Getting so busy and forgot to notify the charge nurse about a small med error

[georgya3]

Hello everyone,

I work with someone who is been treating me like "stupid" for a few months now when she is charge nurse and no other RN is on the floor (I work nights, sometimes is just her and me on the floor and 2 other LPNs). Whenever I go to report her something she makes comments ... like a while ago I told her about one of my patient's magnesium being low and she said "I am sure it was already addressed by the evening staff". After a long talk she called the doctor and we got an order for MgSO4 IV. Thus, the problem wasn't addressed by the evening staff!

We had many episodes when she made me feel embarrassed! The worst one was last month when I had 7-patient assignment (on a surgical floor) at night with patient on insulin drip, one post op, one MRSA iso, one waiting for transportation to a different hospital, one C-diff ...however, the worst night ever. The charge nurse did nothing to help except to give me directions and to ask me to do things, give and bring and etc... and she wasn't so busy! I missed my break because I wasn't ready to leave at 2 am on the first break, so she said I cannot take the second break (3:30 am) because she was going to and I was supposed to cover the floor (being the only RN there except her). Well at 6 am I was almost crushing ... and I still had things to do, so I asked her to let me go outside for 10 min and she said "do whatever you want" not that she cared about me. After that night I filled a PRC with UNA and I had a meeting with my manager. I thought I was ok with this charge nurse and it is a learning process, she needed more time to learn how to get involved on the floor while being charge nurse.

Well last Friday I worked my first night after the meeting. I made a med error. At 00.40 am I gave Morphine 10 mg po to a patient. I picked up the wrong MAR from another patient. After I gave it, I found the mistake, my patient was on 5 mg IV/SC. And she got Morphine 10 mg PO. I started filling and incident report right away and I was called by one of my patients whose tub feeding was beeping. I finished the incident report going back and forth to this patient. I was planning to go to tell the charge nurse about the error and I got busy with another patient who was slightly bleeding from the surgical site. Well, I totally forgot about telling her about my error and at 2 am I want for break. After I came back at 3 am the charge nurse came and told me about the error. I tried to tell er that I totally forgot and I did incident report and my patient was ok. She kept telling me what it could have happen with my patient and how bad is and kept repeating me a few times that this could make me loose my license. Later I told her how I feel around her, I am very stressed out and every time when I get to her she makes me feel embarrassed, stupid and useless.

Last night I called in sick and tonight the same because she is in charge and I am terrified to work with this person when no other RN is around. I cannot function! I am planning to involve the union!

Did anyone experience something like this? Please let me know what to do!

[georgya3, RN]

yes I am an RN. But I am not trained to work as a charge nurse ...yet! After the meeting my manager started training me for charge nurse. I've had 2 days of orientation last week, I was supposed to see him tomorrow morning to schedule me for night orientation whenever he can find a senior RN working nights. These three nights he did not put me in for orientation because this new charge was the only one on the floor! I wasn't taught yet how to call the doctor (the phone numbers to call the extender at night).

[georgya3, RN]

for Conqueror: that's your opinion, thank you for sharing it! It doesn't really fit into this topic!

[caliotter3]

.....You cannot keep calling in because of this.. you must deal. I would deal with it by documenting EVERY time she refused your request for assistance.. and beat the street for another job.

Best advice to give you here. If you must resign in order to deal with this, then find another job and resign. You can not keep calling in, or you will be terminated for attendance issues, making the problem YOU instead of what is happening there. Keep very aware, document, and actively look for a new job. Good luck.

[Sour Lemon]

Just to add another perspective, as a supervisor I have realized over the years that your nurses will NEVER learn time management if you rescue them everytime they get busy. My fellow sup's who do that end up watching their nurses leave at 7 while they are stuck at their desk finally doing their own work. I will help I will not enable. Part of being a good manager is knowing when someone needs help and when they need to learn to pull their own weight.

True. I used to automatically start helping others when I caught up, but I noticed some nurses would slow down even more and just wait to be "saved". I still like to help, but I'm more selective. I help new grads, "elders" who've slowed down a bit, and people who help me when they're caught up. No more one-way-street helping.

[TriciaJ, RN]

Hi Roser13,

I do not try to JUSTIFY anything, I am just asking if anyone went through this. I do not need you to blame me, I got it! I blame myself enough to not be able to function since it happened! And I have 20 years experience as an RN and it never happened to me. Do you know I am on Tylenol#3 for back pain because I broke my back in a stroke unit 2 years ago? Well welcome to my world! Maybe that's why it happened to me! I do not know!

You should just pray to not be in my shoes one day, you never know what future might bring you!

We've all been in your shoes. Many times for most of us. We're trying to give you the benefit of our experience. Maybe we're telling you what you already know. But when it comes to dealing with higher ups, there are dos and don'ts. Everyone here is just trying to help you put your best foot forward.

[caffeinatednurse, BSN, RN]

Thanks a lot, I do work on a unit like that, unfortunately and there is no support at night, no one to ask if you have questions! I am planning on changing my position with days as soon as I can get something. I few months ago we were a nice team but it's a mess now especially since the management cut one staff from nights because of the budget!

I feel for you. I hope you can get switched to days so you can have the support that you need.

[caffeinatednurse, BSN, RN]

I help new grads, "elders" who've slowed down a bit, and people who help me when they're caught up. No more one-way-street helping.

I hope I work with nurses who have a similar mindset as you, in the future. You sound like a great coworker. There were a few experienced nurses on my last unit (on day shift) who did this, but nights were every man/woman for themselves, unfortunately.

[Conqueror+, BSN, RN]

for Conqueror: that's your opinion, thank you for sharing it! It doesn't really fit into this topic!

Actually it does. You stated at least twice that the supervisor was not busy and could have helped you. I gave my perspective on why that may be. And it's . not !

[georgya3, RN]

well, two nights ago I tried to talk with her and I told her about other charge nurses helping on the floor and even picking up the call bells (the phone from the nursing station). She acknowledged that she is new and needs more time to get used to the job. That's why I don't get support from her!

At the beginning of the shift I asked her to clarify an order and she told me to do it myself while I was having 7 patients! And believe me, I am not slow at all, all my patients are very well taken care of and happy with me as a nurse, I 've had some of them telling me that I am doing a great job, I do a bed bath at 2 am if my patients is soiled and dirty! I don't ask the NA to do it because I am busy sitting down and playing whatever on the phone. Why I was trying to work nights? Because I have 2 little kids (Kindergarten & grade 1) and to not pay a babysitter. Not because I am trying to hide and work less! On days people are working very hard. Why? The management is there! Nights? We had float staff taken away right after the report and moved to another unit because they were short and we got shirt after that, each of us having 8 patients including pre and post ops. And this is on vascular surgery where some patients need to be checked q4h including peripheral pulses. The senior RNs are working mostly on IMCU and when they are not very busy they help the charge nurse processing part of the MARs. Some of them are trying to make the manager to bring back an RN on the floor at nights but as I said, they are in IMCU most of the time, not very affected by this. I do have people like you but only 5 nights out of 10. 3 nights are a mess with this new charge and the other 2 nights we have a charge who doesn't help but you go to report something, she doesn't question, grabs the phone and calls the doctor, she treats you with respect! I did have very busy nights and full of events, but charge nurse was very good and we handled everything nicely! So, because I have a very young charge nurse who needs time to learn and treats me like stupid I have to suck it up or change my position, right? To tell you more ...one night we had a patient whose PEG got plugged, she called the resident, got an order to unplug the PEg, she told the resident we don't know how to do it and resident said leave it for tomorrow. I found the policy, I got the medication needed from another unit, prepared the med and asked the charge to call the resident. She did not want it. I was lucky there was RN on the floor (senior) and we pushed the charge to call the resident. She did it, the resident was afraid, said leave it for tomorrow. Next day there was no way to unplug that PEG. I told everything to the manager and he said we should have called the doctor at home! So, this is how we work with this charge nurse! It is a struggle! I wrote everything down about all this incidents! Where is the patients ' safety? Advocating? What do you think as a manager now?? I am still learning, too, and I do have hard time, I don't find excuses for my mistakes but dealing with this stress II cannot function or use my full potential!

[JerseyTomatoMDCrab, BSN]

This is yet another example of the ever growing number of threads where the poster asks for advice/input and proceeds to vehemently reject and argue with those whose responses don't support or agree with theirs.

[georgya3, RN]

I am just trying to picture the situation, that's all, but I got it, all you got is getting blamed most of the time! Sometimes you get solutions which I will follow! I am already looking for another job! You cannot judge anyone before you walk in their shoes! This is the very first time when I ask for advice on this forum! However, thank you for finding all the time to replay!

[Nurse Leigh]

I'm confused. Is this a new job for you? Because you stated you have 20 years experience as an RN, and yet you don't know how to contact the physicians?

Most of us who have worked on an acute floor like MS or tele have dealt with similar assignments. Heck, I routinely had 6 pts (tele) with no aides or monitor tech - AND I was charge!

We've all made mistakes - it's how we respond to them and whether we learn from them that matters.