I am freaking out!

[qcnursingstudent]

Tonight was my third shift on my own. I am a brand new nurse with basically no experience. At my facility, we have report sheets already made that lists the resident, room number, code status and how they take their meds, etc. I came to my shift and took report, we had a resident who was lethargic for two days, aroused by stimulus, with a low grade temp, no appetite, etc. Got orders for a UA, CBC and BMP. I called the covering when I got the results and she asked me if he was a DNH. And I checked my report sheet which said he was so I told her he was. She ordered a chest xray. We got the chest xray and I called her back when I got the results. She asked me what the protocol was for someone who is a DNH but needed to be sent out.( I had reported off to the 11 to 7 nurse already but waited for the covering's phone call. ) I told the covering that I am new and wasn't sure. So I asked the night nurse who has more experience what the protocol was and he said we can send him out and then call the family. I told the covering that and she asked if it's OK if she spoke to the night nurse. Finally, the night nurse double checked the chart and saw that he was NOT a DNH and we got an order to send him out. I felt so bad because I delayed him being sent out because I did not double check with his MOLST sheet.

I learned a very valuable lesson today but I am still freaking out over it. I really hope I didn't hurt the resident... Being a new nurse is so scary and today was just my third shift on my own.

[jadelpn, LPN, EMT-B]

So don't freak out! Going forward, make sure you know code status BEFORE you call the attending. Or as you are talking, look.

If we are talking about sending people out, that is usually handled by the charge nurse or house supervisor.

Going forward, I would talk to your supervisor about what the policy is on transfers. Who is responsible to transfer. And if the attending wants to speak to the family or not. And if the patient was unresponsive, the HCP would be contacted by the attending to discuss options. And unfortunately, sometimes the HCP can decide to do something very different than what the MOLST says.

Team sport, know your resources.

[qcnursingstudent]

It was definitely a learning experience! The patient wasn't unresponsive. He was lethargic but I was able to arouse him with stimuli. I feel like that was such a huge mistake and I feel horrible for delaying him treatment. I am sure to be better prepared for next time a situation arises.

[vanilla bean]

Brace yourself. Get ready for things like this to happen 1,000 times over the next year or two. You're a new nurse. Cut yourself some slack for not graduating from nursing school being omniscient about how to complete every aspect of your new job. We all have to go through the learning pains of a new role - it's just that the stakes are higher when it's a healthcare job. Unfortunately, sometimes this is how you will learn different aspects of your job.

Allow me to share a personal experience...from just last night. I'm also a new nurse (although not new to healthcare) and experienced my first code last night in my new nursing role (instead of my former role, in which I was completely comfortable and confident). My charge nurse asked me if I could record... I said, "I'll try" (having never been instructed in what exactly is required in this role - I mean, someone else always did this when I was at a code! lol). Well, I did my best and accurately recorded what was happening - what time the code was called, when compressions started, when they stopped, when other interventions happened, etc. When the patient was stabilized, my code nurse was stunned to find out that I had not recorded a single vital sign. Oops. Luckily, the patient was on a monitor, so we were able to retrieve the info that I dropped the ball in obtaining. As a result of my botched first attempt, now I know how to accurately perform my role as the nurse recording a code.

Take heart. Every single fabulous nurse you will ever have the have the pleasure of coming across has been a new nurse and been through what you and I are going through. My advice - learn from your successes and failures and continue to grow. At least that's how I'm attacking this new challenge.

[qcnursingstudent]

Thank you for the encouragement! It's going to rake me a long while to become confident. Right now I'm just nervous and feeling scared. I've literally only been a nurse for 3 weeks!