Need advise

Unfortunately we get things wrong and we mess up. To ere is to be human but we must look at what happened and methods of correction. That doesnt mean hitting you with the cane or shouting at you until you go deaf, but trying to help you by going through what went wrong step by step.

Somewhere in the process you either missed something or interpreted it wrong. So accept that you got it wrong but try to think about how this happened.

If this hadnt of bee caught what could have happened.

Next write down the mistake, reflect on it and show management. Talk to them and tell them that you want to do your best.

Aren't we all here because we came into this profession to care for the ill? We never intentionally want to mess up. Ask yourself if you were rushing or you simply did not understand. Does this require further training?

Unfortunately there are people that as soon as you do something wrong will get the big guns out. Look for support but show that you want to gain understanding and accept your mistake.

Be honest and open. med errors can happen so ypu have to check and recheck everything to the finest detail. Know your patient. Know what your doing and why and if in doubt dont do it and get a senior member of staff.

If you want to be the best nicu nurse you can get through this. Its not an easy job by a long shot but you trained for this and im sure this is in your heart.

If you never make a mistake, then you're not a human being.

I wanted to clarify a couple of things: When you said you missed the IV infiltrate when you'd been at work for 4 hours, does this mean that the infiltrate went on for 4 hours before you found it? If that's the case, that's a big mistake because you need to be checking on the IV sites every hour. Sometimes I'll check on them sooner than that, especially with a peripheral IV. I never trust them.

The gentamicin order sounds like it was wrong on your part, but there is also responsibility on the doctor who ordered it and the pharmacist who dispensed it. It sounds like you were the scape goat.

I think you must be doing okay otherwise because why would the unit be giving you the sickest kids in the unit if they don't trust you? Seems pretty irresponsible to me if that's what they thought.

Bottom line, nursing has a backwards approach to mistakes in health care. My program director for my nurse practitioner program put it best, "If the nurse makes a mistake, 'OHMIGODTHEWORLDISENDING,' but if the provider makes a mistake, it's dealt with and the person learns from the mistake and if it's a pattern, then measures may need to be taken. But making mistakes is part of life and shaming isn't a part of it."

Sorry that the nurses aren't very welcoming. I've heard about this over many years on this forum about NICU nurses and I've had some co-workers who weren't welcoming, and it's a shame. I will say that not every unit is like this. Many units are awesome and like family. I was heartbroken when I left my unit that I'd been at for about 6 years, moving on to other things.

In regards to the IV infiltrate...here's what happened. I was assessing hourly. The nurse that was coming in to relieve me had helped me out over the holiday weekend by coming in a little earlier to relieve me. I told I expected to see her no earlier than 11:30. As I was getting ready to start my next cares/assessment she came in at 11:00. Totally threw me off. I did not visualize the IV at that time. Stupid. And that is how "I missed it."

In regards to them "not trusting me" and then giving me the sickest kid. That's what I was thinking too.

Otherwise I thank you both for your responses. I have been feeling sick about this all weekend. I have a meeting with two of my assistant managers tomorrow to talk about everything. Hopefully that will give me more insight as to where I stand on the unit right now. We don't have a nurse manager at the moment so I thought meeting with them would be my best bet for speaking to people I work with and that are actually on the floor on my unit. The previous meeting was with the department head who is acting as our manager right now and the educator. The educator is new, there hasnt been one on my unit in a really long time. She started about a month before my first error. Not sure how I feel about her so far. Especially after her "it's going to be hard" comment. I realize she probably didn't mean for it to sound bullyish or like she was trying to intimidate me but it sure came across that way anyway.

Can I ask you all one more question.....if you had found a DTI to the septum of a 26weeker, would you have put duoderm on it? My thinking was that duoderm prevents the area from being visualized for assessment and the skin was intact so my other concern was that duoderm could cause more problems. Please let me know your thoughts on this if possible.

DTI? Google tells me that it is a deep tissue injury? You should follow your unit's protocol, but 26 weekers are at a huge risk for skin breakdown. I put some kind of soft cushion sticky wherever there is contact with the skin with an appliance like a nasal cannula or CPAP, always as a prophylactic measure. You don't need to lift the cushion for skin assessment all the time either as that will remove the stratum corneum (top layer of the epidermis) and cause further breakdown. You need to use common sense to assess it, but keep in mind that you can't pull it off all the time.

Thank you for being brave enough to post about this SailLove80. -- we all need to remember mistakes happen. I'm not in an ICU, but if it were me and I really wanted to continue, I'd take these as learning moments and go from there.

Don't give up if NICU is where your heart is! Trust me, I learned this lesson about 4 years ago when I left a job in a level IIb special care nursery because my preceptor was a bully! I kick myself almost everyday for it now since I have applied for NICUs in the area, as well as other SCNs and cannot get even an interview because the job market here is just saturated in my area!

Learn from your mistakes and move on, the more nervous you are the more mistakes you will make... Keep your chin up!

HPRN

Never let anyone drive you out of a job either!!

I really hope things work out for you and you get your second chance. :)

Thanks everyone. It looks like a second chance isn't meant to be. I guess with my stress and loss of confidence contributing I made a really STUPID mistake last week. I just posted under the general area regarding advice for a forced resignation...:-(

Wow, your hospital sounds extremely harsh and unfair. I've never heard of anyone in my unit being forced to resign, and of course there have been mistakes, serious ones at times but they were accidents and the nurses were well aware of how serious they were. There's usually a talk with the manager and educator, and then they are made to retake a class in med administration or whatever the mistake was. The only reason new grads have been let go have been for attitude reasons. I work in Canada, and my hospital is unionized but is there no appeal board that you can talk to where you are?

What mistake did you make? Have you contacted a union for advice?