Jump to content

I’m a new graduate working for a month and have had 3 incident reports made about me

Posted
by Taito29 Taito29 (New) New Nurse

Hi all, I started working as a RN a month ago and I’m worried that I’m not doing a good job. Last week I got called into the num’s office to do discuss two incidents that occurred a couple of weeks ago. One concerning a doctor complaining about me due to their patient not going to X-ray in time. Another one about a medication chart being filed as finished when the new form had not been filled out correctly ( I would not do this but coped it on the chin). On Friday I made a medication error. My buddy’s patient required some PRN pain relief and I gave them 1g paracetamol not realising that patient was also written for regular paracetamol three times a day. My buddy told me the error and spoke to the charge nurse. I completed a incident report but I am now concerned about the impression I am making at the job. I’m so stressed that my num will feel I am useless. I am extremely worried that I am failing as a nurse. I have booked in time with my facilitator for a debrief but questioning if I approach my num tomorrow about the error as I feel it is the right thing to do but am extremely nervous. I am really looking for any insight into what I should do! At this point I’m questioning my whole career choice!

Edited by Taito29

LovingPeds, MSN, APRN, NP

Specializes in Clinical Pediatrics; Maternal-Child Educator. Has 11 years experience.

Most people who just start out working as a nurse have a difficult time with it. There is an adjustment period that occurs with novice nurses until they gain some experience. A lot of nurses feel like they aren't doing their best or don't even feel competent until about 1 - 2 years into their nursing career. You're going through a normal adjustment phase.

Everyone in nursing makes mistakes. The important thing is that they are acknowledged, addressed, and a process put in place to improve so that they are not repeated. If you approach your num (manager? preceptor?) tomorrow, be honest about your mistake and tell them any plans you have to prevent the incidence in the future.

Hang in there!

Edited by LovingPeds

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 40 years experience.

A doctor complained that the patient didn't get to x-ray on time? He needs to get used to disappointment. Then you copped to a paperwork error that wasn't yours and then you made a med error.

First of all, never own anything that isn't yours, error-wise. "Sorry, I didn't do that." If you own up to the errors that you do make, you will have more credibility when denying the ones that aren't yours.

How did you make the paracetamol error? Did you have an order for 1 gram? Did you misread the order, or follow a standing order before ascertaining that the patient was receiving regular doses? This one is the real error and should be the only one anyone is interested in.

I'm not trying to minimize anything and you're right to take med errors seriously. But from your post, this is all new grad stuff. Hang in there.

1 minute ago, TriciaJ said:

Thank you for your reply. So the patient was not mine but the nurse I was working with. Panadol was prescribed twice. One as a regular and was as required accidentally. The patient was given regular 0800 Panadol 1g. I walked past at 10:30 and the patient asked for pain relief. I asked the patient if they’d any today they replied no. I did not check the regularly given medications but rather gave them the as required 1g Panadol. This was my mistake. I was in a rush and did not double check the medication chart! Fortunately the patient was not put at great risk but it was a mistake.

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience.

There are two kinds of nurses: those who have made med errors, and those who will.

Don't let yourself get too worked up about these mistakes. You've learned from them, and like someone else already said, they are the kind most new grads make. Just do your very best and take your time doing tasks, even if it seems like you must complete them quickly. Better to be a little too slow than go too fast and make further mistakes.

Good luck to you. You'll get it. It just takes time.

BSNbeDONE, ASN, BSN, LPN, RN

Specializes in Med/Surg, LTACH, LTC, Home Health. Has 35 years experience.

Where is your preceptor while all of this is going on? Around these parts, new grads are like conjoined twins with their preceptor for AT LEAST the first month, and then they’ll take on their own patients (two to start), and gradually increasing the load. They are NEVER left to cover anyone else’s patients during that time unless their preceptor is also covering them both.

Been there,done that, ASN, RN

Has 33 years experience.

1 hour ago, BSNbeDONE said:

Where is your preceptor while all of this is going on? Around these parts, new grads are like conjoined twins with their preceptor for AT LEAST the first month, and then they’ll take on their own patients (two to start), and gradually increasing the load. They are NEVER left to cover anyone else’s patients during that time unless their preceptor is also covering them both.

Your preceptor is the one responsible for the errors. He/she is there to guide you and prevent the errors in the first place.

BSNbeDONE, ASN, BSN, LPN, RN

Specializes in Med/Surg, LTACH, LTC, Home Health. Has 35 years experience.

2 minutes ago, Been there,done that said:

Your preceptor is the one responsible for the errors. He/she is there to guide you and prevent the errors in the first place.

^^^EXACTLY!

Unfortunately I have been unable to work with my preceptor since my first week. In my hospital we get 4 shifts with our preceptor sharing the load and then you work with your preceptor but both taking your own 4 patient load. I feel like this issue has definitely impacted me and these mistakes as I have not got the support I need or require. I will be working with her all week this week so I will be discussing my concerns with her (I live in Australia so it’s a bit different to other programs internationally).

Edited by Taito29

CharleeFoxtrot, BSN, RN

Has 10 years experience.

3 hours ago, TriciaJ said:

....First of all, never own anything that isn't yours, error-wise. "Sorry, I didn't do that." If you own up to the errors that you do make, you will have more credibility when denying the ones that aren't yours.

^this right here is the most important lesson you need to carry forward. Never, ever "cope one on the chin" for something you didn't do. Say that you didn't make (whatever) error, and then sweeten that with something along the lines of "thank you for the reminder to be careful"

BSNbeDONE, ASN, BSN, LPN, RN

Specializes in Med/Surg, LTACH, LTC, Home Health. Has 35 years experience.

3 minutes ago, Taito29 said:

Unfortunately I have been unable to work with my preceptor since my first week. In my hospital we get 4 shifts with our preceptor sharing the load and then you work with your preceptor but both taking your own 4 patient load. I feel like this issue has definitely impacted me and these mistakes as I have not got the support I need or require. I will be working with her all week this week so I will be discussing my concerns with her (I live in Australia so it’s a bit different to other programs internationally).

Oh I see. I don’t agree with it at all, but I see. I hope they change the practices very soon before someone is seriously injured.

No matter the country, how anyone could determine a brand new nurse competent enough to practice independently is just beyond reason, in my opinion.

Been there,done that, ASN, RN

Has 33 years experience.

1 hour ago, Taito29 said:

Unfortunately I have been unable to work with my preceptor since my first week. In my hospital we get 4 shifts with our preceptor sharing the load and then you work with your preceptor but both taking your own 4 patient load. I feel like this issue has definitely impacted me and these mistakes as I have not got the support I need or require. I will be working with her all week this week so I will be discussing my concerns with her (I live in Australia so it’s a bit different to other programs internationally).

All of us would need more support than one week. Even if you each have four patients, your preceptor is still responsible. I realize things are much different in Australia. But in the U.S. I precepted a hundred nurses and felt responsible for them all of the time I was teaching them the ropes.

Best of luck with this mess, let us know how it's going.

Preceptor surely is not responsible for this type of action, even if the OP was still paired with him/her. No. If a new nurse happens by and decides to medicate someone else's patient that is on them.

***

Anyway, @Taito29. I agree with previous comments, we have all made mistakes. The error you made with the acetaminophen is easily made, it has been done before and there's no reason that this type of error hasn't been eliminated by our processes and technology. This patient pretty much shouldn't have had a PRN order for this at all if he already gets 3g a day at baseline.

But, even though you are new, you have to take steps to tighten up your own practice. You said

4 hours ago, Taito29 said:

I was in a rush and did not double check

You can't afford to operate this way. There is a lot of pressure on nurses and you have to decide early on that you're not going to compromise patient safety by succumbing to it. You need to understand that much of the pressure on nurses is directly due to decisions that other people have made. We are not on solid footing when we compromise patient safety when we rush around and don't pay attention while trying to make up for others' decisions (like staffing or having an inappropriate orientation). Uphold the basics you were taught in school.

[I commend you for addressing the need you became aware of but you are so new and have had some sort of very short orientation, you're still in the stage where perhaps the best thing you can do about the needs of other nurses' patients is to let the nurse know of the need so you can stay focused on your own patients for now.]

You also said that you copped to an error you didn't make. This, too, reinforces my thought that you're displaying an MO of accepting responsibility for other people's problems, to your own detriment and your patients.'

Take a deep breath. It'll be okay. You need to refocus. Do what you were taught in school. Stand tall, be proactive, don't get distracted trying to do everything and please everyone.

👍🏽

Been there,done that, ASN, RN

Has 33 years experience.

37 minutes ago, JKL33 said:

"Preceptor surely is not responsible for this type of action, even if the OP was still paired with him/her. No. If a new nurse happens by and decides to medicate someone else's patient that is on them."

Must disagree. I made it clear to all of my new grad orientees not to give meds without running it by me. We passed all meds together. We could then discuss the rationale and biological action, and most importantly review the MAR before administering. If they still pushed a pill without me.. still on me for not making my instructions clear enough.

Edited by Been there,done that

LibraNurse27, BSN, RN

Specializes in Community Health, Med/Surg, ICU Stepdown. Has 8 years experience.

The error with the parecetomal (is that Tylenol?) was a systems error, not your error alone. Dr. prescribed it that way, pharmacy approved it, MAR did not warn you about the total dose. Our MAR has a warning when you're getting close to exceeding 4g in 24 hrs, and I think they changed it 3g. We are supposed to check it manually as well, but many don't since we have the warning or just don't think to check.

For pt safety and others to learn, bring it up as a systems error. Don't discount your part in it, but don't take full responsibility. Also as a new grad with minimal training (so unfair!) don't try to help out with others' pts. You may feel you're burdening other nurses with questions or needing help, but that is for pt safety. You can help out later! Good luck!

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 40 years experience.

Reading all the subsequent replies made something jump out at me: one important quality the OP needs to develop is assertiveness.

The doctor grousing about when someone gets taken to x-ray? Tough beans. Looking after someone else's patients during orientation? "Sorry, I'll get my preceptor." Never take a patient's word for what meds they've already had. Regular acetaminophen plus a PRN that exceeds daily limit? Bad order that needs to be addressed.

Someone pegged it right. The OP is busy trying to please everyone. Great way to get thrown under one bus or another.

OP: while you're developing your nurse brain, don't neglect your nurse spine. You will need it every bit as much.

Nurse Beth, MSN

Specializes in Med Surg, Tele, ICU, Ortho. Has 30 years experience.

If I were your unit educator, first of all, I'd be honored, because you sound wonderful. You are not blaming others and you are learning from your experiences. Best wishes and believe in yourself.

KatieMI, BSN, MSN, RN

Specializes in ICU, LTACH, Internal Medicine. Has 8 years experience.

1 hour ago, TriciaJ said:

The OP is busy trying to please everyone. Great way to get thrown under one bus or another.

1000%