Published May 22, 2011
neeke816
22 Posts
Okay, I've been in med/surg nursing about 10 months...
I had made some stupid mistakes but not too serious so far, but I made 2 big mistakes in a row on Thursday.
That night was the busiest night I've ever experienced..
Pt 1. He was uncontrolled DM, and supposed to go to surgery, but refused sign any consents, which is fine...
His glucose was over 500 (it was running high over 400 all day), and I meant to tell a charge about it after I gave him his scheduled insulin/lantus shot, but before I told her, she came up to me, and told me that I have to prioritize more wisely, which put me on shame.. After that, I called Dr. and got orders 1) Check his glucose every one hr, 2) Give 10 units of IV insulin every one hr until his glucose is less than 300. It's ICU stage order, and I was getting transfer from other unit too, so it was just like hell already...
Pt 2. Very confused DNR patient with RR over 30, oxygen sat 81%, very clammy and wet.. I really worried that I might lose him that night. The bad thing is Dr. ordered him bipap, and I gave him PO Ativan to calm him down, since he kept pulling his mask off, but I didn't know that I can't give PO meds to Bipap pts, since nobody ever told me or maybe I forgot...
Luckily my charge caught me right after, so I took off his bipap, and thank god, no chocking or anything. However, somebody called me when I was about to give him his veni mask, and I totally forgot to put him back with oxygen!!! Lucky again, my charge caught me again, and no harm to patient, and his oxygen sat/ABG was much better later, but I felt really ashamed and stupid... I could cause really serious troubles!!! I was really busy between pt 1 and this pt 2, but that can't be an excuse, and I feel like bedside nursing is probably not my thing..
Pt3. His BP was 200/70... I gave him Dilaudid and he was asymptomatic, and it came down to 160/60..but that was stressful when I was in middle of pt 1 and 2.
Pt4. I was getting a tranfer from PCU, so that was busy, and I forgot to put her on telemtry until my charge told me so..
Pt5. His PCA wasn't working and kept beeping!!!
So, I had the worst night shift I've ever had... It was the worst, I had some bad nights for real, but that one was really bad, and I was sooooooooooooooooooooo ashamed of my stupid mistakes... I feel so incompetent, stupid, and worrying about getting some warning or fired from my job. I have to go back to work this Monday, but I'm really afraid of going back and so disappointed by myself...
PinkRocksLikeMe
122 Posts
Honey, I am not a nurse, just a student, but I am a EMT and I have had bad nights were I left my job wondering if I should even pursue my dream of being a nurse. I beat myself up with how stupid, how this how that I was. Bottom line is this...You had a bad night, you made mistakes, but you LEARN from them and you become a STRONGER, BETTER nurse.
Right now at this moment you feel so bad but I promise a new day will bring a new perspective. You can do this, and you will be OK. Good nurses make mistakes, better ones learn from them.:)
Hang in there,
Jenn
Thank you soooooo much Jenn. I really appreciate your sweet words!!!
No problem!! Let me know how things are going and I will keep you in my prayers OK...
Stcroix, ASN, PhD, RN
450 Posts
neeke816, I too am but a student, but by the description of your patients...man what a night! It is my humble opinion that even a seasoned battle hardened nurse would have been stretched to the limit. Hang in there kid, not every day is gonna be like that one!
Sailingshoes
93 Posts
I don't think you are stupid! That's a crazy night and you are a new nurse. I am a 12 year nurse and I wouldn't want that night and I am so glad to not work med-surg anymore. For me, even with experience, med surg can get too crazy and you multi-task exponentially. Learn from your mistakes, ask for support if you need it. Also, remember there are many differents types of nursing if this is not "your thing". Good luck!
laynaER
228 Posts
It's okay we all have those days and your mistakes weren't life threatening. Use it as a learning experience. Don't be so quick to quit or say it's not for you only because of one bad shift. I'm pretty sure this isn't the last bad shift you're going to have. We tend to be so critical and harsh on ourselves. Don't beat yourself up. Use your day off to relax, clear your mind, and mentally and physically prepare yourself for your next shift. You are still learning you will be alright, it will make you a better nurse!
Millions of thanks to all of you guys!!! I will do my best to chin up and focus on my patients!!! God bless you all!!!
iwanna
470 Posts
Aww... You had the night from hell. It wasn't you - it was the circumstances and patients. You can always find another area of nursing.
*Posh*
52 Posts
We all have these kinds of shifts... Had one myself last week. My question is, instead of criticizing you, why wasn't the charge helping you? She was obviously watching you pretty closely anyway.... Learn from it, hold your head high and go back to work like nothing happened. This is what makes us stronger nurses!
eriksoln, BSN, RN
2,636 Posts
Two things came to mind for me:
1. I notice a trend with a lot of these threads that have a "I don't like nursing anymore" theme to them: Most of the topic creators are either working M/S or LTC. Do with that what you will.
2. I read through your list of things you did during your day and what I couldn't help but recall something I learned while short order cooking that helps me with nursing: Learn good technique and insist on sticking to them even when you don't think its not as important to. They good technique will become habit and pretty soon you'll be doing things right by accident.
The person who told me that was trying to get it into my head to cook like its busy at all times, even when its not. When I was a newer nurse, I left things undone/wrong all the time until I applied this attitude to things again.
AOx1
961 Posts
Yes, 2nd what eriksoln said. Develop a routine that works for you. When I was new, I took a few minutes to organize my day at start of shift on a paper. I had a master sheet with a column for every patient, and rows for each hour. I would place a check in every box as needed. Ex- check in box for 7am fs, check for earliest time to give meds, do assessment etc. This helped me visually see what times a day were busiest and plan accordingly. We did walking rounds, so I would introduce myself, ask if pt had immediate needs then (ex-pain). Chart check. Brief look at any am lab results, then I loaded cart with common items (ex- ice bags, extra towels, etc). I would then do more thorough assessments and am meds. Review vitals, document, check again, recheck chart, etc. I would try to document after rounding in a time frame that had less check-boxes filled on my schedule. Did things sometimes get off plan? Of course! The early morning shift-change code, the huge code brown, the confused line-pulling patient all add in stress. But like eriksoln is saying, preparation and organizing your thoughts and time will make even the worst days a bit less stressful.