I'm SUCH an IDIOT!!

Specialties Geriatric

Published

Ok, you guys...I am currently nursing my sorrows in a beer...I just knocked out a double (3-11, 11-7), and have now officially been up since 630 yesterday morning. So, here's my tale of woe (and ignorance)!

I worked 3-11, was due to be back on 1st shift today. Nights had a call off, so I stayed over for the double, and they replaced me for this a.m. Mind you, I had called off sick the day before, and wasn't feeling quite "up to snuff," but figured, what could go wrong on nights?

Well, plenty. I truly messed up. At 915pm, I (SURPRISE!) found out I was getting an admission who was supposed to come over the w/e, but never did. OK, yeah, that put a snafu in my night (he came during med pass, on a skilled unit of a bunch of A & O folks who are relatively demanding (and lots of prns requested, etc). So, I'm trying to juggle my assessment of the new guy, knowing I'm gonna have to call Doc to verify orders, etc, while trying to knock out the med pass...(don't you DARE be late with their pills!).

So, this guy had ppn (as opposed to tpn) and came with the bag and tubing, just needed to be hooked up to a pump. Here's where it gets sticky. I'm not iv certified, and the other (and only) 3 nurses are lpns like myself, 2 of which are certified. Sticky #1 was that before we realized none of us could mess w/tpn (even though it was through a picc), one of the nurses tried hooking him up to the pump, but we didn't have the right tubing. I should add that by the time she could could come over to try to connect him, it was after her med pass, pushing 11pm.

Well, after realizing the tubing wasn't jibing w/the pump, it was now after midnight (d/t interruptions, etc). We all "pow-wowed," and it dawned on me...(DUHHHH) were we allowed to hang it, even if the tubing was right? We weren't initiating the first bag...blah blah. Well, after hunting for tubing, which took up some time (sounds like a terrible comedy/tragedy, doesn't it??) that's when we busted out the good ol' policy book. Lo and behold, we can't mess w/tpn...just monitor.

At this point, it's getting to be around 1a.m. Here's the Sticky situation, "DUH" moment #2: someone suggested I call the D.O.N., but then, we rationalized that the guy would be ok w/o it til 7am. We figured as such b/c he wasn't npo, and that the reason he was receiving the fluids was b/c his appetite was poor; otherwise, he was on a regular diet (as one of my coworkers pointed out, "we don't eat at night, it won't hurt him to go until 7," when an RN would be in the house), and wasn't diabetic.

I never thought to call pharmacy to drop ship tubing, and didn't want to wake my D.O.N. over this. Well, I should have. The ADON came in, and I told her the situation, and she about ****. Called the D.O.N. to get advice, and proceeded to talk, hang up, and comment that she (D.O.N.) was pissed. UGH.

The ADON called the Doc, who wasn't mad. But, I left out of there feeling like a complete, blithering idiot. I'm smarter than that! what the hell? And, I know there's a write up in my future b/c of it.

I'm sooo frustrated at myself. I've been around tpns, but its been awhile. Then, of course, she had to say something to the effect of-and I KNEW what she was going to say by the way she started speaking- what was gonna come out of her mouth "I'm not trying to pull the "rn-lpn thing, but this is why there's a difference. We've had longer training. The ****** part is, she's partially right, but that was a hard pill to swallow, and I had no leg to stand on in my defense. On the same token, she's a new grad who's on a power trip, which really frosts the cake. GRRRRRR!!!! >>>DUMMY!!! And, I think that was a low blow...I just screwed up. I swear, believe it or not, I know better. Where was my head???

I'm sorry for this being so long and drawn out. I'm just so disappointed in myself. I just wanted to vent. Go ahead, put me on "stupido" blast...just please be gentle!! :shy:

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Specializes in retired LTC.

I mean this gently ...

She may be a new grad, but as DON, her licence (and that of the facility) was put on the line by your failure to follow facility P&P. Fortunately, there was no harm. Hopefully, she will recognize that there were system failures in that the facility was unprepared for the arrival of a late admission. Some of the mixups do fall on you, but some belong to others

I know you weren't feeling well, but nobody would care if any pt injury had occurred. It is VERY sad that you got burnt by a bad situation. I have been, too, so I know your pain. For the future, follow your inner warning voice when something similar comes up. You tried but things could have gone better. And if something isn't sitting right, just call up the chain. (That's what managlement gets paid more for.)

I think your DON and ADON could have be a bit less abrupt but there were serious issues. It seems like nursing admin got caught unawares when good preplanning should have avoided the issues.

And this is NOT to alarm you, or to add more grief , but I hope you do have your own . It's situations like these that catch good nurses off guard. And I'm sure you know who'll be thrown under the bus should negative outcome occur.

Have a beer for me!

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Maybe in retrospect you didn't make the absolute best decision, but a patient not getting PPN overnight isn't the big deal that they were making it out to be. If the patient was that bad off, he wouldn't be in a nursing home. We keep patients NPO for days sometimes.

Unless you have a history of using poor judgement, I don't see why anybody would get mad about that. You messed up, you learned your lesson, now move on. I think your ADON needed to feel superior to someone that morning.

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Thank you, guys. You know, I own my decision/mistake, which is often the hardest thing to do, I am my own worst critic. I appreciate your feedback! My motto is Give me the truth, whether it hurts or not. I believe in learning from your mistakes, and I think that maybe this situation was meant to be a little eye opener...maybe I've been on auto pilot, resting on my laurels. "Ok smarty, time to be put back in check!" I truly appreciate your feedback. Hope all is well at work for you guys!

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I mean this gently ...

She may be a new grad, but as DON, her licence (and that of the facility) was put on the line by your failure to follow facility P&P. Fortunately, there was no harm. Hopefully, she will recognize that there were system failures in that the facility was unprepared for the arrival of a late admission. Some of the mixups do fall on you, but some belong to others

I know you weren't feeling well, but nobody would care if any pt injury had occurred. It is VERY sad that you got burnt by a bad situation. I have been, too, so I know your pain. For the future, follow your inner warning voice when something similar comes up. You tried but things could have gone better. And if something isn't sitting right, just call up the chain. (That's what managlement gets paid more for.)

I think your DON and ADON could have be a bit less abrupt but there were serious issues. It seems like nursing admin got caught unawares when good preplanning should have avoided the issues.

And this is NOT to alarm you, or to add more grief , but I hope you do have your own malpractice insurance. It's situations like these that catch good nurses off guard. And I'm sure you know who'll be thrown under the bus should negative outcome occur.

Have a beer for me!

This DON's license is not at risk for a patient missing PPN for a shift, certainly not because of what the OP did or didn't do. If a hospitalized patient missed PPN for a shift for reasons outside the shift nurse's control, it wouldn't even be an issue (at any decent hospital anyway).

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