Getting Flustered under "the pressure"

[morningland]

I have been a nurse for almost three years, and I had an experience that shook me yesterday.

A pediatric patient came back from a lap coly. Her HR was 146, pretty high but I thought I'd give her a minute to come down since we were transferring her and she was a little scared. 30 minutes later, HR was still not down so I called the surgeon. He ordered a foley and a bolus. I started placing the foley but I am not very good on placing them on females and had no experience doing it on a child with upset family at the bedside.

Anyways, when the doctor came he was understandably upset that it was 25minutes later and I failed to hang the bolus. My logic was "well, lets get the foley in first just incase she is retaining". I see now I was wrong, the doctor was concerned that she was dry and needed the fluid to help bring her HR down. I knew that knowledge but it just didn't come into my head why the bolus was the first priority. Now I know.

Anyways, the whole experience caused me to become very very flustered. I was weak in the knees, couldn't focus and would just lock up when I was talking with the doctor. I have been through MANY MANY stressful experiences and handled them well, this is experience just caused the perfect storm that kinda got to me.

I handled this by just pausing collecting myself and counting to ten, but it was still very difficult for me to recover and focus after that. It was concerning as I want to be a travel nurse soon and can buckle under pressure.

Is this abnormal given that I have significant experience? Does this mean I don't have the nursing chops I need? Can anyone offer any advice or reassurance, if it is warranted?

[Lev, MSN, RN, NP]

I've been a nurse for less than 3 years and I will still say that 3 years is not a long time. You are no longer a novice nurse but you are by no means an expert (on Benner's scale). Take it as a humbling, learning experience. Does this mean you aren't ready for travel nursing? Not necessarily. I think 3 years of solid experience is enough. As nurses, we learn new things every day. I think the family made you nervous and maybe your relationship with that doc isn't all peaches and cream so you got flustered. But like I said, that's OK, none of us are perfect.

[suanna]

As above- 3 years does not give you quite the background to always set the right priorities and never make an error. The patient didn't die- If your BP had tanked or the patient had a big change in LOC and you were puttering around with a foley- yeah you may want to explore why you are in the field you are working- but that didn't happen. Do you see this doc often? Clear the air; something along the lines of " I'm sorry I got sidetracked on that foley the other day- I know the fluid bolus should have been my first priority- I'll not make that mistake again- I knew better then- I just didn't think is through the way I usually do". Whenever faced with a new procedure- even something as benign as a foley- it is going to distract your mind from your usual process. The longer you are in this the less often it will happen. After 30 years I still can get the "deer in the headlights" response and lose my perspective.