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.
DONT QUIT!!! I have been a nurse for 6 years and I remember what its like to feel that way. I questioned everything too when I got home!!! Those worries will lessen over time especially once you get your routine down. We can only learn from our mistakes and NOT ONE NURSE IS PERFECT! I remember waking up in the middle of the night looking at my alarm clock, 2:00a.m. and yelling out loud HIS CHEMO SHOULD NOT BE GOING AT THAT RATE!!! :) The first year is the most challenging. Take one day at a time. It will get better! Your "ocd" will make you into a great nurse!! Its always comforting for me, being a patient too, when my nurse is focusing on EVERYTHING, and not just one part. :) Hang in there!! PM me anytime!
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.
I like this -- I used to journal regularly. It is definitely cathartic. But I like the addition of the "To Do" list -- it keeps you on your toes about your weak spots, but lets you put it aside for a while. I still have year to go, but thanks for this advice.
To onaclearday: As so many have said more adequately than I could, don't beat yourself up so much. Commend yourself for caring enough to see that your patients get the best care you can give, and for the things you get right. Smile and remember why you became a nurse. :heartbeat:heartbeat:heartbeat
Don't give up!!!! You haven't killed anyone so in my book you are doing well. I remember when I was in orientation that I thought I chose the worn career path. I thought I would never be able to do my job well enough to make, and I thought I had wasted my and my family money and time going through nursing school. I stuck with it, and now I'm a great nurse if I may say so myself.
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.
Absolutely wonderful advice! Besides encouraging her, you gave me an idea, I need to do. It is funny in that as you get older, some of this same issues you had when younger, tend to come back. Peace!
I'm a new grad who is in the middle of my orientation and am questioning my abilities to be a nurse.
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.
I really love student nurses and new grads. I love the excitement, the sincerity, the wanting to do the best you can! I love how much you wear caring, on your sleeve. Thank God for you, we need you! You keep me going and not stuck in my disillusionment if that is a word. It brings me back to when I cried over errors, or the constant worry if I was good enough. Now hardened and around those who are hardened, I forget the zeal and joy I once had. Maybe working with someone like you, would lighten things up. Chin up, you are doing fine. You sound like a wonderful person and that is a big chunk of what makes a good nurse. Peace!
I am a new grad too. It sounds like you had a lousy day! I am an ED resident and some days I go in and feel like I can handle it. Other days I feel completely inadequate. I'm proud of you for admitting your mistakes and trying to move on. Don't let one bad day get you down, if you do, it will snowball and you'll have more bad days. I have anxiety issues about nursing sometimes like you. I will lay awake in bed ALL night fretting. I honestly am still working on this, writing stuff down like the other posters said may help, I think I'll try it.
What unit are you on?
Look, you're a new grad, I basically feel like I have 99.9% of nursing left to learn, you make mistakes, but when it comes down to it,
Specializes in Certified Med/Surg tele, and other stuff.
I have been a nurse for centuries, lol, and to this day, on the drive home I replay scenarios of things I could have done better; my dumb mistakes. I try to remember 'this too shall pass' and realize that nobody was hurt and I have learned this is an area I need to pay closer attention too.
Heck, I even have days when I wonder if I can pull off a decent day that doesn't make my hair stand on end. I take a deep breath and realize I need to focus, focus, focus. No panicking allowed.
You will find that having this mindset will help you in your daily life as well. People tell me it takes a lot to get me frazzled. I just laugh and tell them I'm a nurse.
You can do this. Breathe, keep a journal and give it time.
you have had some wonderful responses so far, and mine won't be much different.
i am an rn close to 30 years, primarily critical care. realize what "we" do on the front lines, is intense and can be very overwhelming. especially when we are new to the profession. please do not let it overtake you, and give up what you worked so hard to achieve. we almost all go thru the challenges you have, and all have to learn how to cope as we go.
lean on some of your fellow new nurse friends, if you have them. find a way to communicate regularly with your mentor/preceptor.
the suggestion for a daily journal can be a good one, with the list of stressors, good points and bad ones, and possible solutions. keep your chin up. when you feel overwhelmed, attempt to step out of site for five minutes and take a few deep breaths to compose yourself. or find a few minutes to sit and hold a patient's hand, letting it remind you why you are doing what you are doing.
it will all fall into place. we all need to find our own rhythm in the routine, and the lack of routine, that goes with our job. lean on us in the forums, if you need to.
A lot of good responses already so a lot of what I say will be echoing the others xD
First, about the code...I don't know why but I've found a lot of nurses who have patients who code beat themselves up afterwards. IT'S NOT YOUR FAULT unless, you know, you're like Light from Death Note, who can make people have heart attacks on a whim. If something is going to happen, then something is going to happen, no matter which nurse is on that day. Just as long as you react appropriately and do something about it, no one can say you didn't do your job.
Second, don't beat yourself up over a med error. It happens! You'd be hard pressed to find a nurse who hasn't made a med error at some point in their careers. But, you admitted to it and followed up on it. You did your job. No harm done. If it was a more serious medication (i.e. digoxin, a narcotic) then there are a few more steps involved (i.e. ensuring the patient is safe and monitoring closely) but just follow up on it.
I am reaching almost a year after starting as a new grad. There are still many days where I feel totally overwhelmed. I've even cried at the nursing station once - as in, I completely broke down because I was so completely overwhelmed, frustrated, and feeling my confidence hitting rock bottom. I've cried after shifts and dreaded going back for another. But as the others said, there's no use beating yourself up over it. Think forward rather than backwards. Know your limits and what you can do better in the future. Gradually, you'll find a way to cope and you'll settle in. Talk with other new grads and talk with your preceptor about possible strategies for getting through the tough days.
Also, what one colleague said to a patient really stuck with me: "We'll cross that bridge when we get there." In other words, try not to think too much about what ifs and just concentrate on what needs to get done at that moment in time. For example, I could worry forever about "What if this patient falls?" but ultimately, it does me no good. I put the necessary precautions in place (i.e. call bell within reach, ensuring the patient's walker is nearby, encouraging the patient to ask for assistance, etc.), document, and hope for the best. If the patient doesn't fall, then great! If he does, then we will deal with that when it happens.
So don't sweat it and keep going! Worrying about the past will get you nowhere. Keep your chin up and rock on!
I take a deep breath and realize I need to focus, focus, focus. No panicking allowed. 
travel88
11 Posts
DONT QUIT!!! I have been a nurse for 6 years and I remember what its like to feel that way. I questioned everything too when I got home!!! Those worries will lessen over time especially once you get your routine down. We can only learn from our mistakes and NOT ONE NURSE IS PERFECT! I remember waking up in the middle of the night looking at my alarm clock, 2:00a.m. and yelling out loud HIS CHEMO SHOULD NOT BE GOING AT THAT RATE!!! :) The first year is the most challenging. Take one day at a time. It will get better! Your "ocd" will make you into a great nurse!! Its always comforting for me, being a patient too, when my nurse is focusing on EVERYTHING, and not just one part. :) Hang in there!! PM me anytime!