day 2! and i left sobbing!!!!!

[erin01]

hi,

i hope you guys can help me feel better:crying2: I was just let of orientation i work on a tele unit and was really nervous to be on my own. But the first night went really well, i really felt supported with everyone willing to help. But it has back fired! I had a crazy night of a pt getting bld, no nt, and 5 patients one of them a new admit from er. When i got report she was on a cardizem drip going at 10cc a hr. hr was 132 but had drop down. now i have never had a patient on this before so i was already panicking and asking everyone about it .I know cardizem is a serious cardiac med and iv even stronger. When the patient came up her med record had orders on how to adjust the rate according to her heat rate! this made me even more nervous and i stopped and asked again, at this point i was told to increase it since her hr was still 132 and see how she does and if no change call the dr! Well this made me nervous again so i kept asking different people and getting different answers! Finally some one step up and said we are never to touch this rate! and stopped the med told me to take her bp and called the dr!!!!!!! whole******* to say i was up set is not the word. I knew something was wrong, but i also thought i had support and it back fired. I have never felt so bad! i was overwhelmed all night and then this=( By the time i was to leave i was in tears but made it to my car. I got a call from my manger who explained it was not my fault but we are never to titrate meds on this unit! Well now i know that!!!!!!!! But i really feel discouraged and am really thinking of quitting. I dont work again for a few days so its giving me time to think about it and figure out what i want. I expressed my concern to my manger that there are a lot of new nurses on this unit, and one of them i was working with that night! I asked her if she new this policy and she said no! so i told him something must change since u have new nurses there has to be away to make sure we all know this before we let off orientation! any thoughts or adv? I just think if i wasnt smart and new something was off........ this situation could have been sooo much worse!

[DeepFriedRN]

seems this problem went all the way back to who ever accepted the admit.....should have been going to the unit....

or even further, to the house supervisor or whoever it is that does bed placement for admits..OP, hang in there. It's kinda scary sometimes, but it'll get better. The longer you're there the more you'll know. Like this, you'll know that you guys don't titrate drips on your floor, so if you hear that when you're getting report, you'll know to say "sorry, gotta call house sup, we don't do those." Try to chalk it up to a learning experience, and one where there was no harm to the pt, which are the best kind. Good luck.

[UM Review RN, ASN, RN]

Hmmm.... now you have me wondering why the other nurse turned the drip off when the pt's HR was still clocking along @ 132? If the systolic BP was

I wasn't there, so I don't know what I might've done.

It's impossible to know all the policy & procedures to a facility, so I suggest that you find out how to access the P&P book. That way you'll be able to find our for yourself -- and also help the next poor newbie who comes on that floor.

((((hugs to you))))

[southernbeegirl, BSN, RN]

it WILL get better, promise!

I've been in LTC for over 15 years. a few years ago i decided to try hospital nursing. since i had been a nurse so long they assumed i knew how to do everything and i got little orientation. the second night i was there the charge put me by myself. it was similar to yours...blood transfusion, heparin drips, admits, discharges, IV starts, constant labs and then there was the computer charting. i couldnt even find any data i had entered in the darn thing!

i sat at the desk and just started balling. i didnt even wait till i got home, like you did. i just started crying!

but you know what? by the end of that week, i had it down pat! i even had the computer charting kindasorta figured out, lol.

'ya did good, kid. nobody died ( LOL ) and you survived! it's only going to be easier every day now! i promise!

[erin01]

yep first thing i am gonna do when i go back to work is find that policy and procedure is! I have already started to study these meds but it has now really reinforced me trying to study more..its just so hard to know it all=(

[morte, LPN, LVN]

Uh, Cardizem doesn't necessairly need to go to the unit. There's some info we weren't given here, like other VS.

but this particular patient had orders for titration, not done on the floor, hmm sounds unit material to me.....unless you have some middle ground.....

[highlandlass1592, BSN, RN]

but this particular patient had orders for titration, not done on the floor, hmm sounds unit material to me.....unless you have some middle ground.....

Actually, on the floor my friends work on, they CAN titrate based upon paramaters..again, we don't have all the info we need based upon not knowing the policies there and the other pt info.

[nurseejones]

First of all don't quit......look at it this way, you now have one step up on the next new nurse that is recruited to your floor! I think all nurses have similar experiences and we all learn from them! it will only make you a better nurse. When I run across a mistake, I take the time out AWAY from work and really analyze the situation. A lot of times you realize that you made a judgement call in "PANIC MODE" and didn't Rationalize......why am I doing this? will it make the situation better or worse. Of course we don't have the time to even think.....but don't let PANIC make your decision!

Good Luck, you are a good nurse!