I hate those days where feel totally dumb

[carachel2]

I am new to the ER (4 months now) and I had a day yesterday where I hit NADA IV's (liver transplant patient, dialysis patient, etc.etc,....one right after the other) and a patient from a nursing home whose inner cannula of her trach kept popping out. I have NADA experience with trachs and felt totally out of my territory. Our hospital has eschewed the old proverbial skills lab that used to be required before you transitioned to a clinical area in favor of testing for critical thinking ability. I begged for a skills lab to bone up on all of these things that I had not seen for over 10 years.

Just had to say I hate feeling dumb. I do ask a lot of questions though.

[Dixielee, BSN, RN]

But there will be days you feel completely incompetant no matter how long you have done this. I have been a nurse for 32 years, many of them in the ER. For the most part, I feel like I have a good handle on things, then something will happen, and boom, you are that new grad feeling like a total idiot all over again. Don't be too hard on yourself. Our rewards come in small ways.

This did not happen to me, but it was my patient, I just happened to be at lunch when she came in...a 31 year old woman under a lot of stress at home came in hyperventilating and complaining of chest pain. No medical history, but a smoker. No other symptoms. The RN covering my lunch tried to get her settled in, put her on a heart monitor, got an EKG but the patient decided she did not want a male nurse, so he asked another nurse to talk to her as she was refusing all other treatment. In the mean time, she is settling down a bit, the chart and EKG went in the rack. The tracing was not a great one because she was so agitated and there was a lot of artifact. The first RN had glanced at it and there did not seem to be anything life threatening.

Next thing you know the doc looks at the EKG and freaks out (which he is prone to do), and starts berating nurse #2 for missing EKG changes and not letting him know up front. This nurse had never seen the EKG and was only subbing for the first nurse because of patient request. Anyway, it was a big deal with lots of hurt feelings, and the bottom line was that the changes were pretty subtle and the cardiologist said they were insignificant and sent the patient home.

Bottom line, both these RN's were seasoned, excellant trauma nurses, etc. it was just an easily excitable physician who over reacted. But it still made a lot of people feel bad when it did not need to happen. I was blissfully at lunch when all this went down!

So no matter how good you are, how long you have been doing this, there is always something out there to bring you down to a snivling, weak kneed child again. Now how is that for a downer!:rotfl:

Trust me though, it will get much better. Hang in there.

[carachel2]

Thanks everyone for your reassurance. I need to remember I have had days where I was equally just as competent....but they are hard to remember when you have a bady day, you know ?

[truern]

the ER (andf ER staff) so far has made me feel like a first year nursing student.

There are worse things...remember actually BEING a first year nursing student?!? :rotfl:

[acgemt]

Don't worry, I feel dumb about at least one thing a shift. Either that or I just do something completely random that I have no clue why I just did it. For instance. I was Multitasking my thermometer, pulse ox, and blood pressure. Well, the thermometer beeped, and I took it out, but for some reason I took the BP cuff off at the same time when it was still pumping up. My preceptor for the day just looked at me with the wierdest look, and I took a second and realized what I did. WHY did I just do that????? We all have those moments...just laugh about them later.:chuckle