I have really messed up.

Specialties Ob/Gyn

Published

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.

What did you learn? Consider taking an assertiveness course for nurses or ask your supervisor if the place where you work has such a course that you can take. Thank you very much for caring about your patient. God Bless You!

We all make mistakes--and in health care some of those mistakes can have fatal consequences. fortunately, your mistake did not have ANY consequences for the patient. so, take a deep breath, relax and congratulate yourself for doing the right thing by reporting your error to the nurse manager.

Also, learn from this error. What was the root cause? RUSHING--it will get us every time. The whole team is really responsible for the error. Also, hand offs are always a problem in health care.

Take this opportunity to grow professionally and learn some new skills for

1. managing other people's anger & recovering

2. preventing future errors

3. try reviewing the JCAHO patient safety goals or read some articles about safety in labor & Delivery.

4. stress management

I hope you have a long career in nursing and that you never have another error more serious than this one......If I had more time I would share the professional DISASTERS that I have been personally involved with.....but I'm saving some of those for my book.....the one I'll write after I retire and finally have some free time. Which brings me to another suggestion--write about your experience--even if it is only in a personal journal.

Keep up the great work!

All the best from an old nurse --

Specializes in Cardiology & Critical Care.

Heather A. I've experienced both sides of this situation: as a staff nurse that made a mistake and a nurse manager having to deal with the doc, nurse, and patient when a mistake was made. You did absolutely the right thing (even if it did take you a bit of time). It takes a lot of courage to admit a mistake. I accidently gave 10 times the dose of a med (no sleep, 12 hour night shift, saw what my brain told me to see). As soon as I realized what I did I did report it to my charge nurse, called the doc, etc. My pt ended up going into renal failure and needing temporary dialysis as a result of my error. So yes, I feel your pain. I felt like I must be the worst nurse ever. I went home and sobbed and sobbed, I feared for my job and my license and even getting sued by the family. None of this happened. I didn't even receive any disciplinary action, just coaching from my manager. She and most of the nurses I worked with were very understanding, after all - they've made mistakes too. Unfortunately there are always those nurses that try and pretend they've never messed up and will talk about you behind your back and give you funny looks. It's hard to take, but try not to let it get to you. Don't give up on your job or your profession. I'm sorry you're manager is not more supportive. As a manager, I've stood behind nurses that have fessed up to errors and helped them grow and learn from their errors and become much better nurses for it. I'm much more frightened of the nurse that won't "own" her errors, blames others, makes mistakes and lies about them, and makes the same errors over and over again. I'd take someone like you over someone like that in a heart beat - and that's the message you should be getting from your manager. Good Luck, Sweetie

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.

We all make mistakes. You have to learn to forgive yourself. At least you did own up to it. At least you took that worry away from yourself that the patient had the clamp inside and made sure the patient was okay before she went home. I am almost certain your manager has made a mistake somehwere in her career. Talk to her. As another poster said, tell her you learned from the mistake. I gave the wrong drug to a patient during a cath procedure one time. I owned up to it. The patient was okay after we gave a med to reverse it, but I was terrified. I wondered what others would say. I was not a new nurse. I had been a nurse for 14 years when I did that. I spoke with the MD later. I feel as though Physicians respect me more because they know that I will own up to mistakes. Many people told me that they would have never said a word about giving the wrong med; they would have treated the patient per MD orders, but would not have told. My conscious won't let me do that . I would rather turn in my nursing license than to put the patient's safety at risk. Always remember-- You learned from the mistake. You knew it was wrong not to say anything at first. You are paying for that, but you will never let it happen again. You are still going to make mistakes, but if this same or similar situation happens again--- you will speak up.

Hi I am a junior in nursing school and have not yet taken Peds or Maternal Nursing, what is a lap and how is it significant? My goal is to work in L & D too. This may sound really dumb, sorry!

Laps are towels used during the procedure for sponging, wiping, gripping, etc. They come in packs of five and are counted like everything to assure nothing is left in the pt, and they show up in Xrays.

I love the responses you have received. It shows you things happen. All through your life. NOt just professionally but everywhere. That is what makes the world go around. Sometimes mistakes and things that make us uncomfortable are the BEST teachers.

When I was a new nurse I gave percodan instead of percocet. One of the nurses gave me such a hard time. She made me feel awful. I called the doctor and he thought i was an idiot for even calling him because he said "so what?". I know now it really was not a big deal but that nurse made me feel so bad I went home a cried and considered quitting.

So go to the people who will help you through this and ignore the perfect nurses out there. Something in their life will happen and they will be in your boat. When they are you need to step up and befriend them. That will be their lesson.

Good luck.

Scrapgirl

Heather, I am so happy this worked out the way it did. What a positive ending! If you hadn't come forward, and there was a pad left in the pt, just think of the devastating consequences for all of you! You did the right thing & you should be proud to hold your head up high!

Hi everybody, just wanted to give a little update. Thinkgs are going well at work; the doctor involved has been wonderful to me, he has even requested that I take care of his patients when at all possible. He has been kinder to me than I would have ever expected, and I feel stronger and strangely enough, everyone's support has made me feel like a better nurse. My nurse manager had a "staffing crisis" the other day, someone was out sick and she desperately needed someone to come in and work. She called me, and I went in to work. she was very appreciative. One thing that I didn't mention in my original post is that my NM is also new, she's been in that role for 1 year. I told her that I approaced the physician in person and apologized and she was ASTONISHED. She couldn't believe that I did that and she hasn't made any other mention of him being upset with me. There is a lot that I don't know because this is my first job as a nurse, but I am beginning to wonder if my unit is adequately staffed. I just moved to day shift 2 weeks ago, and it seems like there isn't a day that goes by that we aren't completely swamped. Somedays it is difficult to get a bathroom break, much less lunch. The atmosphere is always HURRIED. This does not in any way explain/ excuse what I did; I take complete responsibility for my actions and it will never happen again. It has just got me to wondering if this is acceptable/ normal on an L&D unit.

ChaosNurse- I just wanted to add that you are completely correct. I should have marched my behind right into my NM's office that very day and spoke with her. Actually, it should have never been an issue because I should have called the MD back into the OR right then; that is what I will do in the future. One thing you might find interesting, however, is that my NM waited an additional 24 hours after I reported the incident before she nofified the MD or proceeded with an x-ray. I think maybe she didn't know the proper way to proceed. As far as what being a Christian has to do with any of this, it is everything. My faith affects every part of life. I think we all answer to a higher authority and the fact that I failed Him is what tore me up inside. My faith in God is what should always guide my decisions, and I obviously failed this test. My foremost responsibility is to my patients and my Heavenly Father; I have never seen that more clearly than I do now.

Thanks again to everyone. I feel I have supportive friends here.

Heather, I am glad you came out stronger from this incident. I am sure many of us said a prayer for you the night before you came back to work.

Take care of yourself because your patients depend on your skills,and you will be able to handle stress better with your strong sense of well-being.

Heather,

All I want to say is I admire your honesty and inspired by your courage. Thank you for sharing with us! It blows my mind sometimes how we can affect each other...;)

You're still a good nurse! You were feeling pressured and uncomfortable and you waivered, but you admitted your mistake so that the pt could be cared for. That's what counts. You made sure that your pt was ok.

This is great news Heather! I am proud of you that you approached the doctor. Things did turn out well. A preacher friend of mine once preached on being righteous. The difference between doing things right and being righteous? Doing things right is what we should do. Being righteous is doing the right thing no matter what the cost. I think you learned a valuable lesson here. If you had brought the MD back in the moment you realized the problem, you would have saved yourself some grief, however I think God helped work things out and you have learned to not be afraid and and do what you know is right in the beginning. I believe that things happen sometimes for a reason. Many of them are caused by our stubborness and/ or fear. I know that when I keep my faith in God, it helps me through. Keep up the good work! I am sure God will continue to guide you in your daily walk.

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