Feel like I'm too dumb to be a nurse

[coconut3431]

I've been working as a nurse for 4 months. Today, i had a resident's family member come in and say that she (resident ) doesn't look right. The family member said they told the other nurse that she is getting worst and worst. Now, this is the first time I had this patient. So, I take her vital signs everything is normal. Her o2 was 92. I even get an rn to come and recheck her to make sure. The rn rechecks her and says nothing seems out of the ordinary but that she'll call the doctor to order blood test to make sure. So I call the doctor. The doctor tells me to get a chest xray and blood work. So i get the chest xray done, and send off for bloodwork. Chest x ray reveal pneumonia. I thought the chest xray was sent to her office. So I wait on the doctors call, meanwhile i finish passing out my meds. She calls at 5 pm and says its 5pm why haven't I call her? I tell her my reason and aplogize, she says I need to take better care of my patient. I have people lives in my hand. During my shift i an taking the residents vital signs they are normal. Towards the end of shift change i tell the nurse taking over what's going on with the patient. She goes a takes her vital signs and they are really low. They send her out and call the doctor . The doctor tells her she should be reported, and that this is unacceptable. The nurse says you right she could've died. I can hear the cna's saying she's a nurse, you think she would know. Im sitting there looking stupid. I feel like I'm too dumb to be a nurse. Does anyone have any advice, became i am thinking of quitting my job.

[nurseinthezoo]

You've only been a nurse four months. As time passes you will experience more and grow more confident. We have all made mistakes, even doctors.

[AngelKissed857, BSN, RN]

The key here is that you "really didn't know". And now you do. Like the song says, "let it go"!

[FutureLPN35]

Don't ever think about quitting or feeling like you're dumb or not good enough for the job. You made it through nursing school right and that is not easy so you belong there. Everyone makes mistake. Just keep pushing on. They hired you for a reason and you show them that they made the right choice.

[LadysSolo]

What several have said is correct - she was going to go septic before you got the x-ray, it was already in progress. An hour or two earlier on the antibiotic was not going to change the inevitable. The fragile elderly can change in a heartbeat, and can crash quickly, their bodies can hide what is going on pretty well. Hang in there, you did fine.

[canoehead, BSN, RN]

Did you ever make a huge mistake in your years as a nurse?

Hell yes. I nearly killed someone about ten years ago.

And multiple bad but not disastrous errors, every day I can pick out something I could have done better. My tips... if a family member says something is not right with their loved one, listen to them. If a patient or family member says the meds you brought don't look right, start right from the beginning and go through each one with them. It will save you and the patient.

If you call a doc, and say you wanted to make sure they had certain information, or you wanted to make sure you understand what they want, they should be gracious about it. Try to go through the whole chart/situation so you can get all your questions answered in one go, of course. Don't feel guilty about clarifying things for the patient's benefit.

If you think a patient is sick, do extra vital signs and assessments, even if they aren't ordered. Put them on a monitor, if you have one. You'll catch them going downhill earlier. Orders are the minimum we should be doing, not the maximum.

[MrNurse(x2), ADN]

The PCP was upset... at his/herself for not following up and lashed out at you. There is a health care team, you are part of that, and it is our responsibility to keep physicians focused on the patient in your care. Numerically, physicians are juggling far more patients than you are. I have overlooked things, even after decades of nursing at the same position, it is called being human. We had a family member living with us, she would have marked lethargy and increased confusion a day before her annual pneumonia admission. We would send her to the hospital, as she needed more care than we could provide, and insist she be admitted. Sure enough the consolidation appeared on XR the next day every time. Moral of that, elderly present uniquely in their infections and you will learn what that looks like. Nursing is a career, not a job, you will need 2-3 years to feel comfortable. You didn't create a sentinel event and the patient may have had care delayed by a few hours at most. This is the best way to learn.

[fightingtobeanurse]

One thing that helped me was the mindset "assume nothing! Verify EVERYTHING! Live by those words and as you progress you will eventually get there. You are going to tread water for a while, 2 years or so (perhaps longer) and then things start to fall into place. Don't beat up on yourself too much though. If its your first shift with a patient, it takes you a bit to "learn" them, longer if you are new at nursing.

Just ignore those people putting you down, suck it up, and chalk it up to experience. Keep your eyes open and soak up as much as you can, but DO NOT beat yourself up. You will make mistakes and have to learn from them. Sometimes nursing is about surviving, where all you can do is try to keep up with it all, and sometimes its about thriving, where you can actually try to get some things done. Every shift is different but definitely don't quit after only 4 months. Just keep learning.

The other part of that is that it's always easy to blame the "stupid nurse" for everything. That doc was just as responsible for not following up on the test THEY ordered as they claim you were even though they were calling for your head. In this case, the lesson learned is that when you see an order for an x-ray, and you have sent and received the patient back from said test, start looking for results an hour or so after they return I can't give specifics but generally speaking a chest x-ray doesn't take forever to read. Just give X-ray a call and ask if it's ready or not. IF they say yes have them send you a copy, if not note this for your hand off report and continue to monitor the patient. Sometimes physicians get a lot done in sidebar conversations too so you may benefit from calling the doc back and saying the test was completed but still no results after a certain amount of time. (They may opt to call the radiologist and 'motivate" them to read and release results) but all of that takes time to figure out.

Just be patient with yourself. You are wading in a deep pond with a lot going on under the surface. Hope this Helps.

[RHope]

You feel dumb. The only problem is there were other nurses that cared for the patient before you. So that would mean you're all dumb together. It took more than one shift for that patient to get like that. The nurse that worked before you, don't you think she could have called the MD, obtained a chest X-ray & blood work? You're the only one that really took any real action. Had you not had been that patient's nurse that day, she definitely would have died. Do you really think the other nurse would have bothered to call the doctor and obtain orders like you did? From what you described here, I highly doubt it. And guess what, they didn't. She may have called a pizza place. That's about it. The next time, just call the doctor and give them verbal results of abnormal X-rays & lab results. Fax the hard copy to their office later. You gave that patient a chance, because you took the time to further investigate potential health problems. The family, you, and the nurse that worked after you, worked together and saved that patient's life. No, you're not perfect. Who is? But you sure as hell are NOT dumb. People who try to make you feel dumb are insecure and feel powerless within themselves. Don't sell yourself short. There are countless patients, families, and nurses out there that need you. Like any other profession, you grow as a nurse everyday. ?