Feeling So Guilty I Could Cry

[AlmostThere19, BSN, RN]

As a new grad nurse, I've only been on my unit for 6 weeks. I've been on night shift, but then the other day I did day shift because my managers wanted me to get more experience with discharges and admissions. This was also only my 2nd time taking 5 patients. As soon as I got on the floor, a patient needed a blood transfusion that I needed to go get from the lab. My preceptor constantly kept telling me to hurry up and give morning meds to my 5 patients so we could go ahead and go down to get the blood. Giving meds took forever because there was a med that wasn't available and I spent forever having to beg pharmacy to send it up. One patient was mad at me because they weren't allowed to sit on the side of the bed without physical therapy. This patient would not take their meds and I ended up having to wait on PT to get there before I gave them. In the middle of med pass a patient's parent came to the nurse's station to tell us about an issue that I needed to call the doctor about. Luckily, my preceptor handled that for me. It was so hectic during the morning that, at the end of the day, I realized I had forgotten a couple of medications for 2 patients. 2 were due in the evening so I let night shift know during report that I had forgotten to give them because I got swamped with a discharge and an admission at the same time right as the meds were due. The other patient had already been discharged so there was nothing I could do about that missing med. I just feel like I completely failed as a nurse and like I made so so many mistakes that day.

[JKL33]

It sounds like you accomplished a lot that day in comparison to the couple of things you did not get done.

Guilt has no place here.

If new grads/orientees are generally following instructions and learning/growing and not stagnant and not going off the rails, I think their culpability in the scenario you describe approaches 0%. It is a lot of pressure, and even experienced nurses have to prioritize things that shouldn't have to be prioritized and fail to do everything perfectly.

The fact that people have cause to start feeling so incredibly crappy about themselves so very early in this game/career is a humongous, toxic problem.

I say pick your head up and get back in there the next day. It will come together.

[JBMmom, MSN, NP]

Don't cry. While I'm not sure what medication you missed, it's highly unlikely that missing one dose is going to have drastic consequences. These things happen. Life moves quickly on day shift by comparison with nights, and it sounds like you did as well as could be expected for a new nurse. I am surprised that your preceptor didn't pick up on the medications that were missed, though, that's part of the role of preceptor. Try to focus at least a little on all the things that went well, because surely there were things you did just fine. Sounds like you got some admission and discharge experience, so it was a good learning day. Stick with it, you'll be fine.

[yournurse]

Thank you for reaching out. I have worked day and night shifts and the work flow during the day is completely different. Days are usually quite busier because doctors and other staff, PT/OT, dietary, family are around during this time. One thing I want to tell you is never rush giving medications. You are the last stop before getting those medications to your patient. Never let anyone rush you especially meds. It’s not safe. Anyway, about your blood transfusion, I always ask myself why I do what I do. And you should ask that question every time you do something that can potentially hurt your patient, for example: blood transfusion. And this patient that needed blood, was she/he actively bleeding? Was she showing signs of losing blood? Low bp? How was the Hemoglobin? A lot of hospitals question blood transfusion if hemoglobin is not less than 7. Rushing is Never safe, it will increase your chances of making a mistake. Remember that. Be patient with yourself, it takes time. You’re doing amazing for reaching out and asking for advice and voicing out your feelings.

[Daisy Joyce]

Actually, this whole thread makes me mad. Not at you, OP, or at the responders, but just at the fact we nurses accept impossible workloads as normal, then blame ourselves for not being able to do the impossible.

And this isn’t just *one* day, but *every* day!

I mean, if OP were in a war zone, or a mass casualty situation, then yes, expect to run your butt off. But in normal circumstances, to accept this overwork as normal?

I can’t say how many times I’ve tried to explain a typical nurse’s workload to a non-nurse, only to have them either disbelieve me (thinking I’m exaggerating) or ask “why do you put up with that? I would *never*put up with that.”

And they don’t. Other professions expect and get their breaks and lunches and bathroom trips, and not as something they’re grateful for, but as something normal people are *entitled* to, and not even remarkable.

Sorry for rant. No I’m not.

[SteelGrey]

Only 6 weeks? You are rocking it!

This is basically what every day is like on the floor— It sets many nurses up for failure and forces employees into making impossible priorities.

I’m sad your were rushed to give meds-that is a breeding ground for errors. I know your preceptor was hot to trot, but the beauty of when your on your own later, is you can be the nurse you want to be.

Don’t be afraid to ask for help or pick a more experienced nurses brain on what you would prioritize.

One shift at a time! You can do this, 6 months from now you will be a whole new person ?

["nursy", RN]

Unfortunately, you are still under the watch of a preceptor. When you are on your own, you can prioritize the way you want. Possibly I would have picked up the blood and gotten it out of the way, then passed the meds afterwards. Or as soon as you find out one of the meds is not available, instead of waiting forever for pharmacy, take that time to pick up the blood. Part of learning as a new nurse, is not just specific nursing skills. It's time management and prioritization. But this takes time. You might feel that 6 weeks on a unit is a long time, but I can guarantee you that you will feel overwhelmed for at least six months, and maybe start normalizing at a year. This can sound depressing, but the learning curve is huge.

[Kooky Korky, BSN, RN]

On 10/11/2019 at 11:33 AM, JKL33 said:

It sounds like you accomplished a lot that day in comparison to the couple of things you did not get done.

Guilt has no place here.

If new grads/orientees are generally following instructions and learning/growing and not stagnant and not going off the rails, I think their culpability in the scenario you describe approaches 0%. It is a lot of pressure, and even experienced nurses have to prioritize things that shouldn't have to be prioritized and fail to do everything perfectly.

The fact that people have cause to start feeling so incredibly crappy about themselves so very early in this game/career is a humongous, toxic problem.

I say pick your head up and get back in there the next day. It will come together.

Yes, I agree. But I am a little concerned about the missed meds. Were they something essential? Should you have notified the discharged patient to be sure to take ___ if that pt was sent home on that med? Or notified the doctor? Or what? Why is it a concern for you if the 2nd missed med was due on the next shift?

You are now through the looking glass, where you are expected to do way too much in too little time. It is the Nursing profession of today. Simply ridiculous pressure.

That said, work on your speed, organization, prioritizing, etc. What did your preceptor have to say about it all? Did the blood ever get given?