In need of encouragement.

[Sunny Lioness]

I'm a new grad who is in the middle of my orientation and am questioning my abilities to be a nurse. Let me explain.

This week I had my first code. It occured near the start of my first shift with this patient. I was doing my a.m. med pass when the patient began seizing. Because I panicked and also couldn't move as the patient would've fallen to the floor I yelled for my preceptor who responded immediately. She helped me make sure the patient was free from falling & activate a code. Thankfully, the patient survived & was transferred to the ICU. I still don't know what caused the incident. The two theories are either a narc OD (I just administered a prn narc) or a possible ETOH detox.

The same day I made my first med error. I accidently administered 2 po Ca instead of 1. I felt bad, admitted my mistake almost as soon as I discovered it, and completed the appropriate reporting steps.

This single day just completely erased what little self-confidence I had. I questioned whether I should quit as I was feeling incompetent. However, I didn't and managed to go in the next day.

Well, the next day started a bit hectic as I got a new patient assignment and was scared to do something that would hurt someone. However, my other preceptor helped me get steady, including getting 1 of my patients ready for handoff to the OR. I was still busy, felt I barely had time to do my assessments and charting between med passes, but for the most part uneventful. That is until the end of the day when the night nurse pointed out during report that there was a standing order on the nursing kardex to administer 1 PRBC for a Hbg less than 10 and my patient's was 9.9 (a drop from 10.2 the day before). I double checked the chart and saw the PA-C knew of the lab but didn't mention anything about administering blood. I mentioned it to my preceptor who told me not to worry.

Now I just keep repeating the 2nd day in my head. I naturally have OCD type behaviors but the events of the week have made them worse. I wonder what I missed, such as did I chart all my assessments, did I sign the documents I needed to sign, did I dispose of the other 1/2 pill from the pill cutter (at least I definitely know I administered the 1/2 pill the patient was scheduled to get), etc. Last night I went to bed hoping to forget the day/week but it didn't work. I woke up thinking about it today & haven't stopped. I am upset, sometimes tearful (especially putting this into writing), don't feel like eating and barely felt like getting dressed today. As the title states, I'm looking for words of encouragement to continue on. However, I would take constructive criticism as well. Thanks for reading.

[Neuro Guy NP, DNP, PhD, APRN]

Feelings of inadequacy can sometimes happen, especially in nursing, where school is only a first step to becoming a nurse. The medical field is something that takes many years to master. Don't feel too bad. You are brand spanking new. Don't beat yourself up about anything, as this will discourage you. You are actually doing just fine. The fact that you are highly concerned shows that you actually care enough to want to give it your very best. Never change. Never get lackadaisical or act is if you know everything - it is a recipe for disaster. Continue to grow and learn all you can.

No need for me to provide constructive criticism here on your technique. Besides, you have probably thought of 1,000 you could do better - no need to beat a dead horse. Again, you are doing just fine. Just be careful with med pass (and at least it was only calcium that you gave an extra. Thank goodness it wasn't coumadin or something.). That being said, I am not minimizing anything. Just feel good about yourself, what your doing, and be satisfied that you know you are doing your utmost. That's all that can be asked of you.

[Black Jade, BSN, RN]

Sunny, it happens to everybody. Don't quit as we all learn from our mistakes. We all grow from our experiences, and it is experiences like this that we grow stronger as a nurse.

Good luck and Hugs,

BJ

[NurseLoveJoy88, ASN, RN]

:hug: This too shall pass OP. Learn from your experience and take the necessary steps to grow as a nurse. It takes time.

[AgentBeast, MSN, RN]

As long as you haven't killed anybody or directly contributed to anybody getting killed you are doing fine.

[AngelicDarkness]

From one new grad to another, take two very deep breaths in and then out. I've learned that no matter how stressful I get or how much I criticize my nursing abilities, I need to remember why I got into nursing. I've had great shifts, and I've had bad shifts where I went home completely freaking out about how I handled things. But at the end of your shift if you know you did things to the best of your ability, that is all that matters. We're only human, and I think people tend to forget that part:(. I made a med error during a busy med pass. I'm still kicking myself over it, but looking back I know nothing I did that shift would change that. I was to give two anti-biotic capsules per the MAR, and I gave one. For some reason that I still don't know yet, I misread the MAR. It was a learning experience for me, because I know I'm not going to let that happen again.

Another thing I've learned is to let things roll off your back. As we become more experienced, we will get this. Think of it as a challenge:). I'm a nights charge nurse, and I've walked in on some nasty falls lately. I walk in, take a deep breath, and do what I know I'm good at. ( A resident fell and split her arm open. Sub q tissue protruding. I know I was shaking like a leaf after the paramedics left, but I know I did the best I could in her situation. She was very appreciative when she returned. I went home and made myself sick with worry thinking of different ways I could have handled it).

Just think of every day as a new day:) I know you'll do great. Things don't always work out the way we plan, but that is half the fun in nursing. Overcoming these challenges:)

[netglow, ASN, RN]

:hug:

Hang in there! Wonder if this would help. Every night after work come home sit down get a snack and write down your thoughts for the day that just passed in a journal. Write down every little worry. Then write down generally how you felt that day, and then what good thing happened, what went smoothly or something your figured out to do or never do. Then, take out a single sheet of paper and title it "To do". On this sheet write all those things you keep trying to remember in your head, things you need to ask, or figure out to make work go smoother. Things that maybe on your off day you will put together a cheat sheet on or study. Hopefully you can train yourself that since this stuff is now written down somewhere, there is no need to keep cycling it in your head. If you feel the need to get at the information, you can find it in the journal or on your list. But your goal should be to put it away and relax for the most part. Do one or two things on your "to do" list for tomorrow. Once you get them done cross them off your list.

[eagle78]

I know you feel bad, but I believe that you will probably be alot more careful as a result of this. I am not a nurse yet, but from what I have read on this forum it is a growing process and you are feeling the growth pains. Please do not give up, your remorse shows that you are a good nurse. The field needs you, so hang in there and continue to grow.

[nursing_girl1210]

Awww!! I feel for you. I'm also a new grad and will be starting my first day next week so I can't really give any tips on how you could have handled the situation differently and what not. But I can remind you that you aren't alone!! Nursing is a tough, tough career and being on our own is completely different than being in clinical, which i feel is like a glorified perception of nursing sometimes! It takes some getting used to and re-organization might be needed in order for you to not have those doubts at the end of the day as to whether or not you did the things you were supposed to do and what not. I've heard these same situations you just described from so many people just starting out... and I have friends who are a year and a half into their career and just now starting to feel truly comfortable... so you really aren't alone!

My advice is to give it some time... i can't remember if your original post said how many shifts you've actually done so far but if it's only been a few you definitely need to give yourself time. Also think about why you went into nursing & also if you can see yourself doing anything else with your life other than nursing. I'm not sure how your preceptor is but have u shared your concerns with her/him? Maybe the two of you can work something out where u have a little more physical support during the day so that u feel more comfortable at the end of your shift. I hope this passes and things turn around for you!!! ::hug::

[RhinoRocketRN]

Take a deep breath at relax. You WILL get through this. You have a preceptor for a reason: You are new, you do not and cannot know everything.

You grow and learn from these mistakes. Nobody is perfect no matter what they say. It is important to reflect on the negative things in order to move on, however it is equally important to focus on what you did right and the good things that came out of that day so you can remain confident.

As for the blood incident... its continuation of care... although you should have infused that unit of blood, there is still a capable RN who can infuse that blood you did not get to infuse.

Talk to your preceptor and other nurses about when they first began working. I'm sure they have stories that will make you laugh and feel better.:hug:

Just remember, no matter how experienced you are, you will still have days where you go home feeling:uhoh3:

[Coulter630]

First, I'm not a nurse. But I will will finish the ADN program in December. Next, we a human girl! We make mistakes, we're not robots! We make a mistake and learn from our mistakes. This is how you become a better nurse. I have plenty nurses in my family and if you ask any nurse, they've all made mistakes, whether it be a minute mistake or a big mistake. We all do it.

I think you are going to be an awesome nurse. Your post shows that you are very compassionate and want to make sure your patients are taken care of....the right and best way. When you don't worry about your mistakes, that's when there's a problem! B/c you'll never learn.

For God's sake, give yourself a break, you're brand new and still being oriented! You're an awesome nurse!

ps. From talking to other nursing, time management is key and you don't walk in the first day knowing exactly how to time manage. One thing that I was told though that could be very helpful. Take one task at a time and put a time limit on it. For instance, I will have all my assessments done by 8 or so. Pass my 9 o'clock meds and be done at such and such time. See? Like I said, I'm not a nurse yet, but I see that this has worked for plenty of nurses. Good luck!

[theantichick]

I'm only through my first semester of school, but had a fantastic skills instructor who almost every class shared something she messed up when she was still a new grad. It was good to know that a competent, successful nurse had rough patches when she started too.

Hang in there, and there's some great advice that's been given here. Don't forget to BREATHE. :)