Day one and I feel like a bad nurse

NURSEJERI, ADN · Dec 22, 2021

On 12/20/2021 at 7:47 PM, Ladycinder said:

So today was my first day on my own as a new grad. I've been waiting for this day for awhile. The day started out great I handled my patient load well and dealt with joint commission all day. I was feeling so good about myself, too good to be true... Right as I was giving report I realized I had been giving Lasix 20mg IV to a patient twice today when he had a Potassium of 3.4 since admission at 0400 and no orders to replace the electrolyte. His heart rate started creeping up before shift change I assumed it was part of his alcohol withdrawals and gave Ativan. Now I'm laying in bed dreading going back to work tomorrow that his Potassium bottomed out and he went into an arrhythmia. I can't help but hate myself... I should know better! Will I ever learn? Will it get better?

I've heard of this happening to many new nurses, it's called nurse imposter syndrome. It's all in our heads, we will not be perfect as we are new nurses. Mistakes do happen and you meant no harm. It's a learning situation and will get better with time. You will be confident in yourself one day, you will look back and laugh at the mistake. keep your head up.

angeloublue22, BSN, RN · Dec 25, 2021

You do realize that you aren't the only one responsible for the patient? The doc didn't order it. Should you have recommended it? Sure, but guess what, after this you'll suggest it next time. Every mistake is a learning opportunity. I never had the audacity (LOL) to believe that I will never make a mistake, but I made it a goal to not make the same mistake twice and you can make that your goal too. The fact that you recognized it, even later, and that you are so concerned means you are heading the right direction as a nurse. Hang in there.

Living2Learn, BSN, RN · Dec 27, 2021

On 12/20/2021 at 5:47 PM, Ladycinder said:

So today was my first day on my own as a new grad. I've been waiting for this day for awhile. The day started out great I handled my patient load well and dealt with joint commission all day. I was feeling so good about myself, too good to be true... Right as I was giving report I realized I had been giving Lasix 20mg IV to a patient twice today when he had a Potassium of 3.4 since admission at 0400 and no orders to replace the electrolyte. His heart rate started creeping up before shift change I assumed it was part of his alcohol withdrawals and gave Ativan. Now I'm laying in bed dreading going back to work tomorrow that his Potassium bottomed out and he went into an arrhythmia. I can't help but hate myself... I should know better! Will I ever learn? Will it get better?

You're fine. It'll likely take more than a few doses of Lasix to dip K to dangerously low levels. And even if his K is like 2.5, that isn't your fault. It'll be corrected (this is why we draw morning labs). An admitting K of 3.4 and a few Lasix doses doesn't inherently warrant a mid shift lab draw.

You're thinking of all of these things because you are a new nurse and it's a healthy sort of fear. The fact that you're doing this on your first day is proof that you already are great. ?

2BS Nurse, BSN · Dec 28, 2021

When this sort of scenario happens, it's most important to think "what will I do next time", or "what steps will I take in the future to prevent XYZ?" Don't beat yourself up.

vintagegal, BSN, DNP, RN, NP · Dec 29, 2021

If you were losing sleep over it, I would have called the nurse in charge of the patient at night and just ran the idea past them. “I noticed earlier the potassium was a little low, not dreadfully, but they are on lasix, do you mind keeping an eye on it?” You can’t remember everything the first day!