8 months as a nurse and I am failing miserably

Updated:   Published

Hello fellow nurses,

I am a new nurse and I made a big mistake last night... my DNR CC patient who I have (probably had) an awesome rapport with her and her family.. had some labs that I just forgot to check.. well she had hgb of 6.1... 6.1! how could I miss this??

so the nurse who I gave report to (who is never nice to me but that is not the point) was of course bitter towards me and rightly so.. doctor of course was furious and rightly so.. 7 hours after the fact... and close to midnight we are getting units of blood and consents signed

I work on a floor of sharks... I can't speak to them about this... I of course began crying pretty much on the spot (I really hate working with women for this reason) .. why does it always feel like when you oversee something, you are all alone?

I am just putting this out there... I realize that most of the people who read this will be women and I hope you know what I mean when I made the women comment above..

I am working so hard to keep all my patient information together here.. I know that 4 patients for me is more than enough to manage... I am in AWE of the night shift who sometimes take on 6.. let alone a charge nurse who has a whole floor to contend with.. and I thought I was making progress but this whole situation is making me take a long hard look at the decision I made... yes we all make mistakes but this???

I am being super vulnerable .. I have been up all night, I am one raw nerve here

I do not want to go back for fear of all kinds of judgement.. legal, the family, co workers... all of it.

If you have read this far, thanks for letting me vent this... If you are judging me... don't blame you but know I can't get any lower than I feel right now.

What do I hope to gain by this? tell me I 'll get better with time .. tell me I am full of sh...and just give it up? I don't know.. just hurting here

1
Up Vote Up Vote ×
Specializes in Family Nurse Practitioner.

Ok, deep breath! Did you learn an important lesson from this? If yes then forgive yourself because you are human. Now take what you have learned and move forward.

Rule #1 Do not cry on the floor ever! No matter how upset you are or need to cry. Find a bathroom or wait until you get to your car. If these women are vicious then know sharks smell blood. Don't be the cryer!

Rule #2 If you start crying see rule #1. You have to toughen up. Remember, you aren't there for friends. You are there for the 2 Ps: patients and pay check!

1
Up Vote Up Vote ×

Don't beat yourself up. Most hospital have protocols of abnormal labs be called in by the lab to a RN, does your hospital have this? If so and they did not follow this write an incident report. Also during report ask if any labs pending write it in red marker this will remind you to follow up. I've been there mean nurses I would cry and I vowed not to do this in the future. I've been a nurse for 18 years and we still forget to check up in things. But we learn and move on. Don't let this intimidate you everyone makes mistakes.

1
Up Vote Up Vote ×
Specializes in Nurse Leader specializing in Labor & Delivery.

It's hard, it's a huge learning curve. It's probably a mistake you will NEVER make again, right? Hang in there. New nurses are bound to make mistakes - I would be more concerned if you didn't learn from your mistakes.

Future FNP had a good point - does the lab call you and report critical values? If not, they should - every facility I've ever worked at had a procedure in place where that was done, and then the nurse was required to immediately report that to the provider. Everything was documented.

1
Up Vote Up Vote ×
Specializes in Inpatient Oncology/Public Health.

First year is the hardest. I've never made the same mistake twice because I was twice as careful regarding that particular aspect the next time. But mistakes are one way we learn. The patient is ultimately okay, right? Hang in there!

1
Up Vote Up Vote ×
Specializes in Complex pedi to LTC/SA & now a manager.

Fear of legal....is the patient alright? If so there is no legal issue you made an oversight without malicious intent and the patient suffered no harm or permanent disability.

Think about what happened that you missed the lab value...what you could do differently moving forward. This is the point of peer review/incident reports. What happened, how it happened and what can be done to prevent it from reoccurring. Is that a critical value for your lab? (Should be) and if so, did the lab call with the alert? To whom did they speak with? Did you take a call/see the lab and forget to address it?

Take a deep breath and a step forward. Get some sleep it sounds like you need it to think clearly.

1
Up Vote Up Vote ×
Specializes in ICU / PCU / Telemetry / Oncology.

Yes, I am surprised that a lab did not call in the critical, but would they suspend that in the case of a CC patient? I know in my hospital we don't even do MEWS or call RRT on a CC. Don't beat yourself up, we have all been there, you just have to dust yourself off and keep going. It will get better!

1
Up Vote Up Vote ×
Specializes in ICU.

6.1 is a critical lab value that is supposed to be called in by the lab and verified it is received and noted by an RN.

That was a system put in place for this very reason.

It all falls on the nurses head in the end, which is really not fair. It doesn't make you a bad nurse, you took accountability for your mistake and no one was harmed.

but this was not your personal failure. This was a system failure.

1
Up Vote Up Vote ×

RN119,

In my opinion, a hgb of that level should be called in by the lab to you the nurse as a critical lab value so that you can be able to report it immediately to the doc. At least that's what happens where I work.

momrn...i just typed the above before seeing your response.

1
Up Vote Up Vote ×
Esme12 said:

NOTE: I'm confused.....I understand that DNR does not mean do not treat....however......Why is a Comfort Care/DNR patient getting blood?

Maybe the patient isn't on Comfort Care, but has a POLST with Comfort Measures Only. This would refer to end of life, and if the patient isn't at end of life, or if they are still able to communicate and make decisions, they can certainly receive a blood transfusion.

1
Up Vote Up Vote ×
\ said:
OK deep breath! Did you learn an important lesson from this? If yes then forgive yourself because you are human. Now take what you have learned and move forward. Rule #1 Do not cry on the floor ever! No matter how upset you are or need to cry. Find a bathroom or wait until you get to your car. If these women are vicious then know sharks smell blood. Don't be the cryer! Rule #2 If you start crying see rule #1. You have to toughen up. Remember, you aren't there for friends. You are there for the 2 Ps: patients and pay check!

 

This is so true...... Never let your co-workers see you cry. I see a lot of parallels between teachers and nurses. These two fields are manly women. Women as a whole are not cruel or mean. The personalities of perfection are what's really in common in these two fields. People can strive for and achieve good quality, but not perfection. Good quality allows for mistakes as people can learn from mistakes and become better at their skills. Perfection has no room for mistakes. No one is perfect and that seems to be what you are being asked at your work. It just sets you up for failure. Dust yourself off and remind yourself that you are human. I'm sure your patient and his/her family know you really do care. That means more to most families than anything. They know you are going to try and do for their loved one what you would do for your own family.

Your story is one of the reasons I'm trying to be very careful on picking (if I can in this economy) my first hospital job. I would have a hard time working with/ for perfectionist. I beat myself up enough over my mistakes, I don't need others joining in on the " feeding frenzy".

1
Up Vote Up Vote ×
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
RN119 said:
Hello fellow nurses,

I am a new nurse and I made a big mistake last night... my DNR CC patient who I have (probably had) an awesome rapport with her and her family.. had some labs that I just forgot to check.. well she had hgb of 6.1... 6.1! how could I miss this??

so the nurse who I gave report to (who is never nice to me but that is not the point) was of course bitter towards me and rightly so.. doctor of course was furious and rightly so.. 7 hours after the fact... and close to midnight we are getting units of blood and consents signed

I work on a floor of sharks... I can't speak to them about this... I of course began crying pretty much on the spot (I really hate working with women for this reason) .. why does it always feel like when you oversee something, you are all alone?

I am just putting this out there... I realize that most of the people who read this will be women and I hope you know what I mean when I made the women comment above..

I am working so hard to keep all my patient information together here.. I know that 4 patients for me is more than enough to manage... I am in AWE of the night shift who sometimes take on 6.. let alone a charge nurse who has a whole floor to contend with.. and I thought I was making progress but this whole situation is making me take a long hard look at the decision I made... yes we all make mistakes but this???

I am being super vulnerable .. I have been up all night, I am one raw nerve here

I do not want to go back for fear of all kinds of judgement.. legal, the family, co workers... all of it.

If you have read this far, thanks for letting me vent this... If you are judging me... don't blame you but know I can't get any lower than I feel right now.

What do I hope to gain by this? tell me I 'll get better with time .. tell me I am full of sh...and just give it up? I don't know.. just hurting here

Everyone makes mistakes. Everyone. You've made a mistake, and hopefully you've learned from it and won't make the same mistake again. But if anyone ever tries to tell you they don't make mistakes, they're either too stupid to recognize a mistake or lying. Everyone makes mistakes.

I don't understand the statement about when you oversee something, you're alone. Did you mean overlook?

And I don't understand the part about how you "of course started to cry immediately) and you hate working with women for this reason. You hate working with women because they cry? Because they saw you cry? I don't get it, and I don't understand your comment about women, except that it sounds somewhat misogynistic and makes me lose some sympathy for you. There's enough misogyny in the world without nurses contributing to it.

I have a lot of sympathy for new nurses who make mistakes and CARE about it. You seem like you do. Trust me, the first year is the worst and the only way to get through it is to GO through it. But I don't have a whole lot of sympathy for misogyny. You may want to rethink your comment about working with women, especially since YOU were the one who was crying.

1
Up Vote Up Vote ×
+ Join the Discussion