Feeling Horrible as a new grad

[Hulababe169]

I need some honest, re-assuring advice...

So yesterday on a med-surg floor I had a patient that had been admitted at 0200 (shift before) (I was day shift) for a SBO (or according to OR nurse possible SBO). The nurse who gave me report said the patient's NG was on susction and was only suctioning out a small out of green drainage in the tube. I checked the tube and she was right- the patient only had green fluid in the tube. I checked and rechecked the suction equipment- It was on. I gravity drained the tubing into the canister for accuate #. Throughout the day the patient complained of a little back pain, but mostly pain from the tube and throat. She hated it. She said it really irritated her nose/throat/ear. Throughout the day I asked several nurses if it was common for there only to be fluid in the tubing and it barley coming through the cannister. My charge nurse said yes. The patient denied pain/nausea in her abdomen, and I continually kept checking the cannister. The surgeon consulted came in the afternoon and consulted the patient for a exp. lap. That evening- around 4:00 I was still feeing strange about the cannister. I asked another RN walking by (another new grad) to look at the suction. By that point I collected 100ml in the cannister. She said it was normal- but then said wait- the switch on the cannister that said suction was turned to off! But the suction on the wall was operating! I felt HORRIBLE. I turned it on immediatly- and the tubing cleared. A few hours later- about 6:45 almost 400ml had been collected (for the whole day!) The patient was NPO all day- and her stomach was not getting any more distended... thank goodness!

So all in all- the night shift nurse did not hook up the suction properly and I didn't notice that the little white switch wasn't turned to on untill the afternoon- only a few hours before surgery. The nurse that helped me out said it was okay- because it will drain it all out, and that I won't ever do it again. I told the NOC shift nurse- and she laughed and said happens all the time.

I am still feeling horrible over it.... all because I didn't notice the stupid little switch. And all because I should have told the nurses earlier that I wanted them to look at the NG drainage.

I work in an enviorment where most of the nurses are so helpful- but the manager is not. Yesterday I asked her to read two words of two orders because I couldn't read the doctors writing and she said to me: "Are you not your normal assignment today--- is that why you have been bugging me all day?" She will yell at you in front of other nurses and patients- and has called me into her office for doing something I didn't do. She confused my name with another nurse- and never apologized. I'm terrified of her.

So what to do? All I know is I will ALWAYS check the suction switch and equipment even if the NOC nurse set everything up! I asked the RNs if I should write myself up or do anything and she laughed and said don't worry you won't do it again- and you didn't set it up. Should I tell my unsupportive mean manager?? Thankfully the patient was okay- and tolerated the suction after it was officially turned on correctly. She still complained of throat, back, and nose pain. No change. No decrease in distension.

Blah... Guilt! Thanks for letting me Vent! I hate making mistakes... i'll never do it again. Note to ALL nurse: Always check another nurses set-up. Understaffed, exhausted, with not enough CNA's and a work clerk- all nurses make mistakes.

[Faeriewand, ASN, RN]

You've learned from your mistake, now move on. :)

[Cessna172]

You learned from it, that's especially what counts. Don't beat yourself up over this. You had a gut instinct that something wasn't right, next time, you will listen to that inner voice and more carefully investigate if there is a problem.

Why bother telling the "unsupportive" manager? Will it do any good? As

to the NOC nurse saying that it happens all the time, well that is a little more disturbing because it should not happen all the time.

And yes, sometimes patients will only put out a little bit of drainage from an NG tube, sometimes they will put out a lot. A new grad isn't expected to know it all, and you checked with the charge nurse and she said it was o.k. too, but apparently she didn't catch it either.

I'm not advocating to cover up mistakes, but writing yourself up for something like this seems a bit extreme. Try to remain positive, you sound like a really good nurse!

[Blackheartednurse]

I there right with you,I have been a nurse for almost two years now and I started working in a home health arena just 8 months ago,I double check myself and question myself on regular basis,I have seen a huge progress in me,my knowledge and confidence has grew,all of the sudden I catch myself answering questions for the family members,recommeding solutions (of course checking in with the physician first), even make suggestions to the MD, it is really amazing how much I learned.

[jbirdee]

I am a new grad as well and cannot give you advice, but wanted to thank you for sharing. It is something I might run into as well and would feel terrible also. That is why we have a training period. I guess mistakes do happen, but when they happen to US, it is awful. I already feel a bit stupid (maybe inexperienced is a better word, but stupid feels right, lol).

Thanks for sharing. Keep bugging anyone you can to answer your questions! From what I have heard, it is when we are afraid and DO not ask questions and/or are bullied by ancillary departments (You HAVE to give this patient contrast ASAP, even though you KNOW your pt is NPO - this happened to a friend of mine during training and he was fired!), you have to check and check again....even if you are "bothering" them. Don't let anyone make you feel afraid to question any orders or something you are unsure of!

Remind ME of this when I need it!!!

Good luck, seems to me you are very concientious and a caring nurse!

[Tina, RN]

You should be proud of yourself for "feeling" that something wasn't right. :) You were right to ask for second opinions. You'll now be an expert on suction set-up. Stop beating yourself up!

Best wishes!

[Hulababe169]

Just wanted to say thanks everyone---

Feel SO much better! I can stop crying now!

Best of luck to all of you! Thanks so so so much.

[Chin up]

I am proud of you! Hope there are more nurses out there like you. You care and have integrity. That is why you are beating yourself up. Now it is time to stop, and remember no one knows, or remembers everything. Nurses must work as a team. We all need fresh eyes and ears, even with the most experience. Now that you had that experience, you will never forget, and I know for sure, will help another nurse one day with that same problem and maybe save a life! Peace!

[headinsandRN]

Sometimes mistakes are lifes best teachers

Sorry to hear that your manager offers as much support as a scoobie doo band aid on an aneurysm.

[wooh, BSN, RN]

In the grand scheme of things, this is a minor thing. In the end, you fixed it, all is good. With your description, I knew exactly what you meant because I spent a good 10 minutes one day trying to figure out why my suction wasn't sucking and finally looked at that little switch. (Why would anyone EVER turn that off?) But hey, I learned that the switch works!

[Weebee, LVN]

Don't beat yourself up. There were 2 other nurses that looked at that and did the same mistake 3 out of 4 nurses or 75% of the nurses made the mistake.

Heck even the Doctor didn't question the lack of output. This goes to show you it is normal output, But that was a Very Nice catch by the one and only nurse who noticed there was a problem.

Again.... dont Beat yourself up in this job... its VERY easy to do.

ADVICE ABOUT YOUR BOSS: Sorry this is long but needs to be said here....

Lets assume, your driving down the highway and some JACKASS about runs you off the road so he/she can get to the bar before it opens....

You have a choice.... you can start your road rage, or, ignore the JACKASS.

The point here is, You choose to let the JACKASS upset you if you run after him.

BUT you can Make the Choice to say ... Ahh another Jackass on the road... and then return to your normal activities...

Which example gives less stress to you?.....

I choose the one that makes me the happiest..... Give them the finger then move on with your life....It honestly is that easy.... dont let the jackass control your life your have the choice.

Trust me.... as I used to run down the jackass before I realize he was the one in control of my actions... and then asked of myself... why am I letting others control me????

People have thoughts to enrich their lives... others have thoughts to define their lives.... dont be the latter

[Orange Tree]

As a new grad, unfortunately, I've learned a lot of things the hard way. And I've realized that asking more experienced nurses for their input doesn't always help when I'm unsure about something ....because they are often not sure either.

Please don't feel horrible...it sounds like your patient was/is OK. Just keep digging for answers when you have a feeling something may not be right and keep on learning.