I shouldn't be a nurse...

Nurses General Nursing

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I started working again on ltc, but first day on the job on my own I made a horrible horrible mistake. As I write this I am trembling and crying and I feel so sick towards myself that I am nauseous and wanna throw up. What happened was someone was found on the floor by a cna. i had someone's meds and insulin on my hands, I set those on the table because I was gonna help the cna, but then I also thought if i let go of the meds, what if someone comes along and eats up the meds or stick themselves with the insulin. another cna came up so I told her to help the other cna lift the patient up. I went to give the meds. Then i don't know what i did anymore. I think someone started asking me their pain meds or something. My intention was to go give the med then go back to the fall patient to assess, but somehow I forgot. So when I got home I was thinking about my day when it occured to me that I did not go back to the fall pt and assess and do an IR . He was not my pt though, but since i was the one who was there first i think i am supposed to make the IR. Or i could just be a witness. I don't know. But I feel really really bad that I didnt do anything. I am so sick of myself, I deserve to die. I feel that I'm a horrible nurse, even though this is only my 6th day as one, assess and write an IR is a basic thing to do with a fall, and i know that, i know why it is so important, and i know the complications if a fall is not followed through...so i am asking myself where the hell was my mind. I wanna talk to someone but I don't know who to talk to, I am scared to death. I don't know if the nurse who had the pt made an IR...i am praying so hard that she did. I really think I shouldnt be a nurse. This is such a horrible horrible mistake.

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Specializes in MS, LTC, Post Op.

Okay first off, you are human and we all make mistakes...I don't know one nurse that hasn't made some kind of mistake in the past.

The best thing you can do, is use this experience as a learning experience. Your a new nurse...don't beat yourself up over this!

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Wow, ok ok ok...take a deep breath and....CALM DOWN:) first of all, if the pt is ok, then the IR is ONLY another piece of paper. Don't sweat it, just fill it out the next time you're at work. Also, if this is bothering you that bad, just call your DON, or Supervisor. It's not that big of a deal.

You will learn in nursing that EVERYONE makes mistakes. It happens. One time i gave the wrong pt a seroquel. You know what happened to me? NOTHING. lol, the pt was much calmer than normal, but the DR. laughed at me:)

You're new, give yourself some time to pick these things up, and don't sweat the small stuff.

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gee.. i'm so sorry you're feeling so bad about this :( I know i hate when i get those feelings.. that dread that just hits you, and feeling sick all over .. from what u've written it doesn't sound like you are being careless at all! You made a decision based on your judgment; that you couldn't just leave the meds out like that and you delegated to another team member to help out. Who knows.. maybe with more experience you would decide to do something else, like tuck the meds away somewhere and help out yourself, but you are still developing that judgment.. I find with nursing, the more you work at it, the greater your brain capacity becomes.. it's as if you're able to hold so many details in ur head in one time. lol, i don't know how much this is true. Maybe to help ease ur mind you can talk to the nurse manager or a nurse you trust? I'm thinking that the CNA might have likely told the actual nurse after the incident??

I know it's hard to keep going in nursing when you see so much potential to make errors.. i know this is how i feel up to now.. I really have no good answer. maybe it's about changing our outlook on life? seeing that really there's a lot of factors that we can't control, we can't always have good flawless days.. we just have to make the best out of what we're given. Take it one day at a time.. :)

hope you feel better, take care!

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i havent been sleeping at all.. I am very worried about the gentleman who fell... I am worried that what if nobody wrote an IR (although it also won't make sense if they didnt)... therefore nobody would've called for the md.. I am thinking of worst-case scenarios in my mind. I am really scared.

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Calm down. I think, if possible, you shoulld call someone supportive in management or a co workers with more experience to help talk you off the ledge, so to speak and put everything in perspective. This patient has a nurse, who isn't you. ShYe or he should have assessed the patient and called the doc. and followed up and possibly reminded you of the incident report, if you even had to fill one out. The CNA who found the patient may have been the witness so you may not have been needed. I understand that you forgot and are upset, but I think you are making it worse than it is. Call someone who knows something that can tell you what you can do, if anything. Letting you imagination run wild is not going to help. I know, I am a new nurse and have had a couple days when I've gone home and all I can think about was what I did and didn't do and what the patient outcome would be and how would it effect my career and so on and so on and so on. I've had days where I cried and couldn't eat and felt sick and sometimes just went straight to bed because I didn't want to think about it anymore. Most of those times, when I spoke with someone who knew more they could put things in perspective for me and that is really helpful. A new nurses imagination can be very creative, so try and talk to someone. God bless.

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You were between a rock and a hard place. As a very new nurse, first day on your own, it wasn't such a terrible thing. If the patient didn't die or have complications, if you called back and informed the current charge nurse that the patient needed to be assessed, or, just to really be safe, went back to work and did it yourself, I'd say you didn't do all that badly.

On the plus side, you did a good job of delegating appropriately and of preventing someone from grabbing the pill cup.

The incident report isn't so urgent but the patient does need to be assessed ASAP. To protect yourself, go do it yourself - now.

Where was your mind? On your 90 other patients probably. BTW, a lot of falls result in no injuries. But I think I'd just go do the assessment now and put your mind at ease. And you do not need to berate yourself up 1 side and down the other in front of other staff. Just try to be calm and do what needs to be done and do it now.

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From what the OP said, it sounds like the two CNAs lifted the pt before a fall assessment was done- actually it seems that no fall assessment was done. This is really disconcerting.

I think the thing to do would have been to put the pills and insulin in your pocket, do a fall assessment on the pt ( Ask the pt "Do you hurt anywhere?" palpate/visualize for abnormalities, pain, check range of motion)then lift the pt, put the pt back in the bed/chair, then get VS and a neuro assessment, question the pt about the fall (How did this happen? Did you hit your head?) inst the pt to call for help (if pt is able to follow directions) make sure call light is within reach, side/rails are up or down (depending on your facility policy) then call MD to report the fall.

As long as you have written a note to yourself w/ info about the fall, you can do the IR at the end of your shift. This is what I do.

You can just keep passing meds while waiting for the doc to call back.

If the pills/insulin get contaminated in your pocket, that's fine. Just waste them and get new meds. With a pt on the floor, it would be fine to just drop all the pills and the insulin into the nearest sharps container and get new meds later. Remember- prioritization.

I think that this being her first day on her own, the OP panicked a little bit, and did not prioritize.

I also think forgetting about the pt and not doing a fall assessment are pretty big mistakes, but not the end of the world. Best thing to do would be to follow up with your NM.

Best of luck to you!

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Specializes in Med Surg, LTC, Home Health.

If you have only been a nurse for 6 days, then you shouldnt be on your own already anyway. Without proper orientation, i would find it hard to fault you for forgetting something. Also, being in LTC, you probably have more patients than you can handle as well. You and your patient are likely just victims of this greed driven lack of standards in LTC. When i became an LPN, i received 5 weeks of training (17-18 days). Now they give 3 days. It is ridiculous.

Henceforth though, the patient should be assessed before he is ever lifted off the floor.

Get yourself a PDA (palm pilot). You can write notes on it and set alarms to remind yourself of tasks that may have been delayed.

Good luck. (Taking care of too many patients requires a bit of luck.):)

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Specializes in ICU.
i havent been sleeping at all.. I am very worried about the gentleman who fell... I am worried that what if nobody wrote an IR (although it also won't make sense if they didnt)... therefore nobody would've called for the md.. I am thinking of worst-case scenarios in my mind. I am really scared.

Is there no one at this LTC place except you? You even said it wasn't your patient.

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There was a chance that the nurse that was taking care of the patient took care of everyhting.

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Specializes in Med-Surg.

Take it easy on yourself. We all make mistakes. I wouldn't worry about the incident report. Forgetting the incident report won't harm the patient in any way. There's no reason why it couldn't be filled out next time you work. Although since you didn't witness the fall and weren't even the first person to find the patient, I'm not sure you'd have to fill one out. The patient's nurse probably should do that. I would assume that the patient's nurse would also have assessed the patient and followed up with the doctor.

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