Made a mistake

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Hey guys. Any insight is appreciated. I'm a new graduated nurse in a residency program. I have 2 great preceptors. I work on a fast paced pediatric unit. I've been working for 3 weeks. I feel absolutely awful. I made a mistake last week and I learned about it on Friday. I just still feel awful. I marked an ordwe for fluids reviewed on this little boy and forgot to look at the order again for the rest of the day. I marked it reviewed at 0955. My preceptor never saw the order so we never hung the fluids. The night shift nurse caught it but the boy was really dehydrated by then. Got stuck over 5 times trying to get an INT on him but no one could get it. Even their most experienced nurse. So the PICC team had to get it on him the next day. I didn't know about it till my review later that week. My manager and preceptor were very understanding and didn't beret me. Just helped me come up with a different game plan from here on out.

But I have to send a weekly summary to the educators and even though I didn't write about this incident, the educator said she wanted to talk to me one on one about my preceptor. Idk why. I'm a nervous wreck. Gahh.

First of all, take a step back and think about what you have learned from this experience. It is nice of your manager and preceptor to find ways to enhance learning opportunities for you. What summaries are you sending to the educators? Don't be anxious and go to the meeting with an open mind.

Of course you are a nervous wreck. I feel anxious just reading your post!

Different "tricks" work at different times in my life. For some reason lately when I start to feel anxious, singing "Hello anxiety my old friend", to the tune of The Sounds of Silence seems to bring it down a notch. Sorry that song is only about 49 years old!

As for the one on one with the educator about your preceptor. Besides trying to keep the anxiety down, try to think of "just the facts...ma'am". (Even better, that reference is to a TV show is at least 60 years old!). Try not to give opinions or assumptions or what you think you or she did or did not do, just state the facts or say in all honestly you're not sure or don't remember.

You are sooooooo lucky. You work for a great hospital that does NOT try to find blame and punishment for mistakes. They just go through step by step what happened and make any adjustments needed so it doesn't happen again to you or any nurse.

They want to find the fault with the system so that mistakes are caught before there is a problem. They don't want to punish a nurse.

"The educator said she wanted to talk to me one on one about my preceptor". That is because when you are on orientation, the preceptor is responsible. They are looking at the preceptor, not just you. Just answer the questions honestly. Your preceptor, should not be precepting.

I had the honor of precepting many nurses, I would NEVER let an orientee sign off an order.

This is an error that should have been written up.

Specializes in Med/Surg, Academics.

Now you know to get in the habit of writing down an order on your task list BEFORE you sign off on it. My brain sheet was my lifeline, and any time an order came up that involved me (which most did, in some way, shape or form), I would write it down, then cross it out after I had done it. It also helped me to be sure to pass on any orders that were not completed verbally to the next shift.

If I couldn't write it down then and there (for example, if I saw it while I was prepping to give meds to an iso patient), I would leave it unsigned until I was able to do so.

Breathe. Like stated above, the educator and risk management have to investigate the incident so that it doesn't happen again. You made a mistake, but it's a learning experience. I understand your anxiety. I once made a horrible mistake. I have like a 100 mg extra of an electrolyte to a patient. She was safe and didn't experience any symptoms, but her labs went into a critical high. I called the doctor who accused me of trying intentionally harm the patient. After the risk management review, it was found that I should've foreseen the error, but ultimately pharmacy violated a policy regarding giving exact doses of electrolytes. I was freaking traumatized and trust me, I learned not to make that mistake again. Yes it's difficult to overcome, but remember that a couple of days or weeks from now you will feel better than you do right now. You're learning and sometimes we learn the hard way. But this too shall pass.

Specializes in Reproductive & Public Health.

Everyone makes mistakes, there's no getting around it. Our mistakes can sometimes cause harm to our patients, and that is one of the *absolute worst* things about working in health care. You will almost certainly make more mistakes in the future, so it's important to both give yourself some grace AND own your responsibility. Take the experience to heart and work to improve your practice. You will be a better nurse for it.

However. I agree that your preceptor bears responsibility as well. One time I let my relatively new orientee sign off on our orders without checking beforehand, and she sent an rx to the pharmacy with an incorrect dose/sig. 100% MY FAULT.

Specializes in Critical care.

So there was an order for IVF that the patient didn't get? I think the solution to this is the orders need to appear in the MAR and the med (IVF) should be scanned out just like any other medication. Everywhere I've worked we scan IVF when starting it.

I marked an ordwe for fluids reviewed on this little boy and forgot to look at the order again for the rest of the day.

Are they teaching you to review/acknowledge large batches of orders? Or review them the instant you see them come up even when you can't complete them right then? If so, I'm not too sure I would agree with either of those two things. First of all I don't see any benefit to it, and second of all having something 'out of sight, out of mind' - what sounds like happened to you, is dangerous.

You could carry a "brain" sheet, or you could just leave the associated notifications visible until you can complete something, completely.

We all do things a little differently, but going through and acknowledging a bunch of stuff just because there's a notification is an idea I'm kind of scared of in a busy environment, so I don't do it.

Good idea! A paper "brain" is very useful. :nurse:

Specializes in Hospice, corrections, psychiatry, rehab, LTC.
Besides trying to keep the anxiety down, try to think of "just the facts...ma'am".

I can't tell you how many times and in how many situations the old Dragnet quote has popped into my head. It works.

Specializes in NICU.

They are being "nice" but still want to hang someone for the delay in care you or your preceptor,..becareful what you say ,let them explain it all to you.Dont offer any excuses ,it will only sink you more,say you regret it happened and will focus on correcting yourself.

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