I am not good at nursing

JKL33 · May 27, 2019

11 hours ago, Lostinorlando said:
I gave IVP ativan to a patient who was scared of an MRI. I gave it at the time it was scheduled, instead of holding it for the MRI, which hadn't called yet. Although it was scheduled, the parameters stated to hold for MRI. How can I explain this to my assistant managers and manager? I know I was wrong, and I was rushing. Luckily I was able to get the patient to the MRI right away, but it doesn't excuse a mistake.

You learned a valuable lesson that rushing with medication administration is/could be dangerous. Concentrate on being mindful with each step of checking the 5Rs and doing the administration process. Prioritization gets easier with time/experience, but we can't ever really afford to rush to the point of not being able to focus.

Ask your manager if s/he can take a couple of minutes to talk about the scenario with you. You did a good job troubleshooting after you recognized the wrong timing.

umbdude, MSN, APRN · May 27, 2019

Learn your lesson and move on. There are so many distractions when working as a nurse mistakes are almost inevitable. The fact that you feel bad and care about mistakes makes you a caring nurse, IMO. Good job on getting the patient to MRI right away.

Jedrnurse, BSN, RN · May 27, 2019

7 hours ago, panurse9999 said:
This post screams of a new grad with unlimited potential and zeal, who is being systematically cut down and put down by a toxic nurse manager. I am sad to read a post like this. I have walked in these shoes. I have had my confidence robbed by a pack of dysfunctional unhappy nurses, whose only goal was to deep six a new nurse. They want you to doubt yourself and ultimately walk away, so that they are perceived as "indispensible" goddess nurses within the organization.
This is the toxic culture that lives in the hospital systems like a pandemic virus that is near impossible to eradicate. Its 20 years since I walked that walk, and it seems nothing has changed. My advice is keep your chin up, keep your confidence up. Do not let them destroy you. I would also document your experiences as a new nurse, with specifics , dates and times. When the time is right FOR YOU, and you can get out with enough time on the job to lead to something else, hand that documented list into the appropriate people at the highest levels of hospital management.
I remember one time using a 5cc syringe nss flush instead of a 10cc syringe nss flush on a PICC line, (because we were out of the 10cc flushes) and was told that I was incompetent, and could have blown a hole in the line. DO NOT LET THEM TAKE YOU DOWN.

Unless I misread the OP's initial statement, there was no information about management's response at all. How did you leap to "being systematically cut down"?

Kooky Korky, BSN, RN · May 27, 2019

21 hours ago, Lostinorlando said:
I need advice please. I’ve worked as a nurse with a BSN for 6 months; and I’m terrible at it. The patients like me, but that’s just bedside manner. I continue to do things wrong. I made one medication error where I didn’t have the correct time. No one was hurt, but this mistake is huge and I have really tried hard to be a good nurse however I just can’t cut it. I work on a busy telemetry stepdown floor for mostly cardiac patients post TAVR. I am book smart, not nurse-on-the-floor smart. My question is what can I do with my BSN career now? Are there any options? I’m willing to go to graduate school but what can I do to with a BSN besides this?
p.s I doubt the hospital would hire me on any other floor, even an “easier” one. I failed here, I’m unsafe as a floor nurse.

Girl, please. You are ridiculous if you are giving up so soon.

A med error that didn't do any harm? Please. How is it "huge"? Every error is "huge", but learn from this, don't flip out like you are doing.

I wonder who is messing with your head?

Is your preceptor any good? Does your Manager build you up or tear you down? What are your coworkers like?

I was down on myself as a new nurse and my boss told me to stop self-flagellating. It was good advice.

Kooky Korky, BSN, RN · May 27, 2019

7 hours ago, Kallie3006 said:
I once gave a 1x dose of ativan for a patient that the neurosurgeon wanted to watch his EEG on. The doc told me he was ordering it and for what so once it came up to pull I did so and pushed it, then told the doc. Was the doc ready to go? Heck to the no. The day was crazy and I was trying my best to stay afloat. I had been a nurse for 3 years when this happened.
A nurse I used to work with guy a patient from PACU who was in a lot of pain when they got to the floor so she gave the ordered prn pain med. She failed to look at the mar to see when it was given last, and it was to soon. She had been a nurse for over 10 years.
I went to a new hospital and learning the charting was horrible for me. This system was awful, and I still stand by that. I missed a whole rotation of antibiotics, new orders and lab results. I swear being experienced was a disadvantage, it was horrible. I now charge on that same unit.
Book smarts is wonderful until it's not. You are learning to draw connections between what you learned in school and how it applies to your patient population. A+B=C or D or Y and YLMK, school teachers you A+B=C and the rest comes with time and practice.
If you can go in early and read over your patients info, get labs and imaging results, write meds and times down, and your orders for the day, then use this to get you a game plan down. Cluster your care when possible, and ask questions. I used to write down different diagnosis and meds used and studied them, then when I would get a patient with said dx I would have an idea of what to expect. Get you a brain, one that works for you so even through the chaotic times you have a reference of what is due and when. Get organized.
Have you thought about nights? Nights has it's own set of advantages and disadvantages but generally the pace isn't so fast like days, you usually don't have many admits or discharges. This could help you feel more comfortable in your work environment and you critical thinking.
You sound like you are someone that is willing to learn, accept when mistakes are made to learn and grow from. Don't give up yet, you're still new.

I don't know that adding Night shift (making the adjustment of her whole sleep/wake cycle, her whole family and her whole life) is necessarily for the best right now.

And Nights can be nuts, too, depending on where you work.

Crystal-Wings, LVN · May 28, 2019

*sigh* nobody is good when they first start out. 6 months isn't enough time to determine anything.

Oldmahubbard · May 28, 2019

This is barely an error, because the ativan would be in the person's system for several hours in any case.

So much of what an RN does is coordinating timing, there are bound to be occasional errors.

SaltineQueen · May 28, 2019

14 hours ago, Kooky Korky said:
Girl, please. You are ridiculous if you are giving up so soon.
A med error that didn't do any harm? Please. How is it "huge"? Every error is "huge", but learn from this, don't flip out like you are doing.

I'm glad I wasn't the only one thinking it.

You say you "continue to do things wrong." What else has happened? Because if you're basing your failure as a nurse on this ativan issue you're just flat out wrong.

Workitinurfava, BSN, RN · May 28, 2019

So what you are saying is you are not perfect, and I am so shocked because you are not suppose to ever make a mistake. Are you happy now? I am kidding. If I knew now what I knew back when I started as a nurse, things could have went smoother. Nursing is not easy and neither is telemetry. Do you feel supported in your enviornment to learn? If you don't like medsurg and would fare better away from those types of jobs, then that is one thing. I did a lot of medsurg stuff and just didn't like it. I am doing psych with a small dash of medsurg and I am happier. It is easier to start out high and come down low versus the other way because if the other way, you will need to be on your toes and alert to get the newer more difficult way down. It is easier to build up slowly for some people. I am at a place that I don't want to run from. I have seen all the bad but I still feel like, hey I got this. If you feel too overwhelmed to the point you can't think, then you need to evaluate this carefully because it is like working impaired. No matter what, you can't think straight enough to work safely and that won't be good. Prior to the mistake did you feel like you could think straight?, because on tele floors things can change quickly and patients sometimes have to go to the ICU. You can take care of critical care type patients and not even know it until you are sending them to the ICU. You will have all sick, high acuity patients. There is a big learning curve so you have to think straight and be up to the challenge, otherwise get your time in and do something else or walk away to save your license but know that you will need to take something you may not want, like rehab, regular medsurg etc.

Golden_RN, MSN · May 28, 2019

I have made two med errors that I know of and I will always beat myself up over them, even many years later! In retrospect, there have been other times that I didn't make the right decision, wasn't assertive enough, shoulda coulda woulda...

It does not mean we are horrible at nursing, but that we are human, always learning and growing from what, at the time, feels like the end of world (but usually is not).

Don't give up and if you REALLY want to transfer to another unit, one med error should not prevent that!

peacepilgrim66, ADN, RN · May 28, 2019

Mistakes in the mechanics of being a nurse will never convince me I am a "bad" nurse. Nursing to me is how we approach a living human being and the struggles they face in their health. You have a license and endured nursing school like we all have. Keep your chin up, things will get better. You'll find your niche and ever wonder why you doubted yourself. You are in good company here. Easy Does It.

Ruby Vee, BSN · May 28, 2019

On 5/26/2019 at 7:32 PM, Lostinorlando said:
I need advice please. I’ve worked as a nurse with a BSN for 6 months; and I’m terrible at it. The patients like me, but that’s just bedside manner. I continue to do things wrong. I made one medication error where I didn’t have the correct time. No one was hurt, but this mistake is huge and I have really tried hard to be a good nurse however I just can’t cut it. I work on a busy telemetry stepdown floor for mostly cardiac patients post TAVR. I am book smart, not nurse-on-the-floor smart. My question is what can I do with my BSN career now? Are there any options? I’m willing to go to graduate school but what can I do to with a BSN besides this?
p.s I doubt the hospital would hire me on any other floor, even an “easier” one. I failed here, I’m unsafe as a floor nurse.

At six months, you're not going to be good at nursing. It takes at least a year -- sometimes two -- to become confident and competent. Being "nurse on the floor smart" is critical thinking, and if you cannot do that graduate school isn't going to help. We don't need book smart CRNAs or NPs who cannot think critically. But I'm not convinced you cannot become "nurse on the floor smart." At six months, it is too soon to tell.

What did you learn from your medication error? What have you learned from your other errors? If you are truly smart, you will learn something from each error you make. Keep learning, and you'll become a good nurse.

You don't say you've been fired or asked to resign, so I'm hoping you still have a job. Take some time and a hard look at yourself and your practice and decide how you can best learn to improve. And then work on that.

I was a horrible nurse for about my first year, but with time and practice, I got better. You will, too.