I have really messed up.

[Heather A.]

As I am writing this I am completely distraught so if this doesn't make sense, I apologize in advance. I am a new nurse (my 1 year anniversary is this month) and I have been working in L&D for my whole 1 year career as a nurse. Up until today, I have felt like I was a good nurse. There are many times when I still feel unsure and lost, but I feel like I am learning a lot and that I take good care of my pts. I love my job as an L&D nurse, I feel that over the past few months I have earned the respect of the physicians I work with and the management. I have had numerous patients make positive comments about me on surveys, and even had the highest number of positive comments this past quarter for our entire dept. All of this is well and good, but fast forward to the events of a day ago.

I was working on what was an extremely busy day in our unit. I offered to watch another nurse's patient for a few minutes while she did a delivery on another pt. While I was looking out for this pt., the MD came in and decided to do a C/S on her, right then, for failure to progress. I went back to circulate the case and handed off report on my other patient to another nurse. The whole scenario was a big mess, a big HURRIED mess because the MD wanted to hurry up and finish the C/S before the next scheduled C/S was due. The case was proceeding well, I performed my counts before the case started, upon closure of the uterus, and upon closure of the peritoneum. All were correct. Just before the doc closed the skin, I performed my last sharp/ sponge count. I counted 10 laps in the kick bucket, 3 on the table, and what I thought at that moment was 2 on the pt. That makes 15. The case ended, and I proceeded to gather washclothes, ect. to clean up the pt. and hurry on to the recovery room. When I approached the drape covering the pt., at this time I only saw 1 lap, not 2. I froze. I KNOW beyond a shadow of a doubt that I should have stopped right then, went and got the doc, and redone the lap count. But I was scared. Scared and intimidated, afraid to inconvenience everyone because they were in a hurry, and just plain spineless. I hate myself for this, but I didn't say anything at that time. I knew, logically, that all the laps had to be there because my first 2 counts were absolutely correct. I am such an idiot; I took that pt. to the recovery room and didn't say a word.

It ate me alive. I couldn't sleep last night, I can't eat, I just cry. This AM when I woke up I couldn't stand it. I phoned my nurse manager and told her the entire story. She was very upset with me; I deserve that. But THANK GOD she did say she would talk to the doc. and do an X-ray to make sure. She did say that there was really no where the lap could have got off to since the first 2 counts were correct, but she was quite cold.

She just called me back and THANK THE LORD there was no laps inside. I am so glad and relieved because I was so worried about the poor pt. I could never live with myself if my lack of courage had caused her pain or worse. My nurse manager was still very cold to me, she proceeded to tell me that I would be written up and that the doc. on the case was furious with me. She said to expect that he might say something to me. I am so scared. I have never been written up in my life, and I feel so horrible and dirty. I thought I was a good nurse, and also a decent person, but now I feel like a nothing. I don't know if I can walk back into that unit again. How could I do something so horrible? I know that I did the right thing by calling my manager, but I sure don't feel like it. I did the right thing, but just too late. I hate myself right now. I am a Christian and I feel like I have high moral standards, I just don't see how I could have messed up this way. Is it hopeless, should I find another job? I am so afraid.

Thanks for reading this. I know it was long, I just had to tell somebody and I feel like I don't have anybody.

[llg, PhD, RN]

Yes ... as you know ... you did the right thing by calling your manager. Now, you just have to find the courage to withstand the consequences. It can be hard to "take your medicine" and face up to your mistakes, but there is no other choice. You just have to bear with it and get through it. Use your friends, your family, your faith, etc. to help you get through this difficult time.

There will be repercussions for your mistake. People (eg. the doc) have a right to be angry with you. Accept their anger and their need to express it. They may also be reluctant to trust you for a while. You'll have to earn their trust.

Think of it like being a boxer -- you are going to have to take a few hits if you want to succeed. Accept their disappointment in you and vow to learn from this mistake and never to let anything like this happen again. Apologizing, acknowledging your mistake, and vowing to never let it happen again are the steps you now need to take. Then you have to be patient and give the situation time -- time for the anger to subside and time for you to earn their trust again.

If they are good people, they will "cool down" with a little time and see that you truly are a good nurse and that you can be trusted. It won't happen over night, but it can happen if you let it.

Think of this incident as a "wake up call" that will make you a better nurse in the future. It will be difficult and awkward for a while, but most people go through some bad times in their lives ... and most survive them.

Take care,

llg

[RunnerRN, BSN, RN]

You are still a good person and a good nurse. Yes, you made a big mistake - but you showed your values by calling the NM the next morning and owning up. A true coward would have just "let it slide." My advice: go to that doctor on your own next time you see him, ask for a moment in private, and apologize. Offer no excuses, simply say "It was a mistake, I have learned my lesson and it will never happen again." Hold your head up high. I would also approach my NM and say pretty much the same thing. You will probably be written up, but read the write up carefully and write a rebuttal to make clear that you came forward with the information, that no bad outcomes happened.

As the above poster said, consider this a wake up call. Trust me, you will never make that mistake again! I have a mentor who loves to tell her stories like that - it is amazing the things we do as inexperienced nurses! (I learned the hard way not to get too close to the tushie when doing enemas, suppositories, and PR Kayexelate!)

[Heather A.]

Thank you so much to both of you for your replies. I needed to hear them. I was questioning my ability as a nurse and a person. Thanks for listening and responding. I appreciate it.

[dance_200]

great job for finding the courage to do what you did many would not have been able to do that give yourself some credit for that and hold your head up high as it could have been any of us in the same position you are

[nambour51]

We all make mistakes - it is what we do afterwards that is important. You share that you are a Christian and you appear to have handled the situation from a Christian perspective. You recognized that you made a mistake, you acknowledged that you made a mistake to the appropriate people. Ask God's forgiveness. Accept God's forgiveness. Accept the consequences with grace. Learn from the situation. Undergo assertiveness trainging so that you will be able to deal with intimidating situations in the future.

[swatch007]

you were shocked when you first discovered that there was a missing piece. then afraid of what would happen next. the feeling of uncertainty and confussion overwhelmed you. you could not sleep and did the right thing by calling your nurse manager. you could have just waited of what would have happened without telling them and suffer the inevitable consequences later, but you did not. you chose to act responsibly and follow your conscience by informing the manager. you made a mistake, but you were not trying to cover it. don't you think you still live by your moral conviction. you take the blame even though patient was alright; don't hate yourself. you might not be able to control people reaction to this incident, but you can control how you response to them. carry on.. there are people here praying for you.

don't quit

when things go wrong as they sometimes will.

when the road you're trudging seems all up hill.

when funds are low and the debts are high.

and you want to smile, but you have to sigh.

when care is pressing you down a bit.

rest, if you must, but don't you quit.

life is queer with its twists and turns.

as everyone of us sometimes learns.

and many a failure turns about.

when he might have won had he stuck it out:

don't give up though the pace seems slow -

you may succeed with another blow.

success is failure turned inside out -

the silver tint of the clouds of doubt

and you never can tell how close you are.

it may be near when it seems so far:

so stick to the fight when you're hardest hit -

it's when things seem worst that you must not quit.

[vampiregirl, BSN, RN]

I think that llg's suggestions were right on target. No matter who you are, MD, RN, CNA etc, there is always the potentional for mistakes. We are human. Owning up to a mistake can be very difficult, but it is the right thing to do. There will be consequences too, unfortunately. Keep in mind though that people may be watching you closely (oh, why is it everyone seems to know when something is done wrong, and less people know when you do something great), but this can be a turning point for you. People will gain respect for you if handle this situation well... great patient care, following all the procedures and policies, remaining professional if confronted about the situation. Good luck to you.

[Jolie, BSN]

I think we have all have had moments somewhat like you describe, some more "urgent" in terms of patient well-being, and some less. You panicked, as we all have at one time or another. Ultimately, you did the right thing, even though it was terribly difficult.

As llg stated, it is now up to you to take the consequences and re-earn the trust of your co-workers. One aspect of that process may be formal re-training. I had a similar incident with two staff nurses in the NICU, and I required them to both undergo a specific course of re-training with the understanding that any unsatisfactory practice during the re-training period and for 6 months afterward would result in reassignment to a different unit or dismissal.

Just be aware that your manager may require you to do something similar, not out of nastiness, but to protect the hospital legally and to give you the opportunity to regain the confidence of your colleagues.

Best wishes.

[Blee O'Myacin, BSN, RN]

For that, you deserve credit. Next time, inconvience someone. Be that pain in the butt circulating nurse that makes every redo the count. Better safe than sorry. Its all a part of the learning curve.

You taking responsibility for your inaction at the time should be viewed in a positive light. Don't let what your manager said eat you up inside. I bet she's moved on - and so should you. Take a deep breath, hold your head up high and go back to work with extra dilligence. I recently made an error that could have hurt someone too - I didn't know at the time and took full responsibility when the error was pointed out. My manager pulled the same "I could write you up for this, but I won't *this time*" attitude with me, and yes, it bugged me. Either write me up (it was deserved) or not. The back and forth was eating me alive!

Think of all of the good things that you do during a shift - all the things you did right. We never give ourselves credit for all of those things - all the good catches and quick action in times of crisis. Unfortunately, I've found nursing in the hospital to be a punitive environment - even though management swears up and down and crosswise that it is "non-punitive".

((Hugs))

Blee

[Tweety, BSN, RN]

You live and you learn and you move on. You will never do that again.

You owned up to your mistake which was the right thing to do, and you can now sleep at night and live with yourself.

A good manager would be a little cold, but I hope she moves on, especially as you prove yourself in the future. Good luck. Hang in there.

[dorimar, BSN, RN]

I acutally cried for you when i read your post. I have to tell you that there are many nurses out there who would have NEVER said a word. Accountability is a strong character trait, and i believe part of my nursing code of ethics. You did mess up in practice and for a brief time morally. But you overcame this brief moral lapse out of true concern for the patient. You could be my nurse anyday, and i don't say that lightly. Hang in there and accept the consequences. Move on.Good advice from all above posters.