter what and appeared really upset with me. Lesson learned there.

So then...I hung the NaPO4 and forgot to open the secondary line clamp and caught it about 20 minutes later. Told my preceptor, and though she was pretty good about it, I could tell she was aggravated with me at this point. Anything I did after that was annoying to her, so I just tried the fly under the radar for the rest of the night.

WHEW, end rant. I feel completely dejected after last night and though I am doing my best to see last night as a MAJOR learning experience, I feel that the stupidity of the mistakes mean that I am never going to be ready to be an RN, and that my preceptor does not trust me. Until last night, I was rocking nursing practice in my last semester.

Have any of you had nights (or days) like this? Student and RN alike? How do you get over it?

Thanks guys!

~Nugget

[Double-Helix, BSN, RN]

I've had days like this. As a student, and as an RN. Days when you feel like your head isn't on straight, your late with meds, missing simple things, forgetting to check orders or follow up, giving patients incorrect information... etc. This may have been your first day like this, but it's not going to be your last.

In the moment, you deal with it the way that you did. You admit the mistakes and make sure they don't harm the patient. Then you make corrections if you need to. You tell the OR the patient got a po med, or you correct the information that you gave the patient that was incorrect.

For the future, you remember what you did wrong and learn from it. You make an effort next time to double check what you are doing and think about why you're doing what you're doing and what affect it will have. Make sure your thinking about the whole patient situation at the time, rather than just on the specific intervention. When you do a procedure, talk yourself through it and then double check to make sure you did everything. Are your IV's on pumps? Our pumps always beep with the link is occluded or clamped. It's a reminder that you didn't unclamp the line. If you don't have a pump, watch your burette to make sure it's running.

This doesn't mean you're a bad student or will be a bad nurse. It means you have an off day. If your patients weren't harmed it's still a good day. You'll do better next time.

[Nugget]

Thanks, Ashley! Your response is encouraging and much appreciated. Hopefully toorrow will be a better shift! Here is hoping.

P.S., your dogs are adorable :)

~Nugget