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!

[BSN-to-MSN, ADN, BSN, RN]

On 5/31/2020 at 9:35 AM, JKL33 said:

Preceptor surely is not responsible for this type of action, even if the OP was still paired with him/her. No. If a new nurse happens by and decides to medicate someone else's patient that is on them.

On 5/31/2020 at 10:09 AM, Been there,done that said:

Must disagree. I made it clear to all of my new grad orientees not to give meds without running it by me. We passed all meds together. We could then discuss the rationale and biological action, and most importantly review the MAR before administering. If they still pushed a pill without me.. still on me for not making my instructions clear enough.

I am somewhere in-between. A new nurse practices with her own license. At the same time, the new nurse medicating a patient on someone else's team without even asking the preceptor is a no-no.

But..

The preceptor does not have to be present for every medpass. The nurse is not a student anymore, and surely can figure out the considerations, vitals, pain level, etc. I help with the technical issues only in the beginning. The student would be another story.

[Raid Alaskri, RN]

I think the most who have new started. they will be under training for 3 moths. then they will carry works alone.

for your reports , the most doctors they want scared the new staffs , and you should be confidant. and tell him the delayed come from X- ray department.

I faces many doctors so mean they just test your personality.

finally work slowly and carefully don’t trust staffs to finish your works.

always double check.

good luck always...

[Tenebrae, BSN, RN]

On 5/31/2020 at 1:16 PM, TriciaJ said:

Regular acetaminophen plus a PRN that exceeds daily limit? Bad order that needs to be addressed.

The OP is in Australia, like NZ we have an upper limit of 4g paracetamol a day. Not uncommon to see charting as 1g TDS and 1g PRN once daily

[Silver_Rik, ASN, RN]

I hope you are able to get things on track. I'm a new grad nurse, 3 months into an RN internship. Tomorrow I will find out whether I'm going to be written up and referred to HR for mishandling a pathology specimen. My preceptor feels it's a process issue and said she'll defend me. I've asked for additional training in the procedures (they changed recently) and have received very positive reviews from the two preceptors I've spent the most time with. I just hope I'm able to stay in the program and without a disciplinary cloud over my head.

[Taito29]

8 minutes ago, Silver_Rik said:

I hope you are able to get things on track. I'm a new grad nurse, 3 months into an RN internship. Tomorrow I will find out whether I'm going to be written up and referred to HR for mishandling a pathology specimen. My preceptor feels it's a process issue and said she'll defend me. I've asked for additional training in the procedures (they changed recently) and have received very positive reviews from the two preceptors I've spent the most time with. I just hope I'm able to stay in the program and without a disciplinary cloud over my head.

I hope you’re okay. What was the issue?
I have my fingers and toes crossed for you tomorrow. Tomorrow and the next day I have been rostered to work with a senior staff to help support me while I try and find my confidence again. I’m doing okay but looking for a change after these 6 months. Medical is definitely not my cup of tea haha. Let me know how you go!

[Silver_Rik, ASN, RN]

12 hours ago, Taito29 said:

I hope you’re okay. What was the issue?
I have my fingers and toes crossed for you tomorrow. Tomorrow and the next day I have been rostered to work with a senior staff to help support me while I try and find my confidence again. I’m doing okay but looking for a change after these 6 months. Medical is definitely not my cup of tea haha. Let me know how you go!

I met with my nurse manager and they were very supportive and basically agreed it was a process issue (but that I need to question when things don’t seem right), but they still need to discuss the incident with my orientation coordinator. Fingers crossed but I think I’ll be okay.

On the chance someone who works with me is reading this I don’t want to give more specifics until the matter is closed.

[Kooky Korky, BSN, RN]

On 6/3/2020 at 4:00 PM, Been there,done that said:

Guess I must have knocked a few heads. Or we were lucky. None of my orientees did something stupid. Please forgive me for repeating myself. But we were joined at the hip.. so they didn't. I felt anything my orientee was on me.

I also always keep a totally watchful eye on students and orientees. But if they are going to do something without running it by me first, especially after being told to involve me, well, that is on them - especially the orientees.

[echill40]

I feel for you! You are only a month in?! You need more support from your preceptor and your unit. Hang in there!

[BeenThere2012, ASN, RN]

On 5/31/2020 at 4:50 AM, 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).

THIS is one of the things that stresses me out with being a nurse these days...

Lack of needed support, especially for new nurses.

I agree with what all have said so far. You are not a “bad nurse” , you are a “new nurse”. But word of caution, NEVER rush when giving meds. That is the number reason med errors are made, and the next one (believe me, there WILL be a next one) could be serious. Just follow the guidelines as taught “rights” of medication administration, even if you don’t see others following them. When you are pressured, the time it takes to do the checks seem longer than it actually takes and will save you and your patients from harm.