I made a stupid error in judgment when working the night shift a few nights ago. I was caring for an 89 yr old man who was in poor condition with multiple health issues. His main issues involved diabetes, CHF, ARF and c.difficle. He had taken a turn for the worse several days prior with episodes of nausea and vomiting and decreasing urine output.
The pt's output had been only 100cc on the previous night. His blood pressure was around 96/55 and hR 65. On days he had an iv started of NS, he had been bolused 1000cc around 1400 and then the order was to run the IV at 100cc/hr for the next 12 hours. I started the night shift and was told by the rn going off that he wasn't doing well. He had only put out 75cc that shift. He was a DNR.
I was told we'd be working the shift short an rn. I was to be in charge (which always scares me because I have only been an rn for 1 year). That left me and 1 other rn on the floor. I began the shift caring for 8 pts and would pick up an extra 4 at 2300. When I did my assessment of this pt I found him much the same way he had been on days, vitals were similar and output was minimal. Per the dr`s orders I stoped the IV 12 hours after it had started. I assumed the reason for this was because the pt had chf. The pt had very little output still. I wasn`t sure what the next step was. It was the middle of the night. I DIDN`T CALL THE DOCTOR. I don`t know what I was thinking. when the day shift started the first thing the rn coming on said to me was why didn`t you call the doctor to address the low output.
I feel awful. I don`t think I am a good nurse. As much as I want to be good at this profession, maybe I am just not made of the right stuff!
