New GraduateWith 3 Incident Reports

[Taito29]

Hi all, I started working as a RN a month ago and I’m worried that I’m not doing a good job. Last week I got called into the num’s office to do discuss two incidents that occurred a couple of weeks ago. One concerning a doctor complaining about me due to their patient not going to X-ray in time. Another one about a medication chart being filed as finished when the new form had not been filled out correctly ( I would not do this but coped it on the chin). On Friday I made a medication error. My buddy’s patient required some PRN pain relief and I gave them 1g paracetamol not realising that patient was also written for regular paracetamol three times a day. My buddy told me the error and spoke to the charge nurse. I completed a incident report but I am now concerned about the impression I am making at the job. I’m so stressed that my num will feel I am useless. I am extremely worried that I am failing as a nurse. I have booked in time with my facilitator for a debrief but questioning if I approach my num tomorrow about the error as I feel it is the right thing to do but am extremely nervous. I am really looking for any insight into what I should do! At this point I’m questioning my whole career choice!

[LovingPeds, MSN, APRN, NP]

Most people who just start out working as a nurse have a difficult time with it. There is an adjustment period that occurs with novice nurses until they gain some experience. A lot of nurses feel like they aren't doing their best or don't even feel competent until about 1 - 2 years into their nursing career. You're going through a normal adjustment phase.

Everyone in nursing makes mistakes. The important thing is that they are acknowledged, addressed, and a process put in place to improve so that they are not repeated. If you approach your num (manager? preceptor?) tomorrow, be honest about your mistake and tell them any plans you have to prevent the incidence in the future.

Hang in there!

[TriciaJ, RN]

A doctor complained that the patient didn't get to x-ray on time? He needs to get used to disappointment. Then you copped to a paperwork error that wasn't yours and then you made a med error.

First of all, never own anything that isn't yours, error-wise. "Sorry, I didn't do that." If you own up to the errors that you do make, you will have more credibility when denying the ones that aren't yours.

How did you make the paracetamol error? Did you have an order for 1 gram? Did you misread the order, or follow a standing order before ascertaining that the patient was receiving regular doses? This one is the real error and should be the only one anyone is interested in.

I'm not trying to minimize anything and you're right to take med errors seriously. But from your post, this is all new grad stuff. Hang in there.

[Taito29]

1 minute ago, TriciaJ said:

Thank you for your reply. So the patient was not mine but the nurse I was working with. Panadol was prescribed twice. One as a regular and was as required accidentally. The patient was given regular 0800 Panadol 1g. I walked past at 10:30 and the patient asked for pain relief. I asked the patient if they’d any today they replied no. I did not check the regularly given medications but rather gave them the as required 1g Panadol. This was my mistake. I was in a rush and did not double check the medication chart! Fortunately the patient was not put at great risk but it was a mistake.

[VivaLasViejas, ASN, RN]

There are two kinds of nurses: those who have made med errors, and those who will.

Don't let yourself get too worked up about these mistakes. You've learned from them, and like someone else already said, they are the kind most new grads make. Just do your very best and take your time doing tasks, even if it seems like you must complete them quickly. Better to be a little too slow than go too fast and make further mistakes.

Good luck to you. You'll get it. It just takes time.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

Where is your preceptor while all of this is going on? Around these parts, new grads are like conjoined twins with their preceptor for AT LEAST the first month, and then they’ll take on their own patients (two to start), and gradually increasing the load. They are NEVER left to cover anyone else’s patients during that time unless their preceptor is also covering them both.

[Been there,done that, ASN, RN]

1 hour ago, BSNbeDONE said:

Where is your preceptor while all of this is going on? Around these parts, new grads are like conjoined twins with their preceptor for AT LEAST the first month, and then they’ll take on their own patients (two to start), and gradually increasing the load. They are NEVER left to cover anyone else’s patients during that time unless their preceptor is also covering them both.

Your preceptor is the one responsible for the errors. He/she is there to guide you and prevent the errors in the first place.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

2 minutes ago, Been there,done that said:

Your preceptor is the one responsible for the errors. He/she is there to guide you and prevent the errors in the first place.

^^^EXACTLY!

[Taito29]

Unfortunately I have been unable to work with my preceptor since my first week. In my hospital we get 4 shifts with our preceptor sharing the load and then you work with your preceptor but both taking your own 4 patient load. I feel like this issue has definitely impacted me and these mistakes as I have not got the support I need or require. I will be working with her all week this week so I will be discussing my concerns with her (I live in Australia so it’s a bit different to other programs internationally).

[CharleeFoxtrot, BSN, RN]

3 hours ago, TriciaJ said:

....First of all, never own anything that isn't yours, error-wise. "Sorry, I didn't do that." If you own up to the errors that you do make, you will have more credibility when denying the ones that aren't yours.

^this right here is the most important lesson you need to carry forward. Never, ever "cope one on the chin" for something you didn't do. Say that you didn't make (whatever) error, and then sweeten that with something along the lines of "thank you for the reminder to be careful"

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

3 minutes ago, Taito29 said:

Unfortunately I have been unable to work with my preceptor since my first week. In my hospital we get 4 shifts with our preceptor sharing the load and then you work with your preceptor but both taking your own 4 patient load. I feel like this issue has definitely impacted me and these mistakes as I have not got the support I need or require. I will be working with her all week this week so I will be discussing my concerns with her (I live in Australia so it’s a bit different to other programs internationally).

Oh I see. I don’t agree with it at all, but I see. I hope they change the practices very soon before someone is seriously injured.

No matter the country, how anyone could determine a brand new nurse competent enough to practice independently is just beyond reason, in my opinion.

[Been there,done that, ASN, RN]

1 hour ago, Taito29 said:

Unfortunately I have been unable to work with my preceptor since my first week. In my hospital we get 4 shifts with our preceptor sharing the load and then you work with your preceptor but both taking your own 4 patient load. I feel like this issue has definitely impacted me and these mistakes as I have not got the support I need or require. I will be working with her all week this week so I will be discussing my concerns with her (I live in Australia so it’s a bit different to other programs internationally).

All of us would need more support than one week. Even if you each have four patients, your preceptor is still responsible. I realize things are much different in Australia. But in the U.S. I precepted a hundred nurses and felt responsible for them all of the time I was teaching them the ropes.

Best of luck with this mess, let us know how it's going.