Here's what's going on. I've been a nurse since July and I landed my first job. I've been working there for two weeks. My first week it was a lot of orienting and I helped a lot. Received a lot of ffeedback from patients and the staff. I was feeling good.
My second week, I was given 1-2 patients, with my mentor there, but I did the charting and the majority of the care. Again, I felt confident and received very good feedback from the staff and patients.
But on my last day on my second week, I made a med error the day before (missed a dose). I caught my own error and reported it promplty. The staff was okay with it, they told me it happens. The patient was okay. And they told me, it will happen again. Well after that, I looked over my charting and caught another mistake I did. I didn't document something on the MAR that needed to be documented, but it was done. I circled it, made a note on the time, and explained that it was charted somewhere else and that it was done.
To make the day worse, I could not start an IV pump and I got a lot of air, I'm talking alot, in the primary IV line and it took the nurse about 30 minutes to get it out. We could've just changed the tubing, but there was a lot of medication in the line (I was hanging a new bag, with new tubing, and I didn't prime the line correctly).
After that, I discharged (feel good about that) and my pt load was 0. So I went to the ER side to help then.
This topped my day. I had to do an EKG, I am slow in putting them on because I am new and they get tangled. The patients and the staff are very patient with me when putting them on. Well, I printed the strips and read it, I saw tachycardia on the strip. I told the nurse and she said okay and asked me to help her with some more task on the same patient. So we are doing that, the admissions lady came in and grabbed the EKG and not even a minute, a cardiac alert was called. It was the patient that we where working with. Turned out the patient was having an MI. The strip I read even said MI in bold at the bottom of the report and I completely missed it! I felt so horrible. I still do. I mean that's a very critical thing to miss. Very time sensitive. Leave it to the newbie to miss it. The pt could've experienced negative outcomes because of me.
After that, I was asked to do another EKG and the nurse came in twice asking if I have done it yet. I am slow. I finally printed it out and apologized for being so slow and the staff member sighed, very loudly, and looked away. That discouraged me so much. I went back to the med surg side (the er and med surg are side by side, same desk and everything) and just sat there for a minute, not speaking to anyone because I felt very bad. Very awful.
My mentor checked on me and I told her how I was feeling and she told me, it's okay, you're still new, you're going to make mistakes and you learn from them. We ate lunch together and she made me feel a tad better.
At the end of the day, I received feedback from my mentor. She said I needed to work on my charting. I'm really bad at it (we still do paper charting). I tend to ramble. My mentor said when they read it, it's confusing. I am investing on a charting book as she suggested. Other than that, she said I am doing very well here, I am one of them, and the other nurses on the unit agreed. They said I am doing very well and I am very helpful.
But I am still feeling very discouraged. I did learn from my mistakes, but I am embarrassed that they occurred. I had such a terrible day and it is still with me. I tried talking about it with my boyfriend, but he's not a nurse. The only thing he could say is, you're new, you're learning, and everyone was okay at the end. I appreciate how supportive he is, but he hasn't been here where I am at.
I need some advice from fellow nurses. How can I get over this feeling. I am feeling very discouraged, slow and embarrassed. I'm doubting myself as a nurse. Typing this is bringing tears to my eyes. Can yall please help me.
I appreciate the time yall put in to read this long post. I know it's long. What is this girl to do besides cry??
Take some deep breaths, review some extra material, and keep at it. Learning anything is a process and you will get there, it takes time. You don't come out of school with the clinical judgment of someone who has done XYZ job for 5, 10 or more years. It takes some time to get there, you aren't there automatically. It takes some effort outside of work to continue learning and growing too.
The ability to reflect and self-assess for needed growth is a huge thing working in your favor. The thing that scares me more than someone I'm orienting (or working with) that makes mistakes is when people make mistakes and do not catch them, do not care, or think they know everything.
If you think there is any nurse you work with who hasn't made a mistake? Think again. The physicians, NPs, PAs - all have likely made some mistake along the way too. There have been events in my workplace in the past several years that have required the staff to meet with the legal team and go through everything about how XYZ happened - and while I can see how I might have acted differently in those situations, more than anything I think "there but for the grace of God go I".
Medicine and healthcare overall are team sports. You do have to be knowledgeable and thinking things through, but the others around you are on the same team you are. Do not be afraid to ask a coworker (ex. your mentor) for help or their assessment of a situation. In my current job, one of the surgery attendings I work with, took it upon himself to do things I should be doing (putting a foley in), and not because they were being mean, but because we all had the same goal for our patient (best and safest, most efficient care possible). I was already busy doing something else.
The EKG thing? It gets better with time. You can practice a little at home with worksheets and the like both for application of stickers for 12 leads and then 3 and 5 lead telemetry monitoring leads. I love the incredibly easy book about EKG and telemtry. Very helpful to me. Maybe once you get further into orientation you could ask for some time to just practice some of the skills you are expected to do but don't get to do as frequently? I am sorry the other nurse was so difficult for you to work with and made you feel badly. Keep that in mind, some day you will be the nurse helping someone newer learn to do their job. There is something to learn from every situation, and not every take away is clinical knowledge. Some lessons are related to inter-personal growth.
With respect to charting. Check to see what abbreviations are acceptable in your institution and what things mean (example: what does WDL/WNL mean in your facility). Review charting that other nurses use to see hints for clarity and conciseness. More importantly, remember to be objective. Describe what you see and what you do, and whenever possible, quote your patients. Charting really gets better as you get more experience.
Oh, honey, it will get better. I still make an occasional mistake, and I have cried from time to time. Try to step back, and give yourself some time - maybe three months, and then do a self evaluation. You need at least a year to feel competent. Even then, there is always something you don't know- and that is okay. You ask, you learn, you research.
It is easy to say get a thick skin- it takes time. Remember, even the best nurse on your unit was a new nurse too!
You've gotten some really terrific feedback here, so I won't repeat it. I would like to share with you something I've posted on here before, though, and it rings true every time. A former clinical instructor of mine told me that if I were to come across a nurse with more than a novice's experience who says s/he hasn't made a med error, that person is either lying or too stupid to know the difference! And I believe she was spot-on, no doubt.
Nurses WILL make mistakes, especially new ones. Lordy, TWO WEEKS? You're still in diapers in Nursing World :)
You will go on to make other mistakes, but if you are SMART, and CARE, you will learn from each and every one and will not repeat the same ones. But they will happen.
I hold out MUCH hope for you, btw, because you care how you are doing. Too often, a new nurse will brush off errors or ineptitude with "oh, well, I'm new, so what, I'll eventually figure it out". And while that might be true in words, it's very telling in attitude. People that don't care will not do well, will not do their best by their patients. It shows.
People who DO care, absolutely are the patients' best advocates.....and it shows :)
Well you certainly are your own worse enemy. You need to calm down and stop being so hard on yourself. You have to learn how to be a nurse. It takes time so take your time. You won't make it, if you keep analyzing your every move. You need to know what you can't miss and what is ok to miss and not know and go from there. Many nurses have made the same mistakes and won't admit it for whatever reason, and that is fine. I am lucky to have had some tell me they did the same things I did early on and to they told me to make sure not to do it again. Usually when you make a mistake, you learn from it, but not by beating yourself up. You need to look at what led to the error, and fix that. Were you rushing, if so why. Are you lacking confidence, if so why and now how do you fix these things. Listen to some calming music, meditate, listen to positive talk on you-tube. You don't have time to beat yourself up at work, to much goes on at work, you need to be focused.
FurBabyMom, MSN, RN
1 Article; 814 Posts
Take some deep breaths, review some extra material, and keep at it. Learning anything is a process and you will get there, it takes time. You don't come out of school with the clinical judgment of someone who has done XYZ job for 5, 10 or more years. It takes some time to get there, you aren't there automatically. It takes some effort outside of work to continue learning and growing too.
The ability to reflect and self-assess for needed growth is a huge thing working in your favor. The thing that scares me more than someone I'm orienting (or working with) that makes mistakes is when people make mistakes and do not catch them, do not care, or think they know everything.
If you think there is any nurse you work with who hasn't made a mistake? Think again. The physicians, NPs, PAs - all have likely made some mistake along the way too. There have been events in my workplace in the past several years that have required the staff to meet with the legal team and go through everything about how XYZ happened - and while I can see how I might have acted differently in those situations, more than anything I think "there but for the grace of God go I".
Medicine and healthcare overall are team sports. You do have to be knowledgeable and thinking things through, but the others around you are on the same team you are. Do not be afraid to ask a coworker (ex. your mentor) for help or their assessment of a situation. In my current job, one of the surgery attendings I work with, took it upon himself to do things I should be doing (putting a foley in), and not because they were being mean, but because we all had the same goal for our patient (best and safest, most efficient care possible). I was already busy doing something else.
The EKG thing? It gets better with time. You can practice a little at home with worksheets and the like both for application of stickers for 12 leads and then 3 and 5 lead telemetry monitoring leads. I love the incredibly easy book about EKG and telemtry. Very helpful to me. Maybe once you get further into orientation you could ask for some time to just practice some of the skills you are expected to do but don't get to do as frequently? I am sorry the other nurse was so difficult for you to work with and made you feel badly. Keep that in mind, some day you will be the nurse helping someone newer learn to do their job. There is something to learn from every situation, and not every take away is clinical knowledge. Some lessons are related to inter-personal growth.
With respect to charting. Check to see what abbreviations are acceptable in your institution and what things mean (example: what does WDL/WNL mean in your facility). Review charting that other nurses use to see hints for clarity and conciseness. More importantly, remember to be objective. Describe what you see and what you do, and whenever possible, quote your patients. Charting really gets better as you get more experience.