I overcame my first year as a new RN and to top it off I got engaged!!!!

[Morettia2, BSN, RN]

So it has been a few months since I have ranted about work and what not. I have some good news to share, I got engaged August 30th while on vacation, and I celebrated my 1 year anniversary as an Rn at the Hospital the first week in September.

I can honestly say that I try not to let things make me crazy any more, but I kow as I write this I will jinx myself but I don't care anymore.

When I took a 2 week vacation at the end of august I was at the pinnicle of hating my job and life. I could not stand working at the hospital, I would crsy every night on my way to work and every morning on my way home. I got to the point I wanted to quit.

My 2 week vacation started, my fiance and I went to Cape Cod, where I used to vacaton as a kid and I absolutly love and was so happy I was able to share it with him, and we have a fab time. He asked me to marry him at sunset on the beach and gave me a stunning ring that I can't even believe it's mine every time I look at it, and the fact he did it at the place I hold close to my heart makes me melt.

I also celebrated my 28th birthday while I was on my 2 week vacation.

After my vacation I had a total attitude change about work. It was like something clicked. I know I am jinxing myself but I don't care.

I have been working more then ever. I came back with the attitude that I am only one person and I can only do so much in a 12-14 hour shift. I have also come to realize that I love working weekends, although we don't have weekend pay it's just less stressful on me and my fiance.

I ALSO noticed that I am no longer the new girl, we hired a few more new nurses, and I extend help to them b/c I know how it feel to be the chew toy. I also learned to SPEAK UP and it works!! I was always head strong but 2 weeks ago when I saw the new schedule and realized I was scheduled to work 4 12's in a week, and I did not sign up for OT and I need the day I went straight to my night shift assistant director and pointed this out. After alot of arguing and headaches and pointing out policy, I am not going to go into details, she realized I was right and took off that 4th day. I was shocked that I actually was able to stand up and fight for ME!

I also have realized that I have alot more friend at work then I realize. After I came back from vacation things seemed like they were different from a nurse to nurse point of view. I still get agitated but I have ways of dealing with it now. I also noticed all of my fellow nurses saying to me, "Congrats you passed your first year of nursing!"

One thing that did make me mad was I was written up for a med error. What happened was this RN, who works days, wrote me up for giving a med during my shift that the order was expired and the pt. was recieving the med regualry, but I didn;t realize the order had expied the previous day ,my bad. I was a little miffed, she has only been on my floor for a few months. I said to her, "I didnlt realize it was expired, but insted of bringing it to the point of writing me up why didn;t you just ask me and point it out and I would have called the MD for a reorder that morning before my shift was over?" Apparently she has a habit of wanting to write people up as a new nurse, and I learned my fellow collegues avoid her at all costs.

Well I went to work 2 weeks ago I arrived to work for my shift, my 3rd one in a row. I recieved report from the nurse who wrote me up. She was giving me back a pt. I had for the last few nights. When I left that morning I gave report to a different nurse b/c the nurse assigned to the pt. was going to be late , but the nurse I gave report to in the morning was familiar with the pt., when I left in the morning b/c this nurse was going to be late and left my cell and home # if anyone had any questions and said I would be back tonight and wanted the pt. back.

The pt's HgB was tanking and had been recieveing transfusions day and night. After I recieved report from this nurse I asked if the last unit of blood was done transfusing, she told me yes it finished 2 hours ago. I asked if there were any adverse reactions, the nurse told me no the pt. is fine, I also asked if she threw away the Y tubing in the BIO bin, she told me yes (now this was a weekend and not crazy busy b/c the nurse told me so...yeaaa, and she swore up and down that she finished the transfusion and threw away the tubing)

I went into the pt's room, the pt. told me how rude the day shift nurse was, I had the pt a few nights in a row so we had a nurse-pt. relationship. I looked at the bedside counter and saw a half a unit of PRBC's sitting on the counter with a full bag of saline and the Y tubing was completly full of blood and no saline flush at all, not even in the pump but just sitting on the counter.

I checked the tubing to see if one of the Y tubes was left unclamped, no both the saline and the PRBC's were clamped. OK..checked the chart to see if the nurse encased the unit with lasix as per MD's orders, no lasix was given. I checked the Pyxis log to see if any lasix was taken in the last 2-3 hours for the pt., no lasix was taken from the pyxis for that pt.

Now I have a half a unit of PRBC's that was never finished sitting in a mangled heap at the pt's bedside, it wasn;t properly tranfused, and even if it were, it was never disposed of properly, it was just sitting there on the counter.

I asked the pt., who was an ex-nurse if the dayshift nurse finished the transfusion, the pt. said to me, she just hung the blood and left, she didn;t even stay with me to see if anything went wrong or check my vitals 15 min into the transfusion, 30 min and 60 min into the transfusion. The pt. said to me, " I may be old, but once a nurse always a nurse and somethings you learn as a nurse are the same no matter how long you have been a nurse, I took my own vitals b/c the vitals machine was sitting right next to me, I wrote them down and told the day shift nurse, the day shift nurse just said to me 'honey this isn;t your fitst transfusion so there is no need for me to stay with you for the first 15 min, just call, you are an ex-nurse you know what to do"

I also asked my pt. if the entire unit of PRBC's transfused, the pt said no and also said the nurse never ran NSS after the transfusion or gave the lasix post transfusion.

I was SHOCKED and horrified that the day shift nurse did that. For someone who is keen and ready to write people up, she was very negligent during transfusion.

I did what all good nurses who are fair do, I called the nurse, it was only 30 min. after she left the hosp. She still claimed she transfused the entire unit and gave the lasix. I asked her agian, maybe she was busy and asked another nurse to finish it for her, the nurse still said she finished it and hung up on me.

What this day shift Rn who likes to write other RN's up, did not know is that at night we pick a new RN to do all the blood transfusions to get the experience and feel comfortable with blood, platelets ect... Eventhough I am no longer the new nightshift RN, I love doing blood transfusions, ect.. so I do ALL the nightshift transfusions on my floor, and I teach the new RN's who come to nights about transfusions, procedure, drug encasement and why the MD's order it, disposal, and policy.

I hesistated at first about weather to write this nurse up, but I gave her the benefit of the doubt, I even called her to see if she would just tell me the truth, I even said to her on the phone, if you didn't know what you are doing I can help you, but the last thing I wanted to do was write her up.

Then I realized, she wrote me up for something that could have been avoided, I was honest with her when I said I didn't realize the order was expired for the med I gave. I also knew I wasn't putting my pt. in imminent danger with an expired breathing treatment, the pt was asthamatic and CHF.

This nurrse on the other hand was putting her pt. in imminent danger when the day shift RN said to the pt., "since this isn;t your first transfusion you should be fine and since you are an ex-nurse you know what to do if anything happens." AND she never encased the transfusion with lasix as per MD's orders. A CHF pt. recieving a transfusion always has the danger of going into fluid overload. 250cc's of PRBC's and a saline flush...for a CHF pt. you do the math.

My pt. had ZERO urine output for about 3 hours, I called the MD and relayed the message that only half the unit had been transfused during the day shift, HE was PEEVED. He asked why, thank god he knows me WELL and was not mad at me, I said to him, "I am trying to reconcile why the unit was only half transfused, but when I get the labs in the AM, if the HgB is still below 7 do you want me to write an order for another unit to be tranfused STAT, I will even stay and do it my self", he said, "Ang, write the order if the HgB is

So that is when I made up my mind, I wrote that day shift nurse up. My first time ever doing it, but it wasn't retalliation b/c she wrote me up, it was show her sheer negligence and endangerment for pt. care, safety and well being. I hope I never have to do it agian.

Ok rant over, I have loved to embrace my job, I have always loved being a nurse and I always give 110% to my pt's no matter what, I have just learned to roll with the punches and have my bad days but I have also learned WHEN LIFE HANDS YOU LEMONS, YOU MAKE LEMONAID or you just get lemonaid and add some vodka to it, makes for a better time hahahahahaha:yeah:!!!!

[lpnflorida]

You did what you needed to do.

I have never had difficulty if I discover a med error writing the incident report whether it is on myself or someone who is unavailable to write the report themselves. If I know they will be back at the end of my shift as we work 12 hours. I wait until I see them and tell them the error letting them know they need to write it up themselves. If they will not be there for a few days I will call them. Then per policy I have no choice but to write it up as it has to be into the Risk Management department within a set time frame.

Med error, treatment errors are learning tools, not tools for punishment. Unless of course a nurse is making too many med errors in which they may have to take a med safety course of some kind.

I keep the reports simple, such as error of omission. give the facts, check with nurse, checked pixis med apparently not given. Let the powers that be look into it further.

You might again suggest willingness to give additional training to this person in regards to transfusion administration. Or if you can find a policy print it up and give her a copy to review at her leisure.

[SuesquatchRN, BSN, RN]

Mazel tov!

[nickos]

1.) HAPPY BIRTHDAY!

2.) vacations are great...and necessary!

3.) CONGRATULATIONS on your engagement! (and first year as an RN!) :)

4.) She screwed up in SO many more ways than one.....and to not admit it....wow. If I was that patient, that doctor, or you? I'd be IRATE.

[dreamon]

Congratulations on your engagement and your first year!!

[nrsang97, BSN, RN]

Happy belated birthday and congrats on the engagement.

[Straydandelion]

Congrats on the engagement! The facillity I worked at ALL med errors required a written incident report by whoever discovers it first. There was no question whether to write it up or not, if not written up it would implicate you also yet it looked better if you discovered it yourself. The blood would have been considered also in that category requiring a write-up.

[texas2007, BSN, RN]

Congrats on your anniversary and engagement! From what you wrote, it sounds like you needed a nice long vacation away from work. I'm looking forward to my own week away from work coming up in a few weeks.

That day shift nurse is just stupid. To say she did all that and then it's sitting there in plain sight on the counter? Sounds like she never even went back to the patients room after the first transfusion. I'm glad you wrote her up, she needs to be more careful!