completely messed up chart check

[fiveoclocksomewhere]

I am a brand new grad just finishing up my first week of orienting on a medsurg unit. I have had a hellish experience so far due to the worst preceptor of all time. Verbal abuse, not allowing me to ask questions and belittling me in front of fellow nurses is just the tip of the iceberg. Luckily I will have a new preceptor starting next week (the other nurses kept coming up to me apologizing for the way I was being treated and encouraged me to get a new preceptor).The other night, I was put in charge of the 24hr chart checks on our patients, including one that was a new admit from surgery. I am still trying to figure out the charting system and feel completely lost, but my preceptor would literally yell at me if I asked her a question. So I tried to go through the charts and orders as best as I could but ended up just signing for the 24hr chart check because my preceptor kept telling me to hurry up and finish. Now I am terrified that I will get fired once the doctors or nurses find things in the chart that were ordered and never entered into the computer all because of me. I thank God that I have a new preceptor who seems much kinder and more patient, but I hope my experience so far has not ruined my perceptions of the unit. I can't sleep and I'm having major digestive issues because I keep thinking how badly I messed up patients care due to my bogus chart check :'( I know I should never have signed my name but I literally did not know what else to do- she wouldn't help me and was telling me to finish, so I finished...!

[Esme12, ASN, BSN, RN]

I am so sorry this happened to you........there is a huge learning curve the first year. I'm glad you got a new preceptor.....organization is key!

brain sheets.......here are a few.

mtpmedsurg.doc 1 patient float.doc‎

5 pt. shift.doc‎

finalgraduateshiftreport.doc‎

horshiftsheet.doc‎

report sheet.doc‎

day sheet 2 doc.doc

ICU report sheet.doc‎

‎critical thinking flow sheet for nursing students

student clinical report sheet for one patient

i made some for nursing students and some other an members (daytonite, RIP) have made these for others.....adapt them way you want. i hope they help

[llg, PhD, RN]

You are right -- you should not have signed your name. However, now that it is done, you have to live with it -- and your first priority should be the safety of the patients.

My advice is to approach someone you trust and tell them that you did your best with the chart check, but that you are not sure you did it correctly. Ask them to look back over the charts to see if there was anything you missed. That will help keep the patients safe.

I am sorry that you ran into such a bad preceptor -- but that seems to have already been addressed. Now you need to focus on taking care of the patients and protecting them from any mistakes that you made.