new grad & written up for the first time today at work :/

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or atleast a verbal warning/ write up as the don called it? it was due to a missed dressing change ( not intentionally, it seems like i missed it on the treatment record, and so it wasnt done. i was just hired at the nursing home i work at, and everything is computerized, so its taking a while for me to get acquainted with the system.) apparently the patient had a drs appt to have the wound looked at and debrided soon after, and because the drssg had not been changed & stuck to the wound, it was very painful for the doc to remove it. its understandable for the doc and fam to be very upset as a result of inaction on my part, and all the DON told me was to "make sure it doesn't happen again".

now im sitting here completely distraught! :uhoh3::crying2: this past month and a half has been so overwhelming, have 30 pts in the rehab sec. of the nursinghome, & feel so stupid sometimes because im making alot of mistakes...and its also taking alot out of me physically and emotionally :( (was planning to continue in the nursing field but thinking about switching majors. its too stressful :/) and for this to happen worries me even more, esp knowing that the fam got involved and i could possibly be named in a lawsuit in the future?

just in writing this, its hard to hold back tears. not only am i genuinely worried about the pts well being, but the fact 'that my license is basically on the line for any harm that the pt suffered from the drssng removal is driving me into a hole of depression & guilt (these days my stomach is always turning and i think im losing my appetite to even eat well).

im just asking anyone here for any helpful advice/suggestions for me in this situation, please. -Cherie

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I wouldnt stress too bad.. Especially is you are new. These kinds of things happen the important thing is to learn from it and move on. They had to write you up in order to cover thier butts.. They know that deep down there should have been someone to check your work. Hang in there & dont dwell on it!

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Specializes in Trauma Surgical ICU.

While I understand your concern, I can say that if this is a new wound or raw.. It would have hurt to remove the dressing no matter if you had changed it or not.. I have changed many dressing, they are all painful to remove the packing. Removing the packing also "helps" debride it. Medicating the pt prior to the removal would have been nice, also re-soaking the dressing with NS helps it to come out easier.

Point being, while yes you did make a mistake, the pt would have been uncomfortable no matter what.

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I wouldnt stress too bad.. Especially is you are new. These kinds of things happen the important thing is to learn from it and move on. They had to write you up in order to cover thier butts.. They know that deep down there should have been someone to check your work. Hang in there & dont dwell on it!

i appreciate your reply, it's just that im constantly worried about making mistakes, esp those that lead to harm and god forbid, death of a pt. and the 1:30 nurse-pt ratio doesnt help either. i notice that i am constantly very concerned about these things, esp cause im relatively new to this profession. like anyone, i just dont wanna end up screwing myself over, losing my license, getting sued and jailed. im so grateful for this job oppurtunity, but it taking a toll on me emotionally...

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thanks for replying, and yes you are right. either way, there would have been some discomfort to a certain degree, and im sure the pt is resting just fine now, but im paranoid that this single incident will come back to haunt me in the future....

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While I understand your concern, I can say that if this is a new wound or raw.. It would have hurt to remove the dressing no matter if you had changed it or not.. I have changed many dressing, they are all painful to remove the packing. Removing the packing also "helps" debride it. Medicating the pt prior to the removal would have been nice, also re-soaking the dressing with NS helps it to come out easier.

Point being, while yes you did make a mistake, the pt would have been uncomfortable no matter what.

thanks for replying, and yes you are right. either way, there would have been some discomfort to a certain degree, and im sure the pt is resting just fine now, but im paranoid that this single incident will come back to haunt me in the future....

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Specializes in LTC/Rehab.

Just out of curiosity how long was your orientation to the floor?

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Specializes in ICU;ED; ASU.

Sounds like the doctor is a jerk. it would have been stuck to the wound when you took it off as well, and he is quite more equipped to handle it than you are. what kind of dressing was it? wet to dry is supposed to stick. if not, try some telfa. take a deep breath, and give yourself a break. look at how you can do better, and don't take anything too terribly personally. people in this field seem to love to blame and pass the buck. be pro active and ask your manager if you can come in a few hours extra to learn the system better.

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Just out of curiosity how long was your orientation to the floor?

4 days, wouldve been only 3 if i had not begged the DON to give me a extra day....obviously wasn't enough

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Specializes in LTC/Rehab.

I just want to tell you not to feel bad about it, I was just recently written up for an incident I proved I had nothing to do with, but they got with I should have been auditing the MARS and caught the problem?? This incident was also reported to the state, lucky me. This incident isn't going to cost you your license and judging by your post they probably didn't give you much orientation which is there fault too this happened. I work LTC too. I work nights with 40-45 people to care for and its just me and an RN who I love for 90 beds. With the patient ratio we have in LTC this sort of thing happens alot more than you would think.

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Specializes in LTC/Rehab.
4 days, wouldve been only 3 if i had not begged the DON to give me a extra day....obviously wasn't enough

OMG do we work at the same place lol. I got the same which is not enough at all. I'm still learning stuff and paperwork I didn't know about 4 mths later. My previous employer there was a union and it was a mandatory 4-6 week orientation.

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Specializes in ER, progressive care.

It would have stuck to the wound regardless....packing helps debride the wound, and in my experience, dressing changes (unless it is something very minor) tend to be painful for the patient. We all make mistakes, just try not to dwell on it! To help me not forget things, I will write down things that need to be done (such as a dressing change) on my report sheet in a different color, usually green or red (tho I save red for the critical stuff).

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