I Can't Sleep!!

[perfectbluebuildings, BSN, RN]

OK usually daytime sleeping, thus far, has been no trouble for me. But today I woke up at 12 and haven't been able to sleep for the past over an hour, I have to go back tonight. I just keep thinking about all the things I may have done wrong or forgotten on my pts or not done as much as I could have or something- I keep trying to forget and relax but my mind keeps going back to things and I feel awful about them! I know I gave report to three very competent nurses today and my pts are going to get awesome care but I feel like I didn't leave them (nurses) in good situations, but I am not sure why.

One thing one of my pts was supposed to be NPO after midnight but forgot and drank up till 1 a.m. And he has an immunodeficiency but I couldn't tell the nurse his most current WBC count when it had been critically low at one point in his admission although not causing any problems at this time. Then another pt admitted last night has a wheezing protocol that has to be done t/o his admission and I didn't do any of it last night- he was febrile and having issues but still I could have done a LITTLE! And I guess I just feel somewhat incompetent in general... last night hanging TPN/Lipids on a pt, I almost gave them someone else's lipids solution but another RN caught it!! I also gave some IV meds late... what is your strategy when you have several IV meds for different pts due around the same time, and closely sequential in one pt? That always seems to get me behind. And my fellow RNs on the shift helped me out a lot, like with an early in shift admission my charge nurse did the history and room orientation, and helped me with the IV and VRP, and I feel like I didn't do anything much for other nurses in return. It is common for the charge RN to do history etc. on admissions that come at change-of-shift but still I should be able to do more of that myself. I don't want to drag others down with me!! OK I am done now... maybe just writing it out will get it off my mind and I will be able to sleep. Thanks for listening!!!

[KarryRN]

Hi, I'm pretty new here, but I could relate to your post about not being able to sleep during the day and then having to work again that night. I haven't worked in awhile, right now I'm a SAHM, but when I worked night shift, I could usually sleep until noon and then I would be up for the day. I was tired all the time.

Also about the IV meds and having a lot to give at the same time. What I did was start a half hour before they were due and drew them all up and then went around giving them all until they were done. Usually I could get them all done in time. I know it is hard when you are new and you feel so incompetent. I'm sure you are doing just fine. I hope you are able to get some sleep and have a better night tonight. :icon_hug:

[Tweety, BSN, RN]

Hope you got some sleep.

There's no way when drugs are due together to get them all done on time. Relax about them. The times need to be adjusted.

I can relate. It's hard to sleep when you've had such a stressful day, especially those first few months out of school.

Good luck. :)

[TexasPediRN]

I dont know your hospitals specific policy is, but ours gave us a 1 hour window when it came to meds. For instance, I would start giving 8pm meds at 7. This usually helped. We also had until 9 to get them done.

Now in all cases, certain meds need to be given exactly 12 hours apart or so, but doing other meds an hour earlier helped me a lot, and usually I had all of them done by 8 and could chart!

[ERnewbie]

Hi, I'm a new grad and I KNOW exactly what you're talking about...you feel (or at least I do!!!) with trying to stay on top of things. What I found what works for me for all my patients that have tons of meds (including IV meds) is that I make a time sheet (a "TO DO LIST) and write down all the meds and tests, etc. that are due and stick it to the front of each pt chart, that way it is right in front of me and I don't have to keep going through all the orders and it is easier to keep track. As far as the no sleeping part because you're thinking about things that you forgot, I think it is something that everyone goes through...I do that all the time and feel bad that I didnd't do more. Don't feel bad about the experienced RN's that are willing to help you, chances are they are the ones that still remember what was like to be a new grad! They are great resources...I've learned very quickly who to trust and who not to trust, and I appreciate the help I get from those that want to see me succeed....Good Luck and I wish all the best!!

[gizelda196]

Some times I cant sleep either. It happens. Benadryl works at that point! Just don't take it to late.

Please put the baseball bat away. This stuff happens. As you go along and get more comfortable in your nursing clogs things settle and come together. remember this :Meds get giving late, People drink in the am and have surgery( I myself am guilty of that one "Yup doc npo since midnight" I had sips of h20 thru out the night)Its a four course meal that is concerning not some liquids. Pateints fall out of bed accuchecks get forgotten IV's blow at change of shift.And as for lab values jeez You cant be expected to know them off the top. That is why the lab post them ! Print them out, staple all together ,put them with your report sheet. Then reference them in report. and don't let any one let you feel like a piece of crap .It is hard enough when you are a new nurse .Do the best you can and all you can do. and remember it is a 24 hour job. we have shift change .if it is not life threatening pass it on. A nurse work is never done and we would never get to go home if we tried to do it all. You will get ok with this concept of "letting go" . if you dont you will crash and burn. I now feel that if I did the best job I could with what I had to work with (which is not much) Then I did fine. I pass stuff off all the time. i also get stuff passes off to me. It happens. Take a deep breath ,take care of your patients. When they hold your hand and say thanks or your a good little nurse you know you are ok.

[perfectbluebuildings, BSN, RN]

Thanks all for your support. It is good to know I'm not alone!!! I have been off and out of town for the past couple of days, that's why it took me so long to reply back. I will try this weekend to "let things go" a little better. The last shift on I actually got to help someone else out who was behind, she had a lot going on with her patients. That was a good feeling. Take care. Thank you again everyone.