Being A New Grad Is Hard. How Do You Deal With Making Mistakes?

[NursingHopeful95, ADN]

Hi everyone. I’m a new nurse. I’ve been working at my hospital for 6 months & graduated in December of 2020. I just need somewhere to vent & constructive criticism & advice. I love being a nurse I Truly do. I work on a busy surgical oncology floor & my patients are absolutely kind and amazing. Our ratio is 5:1 for surgical patients & 4:1 when we have the oncology team. I was just trained to give chemo & I love it! Having 4 patients is awesome I can totally do it! Having 5 patients I’m running around like a chicken with my head cut off. I’ve made two mistakes so far in the last 6 months & I’m beating myself up over it. I leave work everyday with anxiety worried that I did something wrong, didn’t catch it & that I’ll lose my license. I literally struggle to fall asleep after each shift. 

My First mistake was actually my last day precepting. My patient had two separate Toradol orders one for 15mg & one for 30mg. The orders were not in subsequent order. My patient was in pain & I only saw that the 15mg order hadn’t been given that day so I gave it. Not realizing that the patient had already received 30mg in the ER a couple of hours prior & it wasn’t yet due to give… My preceptor caught the mistake. I didn’t get written up. My nurse manager just had me call the doctor & the doctor had me hold the Toradol until the next day. Lesson learned I always scroll all the way down the MAR & quadruple check every med before I give it.

Today I made my second mistake. It was a terribly busy day. I had 5 patients one of which was an absolute train wreck & I was advocating to get them off our med surg floor. The patient was trached with a trach mask, extremely tachy & really needed to be on a Tele floor as we don’t have monitors. That patient took up almost the entire last 3 hours of my shift as they also had a leaking gastrostomy tube. Anyway, during that time I received prescription medication orders for one of my other patients who was discharging. Our hospital policy is that doctors put their own orders in but only a handful of them do. The doctor asked me to put the order in so I did. So on my way home from work I realized I put the orders in under the wrong doctors name. We have multiple doctors with the Same last name. I put the order in under the orthopedist doctor instead of the internal med doctor. I called the nurses station immediately to find that the patient has already been discharged. 

I called my charge nurse for today (who precepted me) & she said she will let the nurse manager know tomorrow & that it was a simple mistake. 

I don’t feel like it was though. At this point I’m feeling so discouraged. I’m too focused on the tasks at hand when I wish I could simply be focused on patient care. 

Does anyone have any advice for me? 

I love my hospital but I’m to the point where I’m honestly talking to my husband about quitting to be a stay at home mom after my 3 year contract is up. I feel like I’m unsafe & I shouldn’t be making these mistakes. 

[Zapi791, BSN, LVN, RN]

The toradol incident is a computer program issue.  Some  hospitals have computer programs that will alert you when the previous pain med dose was given.   I have seen orders and given patients up 60mg toradol at a time so the dosage seems safe anyway.

Most hospitals won't allow the nurses to write orders for the doctors, and fortunately make the doctors do their own job.  If you had to explain to state board of nursing most likely the doctor would deny delegating this task to you.

Instead of beating yourself up about crappy hospital and unsafe hospital practices maybe you can join a hospital shared governance committee to suggest and make changes.  You not only vent your frustrations in these committees but also help improve working conditions.  Usually the hospital committees require evidenced base practice and nursing research prior to making changes.  They also like you to show them how much money they will save.... etc.

Good luck to you in your nursing career, you actually sound like a very caring nurse.

[JKL33]

On 10/26/2021 at 1:05 AM, NursingHopeful95 said:

I called my charge nurse for today (who precepted me) & she said she will let the nurse manager know tomorrow & that it was a simple mistake. 
 

I don’t feel like it was though.

It was a simple mistake and very small potatoes. Let it go. Believing that your every move should (or can) be perfect is a negative, destructive pattern. Through the years nurses have been manipulated into believing that practically every aberrant thing is something that should never happen and that good nurses are meticulous so that these things don't ever happen. That's a lie. We have also allowed business entities to confuse the issue of what is considered a significant mistake.

Another problem in nursing is the fact that simple, human, run-of-the-mill errors (of the non-negligent and non-reckless variety) still seem to carry the stigma of a moral/ethical failing (laziness, carelessness, etc.). This is also generally a bunch of baloney. We can change that, by changing our attitudes. It sounds like your place is reasonable, so that's all the more reason why you should choose not to believe fantasies about human capabilities.

The takeaway from the doctor-picking mistake is hopefully obvious, and is significant even though the mistake itself wasn't: Don't fall into the trap of doing what you know you shouldn't. Categorically that is the kind of thing that does get people into trouble because it is both needless and hard to defend. With all that you had going on that day, and with the fact that hospital policy is that physicians enter their own orders unless there's an emergency or a protocol, you had no business getting involved in entering that order. I know why you did, but you shouldn't have. Avoiding getting involved is as simple as kindly stating, "We were informed that physicians need to enter their own orders" or simply, "I will need you to enter those orders please."

 

On 10/26/2021 at 1:05 AM, NursingHopeful95 said:

I love my hospital but I’m to the point where I’m honestly talking to my husband about quitting to be a stay at home mom after my 3 year contract is up. I feel like I’m unsafe & I shouldn’t be making these mistakes. 

You are wrong. ?

Everything is okay. You sound like a conscientious person. The Toradol error is an easily repeatable error without proper system functions in place; many before you have done the exact same and you won't be the last one to do it, either. The most recent mistake you're reporting barely qualifies as a mistake as it is of no significant consequence.

It sounds like you are doing great. Continue to hone your prioritization and patient management, and add in some pleasant assertiveness. Remember to be realistic. You are not a superhero, a perfect angelic being or any of the other fantasy-like depictions of nurses. Your beliefs about yourself are important for you (your emotional health) and your attitude and portrayal of yourself is important due to how others will see you. So be positive and not self-deprecating!! 

If this is all you have to report I think you are off to an excellent start in your career. Seriously.

????

[Kooky Korky, BSN, RN]

Never do the doctors' work unless it is a true, true, true emergency.  Just for you to understand why you did it - why did you enter the doc's orders?

Toradol doesn't do anything anyway.  Well, that's not true.  But I don't think it does much to relieve pain post op.  Everyone is just afraid to order narcotics/controlled substances, when they really are called for.  Just be super careful from now on.

Carry on.  Don't throw away your education.  Patients need you.  Learn from your mistakes, which are minimal.  Move on.  Wishing you well.