HELP! Is it just me?

[BmichelleRN]

I am really starting to question whether I should be a nurse or not. Long story short got my license in 03 worked two years in med/surg had to move and stayed out of the field for a year working for my husband, returned for 2 years,resource, did a little of everything and as a homehealth director. Decided i am a med/surg nurse and I want to work a flex schedule, after being told by another employer :cry:I was not working out, not enough experience with IVs basically.

So I am working with a crushed self esteem at the moment...Last night I am on my third full day of orientation on a med surg floor. I have three patients, one gets d/c'd within the first couple hours, the doctor doesn't write to DC just tells the pt he is dc'd. Needless to say the pt is antsy, wants to go, I have to wait for the order and then put it into the database along with his dozen meds and all that info, takes me about an hour in between things. I think he was okay, not perturbed when he left,then my next pt has to go to get a stress test...more and more unfamiliar paperwork, rushing his few meds and off he goes, during this time my charge, who should be orienting me to their process is bogged down due to understaffing, so if i have a question I am on my own and was.

Then the charge shows up and wants me to take an admission right before I am told my stress guy is going to another facility for a cath. No, I do not know their procedure here. The secretary does tell me to call report to the other facility and to fill out this and that. In the meantime, they have put my new pt in his bed and never notified me. So I am running like a crazy person without a clue and my new guy has a fever 104, I medicate immediately, stop what I'm doing, and do it. Tear off his blankets, his condition is known for these fever spikes.The supp. brings his temp down within 30 minutes, I check 101. barely over febrile 100.4. So okay good,back to my other responsibilities like verifying new orders, getting them started then at 6p the news comes, he is at 104.6 now. I again tell my charge and I also tell the supervisor. I give him a supp. thinking it has been 4 hrs, when the computer prompts "too early" I can not get out of the program (can not find a soul to help me). I go ahead and give it 15 minutes early and call the doctor at the advice of the supervisor as I am a little worried and in my own 12 hr work coma. Dr calls order after vitals are given of tacypneic, tachycardic, >103 T and temp spike and decrease. Nurse sup seems to think the info I gave is not enough?? He seemed disoriented ,yes, he had a high fever and I saw it dissipate when it came down. We put a fan on him and give him new med. His temp drops down a degree and he is more conversational, in better spirits, even his wife agrees, A&Ox3.My shift is over and I am waiting for report off so I go check his temp again it is still north of 103 after 30 minutes.

Bottom line, I feel like a failure, never had a guy go bad so fast and I am home today praying he is okay. Hopefully they sent him to the unit as night nurse asked why that was not done when I gave her report. Any hoo, I missed a med and didn't know until I was closing out, good times, good times, so I went back and gave it late...It is a routine med so I wasn't too sick about it.

So I am freaking out, about my lack of critical thinking, I should have called the Dr with the first spike but it was in my head that he (said dr) was just in the room with the family and warned them of this so I didn't get concerned and the temp responded so well to the suppository tylenol.

I don't know if I am meant to be a nurse....I have never not given a med on time, let alone missed one. Oh, and my cath pt should have gotten a PNA shot prior to departure, didn't show up on my MAR and it does not alert on the computer, old system, pt unmedicated, another first!! Also, maybe I was too laid back about the temp the first time. What do you all think and have you had these days from hades. And should I go to my supervisor? Let her know about my errors in judgement or med giving....Or the fact that I am in orientation and do actually need someone to guide me somewhat.

[gonzo1, ASN, RN]

Sounds like a typical nursing day on my unit. I don't see where you did anything horribly incompetent. I don't know a nurse that has not missed a med, or been late or early. It happens.

[anne_in_maryland]

Your third day on the unit, shouldn't you have a preceptor?

[shrinky]

I agree that you should have a preceptor at this stage. We lose a lot of nurses because we do not mentor and support them as we should for a lot of reasons. I realize that the charge nurse was busy and she should not be orienting you because of that reason. All that was happening was too much for a new nurse to deal with by herself and you did the best that you could. We are not perfect and do not feel comfortable for 6mos to a year after graduation. Experience will help, don't give up. Hope you get the support that you need, we need caring nurses.:heartbeat

[NurseNora, BSN, RN]

A nurse 3 days on orientation should not be in the count. Her preceptor should not be the charge nurse. Although she probably has good skills, she has too many other responsibilities to orient someone. You do need to bring the lack of proper preceptor scheduling to your supervisor.

Don't fret about the med errors. Look into it, decide what went wrong and how you can avoid making the same mistake in the future, then let it go. Any medication error you make while you're on orientation is the responsibility of your preceptor (or she at least shares equal responsibility with you). This may have been your first med error, but I'm afraid it will not be your last. Part of being human is that we make mistakes.

[nrsgnerd]

Given the situation and the fact that you care enough to post and ask for supporttells me that you ARE A NURSE that cares. You did the best you could in a crazy situation and with time, you'll be rockin. This day you talk about will only make you stronger so when this day happens again, and it WILL, you will have learned and will be more prepared and better able to handle it. Nurses are not perfect, the systems we work with are not perfect and as soon as we learn the systems and get comfortable (paperwork, computer programs)....they change and we get the frustration of learning a new one. However, with each change we learn to be more flexible and go with the flow and some days thats just what you gotta do....just flow....keep running your butt off and do the best you can with what ya got....it sure ain't easy!! Hang in there, not every day will be this way! :urgycld:

[leslie :-D]

considering this was your 3rd day of orientation (if you want to call it that), and there were protocols that you had not yet learned, i think you did just fine.

what's important to me, is you obviously knew what was priority.

i'm not sure if i would have even called the doc re 1st temp, given that md had forewarned this may happen.

i hope you get the orientation you deserve.

it sounds like you were pretty much thrown to the wolves, and you did well.

hang in there...

give yourself and time, a chance.

wishing you the very best.

leslie

[chenoaspirit, ASN, RN]

I agree with all the other posters. You did good, especially considering the situation. I probably wouldnt have called with the first temp either if the doc was already expecting it. Try and hang in there, but I would definitely discuss this with someone. That is not safe for you or your patients to throw you out on the floor without proper orientation. After reading your post, you seem like a very conscientious and caring nurse who will make a huge difference in people's lives. I truely believe that. If you are not comfortable there and they are not willing to give you proper training, then I would seek a job where they will.