Murphy's Law
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This is just a general venting session but I've bottled it up for about 3 weeks now and it's driving me crazy!
Most of my nursing experience is in correctional nursing, and the last 5 years in administration. So my skills are rusty at best but I'm willing to learn and try!
I have Bsn classes with a DON of a small local hospital about 15 miles from where I live. I have a full time job but it's just not paying the bills. So I asked this DON if she needed any PRN help. She asked me if I had any ER experience, she really needed help in ER. I said no but I was willing to give it a try if someone would show me the ropes.
Well, I started working two 12 hour shifts a week at this ER. (as I said , it is a very small hospital and they usually only staff one nurse in the ER at night). I got three shifts of orientation and I was on my own.
The ER is staffed with rent-a-docs for the most part. Also mostly foreign. They are all fairly good Doc's though. I told the physicians right from the get go that I was not an ER nurse and to just bear with me while I was learning.
I had worked by myself for about 6 weeks and had no problems. The ambulance service works out of the hospital and those paramedics really know their cardiac stuff ( which is my downfall and one of my ER fears!) So if I needed help in that area they were always in the building to assist.
As I said, I had worked about 6 weeks and had seen a little of everything, was still not completely sure of myself but getting more confident each shift.
Until one night I had one of those nights where everything I touched turned to mush or went wrong. I couldn't do the simplist thing like get the EKG machine to turn on, had to ask the paramedic. Couldn't get the neb. trt. tubing to connect right for a mask, had to ask the paramedic. A teenage girl came in with classic kidney infection symptoms ( flank pain, painful urination) I was all set just to give her some bactrim and send her on her way but these Doc's always have to go to extremes. He ordered all kinds of lab work, including a pregnancy test, and a KUB. Also had to start an IV on her. ( luckily that was one thing during the shift I did right, got it on the first stick!)I drew blood work and then the xray tech took her for the KUB.
The xrays were done quickly and the tech brought them for the doc to review. The Dr. asked if the pregnancy test was back yet and my stomach went in my throat. I had sent her for the xray not knowing if she was pregnant or not. ( I didn't see the need for pregnancy test in the first place) Of course I got raked over the coals for that. (I'll for sure never do it again!)We kept waiting and waiting for the pregnancy results. I called the lab and the tech said they usually took a fairly long time. The Dr. asked if she did a urine or serum test. I had inadvertantly marked serum on the req. when he had written urine and that's why it was taking so long. I could tell he was getting more irritated with me by the minute.
The next pt. was ordered Demerol for pain. I grabbed the tubex and started to draw it up and just in a nick of time noticed I had grabbed morphine instead of Demerol. No one observed that mistake, just me, and I caught it in time, thank God!
The next pt was an elderly, disoriented woman from a nursing home who had fallen and had a lac. on back of her head. Her blood pressure was bottoming out so I immediately got IV stuff to get it going. She had those little rolling spider veins and I tried twice but each one blew. Rather than keep sticking her unneccessarily, I called the paramedic to try and of course he got it on the first stick. Tried to hook her up to the millineum monitor and couldn't get it to work right or register at intervals.
It was going from bad to worse, I was beside myself!
The night was finally over and I beat myself up all the way home. About 4pm that day, right after I had woken up, the DON called me and said that they had had several complaints about me last night .The caregiver that was with the nursing home lady said I acted like I didn't know what I was doing, I had trouble starting the IV ( doesn't everyone sometimes, that's why I asked for help!) and I didn't wear gloves when I checked the lac on her head. I didn't wear gloves, but I didn't mall my hands all over the lac. I just raised her head up to see where the cut was. The DON also said another pt. complained but didn't elaborate. But the main thing was, the Dr. complained and wanted me written up.
She said she wasn't going to do that, but she was going to move me to the floor so I could get some more experience starting IV's and hanging cardiac drips, etc.If I still wanted to work the ER I could work a daychift as the second nurse. :angryfire I did not take offense to this except for the fact that it was just one bad night! And she didn't even offer to hear my side of the story, or what happened or anything. She just took what everyone else said as the gospel and that was that. I didn't think much of her as a supervisor after that. As I said I've been in administration for about 5 years and one thing I've learned, you always get both sides and all the facts before you start placing blame and making decisions.
This really took the wind out of my sails and I felt inadequte for days and days. But I went ahead and worked the floor and kept my mouth shut because I really need the xtra paycheck.
Sorry this was so long, but as I said I've been holding it in for a while and needed to get al the details out. Thanks for listening!