Mistake after mistake after mistake

iluvivt, BSN, RN · Oct 9, 2019

You need to change your narrative right away.Instead of "mistakes" you need to call these learning opportunities for professional growth.New nurses do not come out of nursing school ready to hit the ground running with all the knowledge and skills they need to succeed! In fact you are just "safe to practice".Safe ,among other things means you know where to look for the answers.if you do not know something.The situation you describe is not necessarily a mistake,it's more of a missed opportunity.In fact, when too many respond to an emergency it can get chaotic and crowded.If they need more help they can call for it.As long as enough help is present all is good!

JKL33 · Oct 9, 2019

6 hours ago, AMRN445 said:
New grad here. I work in the ED and I feel like I keep making mistake after mistake after mistake.

Hello. Okay...the scenario you described does not constitute a mistake on your part. I'm not so sure your preceptor wasn't getting at something else (like....maybe even your level of confidence or assertiveness).

We cannot know whether your preceptor might have meant to simply encourage you or give you "permission" to start taking a more active role in the ED or to even just be more assertive about learning opportunities that arise. I certainly hope his/her words were not actually a flat-out critique/rebuke. It's pretty inappropriate to have experienced nurses take their sweet time wondering if something on the monitor is real but then ask an orientee why they didn't go help...so let's give the preceptor the benefit of the doubt and assume that the statement was more "that would've been a good learning opportunity" than a literal "why didn't you help?"

But tell us more about your orientation. What type of facility, what is the format of your orientation program, and how far into it are you? Do you have examples of things that are actual mistakes, and why do you feel so very discouraged about your performance?

allnurses Guide · Oct 9, 2019

One of the hardest parts about being a new grad is swallowing the humility of being on a steep learning curve in front of your peers - over and over and over again.

Management of your anxiety is going to be key to your success. Find a good, experienced mentor that you can debrief with. It will make all the difference in the world. Hang in there. Keep learning. You will get over the newbie hump.

Guest219794 · Oct 9, 2019

On of the reasons that experienced RNs may have reponded casually is that, possibly, the PT was not in V-tach.

There can be a world of difference between a PT being in V-tach and the monitor alarming for V-tach. A PT yesterday was in A-fib RVR with LBB. That means they had a fast heart rate, and a wide pattern the monitor believes to be V-tach. This alrm is hard to work around.

"I love my job so much but I feel like I absolutely suck at it and everyone else thinks so too."

You may not understand what your job is.

You are right- you are not a great ER nurse. No new grads are, and that is not your job at this point. Nobody expects you to be a competent ER nurse at this point. Your job is to learn as much as possible.

Passing NCLEX was your entry ticket to starting to learn how to be a nurse.

Did you learn from this experience? If so, you are doing your job. If you react differently next time, you will be doing your job well.

My perspective as an ER preceptor.

JKL33 · Oct 9, 2019

1 hour ago, hherrn said:
On of the reasons that experienced RNs may have reponded casually is that, possibly, the PT was not in V-tach.

Yes; quite likely. Although if it clearly isn't VT that begs the question even more why the preceptor was wasting his/her breath with the statement made to the OP. ?

AMRN445 · Oct 9, 2019

4 hours ago, hherrn said:
On of the reasons that experienced RNs may have reponded casually is that, possibly, the PT was not in V-tach.
There can be a world of difference between a PT being in V-tach and the monitor alarming for V-tach. A PT yesterday was in A-fib RVR with LBB. That means they had a fast heart rate, and a wide pattern the monitor believes to be V-tach. This alrm is hard to work around.
"I love my job so much but I feel like I absolutely suck at it and everyone else thinks so too."
You may not understand what your job is.
You are right- you are not a great ER nurse. No new grads are, and that is not your job at this point. Nobody expects you to be a competent ER nurse at this point. Your job is to learn as much as possible.
Passing NCLEX was your entry ticket to starting to learn how to be a nurse.
Did you learn from this experience? If so, you are doing your job. If you react differently next time, you will be doing your job well.
My perspective as an ER preceptor.

I did learn from it and I most definitely will take action next time. But afterwards some of the nurses were staring at me the rest of my shift, I felt very awkward and embarrassed. I don’t want the other nurses thinking they cannot rely on me during a situation.

AMRN445 · Oct 9, 2019

7 hours ago, JKL33 said:
Hello. Okay...the scenario you described does not constitute a mistake on your part. I'm not so sure your preceptor wasn't getting at something else (like....maybe even your level of confidence or assertiveness).
We cannot know whether your preceptor might have meant to simply encourage you or give you "permission" to start taking a more active role in the ED or to even just be more assertive about learning opportunities that arise. I certainly hope his/her words were not actually a flat-out critique/rebuke. It's pretty inappropriate to have experienced nurses take their sweet time wondering if something on the monitor is real but then ask an orientee why they didn't go help...so let's give the preceptor the benefit of the doubt and assume that the statement was more "that would've been a good learning opportunity" than a literal "why didn't you help?"
But tell us more about your orientation. What type of facility, what is the format of your orientation program, and how far into it are you? Do you have examples of things that are actual mistakes, and why do you feel so very discouraged about your performance?

I think the other nurses were either mad or disappointed at the fact that i didn’t take action and that’s why my preceptor had said something. She said “you never know when someone is coding and they need help, you should’ve gone to see if they needed help”. All while she is telling me this the other nurses are staring at me and continue to do it for the rest of the shift. I have been on the floor with my preceptor for about a month. I just feel like everything I do I end up making these simple mistakes like getting the wrong blood tubes or ensuring a lab is getting processed or not being fast enough with my patient care. every time I mess up I feel like I’m being ridiculed or looked down upon by everyone. At this point I fear that I’m the only orientee who keeps making boneheaded mistakes.

**CommunityRNBSN, BSN, RN** · Oct 10, 2019

I think you should get a good night’s sleep! I know that sounds flippant. But I had a day last week where I came home exhausted and thinking “I am literally the worst nurse there is.” Got a solid 8 hours and woke up with a whole different attitude.

This may be more of an ongoing problem for you, but honestly, sometimes everything looks bleak when you’re exhausted.

JKL33 · Oct 10, 2019

8 hours ago, AMRN445 said:
I think the other nurses were either mad or disappointed at the fact that i didn’t take action and that’s why my preceptor had said something. She said “you never know when someone is coding and they need help, you should’ve gone to see if they needed help”. All while she is telling me this the other nurses are staring at me and continue to do it for the rest of the shift. I have been on the floor with my preceptor for about a month. I just feel like everything I do I end up making these simple mistakes like getting the wrong blood tubes or ensuring a lab is getting processed or not being fast enough with my patient care. every time I mess up I feel like I’m being ridiculed or looked down upon by everyone. At this point I fear that I’m the only orientee who keeps making boneheaded mistakes.

Well know this: Some of us feel that your #1 job right now is to learn the ropes and learn to manage your own assignment. Yes, everyone is expected to keep an eye/ear out for the alarms and respond to them. In my book though, honestly, that is more an eventual goal for someone who is essentially brand new. I would 100x rather have you learning how to assess your patients and what is going on with your assignment and learn to keep tabs on whether any of your patients are deteriorating at this juncture than to have you worrying about something else that dozens of other people can also see and keep track of.

(I feel this same way when people advise new grads to earn everyone's good graces by helping them. Help the other staff and help the techs/CNAs and help, help, help. There's something to be said for not being unhelpful, but beyond that a new grad needs to get his/her footing and learn to manage their own load. Then help others. Common sense. When they're off orientation it will have done everyone minimal good for the new grad to have spent most of the learning period running about helping here and there in order to appease people.)

Anyway. OP. You have got to change your outlook/attitude. Hear your preceptor's comments and learn what you can from them and then immediately move forward. A word of caution is that self-flagellation and being stymied by worries about what others are saying or thinking does have the potential to ruin this for you, but you don't have to let it. Get back in the game, put your head up, move with purpose, make good eye-contact, accept feedback, and work on being upbeat and pleasantly assertive. You can do it - - it is imperative that you believe in yourself.

???

CharleeFoxtrot, BSN, RN · Oct 10, 2019

I have this quote taped above my desk for a reason.

Quote
“Finish each day and be done with it. You have done what you could. Some blunders and absurdities no doubt crept in; forget them as soon as you can. Tomorrow is a new day. You shall begin it serenely and with too high a spirit to be encumbered with your old nonsense.”

― Ralph Waldo Emerson

yournurse · Oct 10, 2019

17 hours ago, AMRN445 said:
I did learn from it and I most definitely will take action next time. But afterwards some of the nurses were staring at me the rest of my shift, I felt very awkward and embarrassed. I don’t want the other nurses thinking they cannot rely on me during a situation.

Hello!

I like that you say that you still love your job despite all of that. ? first, stop thinking about what other think about you, if it doesn’t make you a better clinician, why worry? it’s wasted time and energy! there are so many reasons why the monitor would say « vtach » ... but always check on the patient and never rely on machines. Monitors can catch a lot of artifacts that would lead the machine to beep and say vtach. Anyway, when I was a new grad, i subconsciously do not go into rooms because I didn’t know what to do and I felt uncomfortable. if you feel uncomfortable in unfamiliar situations, I would look at other ways to feel comfortable, look at other avenues, like read more about Vtach, how it’s treated and what you do right away if the patient is in vtach. There are so many YouTube videos you can watch! Knowledge is power. I think once I’ve truly learned and know what to expect, how the patient would present in vtach (every patient is different) , you’ll be more comfortable. Hope that helps. And Gluck! ER is a great place to learn!