How do I rest after my supervisor noticed another major mistake before I did?

diane227, LPN, RN · Sep 26, 2009

What unit are you working in and what mistakes did you make? As a manager in the past, I would be watching you also. Need more info.

rainbowbright2 · Sep 26, 2009

What unit are you working in and what mistakes did you make? As a manager in the past, I would be watching you also. Need more info.

Adult med. surg. First error: I noticed that a post-surgical 70 yr. old patient didn't urinate after way too many hours had gone by (and only then notified the surgeon). Most recently, I didn't notice a pin-point red rash that had developed on my patient's left leg throughout the shift because I was too intensely focused on struggling with his terrible pain throughout the night (unrelated). I feel terrible.

allnurses Guide · Sep 26, 2009

How are you planning to avoid these errors in future?

Not wanting to dump on you more, but no urine output in elderly post-surgical patient? I would be concerned about you too. The rash? Not so much - I'm not checking every inch of my patients every hour.

It's hard to make the move from task-oriented to being able to rapidly manage and assess multiple patients. It takes at least a year or two. In the meantime, do what you need to do in order to remind yourself of basic things, and how to prioritize. Postsurgical? You need to check for complications more frequently (vital signs, I/O, signs of bleeding etc).

As a new nurse, I always kept a worksheet where I divided it into sections, listed the hours of my shift, and wrote in drugs due, then wrote notes to remind myself of things to do/check over the course of the shift. Of course you can't stick to a strict schedule, but writing down the things you HAVE to do helps keep you on track.

Would it be worth going to your manager and telling her that you realize what's happened, and that you're working on improving, and seek constructive feedback? The people I worried about as a manager were the ones who didn't know what they didn't know.

californiaguyyeah · Sep 26, 2009

Eh, that first comment you received wasn't too helpful I'm guessing? You came on here for support and that is what I will provide. You've made mistakes. We ALL do. You cannot tell me that new nurses nor experienced nurses made dumb errors. Yeah, you screwed up. Not the best thing to do, but you can't reverse it and you learned from these, right? I bet you'll never neglect these important things again. The last comment about making a check-off list is important. Remember to not become too task-focused. It's very easy to get caught up in that process as a new nurse as I'm assuming you are? I also bet it opened your eyes to see the big picture, right? Keep your head held high and ask for support from the ones you know will provide it. The worst nurses are the ones that don't care to learn from their mistakes and the ones don't support other nurses in the learning curve it takes to be a new nurse.

Sirapples · Oct 2, 2009

pin point rash huh? That doesnt seem all that important unless it was actually a bedsore that was developing.

As the previous poster said, I am 100% sure that you wont miss a post op patient not voiding. Or what the urinary output is.

Its unfortunate but nursing does have a learning curve, especially med/surg or any hospital based care unit. The worse thing you can do though is doubt yourself. Accept the fact that you made a mistake and you wont do it again. I made a mistake of flushing an iv in the dark, at around 2am and it flushed great. Didnt want to wake the patient up because she had a very long day. Dayshift showed me in the morning and the thing looked infected, and the patient ended up being on vanco because of it.

This isnt something that happened in one shift, but I definatly should of assessed it (I was a nurse for 1 year at that point). Would that of made the manager in the second post look at me more closely? Im sure of it, and it would of been waranted. I appologized to the patient and also to the hospitalist for this action, or my lack of.

But I learned from that incident and made sure that my assesments were 100x better from that point on. The trick to this field is that you learn from your mistakes and never repeat them again. And to apply that mistake you learned from to all aspects of your practice to be more vigilent in all things. Do not beat yourself up, dont tell yourself that you can not be a nurse because of this. Be more vigilent and really work on those assesement skills.

Good luck!

Cheers!

Mike

ps.. remember too that if you do find that you can not do med/surg that it doesnt mean you cant be a nurse.

oldiebutgoodie, RN · Oct 2, 2009

Number one: Don't beat yourself up! You'll never forget to check urine output on a post-surgical patient again!

Number two: You are a new nurse. Patricia Benner described the stages of a new nurse in "From Novice to Expert". You WILL transition from task-oriented to big-picture. I think that more experienced nurses forget how it was.

To any managers reading this:

THIS IS YOUR OPPORTUNITY to mentor, not eat a new nurse. If you give them the evil eye every time you see the newbie, you are just going to increase their anxiety level.

You (I'm talkin' to YOU, nurse manager) could assign an experienced nurse to work with this nurse on occasion, "round" with the new nurse, discuss common pitfalls, etc.

I think is it SHAMEFUL how new nurses are thrown to the wolves these days.

And to the original poster, hang in there. I was pretty clueless when I got out (I'm not saying you are clueless, just that I wasn't "on top of my game") and I have progressed, and am now in an MSN program, have a specialty nurse job, and am well respected.

Randy Pausch said,

"Brick walls are there for a reason. The brick walls are not there to keep us out. The brick walls are there to show how badly we want something. Because the brick walls are there to stop the people who don't want something badly enough. They are there to keep out the other people. "

Keep the faith, all you newer nurses!

Oldiebutgoodie