First year nurse. Thinking about leaving field altogether.

[mhadvrn34]

Hey y'all. I've been a nurse for almost 9 months now and I'm seriously considering leaving the profession altogether. I graduated in December of 2018 and was ecstatic when I got a position as a new grad RN in a med surg residency program starting July of 2019. Packed up all my things and moved three hours away to a very rural community knowing no one.

From the moment I started, I struggled heavily, mostly due to anxiety which I was clinically diagnosed with two years ago and take meds for. I made a lot of mistakes and was constantly on the radar of my nurse educator and supervisor. Two months later, I got called in to my boss's office and she let me go over lying to my preceptor over charting something which I didn't. They felt as if they couldn't trust me anymore.

My options were get fired or be forced to resign. I was devastated. Moved back home to my parent's house and began looking for a new position.

Luckily, I landed another job in a psychiatric rehabilitation facility. Even before starting nursing school, mental health was my passion. I knew I wanted to work psych in the long term. I started this position late October of 2019 and lasted 3 1/2 months until Valentines day. I worked NOC's and was the only licensed staff for that shift. I was overwhelmed, had virtually no support and had to deal with toxic coworkers.

On February 12th, I made the mistake of covering an AM shift and was responsible for pulling meds from a med cart in sheets the old fashioned way and giving them to 50 patients. The next day my boss found out I made a ton of med errors and I seriously thought I was going to be fired on the spot. He gave me another chance to my surprise, but I had had enough and decided to quit.

My current position is in an acute psych facility which I started per diem in January of 2020. Here I feel like I have tons of support, charge nurses who are constantly checking up on me. I've only been called into my boss's office once in 5 months over messing up charting. I feel as if this is less hectic than my last job but I am very unhappy with it.

Psych nursing is not what I glorified it to be. What I thought psych nursing was vs what it really is is not what I expected it to be. What I feel like I really want to do is more in the line of social work or clinical psychology.

On top of all this I screw up constantly and have this fear of getting fired every time I step into the hospital. Today, I made a med error and sort of freaked out and stormed outside the patient's room after realizing I gave meds to the wrong patient. My coworkers tried to comfort me but now I feel like they feel like I can't be trusted.

I'm starting to think nursing is just not for me.

I'm fed up, burned out and I've come to the point where I just don't care anymore and I feel numb. I've had 3 jobs in 9 months which says a lot.

Opinions?

[Danielle Lynn]

As a first year nurse I strongly recommend you slow down and pay attention to the medications and which medications belong to which patient. I have made 2 med errors in my first year. The first one I gave the wrong dose for that specific time frame and just gave the smaller dose that was due at 00:00. At 0600. The second med error was giving the medication the ring route. I gave a medication that is originally used as ophthalmic in the eyes instead of sublingual. I totally missed the order in the MAR that said “Sublingual, Do not give in Eyes” a total mistake that was easily missed because it had happened before. But because of lack of communication It happened again with me. I immediately told my charge nurse and manager and even cried to them because of my mistake. My last mistake that happened was a patients IV. It had infiltrated most likely when I got on shift from the pervious shift. However the patient was already puffy from edema and Intubated. I checked the IV site where fluids were running in and. I didn’t see any leaking in that IV not swelling at a specific point that indicated infiltration like I did with a different IV site. Let’s just say the swelling got worse and had noticed the patient was getting blisters on the arm. I immediately knew something was wrong. I stopped the fluids and contacted the provider and was told that the IV site was infiltrated because I couldn’t get blood return (mind you I have checked for blood return in previous patient’s IV’s and got nothing so it doesn’t immediately indicate infiltration) total accident and even more so because the patient couldn’t tell me something was wrong. I felt terrible. I elevated the arm on the pillow and charge nurse knew the situation. I’ve never seen nor heard of something like that happen before. Because I never learned it in nursing school. I’m very afraid I’ll end up getting a lawsuit from the patient’s family if something bad were to happen to that patient’s extremity. Moral of the story is I’ll never let a mistake like that happen again just like I haven’t let the mistake of a med error happen again. Nurses are human and make mistakes. The key takeaway is to learn from them to better your practice.

[EDNURSE20, BSN]

I think you need more education if you are going to remain a RN. the amount of errors you’ve made is not OK. As well as staff not trusting you.

[JadedCPN, BSN, RN]

I would like to throw out that maybe your mental health and anxiety, even though you are on meds, isn't as well controlled as you think it may be and could be the root of your issues. Yes you need more education/training and to improve your work ethic and diligence, but if your anxiety isn't fully under control then there's only so much improvement that can happen.

[pixierose, BSN, RN]

On 5/13/2020 at 2:42 AM, caliotter3 said:

Why don’t you try taking three days off to rest? When you return, don’t make any med errors for the shift. Successful. Good. Next shift, don’t make any med errors. Continue in this fashion one foot in front of the other. Stop with the obsessive negative thinking. As it is, you are not giving yourself a fair chance. You can look for a better fitting job when you have settled in this one. The world won’t stop if you calmly and rationally decide that psych nursing is not for you.

Please do this.

You’re not giving yourself a fair chance. You identified the med errors - and it sounds like you’re going wayyyyyy too fast. Always always always go by the 5 rights.

At the psych facility I work at, we have very few errors on my floor BECAUSE of the 5 rights. Other floors? Forget it - they pull meds ahead of time, have them lined up in cups at the med room and grab and go. They don’t scan the patient or the med, just click “given” in the MAR ... and you can tell who floats to our floor bc they do the same thing ... and a med error did happen one shift.

Psych nursing is highly rewarding. As is nursing in general - but anxiety and negative thinking can make it that much worse. It can make any career worse. If it’s meds in nursing, it might be something else in social work (our social workers in the ED and psych are superheroes who are always on the go, making constant phone calls RE: patient care, not to mention the patients themselves).

[Nunya, BSN]

14 hours ago, caliotter3 said:

Why don’t you try taking three days off to rest? When you return, don’t make any med errors for the shift. Successful. Good. Next shift, don’t make any med errors. Continue in this fashion one foot in front of the other. Stop with the obsessive negative thinking. As it is, you are not giving yourself a fair chance. You can look for a better fitting job when you have settled in this one. The world won’t stop if you calmly and rationally decide that psych nursing is not for you.

LOL if only it were that easy. This sounds like you think she's making med errors on purpose.

[JadedCPN, BSN, RN]

14 minutes ago, Elaine M said:

LOL if only it were that easy. This sounds like you think she's making med errors on purpose.

I disagree. I think the advice sounds like caliotter3 thinks the OP is making med errors by getting in their own head too much.

[TriciaJ, RN]

The OP's own expression "a ton of errors" is what jumped out at me. I started back in the stone age (in a psychiatric hospital) and had to medicate up to 37 patients with stock meds. That involved the metal trays with the slots and the holes and the little cards. You put the pills and liquids in little cups; crushed some of them to mix with jam. Because most of the patients were there for life, no one had a wrist band. The five rights were crucial.

It was a godsend when unit dose was invented. Each pill in its own little labelled package. No risk of grabbing the wrong little cup.

Fast forward to barcode scanning. But no system is infallible, because people aren't infallible. NO system ever eliminated the five rights.

Besides the commission of multiple errors, other red flags jumped out at me. Minimizing the harm done by the error. Justifying the error. Inaccurate charting. (Medical records are legal documents and can make or break a malpractice case. Boards of Nursing have been known to issue disciplinary actions for inaccurate or falsified charting.)

New grad errors are usually forgiven. Poor attention to detail and lack of honesty will keep you on the radar. Take the feedback you've been given so far and decide if it's worth it to you to shore up your practice or if this just isn't your scene. Unfortunately there is a big disconnect between nursing school and the real world, which I think is unfair. More than one person has walked away after a big expenditure of time, effort and money.

[Lynker, LPN]

You are not alone. I made my first med error when I was still training. I understand the super scary feeling you get.

Recognize your problems and LEARN FROM THEM. Don't listen to the people in this thread telling you to leave nursing. There is ALWAYS time to relearn and do better! Give yourself time to go over meds and know who they're for. 5 rights, patient identification, and then you check the meds 100 more times (If you're me :P).

It might even be a good idea to look into a slower/easier setting, such as a LTC. My first job is an LTC and I've learned a lot, and I actually ENJOY going to work. I've made mistakes, big and small, but most importantly I've learned from them.

You can do this. You're an RN for a reason. Make yourself proud and do better for your patients and yourself. ❤️ We're all human!

[caliotter3]

10 hours ago, Elaine M said:

LOL if only it were that easy. This sounds like you think she's making med errors on purpose.

I don’t need to tell the OP how NOT to make med errors. I take for granted she knows the 5 (or 7) rights. And no one who reads the OP should conclude the poster makes errors on purpose.

[LovingLife123]

This is what stands out to me. The OP is not taking responsibility for their errors. It’s always a toxic culture, of somebody lying about her. OP, you’ve been a nurse for 9 months, have worked at three facilities and have made errors and called into the office at all 3.

And when they weren’t going to fire you for your ton of errors, you quit. Maybe that manager was going to work with you and give you more training. Then, you are downplaying your errors.

What drives me crazy with new grads is the not taking of ownership and learning from errors. New grads and experienced nurses make errors. It’s being open to correct those errors and learn from them.

If you willing to recognize that your errors are dangerous, and are willing to change to practice to ensure this doesn’t happen again, you can be a successful nurse. If you are not, then perhaps a different field would be better suited for you.

I made an error several years ago. No harm came to the patient but harm could have very easily happened. I could feel in my gut something was off. I truly checked my pump and went to the MAR probably 5 times to check what I was doing wrong. I let my mind override my gut. But then things went a little awry. I called my charge over to look at what was wrong and I messed up the dosage by a decimal point. I was in tears. I called the physician, the pharmacist and reported what I had done. I wrote an incident report. I learned from it. I learned to always listen to that little voice. I have not made an error since. I learned to grab a second set of eyes if I think something is off.

[Tegridy]

Yeah this is a personal issue. I made a few med errors when I first started. No harm. I took corrective action myself and started following the protocols better and wala no more errors. Yeah I had a few toxic nurses but toxic nurses don’t make you perform med errors. Find a system that works for you and there is probably one in place at the job you are at to prevent med errors that you are refusing to follow. You can improve after you stop blaming others.

[CommunityRNBSN, BSN, RN]

You could find a nursing job that doesn’t involve meds. I work in an FQHC. Aside from the occasional flu shot, I rarely handle medications at all. Maybe you should look into outpatient work.