going backwards?

mustlovepoodles, RN · Mar 1, 2010

i know i sound like i'm on the pitty-pot, but i own my mistakes and take time to find out where i went wrong. a lot of it comes down to how incredibly busy the floor is, constantly admitting and discharging, multiple MD orders on each patient throughout the day, etc... but i won't allow the busy-ness of the unit to be an excuse for my errors. i'm just incredibly frustrated with myself, maybe i'm not paying enough attention? maybe i'm not taking this as seriously as it is? i have a very organized brains sheet i carry around, and i write out an hourly to-do list on it too.

THere's a difference in owning your mistakes and wallowing in them. Everybody feels this way when they start a new job, whether you're experienced or not. As a young nurse, you probably haven't yet developed the ability to compartmentalize at work. It will come with time and practice. Nothing is going to change by perpetually turning your day over and over in your mind. It's going to make you sick if you persist.

Here's the thing: Nursing is what you do, not who you are. Yeah, yeah,I know, you're a nurse, we're all nurses. But you have to learn to leave work at work. As you say, once the shift is done there is nothing you can do to change things. It doesn't sound like you're killing people every day so you need to learn to let your daily experiences go. I'm all for learning from mistakes, but this seems like overkill.

Everyone makes errors when they first start. My god, you've only been practicing on your own for 2 months. Did you know that it takes an average of 1-2 YEARS for a new grad to become comfortable with her practice? When you start to ruminate you need to tell your brain to STOP. Tell yourself that you will give yourself 15 minutes at a later time to worry about this, but you are not going to entertain the thoughts constantly. AT first you will have to do this over and over again, but with practice you will learn how to let go of circular thinking.

And be sure that you are finding ways to occupy your time outside of work. You have to do this for your mental health. I don't think you're a bad nurse, just an overwhelmed one. You can choose to just sit in this or you can choose to make a change in your thinking. I vote for the latter.

1louise1 · Mar 1, 2010

yeah, this is what i needed to hear. give myself time, patience, take my time at work. i just worry about becoming someone that other people loathe to work with. thanks for your two cents!

mustlovepoodles, RN · Mar 2, 2010

yeah, this is what i needed to hear. give myself time, patience, take my time at work. i just worry about becoming someone that other people loathe to work with. thanks for your two cents!

Yep, that's how you do it. If you are earnest, dependable, careful and hard-working I'm pretty sure people will be happy to work with you. Sometimes older nurses forget what it's like to be new, how dumb it makes you feel. I have worked in many different hospitals due to transferring with my husband's job. I've had many opportunities to be the new nurse. Even being an experienced nurse didn't protect me from feeling inadequate in the first months. But I stuck with it and eventually I found my groove. You will too. Give yourself time to work through it and don't hold yourself to the impossible standard of perfection. We all make mistakes--we just try to keep the consequences to a minimum. :clown:

HollyHobby · Mar 4, 2010

louise, you sound to me like a very good, conscienscious nurse. You haven't had much time yet to get into your groove, but that time will come. That isn't to say that your work won't always be challenging, but truly it takes time before it all "comes together".

Experience is what leads us to automatically know what to do in any given situation. Experience takes time. You will find that you'll spend less and less time doubting yourself and more time taking action.

I often work with new nurses who are just panicking over things they've left undone, mistakes, etc. just as you are distressed about these things. I've had to comfort nurses who have broken down in tears because they feel like they're on the verge of madness. It's time for a little perspective. Like I tell my newbies: relax and think of the ABCs. Do your patients have airway, breathing, and circulation? Okay, good. Breathe.

You mentioned that your patients' safety is a priority for you, so you are on the right track. Safety comes first, and you're managing that very well. Also you have your organized brain sheet, which is a must-have for a busy unit. Obviously you are working your tookus off to give the best care you can, and you care about your patients.

I'd suggest that you step back for a moment and recognize you successes. I'm willing to bet that for every mistake that slips through your cracks, you've done a hundred other things with stellar performance. You are working to the best of your abilities, you are not a slacker, and you deserve a LOT of credit. And don't forget the most important thing of all: you are human, you are not perfect, and you are striving to do the best you can. (Who would want to be perfect, anyway? That would be boring, and you'd have no friends.)

Next, try to locate patterns that trip you up. Missing doctors' orders for example: how can you resolve this problem? Maybe by taking a few minutes every couple of hours to glance through the chart for new orders. I have no doubt that you can find a way to rectify this situation in a way that works for you.

Try to identify the recurring problems you face. Then use those highly-honed critical thinking skills and find a solution. Are you delegating sufficiently? When I'm slammed with a hundred things that have to be done RIGHT NOW, I am not afraid or ashamed to ask my co-workers to help. And I return the favor, of course.

I think the point of this post is to encourage you to avoid sinking into despair. Despair won't help your patients and it certainly won't help you. You have one of the most challenging jobs on earth. You are highly intelligent. You are motivated. You can do this.

If you identify systemic problems that drag down the unit's efficiency, think of ways to solve those problems. Consult with your nurse manager, if appropriate. Brainstorm with your colleagues; chances are they face the same problems, and you know that putting more heads together can often bring about results that one person can't achieve alone. You may not be able to change the system, but if you are aware of the specific deficiencies in that system, you can find clever ways to work with and around them. Learn from the nurses on your unit; don't be afraid to ask them how they manage such-and-such a problem. Our co-workers are often our best source of wisdom.

Try to see the things that stress you out as opportunities for growth. Embrace those opportunities. Every day you work is a chance to learn and grow. You ARE doing a good job, and as time goes by you'll get better and better as long as you keep your enthusiasm and determination.

You survived nursing school; you can do this. You sound like the kind of nurse I'd love to have on my unit. You are worthy of your title and you will succeed. :heartbeat

1louise1 · Mar 4, 2010

wow....great words of advice to hear just before i leave for work! thank you HollyHobby! my immediate solution is to check, double check, and triple check everything from meds, to charting, to orders, etc... and maybe take a yoga class so i can learn to chill out.