Better Ending to a bad shift

[chellelynn25]

So I work in LTC. My normal assignment is a unit with 25 residents. On my med-cart the narcotic drawer has 46 count them 46 cards of narcotics, everything from, Lortab to Kadian to Methadone. There are residents with multiple scripts of narcs. When I did my count at end of shift last night with the oncoming nursing there was an Ativan missing. I had signed one out from the card and gave it, but have no clue (serioulsy) where the other one went. The rest of the count was correct. So in turn tonite I was wrote up for a med error. Which I understand. I've been at the facility long enough that the DON and Administrator know that I didn't swipe it but made a mistake somehow. I'm just bummed that I have made the mistake because I'm a new nurse. But nobody seemed mad, my DON wasn't extrmely nice about the whole thing. I'm guess I'm just wondering what med error early in your career could mean. My friend who is the other LPN on my unit told me not to stress she's been a nurse for 20 years and says that she's wrote herself up for med-errors in the past. So should I really not stress, but take it as a learning experience?

There was resident readmitted to our facility, not on my unit. She came back in worse shape then she had been the first time she was there. She came from the hospital with an order for IV antibiotics. She has a port but the RN that was there tonite couldn't acsess (sp?) it, so the house MD gave a vo to start a peripheral. So two LPN try to stick her and don't get anything. I'm the only IV certified LPN who hasn't tried so far. so they ask if I want to try. My friend (bless her heart) says that I should give it a try. So I do I go into the room with her nurse and tie her off and I'm poking around. I found a vein that I thought I could use, so I went for it. And what do ya know FLASHBACK!! This was the first IV that I started on my own since I got my license. I have to admit I was kind of proud of myself for getting it after two other experienced nurses had tried with no luck. It felt good to do something right after being wrote up for doing something wrong.

I've wanted to be a nurse for a long time and a good nurse. Sorry to be lengthy I just needed to get it out. My SO is not in the medical field, so can not give me any input. Is the beginning after getting your license this hard for everyone? I just want to do my job well. I feel a little over whelmed at times and stressed and even after doing something right, I'm petrified of doing something wrong again.

[morte, LPN, LVN]

is this a med that you would give two of and only signed off one?

is this a once a day med, and you think you signed it off but that was the day before's?

is it possible the shift before you didnt sign off something and gave the wrong info when you counted off with you? if this turns out to be the case you still are somewhat at fault....since tech you should be watching both the cards and the book......

is it possible that you knocked it out when you punched the one you wanted? did you search the drawer?

Can you tell i have been were you are? lol...good luck

[GeauxNursing]

Ha! I just had my 4 month licensing anniversary! As a new LVN, I am scared of so many things! I know dialysis as a PCT, that's what I did for over 3 years! Learning dialysis as a nurse is so much different. I'm drawing up and giving meds everyday. No narcotics or anything(the strongest thing we have is regular ole Tylenol!) But the drugs are expensive! I almost wasted a syringe of EPO, but the preceptor jumped in and was like "No! Never do that!" then showed me some fancy, MacGyver-way to salvage it, lol. I'm finally getting more comfortable doing it every day.

At the start in my "training", I had so many things to do and learn every day that I went home exhausted and feeling defeated. I thought this would be an easy transition! I was so wrong. Now I have catheters to access and dressings to change, meds to give and pts to assess and charting, charting, charting AND my normal assignment of 4 patients! At first, yes it was crazy and overwhelming and stressful.

I still frequently worry that I will assess lung sounds incorrectly. I will say someone is "clear" but they actually have crackles down there! I'm thinking, "Is that crackles? Or is that my fingers creaking? I can't tell! I can't keep my fingers still enough!" LOL. They keep saying "You'll pick it up in time." I try to get the other nurses to let me know when they hear something so I can listen, too.

Good job on the IV! I know that felt awesome, right? In my opinion, there can be many crappy things that happen during the day. But then something awesome happens and it changes the perspective. Like me, being super-slow drawing up my meds and then giving them and then cleaning my messes up and getting my vitals and taking someone off the machine...Well then, someone calls me to stick a difficult fistula, or maybe a brand new one. I get it done, and do it awesome! That makes the day good.