Feel like an incompetent nurse

Nurses General Nursing

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I've been a nurse for 3 years now, 2 years in an acute care setting. I recently started working on another unit at the same hospital (newly opened surgical unit too). My fellow co-workers are so amazing, reliable and smart that I feel so inadequate next to them. I don't feel like I'm good enough to be a part of their team. In the past 2 days I've done some hiccups that were plain common sense such as:

- not connecting the PCA tubing correctly

- asking the doctors to put parameters on blood pressure meds (d/t the fact my pt's HR was in the 50s), only to have my lead tell me I could just look it up the medication to see if it's ok to give.

- patient had dialysis for the second time EVER today (first time was yesterday), and was quite lethargic after. Vitals were stable, she did open her eyes when we tried to wake her up, and blood sugar was normal. However she didn't eat anything all day until dinner time. The next nurse asked if this was her baseline LOC and I FELT SO STUPID I COULDN'T GIVE HER A CLEAR ANSWER. I know she was also lethargic from the first dialysis, but I didn't ask the last nurse if that was her baseline.

- patient admitted with abcess, forgot to look up the patient's WBC level (wasn't critical to begin with, and she was getting 3 antibiotics).

There have been several instances during report where I don't know the answer to their question. How can I be a better nurse? I feel so incompetent, and I don't want to be that nurse that gives terrible reports. I try so hard to make sure I don't miss anything, and make sure the patient's needs are met, and I keep an eye for critical changes, yet I still miss something. Some days I feel like giving up because I feel I'll never be as good as my fellow nurses.

What do I do?

MunoRN, RN

8,058 Posts

Specializes in Critical Care.

There wasn't anything inadequate about the care you provided. Any nurse who asks if being lethargic after the patient's second HD run ever is in their baseline is an absolute moron and there's no benefit in trying to answer any of their questions. Give report and tell the nurse to direct any of their questions to their nursing school instructors who had so severely failed them.

Keep in mind that as a new nurse you'll frequently come across situations where you and a more experienced nurse might disagree. Which might be due to the more experienced nurse having more wisdom than you. But it might also be that the more experienced nurse is an idiot.

Specializes in SICU, trauma, neuro.

You were correct to ask for parameters on the BP meds — the drug reference didn’t prescribe them, nor does it know the patient. Why on earth would a provider defer to a drug reference? That’s just plain lazy.... and unwise.

Katie82, RN

642 Posts

Specializes in Med Surg, Tele, PH, CM.

New floor, new co-workers...perfectly normal to feel a little unsettled. I predict that a month from now you will feel totally different.

Lily6310

1 Post

I'm sorry she made you feel this way, but her question about baseline LOC shows she her lack of knowledge more than anything! First of all she is a dialysis patient, not a neurological patient or a stoke patient, for which a question of baseline LOC would be pertinent. That's like saying, I have pneumonia and I am feeling lethargic and than you ask me "but what is your baseline LOC today??" Get it ! That's a ridiculous question. Your mixing apples and oranges together. If her vitals are stable, and she has no diagnosis of any brain abnormality/trauma or neuro deficits than people are allowed to be lethargic without being asked about baseline LOC.

Specializes in Ortho-vascular nurse.

It sounds like you are doing a great job. You will become more confident the longer you work.

I too have anxiety about not giving a thorough report. My floor gives the assignment before the next shift comes in. I use this to my advantage and come in early to study my patients. I am unpaid for this time, but I really feel this preparation sets myself and my patients up for a safe shift. I research and write down: allergies, pt history, pt chief complaint, pertinent labs and tests, meds that are due, and any questions I want to remember when I am getting report, I sometimes also read some of the notes. I really feel like this brings me peace of mind before I start my shift, and at the end of my shift when I'm giving report.

canoehead, BSN, RN

6,890 Posts

Specializes in ER.

For the patient with abcess... no matter what the WBC level was you are still going to do the same treatment. It's nice to know the WBC, and you should notice if its going up or down if blood is drawn on your shift. You aren't incompetent though, if you have to say, "let me check" if someone asks.

Specializes in Perinatal Services.

I want you to know this really resonated with how I'm feeling too.

I recently went from DON and expert in my field and now back at bedside in a totally new field. I got so frazzled yesterday I made an error. It was simple and stupid and I should have known better. After that my preceptor said "oh there's not much to do, go in an empty patient room and read this binder with the policies in it." I felt dismissed, rejected and stupid.

Nobody wants to be "that" nurse.

After getting home and licking my wounds, I realized we are all "that" nurse. We are all capable of making human mistakes. The only thing I can control is making sure I don't do the same thing again and trying to anticipate potential events and figuring out how to handle them.

For me it's really hard because I feel very alone. I don't have friends in this new place. But finding someone who is supportive and can walk you through it is helpful, like a mentor or friend to vent to.

Remember, the next shift isn't perfect either. That nurse your giving report to isn't perfect. The way you work will always be different from the next person. Your clinical judgement is sound and that's what matters.

I guess what I'm trying to say is this: We're all in this together, we are all here for the benefit of our patients. Don't give up!! You will get there and I will too. Be patient with yourself.

Specializes in Perioperative Services.

From your statement you are not incompetent just inexperienced in a new area. Nursing is about teamwork, relying on each, bouncing off ideas, supporting & teaching each other. Although I have been a nurse for 25 years there is alot I still do not know. With so many speciality areas, new drugs, and new diagnosis and treatment a nurse will never know it all. Hang in there. You got this. We need you!

beekee

839 Posts

Don’t sweat the small stuff. Sounds like you are doing fine (and a lot of those questions fall in the “nice to know,” not “need to know” category). I’m sure you noticed stuff they didn’t. It’s a team effort.

Honestly you just sound new, inexperienced in the area in which you work now. I think it's healthy to be cautious and concerned about whether you are doing well or not. Frankly it's people who are not concerned or cautious that scare the heck out of me! A nice helping of humble pie would work for SOooo many.

Anyway what you describe now are the kinds of things you will be telling another new nurse, several years down the road, and sharing with her how incompetent you felt at her stage of the game--and how you beat it back to go on to do very well ?

Thank you all so much for your kind a reassuring words! I feel more ensured knowing I'm not the only one who went through this stage. At the old unit I worked at, I was night shift, and was so comfortable and familiar with everything. Now not only am I on a new unit, I'm on day shift! I still have days where I feel down, but I'm hoping with time, I'll gain more wisdom and experience. ?

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