new nurse feeling like im forgetting/missing things

[ddrn97]

I just started a nursing job as a new grad RN a couple of weeks ago. Things were going great and my preceptor thinks I am doing well. However, yesterday was a terrible shift. The few days I did before yesterday were smooth and I was taking care of about 4-5 patients independently on a busy tele floor getting everything done for the most part on my own. Yesterday morning I walked into a code blue, long reports on my heavy patients, stressed out and difficult family members, NG tubes and pegs on a few of my patients, etc. I couldn't do as much as I normally could on my own so my preceptor helped me out more. At the end of the day after I left I realized things we forgot or should have done differently. I am feeling discouraged as if I will either get into trouble or if I am cut out for job this overall.

1)Normally I sign off on each patient in the morning that a chart check was done and I didn't check them off this time even though we both chart checked together. Between the long reports and me trying to make sense of everything, being interrupted every 2 minutes, I forgot to sign off on chart checks. Not sure if anyone looks into when checks were done which are usually shown under the patient's orders.

2)My facility is strictly monitoring overriden meds and I had to override a multivitamin because the barcode wasn't readable. I didnt want to do this but I was so overloaded I just had to override it.

3)we had a patient who had a blood pressure SBP 190 and my preceptor consulted with the practitioner about it who said they wanted to wait another hour and re check it. Even though my preceptor took care of this I couldn't help but think after: did she chart that the provider said this? I could also be responsible if this was to be questioned and/or something went wrong.

4) After giving tylenol IVPB near the end of shift to a patient with a 103 fever we repeated a rectal after which went down to about 100. Did I remember to document the temp...nope.

[Mrs.D., BSN]

Congrats on your new job! I'm also a new grad and I haven't even started working yet! But I know many who have, and I can say with confidence that you are not alone in your feelings and also replaying what you could have done better.

From what I can read, those sound like excellent learning opportunities, and because you made them now, you most like will not forget to chart a recheck and will remember to document all calls and orders, for example.

Try not to be too hard on yourself. I try and remember that mild anxiety in new situations is healthy and keeps me focused and improving. Maybe try to limit how often you do it? For instance, give yourself one hour to regroup after a shift and take a couple of notes of questions/goals for next shift. Then leave it all at the door because there's nothing you can do. Worrying will not help.

LISTEN to your preceptor if she's telling you you're doing well. It's her job to tell you if you need to improve something. The DON that hired me told me during my interview that he expects new grads to make mistakes and be afraid of things. There's a reasonable predictable timeline that most of us will follow. I'm impressed that you even know how important it is to document *everything*. I'm not sure everyone does.

Good luck, and I hope you get a break before the next really hard shift. :)

[meanmaryjean, DNP, RN]

New grad, old grad, experienced RN- we ALL have days like that. You were right to delegate a couple of things- and you learned something from the experience.

Deep breath. You got this!

[ddrn97]

Thank you for your opinions