Does A Bad Shift Ever Make You Question Your Abilities?

Published

Hey!

So I'm a fairly new RN (almost 1 year as an RN/Emergency Room) though I've been an LPN (LTC) for a while.

Any-who I had one of those notorious bad shifts (or what I assume to be a bad shift) :mad:

I've never had so many intubated- vents/trach patients in one shift in my entire nursing career!

Now I've always been one to be very hard on myself, when it comes to grading my nursing skills. Since I became a nurse years ago, it's as if I need to know everything I possibly can and that if I don't know exactly what to do in every situation I failed somehow. Coupled with the fact that I deal with alot of critical patients, it's as if I always need to be better or do better, or move faster, think faster.

My co-workers always say that I'm cool under pressure or that I'm good for a ''new grad'' and that's nice and all but it's as if I need to hear that I'm one of the best you know? I think it's my ego really :down:

Working in a terribly hectic (multipile hospital closures in town, you know what that means, MORE PATIENTS/OVER CROWDED ERs, ) level 1 trauma center, I guess I COULD say that I'm doing pretty well for what we have to work with (horrid nurse to patient ratios, etc.)

You may remember this thread:

https://allnurses.com/general-nursing-discussion/feeling-burned-out-613185.html

and to make matter worse I had to work with the most arrogant, know it all ER tech last night! (that's another story)

But do you ever have that shift, or that patient situation that makes you question your nursing skills, even years into your nursing career?

Up Vote Up Vote ×
Specializes in LTC.

I've been a nurse for almost 2 years now so I've had enough of those bad shifts to answer your question.

No it doesn't. If I start to get that thought in my head I think .. it takes some skill to be able to juggle 25 patients and whatever is thrown at us that night. I always get told that I'm so calm and cool by my co-workers but to be honest in the inside I'm kinda freaking out lol.

Up Vote Up Vote ×

You know, having to question your own skills once in a while is not always a bad thing; it prevents overconfidence and shows you areas in skills that need work.

Yes, I have had those shifts, and sometimes I am humbled.

The next day is often better.

Up Vote Up Vote ×
Specializes in ICU, Telemetry.

I had a truly horrible shift one night...started out with 4 patients, 2 nurses in the ICU. They were sick, but it was okay. Then it was like everyone who was going to go into respiratory arrest, cardiac arrest or throw a CVA in the entire county all got together and said, "tonight's the night." I was on call, and got a rather panicky "how fast can you get here?" from a nurse that's usually not very excitable. I threw down my fork, left my just-outta-the-oven dinner and took off. I get on the same elevator with my patient -- zoll pads on, in trendelenburg in the freakin' elevator, took a look at the monitor and went, aw, s**** because they were in 3rd degree block. The nurse from the ER says, "We're trying to fly them out but nobody has a bed, you're first open CCU bed at 2 different places." Guy is grey, looks dead, sick as all get out. We just get him settled and I'm hanging levophed, dobutamine, dopamine, the whole constellation when another bed decided to code. I vaguely remember yelling at the house supervisor (who'd come up to tell us we had a NSTEMI and a GI bleed with a hgb of...get this, 3.9!...that needed to come up) that we needed a 4th nurse, NOW.

By the end of the night, the first code had died, my patient had died, the GI bleed got flown out because we ran out of their blood type (no O neg in the house, isn't that scary? We gave everything we had, 2 FFPs, 6 units of PRBCs, and flew them out with our last bag hanging!), 2 more GI bleeds that were gushers, an evolving CVA, and a second MI, and at least 1 more vent. When I dragged myself home, I felt like a complete failure as a nurse, couldn't remember if I'd charted my restraints on the vent patients, was scared silly I'd screwed something up, wanted to just throw up my hands and run screaming. We took 8 admission in 7 hours, had 2 codes, and one emergency fly out.

Somedays you're the windshield, and that night, I was definitely the bug. You always feel like you should have been faster, quicker, got more done, but the truth is, this is a 24 hour business, and sometimes you just can't. Give yourself a chance to realize how good you are.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Yup! and times made me wonder why I became a nurse at all....that's a busy ED for you.....I'm sorry you had a bad night :hug: Every Time I'd be ready to throw in the towel the powers above reminded me

1) I didn't have it so bad

2) others have it a lot worse than I do

3) just when I think I've seen it all I'm reminded the are no boundaries to human stupidity and human compassion.

4) in a hundrend years is any of this going to matter????

My favourite poem that reminds me of being a nurse is all about...

Being a NURSE means…

You will never be bored.

You will always be frustrated.

You will be surrounded by challenges.

So much to do and so little time.

You will carry immense responsibility and very little authority.

You will step into people’s lives and you will make a difference.

Some will bless you. Some will curse you.

You will see people at their worst… and at their best.

You will never cease to be amazed at people’s capacity for love, courage, and endurance.

You will see life begin…and end.

You will experience resounding triumphs And devastating failures.

You will cry a lot. You will laugh a lot.

You will know what it is to be human and to be humane.

-Melodie Chenevert, RN

Up Vote Up Vote ×

Nerd to nurse that's exactly how I feel. I mean from about 11p to 7am (not to mention the usual madness coming on shift at 7p that runs through midnight) I was running around, got no break (and you know how your brain functions when that happens)

All my patient last night were respiratory, with the exception of one that was a neuro patient. So I had a vent with seizures, another vent with possible head bleed and seizures in SVT tachy up to 160, calling this resident, that resident for orders. Then in comes a pneumonia who CANNOT breathe, then another, then another. It's like the waves just keep taking you under before you can come up for a breath.

My manager then says (jokingly) he'll NEVER put me and another nurse to run the resusciation room together because we're omens/bad luck in there and even he had a rough night, which made me feel even worse (although I know he was joking, still it stung hearing that. Mind you we're both fairly newer nurses, still getting this trauma stuff under our belts. I can't remember a thing I did, my head and my feet hurt so bad.

Up Vote Up Vote ×
Yup! and times made me wonder why I became a nurse at all....that's a busy ED for you.....I'm sorry you had a bad night :hug: Every Time I'd be ready to throw in the towel the powers above reminded me

1) I didn't have it so bad

2) others have it a lot worse than I do

3) just when I think I've seen it all I'm reminded the are no boundaries to human stupidity and human compassion.

4) in a hundrend years is any of this going to matter????

My favourite poem that reminds me of being a nurse is all about...

Being a NURSE means...

You will never be bored.

You will always be frustrated.

You will be surrounded by challenges.

So much to do and so little time.

You will carry immense responsibility and very little authority.

You will step into people's lives and you will make a difference.

Some will bless you. Some will curse you.

You will see people at their worst... and at their best.

You will never cease to be amazed at people's capacity for love, courage, and endurance.

You will see life begin...and end.

You will experience resounding triumphs And devastating failures.

You will cry a lot. You will laugh a lot.

You will know what it is to be human and to be humane.

-Melodie Chenevert, RN

:nurse: *hugs* this was encouraging.

Up Vote Up Vote ×
Specializes in Trauma Surgical ICU.

UGH, I had one of those night last night,. I ate at 6p and didn't eat again til 8:45 this morning.. Got a new admit, had to transfer the pt that was there to a different unit just to get the "new" one and had a pt with q1h neuro checks climbing out the bed all night long.. Then at 5am, SBP tanked with little urine output.. Only PIVs for several gtts.. I have to go back tonight.. time for bed... Give yourself some slack.. Sometimes it just happens not matter how much we know..

Up Vote Up Vote ×
You know, having to question your own skills once in a while is not always a bad thing; it prevents overconfidence and shows you areas in skills that need work.

Yes, I have had those shifts, and sometimes I am humbled.

The next day is often better.

Exactly. I've been in nursing (as a staff nurse for quite a few years and then as an APN) for nearly 30 years, and I do sometimes have days that cause me to question my abilities and usual practice -- not in the sense that I'm destroyed, and go home and weep into my pillow, but in the sense that I do my best to analyze what my weaknesses were and how I could have handled the situation better (inc. sometimes seeking feedback from trusted colleagues) so that I can continue to improve my skills and practice. I hope the day never comes that I don't recognize the need to continue doing that. To me, the really scary nurses are the ones that are completely confident that they know everything they need to know and they always do everything right ...

Up Vote Up Vote ×
Specializes in ER, ICU.

Yes, I had one of those last week. If it were too easy I guess I would get bored. As long as it doesn't happen too often it keeps you humble.

Up Vote Up Vote ×
+ Join the Discussion