I am a complete failure; incompetent, stupid, and outright humiliated!

[ZanatuBelmont]

Hi everyone, this post comes with great humility. I just need to vent in a forum where I know people can understand and, possibly, offer me some wisdom.

I was licensed August 15, 2009, as an LVN in the state of Texas. I began my nursing career at a nursing and "rehabilitation" nursing home. Everything was excellent, until I began using my "book smarts" to guide me. Then, slowly but surely, I became less and less liked by staff, especially aides, whom I expected to NOT lounge around in a resident's room for "breaks." Come December, ALL PRN (that was my title, but I began as FT) were laid off.

THE HUMILIATING PART --

I began work at a well established national rehabilitation hospital. Here I loved what I did: the hours, salary, staff, and patients. At its core, rehabilitation was "my calling." After six weeks of floor orientation, I was "let loose." Not even three weeks into my freedom I was placed back on orientation. I administered six doses of 10/325 hydrocodone within a six-hour period. This brought to question my knowledge about medication administration.

Fast-forward another month. My 90-day review comes up. I was ranked "does not meet expectations of this position." I was placed on a probationary 90-day review, where I'd spend most, if not all, of my time under the direct supervision of another nurse. The CNO even stated, "Although you are spending the longest time compared to others on orientation, consider it a learning experience."

OK, fine. I can do that.

So today - the day after this 90-day review (first day on my probationary period), I made several mistakes. First, I forgot to sign off a medication I gave. "If you were to disappear and we went through your MAR for a med pass, we would end up giving the medication twice because you neglected to sign it off." That was the CNO's example. Point taken.

Then I told my preceptor I had not collected the three blood sugars I needed to check before lunch. I then told him, "Don't worry, though - the policy and procedure guidelines state if in this case check the BS either one hour after (with an expected result

And finally, here's the kicker. I gave a blood pressure medicine to a patient with a BP of 101/58 and a pulse of 70. The parameter states, "Hold if systolic

So essentially I was told, "I can't fire you, I'll have to speak with HR on Monday." I of course cried, pleaded the many frustrations with my entire situation, and called my stay with this facility "hopeless at this point." So I was fired in a round about way, but I was not actually fired - I resigned immediately. Even if given a "second chance," how could I function in a place that would now microanalyze me so closely, that neglecting to cross a T or dot an I would probably result in termination?! So, I quit.

I just feel so pitiful right now. I always wanted to go to Med-Surg, but now I have second thoughts. If I can't even function safely in a REHAB hospital, why would I even THINK about a hospital? I'm going back to nursing homes until at least August (that will be my one-year experience) to work on my med. admin skills.

Sigh.. I don't know what to think. To do. To say. I just feel so hopeless with this career now. Everything I was taught in nursing school is for the birds. Most of it does not apply. And you're damned if you do, damned if you don't in this wonderful profession.

On a side note, I've NEVER had a patient complaint. In fact the CNO said my customer service skills often exceed expectatons, so at least I've mastered that. But anyone can do that. If only I were a REAL nurse. :(

[rn2bemle]

Your brand newish, don't beat yourself up! It will get better I promise! For some reason some nurses are jealous of new nurses and have to "prove" that they are better.......some not all! But just stick with it! Good Luck!

[kmom]

the six doses of hydrocodone 10/325 is quite questionable. did you misread the order? as far as the blood sugars are concerned...well, at your next job, get them before lunch. even if you know the policy (which is great) it is just a standard that fsbs(finger stick blood sugars) are performed before a meal.

i would have called the md for the b/p 101/58 to ask if they may have wanted it held. i wouldn't have just held it. remember, a nurse can use her discretion but still needs an order to hold an ordered medication. if the patient was caused harm by you not giving the medication, you could have been sued because the order reads systolic

we have all been in your shoes sometime or another. i dare say that those that are being so hard on you have never made a mistake. hang in there and just look for another job. nursing is 99% common sense - not book sense. know you p&p but use your common sense too.

[kimmie4476, ASN, RN]

Well, i can see both sides of the story, yours and theirs in this situation. First off, we are all human, and we ALL make mistakes. This is not a flame post, so please don't take it that way, I am trying to help :redbeathe

I think maybe you are in a task-oriented mindset right now and you need to try to get into a thinking style mindset. For instance, in the hydrocodone scenario, you just kept giving the hydrocodone (probably because the patient was in unrelieved pain right?) without thinking about how you were taking them halfway to a tylenol overdose (MAX is 4 grams in 24 hours, you gave them almost 2 grams in 6 hours which could cause liver failure), not to mention the possibility of respiratory failure from that much narcotic in such a short time frame) But the patient was still in pain right? so you kept giving it. At some point you need to stop and say "why am I giving so many pills in such a short time" the answer is the med is ineffective, call the MD and get something else ordered

As for signing out the med on the MAR, their explanation is the reason why it is so important, but I'd be willing to bet that most all of us have done that...I know that I have done it several times (I am working on it though). It's just your bad timing to do it on the day after your bad review. The same goes for the blood sugars.

Now, on to the blood pressure med. Technically, you did not make an error. If the order said hold for SBP

Here is my advice to improve. Take this scenario and run it over again in your mind..why should you call the doctor even though it is technically correct to give it? And don't just say "because their BP dropped after I gave it". I guarantee you will come up on this situation many times throughout your career and you need to know when to follow orders and when to question them

When presented with this scenario, here is a few things that go through my mind... how long ago was that BP taken, and what position was the pt in (side lying on the upper arm could make the BP lower, put the pt on their back and retake it to see what I mean) was the pt sleeping? Is this a change in their BP (are they normally 175/80 at this time)? what was their BP yesterday when the med was given?

Take this opportunity to go over all of the mistakes you made the whole time you were there and learn from them by trying to understand WHY they were mistakes and how you can keep from repeating them. You ARE NOT A COMPLETE FAILURE!!!!!! Please stop thinking that. You are new, and apparently no one who has trained you cared enough or knew enough to recognize what the problem is. You will find your place in this profession...please don't give up!

[nursel56]

Hey Zanatu- what I wrote may sound harsh to you, for which I aplogize in advance- but I really felt I had to write these things for better or worse. . .

[

QUOTE=ZanatuBelmont; I administered six doses of 10/325 hydrocodone within a six-hour period. This brought to question my knowledge about medication administration.

To the same patient? If so, honestly speaking- I wonder what you were thinking about giving ANY medication once an hour for six hours. Trust me, I'm no big meanie- but that calls into question more than the average medication error.

OK, fine. I can do that.

Point taken.

Without knowing you better, I can't say for sure, but these answers give the impression you aren't grasping how serious this situation really is.

Then I told my preceptor I had not collected the three blood sugars I needed to check before lunch. I then told him, "Don't worry, though - the policy and procedure guidelines state if in this case check the BS either one hour after (with an expected result

You've had your probation extended, you still have a preceptor. Yet, you chose not to do "blood sugars I needed to check before lunch" without running it by him and then challenged his authority based on a procedure manual? I would have "blabbed" (again, flippancy) to the nursing manager, too. If he appeared stunned, I doubt it was because of your awesome knowledge.

And finally, here's the kicker. I gave a blood pressure medicine to a patient with a BP of 101/58 and a pulse of 70. The parameter states, "Hold if systolic .

You seem to be very proud of your nursing interventions. That's fine, but that shouldn't even be on your radar screen when you discuss a med error. It's an error. Period.

how could I function in a place that would now microanalyze me so closely, that neglecting to cross a T or dot an I would probably result in termination?! So, I quit.

Sounds like you think they're just picky. They've bent over backwards for you. You then feel persecuted because they put the patient's safety first? Why do YOU think they want to microanalyze you?

Sigh.. I don't know what to think. To do. To say. I just feel so hopeless with this career now. Everything I was taught in nursing school is for the birds. Most of it does not apply. And you're damned if you do, damned if you don't in this wonderful profession.

Again, you are not taking responsibility for what happened. You say you are humbled, but that's not what comes across with these statements.

On a side note, I've NEVER had a patient complaint. In fact the CNO said my customer service skills often exceed expectatons, so at least I've mastered that. But anyone can do that. If only I were a REAL nurse. :(

YOU ARE A REAL NURSE!! The one and only reason I became very blunt is that you will get lots of replies of the hearts and flowers variety and I'm just being all Simon Cowell on you because I know you love this, and it's obvious. Please do some honest soul-searching and figure how all this happened, a through z. I sense you have great potential, I hope you make it and are able to adapt and grow in your profession as a nurse, learning from this experience!!

[al7139, ASN, RN]

Heres from a nurse who has worked on a tele unit since graduating:

First you will make mistakes...its' a fact of life just hope you don't kill you patient in the meantime.

If I had to be giving Q1hour hydro for however many hours, I would question to order and the med, since it's obviously NOT working. Switch them to something stronger that doesn't kill their kidneys.

Take responsibility for your errorslike getting blood sugars late. Do you realize that the before meal blood sugar is key in basal/bolus dosing?

If you feel like you are being held back, think about your errors. Do they want to put a nurse who doesn't stop to think on the floor, or would they rather put someone who has some common sense?

You learned it in school, now use it!

Amy