Anywho..I'm a nurse on a med/surg unit in a fairly rural area. I have gained a lot of confidence and the house supervisors actually refer to me as "the best nurse on med/surg"...which boosts my confidence even more...BUT...I am still finding though...(after 6 years now..eeek)...that I tend to let isolated incidents stick with me.
Without giving too much info....I had a patient that never should have been admitted to med/surg in the first place. She was a trauma patient...elderly..enough said. Anyways...I walked into her room and she did not look good..I called the on call doctor..got a few orders..and monitored...by am...still wasn't feeling right about her...called her regular doc(he was to take over in the am)..he came to see her and immediately had her copter'd out.
I felt soooo bad after this whole thing...like I should have called again, been more aggressive, called again sooner,etc. I guess everything turned out ok but I still think about the whole thing everyday. Her doc..(who is also my family doc)..didn't appear mad at me or anything...but i'm just wondering if he thinks I'm a big dummy or something. I haven't even been in to see him because I feel like he thinks I'm a horrible nurse. I did call two physicians, monitored the patient closely, and she didn't ever change the whole night..it was just that she was down the tubes from the get go. I think my doc was more upset over the fact that she was admitted to med/surg to begin with.
I feel so stupid that I let things like that stick with me. I guess I just want to be super nurse or something and when things don't go right or if I kick myself for the "should have done that' thing...I get anxious, depressed...even to the point of wanting to quit nursing. I'm seriously starting to wonder if I need Xanax or something? Anyone feel like this every...or am i the only one?
I guess maybe I don't have as much confidence in myself as I thought.....I know stuff happens and we need to just go on...but for some reason..I can't..I think about this night all the time and sometimes it makes me not even want to be a nurse anymore....does anyone know what I'm talking about? Of course..I was super worried about the patient...but now...two months out..I'm worrying about what others...i.e. my doctor thinks of me...is that crazy or what? Ok..I guess I'm done rambling...I think I needed to vent more than anything....any comments or similar feelings anyone could share might make me feel better.......??? Ok..thanks everyone....
UPDATE:
Ok..here's a little update on this whole situation. Ok...apparently..I wasn't feeling bad enough about this patient....SO...I come to work last Wed., check my e-mail and find an e-mail and powerpoint regarding the new SBAR and rapid response team our facility is implementing...well..guess what the case study on the first part of the power point is...??????? This lady that I had...errrrrrrrrrrrrrrrrrr. The only problem is that they only picked out the bad things about the story....they didnt mention that two seperate physicians were called, that house supervision was involved, that the patient was monitored..basically one on one all night...I was soooo peeved!!!! There's a lot of people that know that whole story with that lady and it was easy to pick out the fact that it was her by the case study. I was so irrate that I went to our DON and she whole-heartingly apologized saying "that she never thought to ask me my opinion before letting one of our internal med doc's use the case study in his power point for all the facility to see. I talked with the DON for a long time and she knows that I am very upset about the whole thing.
Then she decides to tell me that our quality control lady and others have been meeting and are doing a "cause and effect analysis" on this case. She said don't think it is just you they are zeroing out....they are looking at the whole case from ER til the time she was flown out. I told her..."how can I not think about it"...I told her that I was just now finally mentally forgetting about it and going on with things and then I find the whole episode in a case study and find out they are studying it for some darn cause and analysis". I'm all like "so when am I going to be a part of this"...since thus far..they've been doing everything behind my back. She was like: "oh..they will be contacting you for an interview shortly"....I'm like oh great...now I can think about it some more...uggggggghhhhhh. She said they are really looking at the doctors too....cause' i guess a lot of people are really wondering why the lady was admitted to med/surg in the first place....so..she's right...it's not just me they are looking at...it's the whole process. But someone like me...that stresses big time anyway....can't help but think they are looking at me. But I guess...if you think about it.....I actually did follow the rapid response...I contacted md's, contacted house supervisor, monitored closely,etc....but I still can't help think that I should have called back more when the doc wasn't really listening to me. I'm wishing I would have called back and said "this lady is too critical, may I move her to CCU" or "come in and see her"....etc.
Good news is...the lady did turn out ok an is at a local nursing home now...still recovering from her fractures. I told my DON that I was going to start ultrasound school...lol..cause I was so upset. (actually I have been thinking about it). I told her that I get stressed out easily and that this whole thing is making my life hell. She apologized again and said that she thinks I am an excellent nurse...one of the best we have..she goes. She says she's heard numerous times from house supervision that I should transfer to CCU or supervision. My nurse manager on med/surg also sent me a little poem and wrote that "there is no other nurse I'd want caring for patients on nights"......I know they are just trying to be nice because they know I'm feeling so bad....but I do think there's some truth to it...I am a good nurse. I just have to start believing it more....i'ts just so hard for me when this case where things didn't go exactly right....comes back to bite me in the butt. Why me???? There's been other cases...some with worse outcomes than mine...my lady survived. Why can't they do cause and effect carp' on some of these cases....uggggggggggggggghhhh.
Ok..I just wanted to update. Sorry it got so long. I'm just feeling really bad about it all and needed to vent and look to you guys for some help. Thanks...
It sounds like you did everything right, but need some help leaving work at work. Playing the "what if " game, and seconding guessing ourselves leads quickly down the road to burn out.
I have had to learn not to bring "work" home, sometimes something sneaks in, but I need to have a home life and a seperate work life.
I agree, over time you will learn to leave work at work, and it's not "all about you". Learn to look at the "big picture" & be thankful that your facility appreciates you as you continue to learn & grow.
have also noticed myself losing interest in things, sleeping all the time,etc. I am also battling some other problems like trying to work with chronic pain from endometriosis and we're dealing with infertility as well. Oh yeah..then I passed out at work the other week and hit my head and needed nine stitches to sew my ear back together..lol. Overall...I'm just feeling sad and worn out...
There is more going on here than the one case, I think this is just the one tipping you over the edge. Yes, do find someone to help you with stress! Smartest thing you can do for yourself. Even if it is "just" debriefing over this one incident, or if it is helping to cope with everything going on in your life, it'll help. Promise:) And I don't think all those folks told you good things about yourself just to make you feel better, I think they told you the truth, YOU ARE A GOOD NURSE. Find someone to help you reaffirm yourself, because you are worth it! and we need nurses like you. :kiss
Your charting reflects everything that you did. You were excellant. A lesser nurse would have dropped the ball on that one and had a bad outcome. I wish I had a pat on the back smiley.
Oh my gosh...thanks again everyone...it really means a lot to me!!! Now tonight..I had a great night at work....(i even got to come home early on call..yeahhhhh). Anyways....yeah...I have been talking to a few people about the incident...including you guys of course...which actually has helped me to feel a lot better. I am still wondering about some depression and anxiety issues though...seriously. I think I may make an appt. and talk to my doctor(the one that I think thinks I'm stupid..lol). I may mention the lady to him and the whole episode and say that it has been really stressful for me...along with my pain, infertility,etc. He's so sweet...I'm sure that he will re-affirm that I did a good job too....but maybe I need to actually hear that from him...it sounds dumb..but that's just where I"m at right now. I am feeling better about the whole thing though...and as time goes by I"m sure it will get even better and soon I'll forget all about it...(which is what I want to do). I must just keep focusing on the things I did right...I monitored closely, called two MDs, involved the house supervisor, was actually the one that discovered this lady was a COPDer and used my critical thinking skills to realize maybe she's in CO2 narcosis versus 'must be the morphine',etc. Anyways.....
Tonight..I had this sweet little man (I had him a few nights last week)...I walked into the room and he grabbed my hand , squeezed it tightly, and said "i'm so glad you're back tonight"...that makes it all worth it to me. Ok....thanks again everyone....you are all great!!!!
Oh yeah...I failed to tell y'all about that in the initial "story".....the lady had been on 10 liters of o2 via simple mask for hours.....they put it on in the ER..or maybe even in the ambulance. Anyways.....that's what ended up as her main problem. She was a COPDer and that was never mentioned or thought of by the ER doc, ER staff,etc. Orders read "o2 by mask to maintain sats greater than 93% or something like that. This lady was basically unresponsive...anyways....toward morning..I got a quick chance to peek at her charts..(you know how that goes...especially when you are one on one with someone and have other patients too). Anyways..I find somewhere that she's a COPDer and then thought oh my gosh.....what if she's a retainer?That's when I called her usual doc and told him the story and I mentioned the possible retaining thing...right away he's like "oh yeah...she's a retainer"....after all...he sees her all the time..he just knows this. Anyways...once they got her on bi-pap,etc and were able to blow off some of that CO2....she came around. Ok..I just wanted to add that to clarify my above post.
If the OP really felt bad about how she handled the situation, she would not of been so outraged and indignant over the case being used for a rapid response scenario (or would of felt the need to re-post, and lay the "blame" on the ED and the Doc)-if anything she should of been relieved to see that EVERYONE involved in the case was a part of the problem, that it wasn't entirely her burden-it was obvious that she felt that with her status of "Best nurse" she should of been immune to any constructive criticism that everyone involved in this patient's care was given-that makes her original post a bit disingenuous, a bit coy-I think the response that she was looking for, and got was all the "you did great" posts as above. Kind of like asking your someone if you look fat, when you know that you do, because you know that they'll tell you that you look great. It would be crummy to see a case that you were involved in used as a "what not to do"-but if you really and truly felt bad about how you handled it, there would be no self-righteous indignation over it; it would be like "gee, I had a feeling that there was more that I should of done-so my gut feeling was right, next time I'll Know to follow it"-the fact that she was upset enough to complain proves that she didn't really feel that she did anything wrong-or at least not "wrong" enough that she should of been included in the case study-in which I am sure her name was not mentioned....Just my cranky two cents. We all have cases that, for whatever reason, we could of done a better job. No excuses, no qualifying; Just, "Darn, I could of done better"-and learn from it
If the OP really felt bad about how she handled the situation, she would not of been so outraged and indignant over the case being used for a rapid response scenario (or would of felt the need to re-post, and lay the "blame" on the ED and the Doc)-if anything she should of been relieved to see that EVERYONE involved in the case was a part of the problem, that it wasn't entirely her burden-it was obvious that she felt that with her status of "Best nurse" she should of been immune to any constructive criticism that everyone involved in this patient's care was given-that makes her original post a bit disingenuous, a bit coy-I think the response that she was looking for, and got was all the "you did great" posts as above. Kind of like asking your someone if you look fat, when you know that you do, because you know that they'll tell you that you look great. It would be crummy to see a case that you were involved in used as a "what not to do"-but if you really and truly felt bad about how you handled it, there would be no self-righteous indignation over it; it would be like "gee, I had a feeling that there was more that I should of done-so my gut feeling was right, next time I'll Know to follow it"-the fact that she was upset enough to complain proves that she didn't really feel that she did anything wrong-or at least not "wrong" enough that she should of been included in the case study-in which I am sure her name was not mentioned....Just my cranky two cents. We all have cases that, for whatever reason, we could of done a better job. No excuses, no qualifying; Just, "Darn, I could of done better"-and learn from it
What's up with that? We come here for a safe place to vent, and vent we all do. The support that Snoop received is what we all do for each other every day. This is not an easy job and we all need a safe place to discuss the situation and receive the support we need to go out and do the job another day.
Snoop, don't feel bad, as the poster above mentioned, we all go through these things, but I for one am thankful that I have a place to go to vent.
I had a similar incident happen and to this day, many years later, it still comes back to me. I had a patient react very badly to anesthesia and I spent most of my shift evaluating the situation and calling anesthesia, the surgeon and my supervisor about it. Although the situation got worse over the next few hours, I continually kept all the important people in the loop, and I documented my a$$ off.
The next day I found out that on daylight my documentation was held up as an example of documentation at its finest. I was very proud of myself. but the same day, I found out the family was complaining about the "nurse" who was very rude to this patient.
My head nurse and supervisor both said that the reason they knew it was not me was due to my excellent documentation.
It turned out that the stupid nurse aide was going in when I wasn't around and bossing the patient around and treating him like an unruly child, right in front of the family! When they described her, it was obviously not me, but the aide I worked with and she was disciplined. But I could not help feeling like my good work was discredited by this stupid nurse aide who had no social skills at all.
Oh yeah...I failed to tell y'all about that in the initial "story".....the lady had been on 10 liters of o2 via simple mask for hours.....they put it on in the ER..or maybe even in the ambulance. Anyways.....that's what ended up as her main problem. She was a COPDer and that was never mentioned or thought of by the ER doc, ER staff,etc. Orders read "o2 by mask to maintain sats greater than 93% or something like that. This lady was basically unresponsive...anyways....toward morning..I got a quick chance to peek at her charts..(you know how that goes...especially when you are one on one with someone and have other patients too). Anyways..I find somewhere that she's a COPDer and then thought oh my gosh.....what if she's a retainer?That's when I called her usual doc and told him the story and I mentioned the possible retaining thing...right away he's like "oh yeah...she's a retainer"....after all...he sees her all the time..he just knows this. Anyways...once they got her on bi-pap,etc and were able to blow off some of that CO2....she came around. Ok..I just wanted to add that to clarify my above post.
snoop :)
You FORGOT to tell us???!! My dear, that is the MOST IMPORTANT part of the story!!
Case studies and root cause analysis are how facilities improve patient care. Don't feel singled out. Take pride that your facility is "dissecting" a case that was bothering you in the first place.
If the OP really felt bad about how she handled the situation, she would not of been so outraged and indignant over the case being used for a rapid response scenario (or would of felt the need to re-post, and lay the "blame" on the ED and the Doc)-if anything she should of been relieved to see that EVERYONE involved in the case was a part of the problem, that it wasn't entirely her burden-it was obvious that she felt that with her status of "Best nurse" she should of been immune to any constructive criticism that everyone involved in this patient's care was given-that makes her original post a bit disingenuous, a bit coy-I think the response that she was looking for, and got was all the "you did great" posts as above. Kind of like asking your someone if you look fat, when you know that you do, because you know that they'll tell you that you look great. It would be crummy to see a case that you were involved in used as a "what not to do"-but if you really and truly felt bad about how you handled it, there would be no self-righteous indignation over it; it would be like "gee, I had a feeling that there was more that I should of done-so my gut feeling was right, next time I'll Know to follow it"-the fact that she was upset enough to complain proves that she didn't really feel that she did anything wrong-or at least not "wrong" enough that she should of been included in the case study-in which I am sure her name was not mentioned....Just my cranky two cents. We all have cases that, for whatever reason, we could of done a better job. No excuses, no qualifying; Just, "Darn, I could of done better"-and learn from it
Wow, I think that is a really crappy response and uncalled for. From what she has told us I think she handled the situation the best she could have, and probably better than alot of nurses would have. The fact that she is upset about it obviously shows what a compassionate person she is! I think at no point in the story did she say she was outraged about the situation but felt like she was being singled out in the situation!
Specializes in Med/Surge, Psych, LTC, Home Health.
If the OP really felt bad about how she handled the situation, she would not of been so outraged and indignant over the case being used for a rapid response scenario (or would of felt the need to re-post, and lay the "blame" on the ED and the Doc)-if anything she should of been relieved to see that EVERYONE involved in the case was a part of the problem, that it wasn't entirely her burden-it was obvious that she felt that with her status of "Best nurse" she should of been immune to any constructive criticism that everyone involved in this patient's care was given-that makes her original post a bit disingenuous, a bit coy-I think the response that she was looking for, and got was all the "you did great" posts as above. Kind of like asking your someone if you look fat, when you know that you do, because you know that they'll tell you that you look great. It would be crummy to see a case that you were involved in used as a "what not to do"-but if you really and truly felt bad about how you handled it, there would be no self-righteous indignation over it; it would be like "gee, I had a feeling that there was more that I should of done-so my gut feeling was right, next time I'll Know to follow it"-the fact that she was upset enough to complain proves that she didn't really feel that she did anything wrong-or at least not "wrong" enough that she should of been included in the case study-in which I am sure her name was not mentioned....Just my cranky two cents. We all have cases that, for whatever reason, we could of done a better job. No excuses, no qualifying; Just, "Darn, I could of done better"-and learn from it
I don't really think that the poster was in any way trying to say that she didn't shoulder ANY blame. Quite the opposite; she said that she felt like she could have been more aggressive and INSISTED that the patient be transferred immediately. One other poster actually did agree with this, that yes she could have been more insistent, but "hindsight is 20/20".
I think that the poster is just really bothered by the whole situation and was just coming here to vent about it and yes, maybe get some reassurance that she handled the situation OK... but what's wrong with that?? All of us as nurses need a little reassurance now and then; more than what most of us get on a daily basis.
Then when the OP got the email about the situation being used as a case study.. again, I don't see where she felt like she shouldn't have had any blame in the situation. Again, quite the opposite.. sounds like the OP has a rather skewed view of things and thinks that everything went bad because of HER.
If the OP really felt bad about how she handled the situation, she would not of been so outraged and indignant over the case being used for a rapid response scenario (or would of felt the need to re-post, and lay the "blame" on the ED and the Doc)-if anything she should of been relieved to see that EVERYONE involved in the case was a part of the problem, that it wasn't entirely her burden-it was obvious that she felt that with her status of "Best nurse" she should of been immune to any constructive criticism that everyone involved in this patient's care was given-that makes her original post a bit disingenuous, a bit coy-I think the response that she was looking for, and got was all the "you did great" posts as above. Kind of like asking your someone if you look fat, when you know that you do, because you know that they'll tell you that you look great. It would be crummy to see a case that you were involved in used as a "what not to do"-but if you really and truly felt bad about how you handled it, there would be no self-righteous indignation over it; it would be like "gee, I had a feeling that there was more that I should of done-so my gut feeling was right, next time I'll Know to follow it"-the fact that she was upset enough to complain proves that she didn't really feel that she did anything wrong-or at least not "wrong" enough that she should of been included in the case study-in which I am sure her name was not mentioned....Just my cranky two cents. We all have cases that, for whatever reason, we could of done a better job. No excuses, no qualifying; Just, "Darn, I could of done better"-and learn from it
This is kind of funny actually....apparently you must be cranky..lol. Anyways....thanks for your "humble" opinion....but everything you said is sooooooooooooooo far from the way I feel...it's almost laughable!! If you'd read my original post...you would know that I was upset about the case study because it failed to show the whole story...which yes...does make me upset. It showed the ladies vital signs basically, her LOC, and the fact that she was shipped out. It failed to show ANY interventions at all....therefore it makes it look like I sat on it and did absolutely nothing all night....yes..that does peeve me because it fails to show what I did do.
As far as "her status as best nurse"....that is absolutely the funniest thing I've ever heard.......you must be completely off your rocker..i have no idea where that's coming from. I have been mulling this case over and over in my head from the beginning because 'yes'....'I feel like I could have done something more and didn't'.....oh yeah....that's a true sign of being self-righteous...don't you all think? I am not solely blaming the ED or doc....did I ever say that??? No...I don't agree with that fact that they ever should have let her roll down to med/surg...BUT....what did I do about it to get her transferred out of there..not as much as I should have...and that's partly what I"m upset about.
I'm just glad that the true veteran nurses here understand this whole situation and have helped me to feel better about this all. Yes...I do think I did an ok job....yes..I do think I could have done better....no...I'm not trying to push all the blame away from myself....no ...I am by no means "best nurse"...quite the opposite...I've been struggling for so long with self esteem/anxiety issues...I think I am a good nurse...but believe me...it's taken years to finally get to that point....yes..I am upset about the case study because it failed to show the WHOLE story and yes I was upset about the cause and effect analysis because they failed to include me....but now they are including me and I realize it is to improve patient care and I'm happy about that....and yes..I do feel bad about the whole thing in general..not because I'm "best nurse' and looking for a pity party on snoop and tell snoop how wonderful she is....BUT...because it makes me question myself and wonder about what I did and didn't do.... I came here looking for support because I know many veteran nurses have been thru similar event and feelings. Oh yeah.....I DO think I am "best nurse" when it comes to being compassionate,caring, and understanding of others feelings....that is something Typical Fish....you apparently know nothing about...if you did....you wouldn't have posted such a mean and uncalled for response...although..it was good for a laugh because it was "so out there"...thanks for that.
I wish I had a pat on the back smiley.
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spidermonkey
144 Posts
I agree, over time you will learn to leave work at work, and it's not "all about you". Learn to look at the "big picture" & be thankful that your facility appreciates you as you continue to learn & grow.