New Job - I don't know if I can make it

Nurses New Nurse

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Specializes in peds.

Hi

I just started my job at a pediatrics hospital. I worked there as a tech for a year before being hired in as a new nurse. I'm almost done with orientation and I just feel so lost. I don't feel ready at all to be on my own. I'm so worried because I almost made a med error, one of my patients needed tylenol and we just stock bottles of it on our floor and draw it up as needed. I did the math wrong in my head and drew up 7.5mL instead of 0.75 mL , the mom caught it and my preceptor was in the room and she caught the mistake too. I left and got the right amount of tylenol and administered that. Now almost two weeks later the mom called the hospital to tell them about a nurse that almost gave too much tylenol.

My preceptors now need to double check my meds which is fine I understand the problem it's just no one really told me about it and no one has told me for how long this is going to last. I made cheat sheets for tylenol and motrin so I know about how much is needed per dose so I hopefully won't make the same mistake again.

I just don't feel good at my job and I hate that. I hate not knowing what to do and feeling useless. I just really don't know if I can stick it out.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

I don't think you should give up so soon. When you were a tech you weren't giving meds, right? I have shared here about a co-worker who gave a baby ten times her dose of epinephrine and she was a really good nurse in her first year also. It's hard to grasp how small the doses for children really are compared to what we are used to seeing. So now you know that you had a close call, and a dose of 7.5ml will jump out like a flashing red light from now on if it's for an infant or small child.

Do you want to stay in pediatrics? If you do and are just unsure of yourself take the extra help and mentoring and just keep on growing!! :) It can be really rewarding but it's a field that people run either hot or cold. If it's the age group that is getting to you, you might consider moving on but if you really want to be there just get right up and go at it again- lesson learned. Best of luck to you as you go forward!

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Specializes in Pediatrics, Mother/Baby, some NICU.

I also work on a Pediatrics floor. We have double checks on ALL meds on all patients under 14. It cuts down on med errors greatly. I'm surprised you guys don't do this, I thought it was a standard.

Second of all, Peds is a VERY hard area to learn. I've just gotten off orientation and started my first week of nights. I've been an RN for a whopping 3 months and feel I have a LONG way to go. Use your preceptor. Ask questions. Get feedback. Do whatever you need to do but don't give up. Most nurses I talk to about it say that it takes a good 2-3 years before you are completely comfortable with being a nurse.

If you love Peds then stick it out. You work in a Peds hospital, that's a very hard job to get and very coveted. I think as nurses we ALL question our abilities at one time or another but just remember to snap out of it and get back to work. I promise it'll all pay off!

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Specializes in NICU, PICU, PCVICU and peds oncology.
I have shared here about a co-worker who gave a baby ten times her dose of epinephrine and she was a really good nurse in her first year also.... you had a close call, and a dose of 7.5ml will jump out like a flashing red light from now on if it's for an infant or small child.

I wasn't a new nurse when I gave a 10-fold overdose of propofol to a small baby... in front of a physician. The instant the drug was in I realized what I'd done and told the doc and the others who were nearby. We were able to bag-valve-mask ventilate the baby until the drug wore off... the longest 7 minutes of my life. I filed an incident report and analyzed what had contributed to my error. (I was new to the unit and new to preparing my own drugs - had just come from a unit where ALL medications were prepared in unit doses by the pharmacist). I learned a lot from that incident and have never made that mistake again. Neither will you.

... if you really want to be there just get right up and go at it again- lesson learned. Best of luck to you as you go forward!

I wouldn't worry about the mother too much. The error didn't get to the patient and while the added scrutiny is uncomfortable, it's going a long way toward making the mother feel more secure in the care her baby is receiving. Human beings make mistakes. Humans also understand cause and effect. You'll be fine; use a calculator to figure out your doses every time until it becomes automatic. And don't feel weird about asking someone to check your doses even after the scrutiny is gone, because it will show you to be a careful nurse.

I also work on a Pediatrics floor. We have double checks on ALL meds on all patients under 14. It cuts down on med errors greatly. I'm surprised you guys don't do this, I thought it was a standard.

You'd think that would be a really common practice, but it's not. In our hospital the PICU is the only peds unit that is required to have ALL medications double-checked and double-signed. On every other unit there, the nurses are on their own. A while back we had a kiddy admitted to PICU from the ward with a 100-fold OD of clonidine due to a conversion from milligrams-to-micrograms error. The analysis of that incident resulted in a change in labeling by pharmacy so that the label uses the same dosage measure as the order. But it didn't result in a requirement for ward nurses to have their meds double-checked.

... Use your preceptor. Ask questions. Get feedback. Do whatever you need to do but don't give up. Most nurses I talk to about it say that it takes a good 2-3 years before you are completely comfortable with being a nurse.

EXCELLENT advice. That's why you have a preceptor. S/he's there to help you learn the ropes of your job; you're not theie to take over her workload. I welcome questions from new staff. It shows me that they're willing to look a little foolish in order to learn and keep the kids safe. For me there are no stupid questions. The only stupid question is the one you don't ask. Nobody knows everything. Not even me... :uhoh3:

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
QUOTE=janfrn;4539511]I wasn't a new nurse when I gave a 10-fold overdose of propofol to a small baby... in front of a physician. The instant the drug was in I realized what I'd done and told the doc and the others who were nearby. We were able to bag-valve-mask ventilate the baby until the drug wore off... the longest 7 minutes of my life. I filed an incident report and analyzed what had contributed to my error. (I was new to the unit and new to preparing my own drugs - had just come from a unit where ALL medications were prepared in unit doses by the pharmacist). I learned a lot from that incident and have never made that mistake again. Neither will you.

The person this happened to went through pretty much the same thing. We worked together in a room with 3 patients each when this happened and it took a relatively short period of time for the baby to clear the epinephrine but L was fair-skinned so I could see the blotches on her skin from the nerves of it. I know her patient's pulse and BP were crazy high for a few minutes of total hell for her. Child came through OK. I remember that our nurse manager was supportive of her and we all pitched in to take care of her other patients while she was 1:1 with that one. Now-a-days I worry that sometimes the IR is viewed almost as a "gotcha" event which it should never be.

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