New Grad, bad day.

[vashtee, RN]

Note: this is just a venting thread.

I'm a new grad, started working on a DOU (step down from ICU) floor in early February. About 75% of the time, I feel good when I go home from work. I feel like I did a good job and was on top of things, felt my patients were safe and had competent nursing care. Some days though, like yesterday, make me want to quit and never come back.

One of my patients went into V-tach as I was receiving report, first thing in the morning. The previous nurse noticed his IV was going bad, but didn't take care of it. After numerous attempts by multiple people, and even trying to start an IV on his feet, it was determined he needed a PICC, but our radiology department doesn't put them in on Sunday. It took the entire day for this guy to get a central catheter placed, and he was septic and not receiving his antibiotics or the electrolytes that were prescribed to treat his V-tach. Meanwhile, he was also incontinent of bowel and bladder, and had to be changed (bedding and gown) at least 6 times during my shift. Icing on the cake was that someone kept stealing his IV pumps since they weren't being immediately used, rather than contact central supply and get their own pumps. I had to put in orders for IV pumps 4 times, knowing they would eventually be needed, and I am quite sure they now think I am insane over in central supply.

My second patient went bad around 11:00. Her O2 SATs and blood pressure dropped to the point that we had to call a rapid response team. After trying for a couple of hours to stablize her, we ended up transfering her to ICU. She should have gone sooner, but there wasn't any room, and we had to wait for someone else to die.

My third patient was a lovely little old lady with a horrific, huge hematoma and wound s/p fall while on coumadin, with mild dementia and a hairline fracture to her ankle. (Incidentally, her IV was also no good, and she was another hard-stick.) She was fine unless you left her alone for more than 5 minutes, and then she'd be trying to climb out of bed so she could go home. Fortunately, her family was with her when my 2nd patient was crashing. I hate restraints, but at 6:00, overwhelmed with all of my other responsiblities, I finally had to get a doctor's order for a posey vest because I didn't have the time to stay close by.

My 4th patient was an isolation patient (MRSA and C-diff) with a recent BKA and poorly controlled pain. He didn't speak any English, and was (I suppose understandably) hostile each time I went into the room. (His doctor knew about the pain being poorly controlled.)

Icing on the cake was that I was so overwhelmed, that I actually welled up in tears when the charge nurse came to me late in the day to ask me a question, and now I am humiliated because I am normally a pretty hearty girl.

I hope these kinds of days will diminish in number as I gain experience, and that I am not so overwhelmed when they DO occur.

[jmking]

Hang in there we all have bad days, it's normal to feel this way.

[SDA3694]

Obviously the fact that you're still concerned/upset just tells me that you must be an awesome nurse! I think EVERY new nurse experiences days like those. Hang in there... when I feel like Ive reached my limit I just take a minute and pray, and then in the end if you did all that you could do to take care of your patients then I think you should feel really good about yourself!!!

[texastaz]

Wow! That is a BAD DAY. You are one tough cookie - I want you to be my nurse

[vashtee, RN]

Wow! That is a BAD DAY. You are one tough cookie - I want you to be my nurse

Oh my gosh! Thank you for saying this! When I have tried to vent about this kind of thing before, I usually end up hearing something along the lines of "well, that's a pretty typical day". I am happy to hear someone else confirm that I actually DID have a bad day!

Thanks for your understanding, you guys!

[Virgo_RN, BSN, RN]

Those days do happen. You can only do your best.

[HouTx, BSN, MSN, EdD]

That was a Horrible Day! I hope you don't have another one like it for a looooong time. Sounds like you're still sane, so you made it through intact. Congrats.

BTW, when you have time to take a breath - be sure to follow up on the whole "IV Pump swiping" issue. It's understandable when patient conditions change and your day spins out of control..... but it's a whole 'nother thing for co-workers to add to your problems. That's so not cool. See if you can get your manager to create/enforce rules about this. Most ICUs I have worked in have very clear rules - you can't take any equipment out of a patient room until you check with the nurse that has that room.

[yetpraiser]

I'm happy you made it through. I know you did the best you can. Being in the middle of finishing school myself this confirms that bad days will come but if you posted this note, you got through it. Good work and God bless

[Mollypita]

I hope your manager or charge nurse stepped in to help you. That's what they are there for. And don't even get me started on docs who refuse to order adequate pain meds!!!

[canoehead, BSN, RN]

That was a crappy day. In some ways the hospital let you down. Patients waiting all day for a central line because it's Sunday, inadequate pain meds, and waiting for someone to die in ICU before you can transfer are all rotten. Central lines should have a surgeon or radiologist on call to get it in within a few hours, pain control should be more than adequate, and dying people don't belong in ICU, OR they should pick the least sick, and trade with you.

The pump issue- if someone needs a pump lickety-split I understand why they took one that's not being used, but they should have made a call to replace the one they took. I've also worked in units where they kept two on standby hidden, and then called whenever they used one to replace it in the standby room, so there was no delay starting meds. then some loudmouth would tell the boss where we hid them and we'd have to move them elsewhere. Sometimes you can't wait an hour for a pump.

[clairebearrn]

I have had BAD days just like yours, we all do, but you handled it...so youre an awesome nurse, its okay to get stressed and emotional about it,just take a second go to the bathroom and get together... but once youre home, Im pretty sure you feel awesome that you were able to do so many things and learn a lot in just one day...wow!!!!!!!

[UM Review RN, ASN, RN]

That's the kind of day that would have even an experienced nurse combing the Want-Ads after work. (((Kudo and hugs to you,you did great. Seriously.))) Also, you might find you're in good company if you read a few threads on the First Year Nursing forum: https://allnurses.com/first-year-after/.