New Nurse Feeling like a Failure

[Menagerie]

Hello Everyone,

First, I’m sorry for how long this is. I’m really struggling as a new nurse and feel a bit like a failure. I am searching for a place for support, advice, or just your own experiences. Opinions are totally welcome; the good, the bad, the ugly. I just want to know where I stand with the problems I’m facing and the mistakes I have made in my first 3 months on my own as a new nurse. Who better to ask that internet nurses with no personal attachment to me that can tell me like it is? 

I have made numerous mistakes brought up to me by management. It has been made clear to me that if I make more mistakes I could be terminated, I even had to sign the warning for it. I’ve never been fired from a job and I don’t want to be thought of as incompetent. 

My errors:
I wasted lomotil incorrectly 3 times (all within two days). I didn’t realize it was scheduled - I was like, diarrhea meds, its fine. Also the patient who had refused it was in a contact room, so I thought I couldn’t bring it out of the room. This is true - but I still needed to find a witnessing nurse. Now I know better. I should have known when the Pyxis prompted counting that it mattered. One of my faults is being absolutely dumb not realizing just how much red tape there is in nursing, for controlled meds for diarrhea. I feel like an idiot - but at least now I know better.

I had a no call no show. Yeah, I know, yikes. I didn’t check my schedule after the final was posted and the schedule I had in my calendar was from before they finalized it. I struggle with anxiety, and the night before I was supposed to go in, I wasn’t able to sleep. I couldn’t go in when they called; I would have been a danger to my patients. If I had slept I totally would have gone in. I felt I couldn’t tell them that, so I made up an excuse as to why I couldn’t come in (also told them about having written my schedule wrong). I know I need to get a handle on my sleep and my anxiety - I’ve started taking medicine for anxiety recently. Even before this happened, I always made sure that I was sleeping at a good hour. I am now constantly checking the official schedule too. 

I forgot to change tubing one day when I was really busy and overwhelmed. 

I brought an immunocompromised patient Starbucks (the Starbucks is in the hospital, I was thinking of going on my break, so when he asked me to, I was like ‘sure, let me see if I can’. I asked our clerk if it was okay when I should have asked a nurse. The clerk told me it was fine, so I thought, yeah, it should be fine, maybe its a normal thing. I also reasoned that that his family probably would have done it for him as I’d seen other patients families do it. I still should have known better. *face palm*. 

I am not social enough with coworkers. This one bothers me because while I am equal parts introvert and extrovert, my entire shift is spent talking to people and I enjoy being on my own at lunch, not talking or catering to other people. I also feel uncomfortable around a lot of the other nurses - part of that being that I am new and feel like a bit of a screw up so far. They also feel a bit unapproachable. 

I asked the wrong question to the wrong nurse. I was doing my first chemotherapy since orientation (this was in late September, the last time I had done it was when I was with my preceptor in July). My epic sidebar layout was different that everyone else’s for some reason, so I asked a senior nurse where I could find the chemo checklist. She told my manager and they acted like I didn’t know anything about what I was doing - when in reality, I had done a refresh, read the policy that morning, and was pretty confident for my first chemo admin alone. The manager had the audacity, after telling me this complaint, to say “if you don’t know something, ask questions!”. I normally ask a ton of questions. Even things I know, sometimes I ask just to be extra positive I am doing the right thing. Now, I feel like I can’t ask questions, because if I ask the wrong person, they are going to tattle and make me seem even more incompetent than they probably already believe I am. Than I am starting to believe I am, if I’m being honest. My confidence is really going down the tube. 

I spend too much time talking with my patients. While I am learning time management and critical thinking, this is totally valid. It's also not that I am a huge socialite trying to talk to them and waste time - its that these people are all in really difficult situations, in the hospital for weeks, sometimes months at a time, and I want them to feel heard. I just think if it were me in their shoes, having my nurse stop to listen to how I am coping or how much I miss my dog would mean the world to me. I just need to focus on nursing, my true priorities, and remember that at the end of the day I am not these peoples buddy. Maybe I can be in the future, but not while I am learning and management is up my ***. 

I gave Tylenol to a patient for fever when they were at 38, not 38.3. I had been with the patient for two days and they were febrile; I wasn’t stopping to process their actual temperature. I was thinking that it was elevated, so I’ll give Tylenol. The patient was having aches as well, so it wasn’t really *that* wrong as they were also prescribed Tylenol for pain, but really: I totally gave it for the wrong reason. Thankfully this hasn’t come up to management but it is still something I know I did wrong and it sticks with me. 

I forgot to do blood cultures on that patient I gave Tylenol to. I didn’t actually forget - that day when I was getting report, I was recovering from blocked Eustachian tubes after having had a bad sinus infection. I couldn’t hear well and thought the other nurse told me they had been completed (when a pt spikes we do 3 cultures every 24hr. One had been done.). Still totally my screw up because I need verify everything myself in the chart and protect my own ***. I messaged the MD and told him, asked him if he wanted more cultures, and he said it was unnecessary. *face palm*

Writing this I just keep cringing, because right now I’m relaxed and thinking, how could you do those things? Are you not using your head at all?

Also part of me feels a bit unsupported by my administration and coworkers. I am totally responsible for my actions; but I just feel overwhelmed and maybe I’m not ready for this or am in the right career. My favorite part of my job is the patients - everything else is draining me/bleeding into my life in negative ways. 

[HiddenAngels]

Breathe Nurse Friend, 

It is okay, you are new. And you are a fantastic nurse! You are thoughtful conscientious and compassionate, a lot of other nurses are not. Trust. 
Next, relax, EVERYBODY makes mistakes and these are NOT grave mistakes contrary to what your flip flop flippity flopping managers think.
It seems though that you are in your head waayy too much and I know because that’s how most of us start out and it should start to get better soon.   Now, you are good at what you do but pay attention to the details. The type of nurse you are sounds like some of the old school nursing which takes care of the patients, prioritizes bedside care,  and actually considers the patient first.  Those days are passing.  Unfortunately there are tickmarks, parameters, minute details that they want us to follow and we should, I shouldn’t have said unfortunately but yea, I said it.  We are now task driven nurses and these  details will get us fired in trouble embarrassed humiliated so yea, we don’t want that. There are some things which we don’t see that are out of our scope and some nurses don’t follow those details and I’m not talking about those types but the ones you didn’t follow, nah they’re not that bad, but get in the mind of checking and double checking and then you’ll be able to relax and move onto the next task.  
Charting is always changing and your corny coworkers should be a little but more understanding, but make no mistake your work environment is toxic and petty. It is NOT you.  I would eat lunch by myself too if I had to eat with ogres lolol.

So stay strong, hang in there if you can. If you can’t, learn what you can then bounce.
The world is waiting…. (Hugs)

[Leader25, ASN, BSN, RN]

No doubt you have made mistakes ,stop.You can not make assumptions,you must follow protocols,standing orders,first talk later.Do not expect supportive staff,they are women and their attitude is not kind,so stop expecting it.Do your job,complete what is required.I knew nurses that were lazy,sloppy,but never got in trouble because their game was to check off all the "required" ticks, ie; show up for work,be on time,chart,chart chart.Practice defensively,you think tylenol  incident is no biggie but imagine what a good malpractice attorney can do with that....from side effects to reactions,drug interactions. You sound smart and knowledgeable while it is nice to put yourself in patients shoes ..stop..they need their meds on time,their meals,their treatments....handholding later after you correct bad impression on the boss.Hope you can do this, and..there are other areas to work in,but you need a clean record,and experience. Best of luck for you o young one.

[acceleratednurse]

I'm sorry you are going through this. It does sound like this a petty unit. I'd look for a different job if possible. Maybe complete a year and move on. I came here because I'm a new grad still on orientation and I feel like I'm failing terribly, and I wanted to see if other people had the same situation. 

 Yesterday, one of my patients temp was 38 and I didn't give him Tylenol and the nurse precepting me (not my actual preceptor) was not happy. The temp was 38 on the dot and he said he felt fine and even asked me to close the blinds because the sun was hitting him and he was hot. So I didn't think he needed anything. But anyways. My actual preceptor is great, but we do have a few nurses (especially the charges) who have that behavior. On my third day on the floor I was giving crushed meds and I put some pudding in a little med cup before giving it to the patient like I was taught by another nurse. The charge was watching me because my preceptor was on break and she made a big deal about it being a waste of time in front of the patient and even took it out of my hands and force fed it to my patient. Later, I saw her complaining to my preceptor about it when he came back. At the end of the day, he actually told me about her complaint and said that he also prefers to do it the way I did it and to ignore her. Yesterday, I asked another charge how to print a requisition for a sputum collection, she looked at me as if I was asking how much was 2+2 and even rolled her eyes. Thankfully another nurse overheard and offered to walk me through it.

It's sad that these nurses have soured up so much. Luckily, in my unit they are few and far between since most older nurses have retired during COVID. But it scares me that they are supposed to be my resource when I'm on my own in a few weeks. Hearing your story really scares me. It sounds like you are in a place with a terrible culture. I honestly don't think it's you. Take some of the criticism and try to improve but if your don't feel supported, move on. Best of luck!

[kkbb, MSN, RN]

Oh my, I feel like I could have written this when I was a new grad.  I am so sorry that you are feeling like this, and are unsupported by your unit.  I was the queen of filling out incident reports my first year and even had 2 patients fall within one week of each other during my first month off of orientation.  I also struggled with time management.  I was also acutely aware of the fact that no one trusted me.  I remember knowing that I was going to be let go at the end of my residency.  

First, find one or two nurses that you know you can ask questions to.  Also, learn who to avoid unless it is absolutely necessary.  As I have learned over the years, even the best nurses still ask questions.  But the key is to know who to ask.  But you also need to learn how to trust yourself.  I know this is hard, especially given your confidence has been shaken.  But if you are sure you know the answer, then have faith in that.  

When you make a mistake, learn from it, grow from it, and then move on to be a better nurse because of it.  You identified incorrectly waisting a medication and correlated the required pyxis count as a hint.  Great!  You learned and don't make that mistake again.  Honestly, I get more concerned when I see repeated mistakes and not learning than making a mistake.

The chemo treatment plans in Epic can really suck sometimes.  It can still mess me up after years of doing it.  I have a chemo-specific brain I use that walks me though all my checks (Echo date? Pregnant? Central line? Current lab values, and so on).  Maybe create something like that to help guide you as you prepare.  What concerns me more is that you were doing your first hang independently and there was no support.  Any time we have a new chemo nurse hanging the first few times, we keep a special eye out on them. Chemo is stressful.  This sounds like a unit problem, not a you problem.  

Time management is a skill that can only be learned.  If you know it is an issue, make it a priority to work on.  Each shift ask what went well, what didn't (why and what could have been changed), and what was beyond your control.  Then (if you have the same patients the next shift) apply what you figured out.  

Sorry for the long reply.  As I said, I feel like I am writing this to my new grad self.  So with that in mind, I say this.  I knew I struggled.  But I made it.  5 years later I am a preceptor, charge, and resource to my unit.  I am a better nurse because of all my struggles in my first year.  The biggest difference I see between you and me is that I did have support from management.  I am sorry you clearly don't.       

  

[Menagerie]

Thank you all so much, I’m a little in tears reading your words. Your encouragement and advice moved mountains for me.

This has been one of the most stressful periods of my life, and after careful consideration I have decided to resign and find other employment. Other nurse friends I have confided in have stated they are micromanaging me like crazy and bullying; I have been thinking its just been my lack of tough skin and nursing skills in general (though likely its not that black and white, its all of it). 

Its crazy how many of you are mentioning the poor work culture based on the few examples I brought up. There is actually so much more stuff I left out (and have experienced since posting this) that I could write another essay just about how the environment/my colleagues.

So, I am moving on and searching for a better place to work.

I took this job because of the pay and *seemingly* nice work culture, but it is a massive hospital system, and someone told me that its harder to keep a positive culture in the larger organizations. There was another hospital I was accepted at but ultimately declined for this job; the manager had told me they treat each other like a family. I felt good there during my interview. I hope to find that in my next workplace.

[Robin Browne]

Please don't quit nursing💕 your seems to be in the right place, and too many nurses/providers lack the heart at all. We all mistakes or miss something, even years into it. You are not alone in how you feel in this career, new or old. Spending time with patients is one thing they want!! Not to feel alone!! Eh...time management stuff is learned, you can always be honest with patients and their families, hey, I have some 'nurse stuff' to go take care of for a bit, can come and chat when I'm done with thise things :)