Feeling like a failure: maybe nursing isn't for me?

[Little_Mouse]

Just when I thought things were getting better at work...they really aren't.

I wrote a previous post regarding excess write ups at work. Well, it's still taking place and no, I have not had the guts to call union during any of those write ups/counseling.

It has been approximatly 7 months working in the same unit. I have made mistakes. I feel like confessing every single one of them I have been written up for to find others' opinion on how I am doing...and in a way validate that I am a " failure" considering that all throughout nursing school a few of my instructors showed that I didn't have what it took to be a nurse..but that's for another post.

Oh and being told by a fellow co worker that the DON happened to mention that she is "worried about (me)"--aka my performance-- is heart sinking.

The latest incident is regarding a pt's blood sugar. Order is to sheck pt's blood sugar every other day BID. If >200 call MD. Pt has no insulin coverage. Pts bs is >200 on finger stick #1 and #2. Notified md. Md said "no new orders, we'll just see what the BS is tomorrow and I will be coming in tomorrow". I documented "no new orders" but failed to mention to MD of pt's blood sugar check every other day and forgot to do a TO for blood sugar the following day. MD came in next day. Asked what the bs was, none had been done (obviously) so he told the nurse for the pt to take it and it was done...less than 200--within normal range for pt. MD did state that he told the nurse he spoke with (me) the previous day to check what the blood sugar was the following day. I failed to note that order = write up #9...or was it 12?

The one before involved failing to put a wheelchair alarm on a pt, despite not everyone putting alarms on w/c on my unit, my pt sustained a fall. Pt was okay, thank goodness= write up #8?

Gave a second dose of lovenox after an md wrote a duplicate order of it on a VTE form we have..notified MD, was cool with it, just hold lovenox the next day....so failed to double check if pt was already on medication on MAR=write up #7,8,13? I've lost count...

I could go on but I will spare you. Each write up is crisp and clear in my mind as the day it was given.

So, this post is just part vent, part confession and a whole lot of wondering if the overall census deems me as a failure as a nurse...?

[shoegalRN, RN]

I would not say you are a failure of a nurse. You are learning. It is your first year of nursing. It's the most vulnerable and trying time in a nurse's career.

What I would do is every time you have to call the doctor for ANY reason, document EXACTLY what the doctor said. Their name, the time you called, the reason, and if no new orders were given, state "Dr such and such notified of pt's condition, (give lab values), Dr advised of (lab values), Dr states will check on pt when making AM rounds. Dr did not give any new orders. Will continue to monitor pt".

Also, if you are still using paper MARS and computer MARS, double check all your meds prior to giving them. My hospital also uses VTE forms but if heparin or lovenox is not on the MAR, it is not given, regardless of what's on the VTE form. We only go by what's on the MAR.

Also, is there anybody you can sit down with that can be your mentor? Someone who is a go to person on your unit, who has been a nurse for a long time (>5 years), and who likes to teach? I would suggest you get a mentor to take you under their wing and to guide you a little bit.

Lastly, what have you learned from your write up's? Do not focus too much on the fact it was a write up, focus on how you can prevent the same thing from happening to another patient in the future.

Good luck to you!

[kasendamiles86]

If you are written up I would say take it as a learning experience. Do not be written up for the same thing twice. I was written up in my first 90days,and was not even aware of my mistake until I was handed the paper to sign. There were fortunately no negative patient outcomes as a result of this error, but I learned to not do that again.

[mikeicurn, ASN, RN]

I have made a lot of mistakes in my life. I try to learn from them, and to not make the same mistakes twice. That is all we can do. It is all fine and well for you to try and be perfect, but it isn't going to happen, and you are setting yourself up for failure. Be a good nurse, give your patients excellent care, and quit worrying over every little error. Make sure and use these "incidents" as learning moments. You will do fine. If your DON doesn't see that then you are not in a good environment, and you can't help that. If the DON is mentioning her worries about you to other nurses, then she doesn't sound very professional to me. That isn't your fault, it is hers. I would rather have a co-worker like you who is concerned with doing a good job, then 10 of these whiny, gossiping, crabby, nurses who gripe about everything, and call in every other day.

[Cmanursestudenta]

The very first order I was given was for Warfarin. I wrote down the order but was written up for giving the previous dose. I gave the dose before I spoke to the doctor because the labs were very late getting back. I complained that nursing school did not teach us how to take a written order and it was my very first time taking a verbal with no instruction or examples. I then asked and learned how to take an order including date, time, and took order read back or TORB. I also have since learned to pull up the MAR, TAR, and chart of the patient as well as to have current dose of med, current orders, and if the doctor wants anything done different to write everything down. Now that being said the next few times I got orders I had the doctor on speaker phone and another nurse nearby to ensure I got it right, had the ADON show me exactly what they wanted on every single order by writing a practice order and I made damn sure I didn't screw up again. 

1. Slow down. 2 Before you call the doctor get vitals and all that stuff pulled up and reviewed 3.  Whatever the doctor tells you write it down and if you need something more CALL BACK for clarification.  

Nursing is hard and nobody is perfect. Maybe this isn't the right job for you. Personally I love nursing homes and the relationships you get to build with your patients and their families. Maybe you need a slower pace and more time to get on your feet as a nurse. I doubt I'd be happy in a hospital but maybe you should reconsider your options and go for a slower pace.