In the pitocin thread, a suggestion was made about starting a thread about dangerous first year lessons learned. Personally, I shudder at the fact that there is no way I can know everything before I am on my own on the floor. I hate that some patients will be at my mercy as an inexperienced new nurse, and I am seeking all information possible in the interest of my patients' safety. So this is a very loud, desperate plea for all of you experienced OB nurses out there to contribute and share about scary situations that taught you valuable lessons.
Here are my two valuable lesson learned thus far:
1) NEVER TAKE SHORT-CUTS. Chances are, you will miss something, and it will be something big.
2) Suck it up and drink some coffee when you are tired and feeling lazy. These are the days that some crazy stuff happens, and your pts are depending on you.
To anyone and everyone: please contribute, no matter how small or insignificant you may think your words are!!!!!
when you feel the most rushed and busy, like you can't slow down for a second, that is when it should be a warning signal in your head to double and triple check everything.
I am on our hospital's Peer Review Committee. It has taught me sooooo... much. The biggest thing we hear is, "it was so busy that day" and "I didn't feel safe with the staffing that day". Our leader ALWAYS says, "what would you have done differently?" Usually the nurse says I would have slowed down and double checked things or I would have made it clear to my supervisor that I wasn't feeling comfortable. . .
You have to CYA. Check, double check and triple check your R's. AND, no one can help you later, when you say "I was too busy" if you didn't ask for help. If staffing isn't safe, make your position clear to your supervisor. If she/he doesn't do anything to help the situation go above their head. You will be much better able to defend yourself later if you can say, "I followed the chain of command." Don't compromise YOUR license for the floor. Normally, we hear the admin's say, "you should have let us know" , "we can't do anything if we are unaware".
Short staffing happens everywhere and many times we have to suck it up and work our butts off, but we don't have to be so busy we kill someone. The charges can take patients, the DON can answer phones and call lights ( I doubt ours would ever do pt care again ), etc. . . There are always options.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
We have in place where I work a couple of mechanisms to address short staffing/crazy-busy times.
The charge nurse shift report, which details census/acuity/staffing and problematic issues.
The occurence/variance reporting system. This is used when something unusual and out of policy occurs for any reason. These reports go to our Risk management department, as well as our manager. I make sure i get a copy myself, when I write one.
Using both of these, at least, the charge nurse and staff have the means to reliably document staffing variances and situations that are dangerous or risky. But we have to USE them in order for them to WORK.
Yes, I absolutely hate the term Braxton Hicks. I can't tell you how many people i know lost their babies b/c they thought, and were told, by everyone around them including drs. and nurses, that they were Braxton Hicks. I even read an article by an OB addressing this once but could never find the link again.
First, let me say that it is normal to have the "imposter" syndrome as a new nurse. It was about 6 months before things started really making sense to me after graduation.
Secondly, despite being new and feeling inept in nearly all phases of nursing, LISTEN TO YOUR GUT...I was not out of school 3 weeks et I had a med error that was caused by my own insecurity, et my ASSUMPTION that an RN who had her license for years could count correctly. All i had to do to avoid the error was to simply trust MYSELF et look at the card of meds et I would have been fine.
Third, remember that regardless of the advice you may get from other nurses, if it is your patient, it is ultimately your call. Not long ago, I had a woman who was lethargic, hyperglycemic, diaphoretic, et complained of generally not feeling well. I told several of my colleagues that I didnt think everything was right with her, but I wasn't sure what. They all commented that she was afebrile et her VS were WNL, so she should just be monitored. I felt uneasy about it though, et thought that even without a fever, she might have an infection. Thankfully, I called the MD, because the woman had a nice abdominal infection brewing. It drained for more than a week!
I am very glad I trusted my gut instinct on that one. Moral of the story is, advice from peers is nice to aid you in your thought processes et critical thinking, but the buck stops with you.
kastas, BSN, RN
137 Posts
I am on our hospital's Peer Review Committee. It has taught me sooooo... much. The biggest thing we hear is, "it was so busy that day" and "I didn't feel safe with the staffing that day". Our leader ALWAYS says, "what would you have done differently?" Usually the nurse says I would have slowed down and double checked things or I would have made it clear to my supervisor that I wasn't feeling comfortable. . .
You have to CYA. Check, double check and triple check your R's. AND, no one can help you later, when you say "I was too busy" if you didn't ask for help. If staffing isn't safe, make your position clear to your supervisor. If she/he doesn't do anything to help the situation go above their head. You will be much better able to defend yourself later if you can say, "I followed the chain of command." Don't compromise YOUR license for the floor. Normally, we hear the admin's say, "you should have let us know" , "we can't do anything if we are unaware".
Short staffing happens everywhere and many times we have to suck it up and work our butts off, but we don't have to be so busy we kill someone. The charges can take patients, the DON can answer phones and call lights ( I doubt ours would ever do pt care again ), etc. . . There are always options.