New nurse feeling incompetent

RedhairedNurse, BSN, RN · Dec 1, 2008

I think what you're experiencing is totally the norm. Here lately, there have been a couple of issues that make me feel the same way. I spoke to my charge nurse, tonight actually, and other's about making small errors now and then and they've made suggestions on how I can be better.

I say give it a full year and then if these type of errors keep happening....I'm really going to have to check myself then.

Up2nogood RN, RN · Dec 1, 2008

I think all new nurses are in the same boat. I'm VERY fortunate to work on a unit where everyone supports me and is helping to train me. I've been in this hospital for about 10 yrs as a tech so I've worked with the older nurses for a while and they're very supportive and human too. The most important advice I've been given is to learn from your mistakes. :nuke:

americanlatina313 · Dec 1, 2008

i think what you're experiencing is totally the norm. here lately, there have been a couple of issues that make me feel the same way. i spoke to my charge nurse, tonight actually, and other's about making small errors now and then and they've made suggestions on how i can be better.
i say give it a full year and then if these type of errors keep happening....i'm really going to have to check myself then.

my problem is that i couldn't see the forest for all the trees with these 2 pts i was talking about. that's what's got me down, where i can't sleep well & i cry alot. it makes me feel like i don't want to go back to work, for fear that someone else will need me & i won't be there mentally. :scrying:

americanlatina313 · Dec 1, 2008

i think all new nurses are in the same boat. i'm very fortunate to work on a unit where everyone supports me and is helping to train me. i've been in this hospital for about 10 yrs as a tech so i've worked with the older nurses for a while and they're very supportive and human too. the most important advice i've been given is to learn from your mistakes. :nuke:

oh, believe me, these mistakes aren't ones i'll easily or soon forget, if ever. however, i think part of the problem is that since i was the cna on my floor for 2 years, i get the vibes of "shouldn't you know that already?", and there are many times i don't feel at all supported. i love my coworkers & i love my unit. i just wish i could feel less like an incompetent idiot, and more supported. but in the meantime, i'm gonna be delving back into the books, trying to get some wisdom without having to ask soooooo many questions. hopefully it works. :up: thanks for the encouragement. :nuke:

RedhairedNurse, BSN, RN · Dec 1, 2008

oh, believe me, these mistakes aren't ones i'll easily or soon forget, if ever. however, i think part of the problem is that since i was the cna on my floor for 2 years, i get the vibes of "shouldn't you know that already?", and there are many times i don't feel at all supported. i love my coworkers & i love my unit. i just wish i could feel less like an incompetent idiot, and more supported. but in the meantime, i'm gonna be delving back into the books, trying to get some wisdom without having to ask soooooo many questions. hopefully it works. thanks for the encouragement. :nuke:

i'm sorry you don't feel support. i get that drift from some of my fellow employee's at times, but not often. do you mind actually sharing these mistakes with us? we may actually learn from what you've been through.

i'll share with you a mistake i made last night that gave me that incompetence feeling. i was feeling rushed, had an incontinent pt that i was trying to clean, as well as several other things going on. i gave an npo pt food! i should have known better, stupid me! this is just one example of a mistake i've made. i learned from this, and, in the future will always stop, look and listen before i make any impulsive decisions like this again. i should have looked at my paper brain or the cardex first, or even just the outside of the door. the positive side, the pt was not hurt.

i've been in nursing for 6 months now and i'm still asking questions. there is nothing wrong with asking, nothing at all. i have a charge nurse that actually commended me the other day for asking questions; it surprised me when she said this. but these questions i ask are things i feel like i should know from nursing school. nursing judgement also comes from experience and not just books!! you have to quit being sooo hard on yourself. you'll do fine. just continue to ask when you're not sure, because in the end, it's your responsibility to make sure your pt is safe, and if you need to ask, then ask.

americanlatina313 · Dec 2, 2008

i'm sorry you don't feel support. i get that drift from some of my fellow employee's at times, but not often. do you mind actually sharing these mistakes with us? we may actually learn from what you've been through.
i'll share with you a mistake i made last night that gave me that incompetence feeling. i was feeling rushed, had an incontinent pt that i was trying to clean, as well as several other things going on. i gave an npo pt food! i should have known better, stupid me! this is just one example of a mistake i've made. i learned from this, and, in the future will always stop, look and listen before i make any impulsive decisions like this again. i should have looked at my paper brain or the cardex first, or even just the outside of the door. the positive side, the pt was not hurt.
i've been in nursing for 6 months now and i'm still asking questions. there is nothing wrong with asking, nothing at all. i have a charge nurse that actually commended me the other day for asking questions; it surprised me when she said this. but these questions i ask are things i feel like i should know from nursing school. nursing judgement also comes from experience and not just books!! you have to quit being sooo hard on yourself. you'll do fine. just continue to ask when you're not sure, because in the end, it's your responsibility to make sure your pt is safe, and if you need to ask, then ask.

well, i'm not sure how much i can share, but i'll try to explain without being toooo detailed (hippa)... the first event was when i had a pt who was a gi bleeder... supposed to go for endoscopy/colonoscopy the next am. pt states that she was talking to the doc about doing it outpt. she was a shift-change admission (previous shift), so they didn't want me touching her orders till they were finished. i got to look @ them @ 9pm. by that time, pt didn't want anything to do with go-lytely. (who could blame her!) also, there was an order about a blood transfusion, but not clear if she should have another unit once she arrived to the floor. nurses from previous shift said that i needed to call the on-call md about the blood. anyways, that night i just didn't have my head screwed on straight, and didn't really understand them when they were talking about calling for the blood. somehow, the pt never got the go-lytely nor the blood during my shift. thankfully, no harm was done, the pt came out fine, everything was done that next afternoon. however, as my boss stated, what if she had started just bleeding outright? her h&h was already low. i could have had a hemorrhaging pt who was in desperate need of that extra unit of blood that was never administered. :crying2:

well, then, we (both my boss & i) thought it was just a bad night... till almost 2 weeks ago. i had a pregant pt with pyelonephritis develop sob around 3am. she had a history of childhood asthma, so i thought it might be an asthma attack, especially after it calmed down after a few minutes. i listened to her lungs during her sob episode, but did nothing else, since she was clear. duh! asthma creates wheeze! should have set off whistles in my head, but it didn't. i didn't even do a spo2, let alone any other vs. :banghead: thankfully, she "only" had pneumonia. but what if it had been a pe? or septic shock? i could have lost 2 pts that night, both the lady i could see & her unborn child, which i could not see. :crying2: i realize that on that particular night i was already somewhat preocupied with another pt with preeclampsia... but to miss that soooo badly?! i imagine that you can see why it would keep me awake @ night. these aren't just giving npo pts food. it's putting lives in real danger. and what made it worse was that especially with the pregnant pt (pyelonephritis), i felt like the other nurses didn't want to hear my questions, so i didn't ask them anything. doubtless they would have directed me in the right way. i have since learned that it doesn't matter. the other night i had a pt who's bp was like 80/49 or something like that. she had gotten 50mg demerol & 25mg phenergan iv just under an hour earlier, plus she was laying on her left side. so i wasn't worried. but i still asked another nurse, and she said that it was awfully low & i should go & recheck. i did (manually) and it was 90/58. no problemo.

i don't know how much this can help (so someone else can learn), but all i can say is that you don't need to get soooo frustrated that you don't see the forest for the trees. i mean, come on, it doesn't take a rocket scientist to know to check spo2 when a pt has new onset sob. :uhoh3: but like i said, these are lessons that i will not quickly forget, if ever. all i can do is pray & beg god to use it to make me, not only a better nurse in the end, but rather an awesome one! :nurse:

RedhairedNurse, BSN, RN · Dec 2, 2008

I too, had a pt one night that had a very low H&H, but our computers went down about two hours after my shift started and were down for almost half the night; I didn't realize this until around 2am. The highly experienced day shift nurse didn't notice it at all!! This person was like 6.2/21 earilier in the day and still bleeding. I would have known of this H&H, if.... I would have checked at the beginning of my shift instead of waiting until computers came back up at 2am. Well, needless to say, I always check my labs at the beginning of shift just in case the day shift didn't do anything, as in this situation.

When these errors are made on my part, it really sticks in my mind to Not let it happen again. We're new nurses, there are times we're just going to have bad nights. I'm extremely thankful for my peers in helping to guide me in my lack of experience.

I believe you'll be an awesome nurse. Nursing is a continual learning process. I'm learning more now than I could ever imagine. I was once told that school really starts when we're on the job......that is so true! Thanks for sharing your stories.

crb613, BSN, RN · Dec 2, 2008

WE all make mistakes.....I bet you won't make the same ones again.

The key is learning from your mistakes & asking for help when you are overwhelmed.......do not ever hesitate to ask! If you don't think your coworkers will be helpful......call your charge!

If you do make an error own up to it.....and seek help for your pt if needed!

Don't be too hard on yourself....just keep on learning!

BTW... I am the question asking queen :)

mcknis · Dec 3, 2008

You will definitely learn from your mistakes and will be a better nurse because of it! We all make mistakes, but at the end of the shift, you have to realize the good you have done for your pts and understand that there is a reason why we have other nurses working with us. I have made so many dumb mistakes in few months, but with each one, I learn that much more about myself and also about my pts. It is because of the mistakes I have made, that I feel that much more competent.

I had a pt the other day with h/o CHF, not on lasix in hospital, active crackles that didnt clear with a cough and 2-3+ edema BLE. When I first started, i would have just looked at it and said well they need their meds but this is expected becuase of CHF. DUH! Well I looked through the meds and saw that she had NO lasix even ordered (it was even d/c'd a day earlier by another MD). Questioned the MD, but never got an order for Lasix (definitely charted to cover my butt that day).

Had another pt (38yo M) the day before that was admitted to our unit d/t c/o C/P (just wanted three hots and a cot) but was throwing frequent PVC's (had a low mag of 1.4...eek). Mag was given and GI cocktail was prescribed by cardiologist to r/o cardiac C/P. i had never given the cocktail before, so i didn't know that our pharmacy was to mix it. When it showed up on my med screen in the computer it just showed 20mg in 30ml viscous lidocaine and not the rest of the mixture (maalox and donnatol). so what did i do...I gave 30ml of lidocaine. BTW, only supposed to give 10ml of lidocaine. After giving it to the pt, i caught my mistake and realized what i had done. i called the pharmacist and they advised me that nothing would likely happen, but to be cautious of a numb throat and cardiac changes (when i gave it to the pt, i advised him i was giving it to keep his heart in a nice rhythm). pt was ok, but did tell me that his "thwoat ithh nummmm" LOL!!! Needless to say, when i went home, he didn't have any PVC's

HM2VikingRN, RN · Dec 3, 2008

You "practice" a profession. IOW you will be working on getting every day the rest of your working life. I think the trick is learning how to get further away from the near misses every day.

americanlatina313 · Dec 10, 2008

i too, had a pt one night that had a very low h&h, but our computers went down about two hours after my shift started and were down for almost half the night; i didn't realize this until around 2am. the highly experienced day shift nurse didn't notice it at all!! this person was like 6.2/21 earilier in the day and still bleeding. i would have known of this h&h, if.... i would have checked at the beginning of my shift instead of waiting until computers came back up at 2am. well, needless to say, i always check my labs at the beginning of shift just in case the day shift didn't do anything, as in this situation.
when these errors are made on my part, it really sticks in my mind to not let it happen again. we're new nurses, there are times we're just going to have bad nights. i'm extremely thankful for my peers in helping to guide me in my lack of experience.
i believe you'll be an awesome nurse. nursing is a continual learning process. i'm learning more now than i could ever imagine. i was once told that school really starts when we're on the job......that is so true! thanks for sharing your stories.

thanks for the input. that was really interesting about the h&h; maybe i'll start checking labs @ the beginning of my shifts too. :nuke: it is true that the learning really starts on the job. i wish i would have realized that a whole lot sooner. i was trying to rely on having been a cna for 3 years while doing pre-reqs/nursing school. i wanted so hard to believe that i already had some experience. well, i did, but only in certain ways. there's waaaayyyy too much that i don't know. i have already begun to ask questions again. the nurses may get exasperated with me, but i have this "i don't care" attitude. i'm waaaayyy too new not to ask! :bugeyes: thanks again for the input! :up: