New Nurse Mistakes

allnurses Guide · Aug 1, 2014

Thinking back, the biggest mistake I made in my early days as an RN was to try to "force" families to face reality about their loved one's illness and terminal state. I have personal reasons for being a BIG palliative care proponent and I was too blunt in trying to introduce the concept to a family more than once. I am better now about offering support without giving false hope and being ready, when the family indicates THEY are ready, to provide information about our palliative care program. I have learned that until they are ready, my pushing the idea will only be met with hostility and lost trust that will taint their reaction to ALL of the medical team from that point forward.

Now I meet them where they are, answer honestly but gently (ie: Scenario is Stage IV pancreatic cancer with liver and kidneys both shutting down. Them: But this will get better, he will come off dialysis eventually, right? Me: Unfortunately it is likely this is a permanent change given his overall state of health. *long pause while shock registers on their face* *wait to see if they ask more questions or drop the curtain of denial back down*) I have learned it is best handled a lot like children asking about where babies come from....they will ask as much as they are ready to receive. I let them lead the way rather than taking the first question as a sign that I should introduce the idea of hospice. This was HARD for me. I hate torturing people, especially the elderly. But until a family is ready, it does nothing but injure them.

Columnist · Aug 1, 2014

OK.......Admin here....stepping in with my Community Manager hat on.

All the "old" members here know that questions have been repeated time and time again. True, there are many threads to refer to.

But.......everyone was new here at one time......even you "older" members. You asked questions that I'm sure were not "unique" and had probably been asked many times before you came on the scene. How would you have felt if your questions had been met with some of the remarks that are posted in this thread and many others, especially in recent days??

It is not the information being shared, but the manner, language and attitude that is being used. We want to welcome new members and their questions. We should be happy to tell them about all the wonderful information that has been shared over the years, ......and make them feel welcomed to our community of so many wonderful and informed members.

Yes there are even times when questions asked may be part of a homework assignment. No one is telling you to do anyone's homework, but again, you need to be careful of the attitude and language you are using.

And by the way......I'm sure this is not the first time you have heard this. But some things are worth repeating......and need to be repeated.

TheCommuter, BSN, RN · Aug 2, 2014

What is your most regrettable mistake that you have made as a new nurse? What would you go back and do?

This has nothing to do with patient care...

During my first year of nursing, I regret that I did not have strong personal boundaries and a sense of self-efficacy. Some coworkers sensed this weakness in me, so they pounced like a pack of dogs and were mean at times.

Over the past four or five years my personal boundaries have become three times as strong. I also have a high sense of self-efficacy. And you know what? Other people can sense this, so no one messes with me anymore.

I've learned the hard way that rude people, bullies and passive-aggressive folks pick on those whom they perceive to be the weakest links. If you carry yourself with dignity and lay down the boundaries in the very beginning of the interaction, mean people will usually move on to another easier target.

Karou · Aug 2, 2014

Not verifying a patients home medications prior to sending them to pre-op. I spent all night on the phone with the physician determining the cause of unexplained tachycardia. Interventions, reassessments, phone calls. Finally pre-op calls after he is there to tell me that the patient had not taken his blocker.

Yep. Now I verify home medications even if is not have time to do the rest of the admission assessment. Lesson learned.

Also, not checking a foley bag for over half of my shift, then seeing it full with bright bloody urine.

Now I always check my tubes (foley, JP, NGT, ect...) every time I to in the patients room.

la_chica_suerte85, BSN, RN · Aug 4, 2014

Seriously, anytime I Google anything for research, the most frequent top hits I get are from allnurses. That's how I found this site. So, I've been using the search function since even before I joined. It is entirely possible to search for any topic (and you will get results going back years upon years) and there are no restrictions to this. I have found so many awesome insights and resources this way.

However...........

I think with the way social media and forums have evolved, there is some kind of intrinsic value to creating a new post on a topic and the idea of "let me check if this has been asked before" tends to be overshadowed by this drive to create something "original/fresh" (soon, if it isn't already, social media will be regarded as some form of self-esteem boosting strategy). Just my two cents as to why this happens here and on other forums as well. :whistling:

Graduatenurse14 · Aug 8, 2014

tnbutterfly Admin OK.......Admin here....stepping in with my Community Manager hat on.
All the "old" members here know that questions have been repeated time and time again. True, there are many threads to refer to.
But.......everyone was new here at one time......even you "older" members. You asked questions that I'm sure were not "unique" and had probably been asked many times before you came on the scene. How would you have felt if your questions had been met with some of the remarks that are posted in this thread and many others, especially in recent days??
It is not the information being shared, but the manner, language and attitude that is being used. We want to welcome new members and their questions. We should be happy to tell them about all the wonderful information that has been shared over the years, ......and make them feel welcomed to our community of so many wonderful and informed members.
Yes there are even times when questions asked may be part of a homework assignment. No one is telling you to do anyone's homework, but again, you need to be careful of the attitude and language you are using.
And by the way......I'm sure this is not the first time you have heard this. But some things are worth repeating......and need to be repeated.

THANK YOU, tnbutterfly Admin!

I've been disturbed since venturing out of the NCLEX forum of the tone of some very active members who've been here a long time. They've not been very helpful or welcoming to new members with their responses and then others pile on and comment in the same vein and/or Like their not helpful, not welcoming post.

Nobody forces anyone to come on here to read or answer any post yet some of them act like this is their job and they're being forced to deal with such lazy students and their nonsense. It's certainly not about teaching the newbie critical thinking skills nor the value of the search tool. I'm not sure what it's about.

I have a BS in Education and taught children and adults for years and was paid to deal with lazy students and their nonsense but never, ever treated them with a haughty attitude or disdain when they were asking for help.

I hope your post to them will put an end to it since it just isn't right.

Isitpossible, LPN, LVN · Aug 11, 2014

My very first job working in an LTC facility. The MARS for Coumadin were a bit confusing, and I missed giving Coumadin two nights straight... YIKES... reported immediately to my DON, family, physician. Doctor dc'd Coumadin and family very gracious. However, I learned if I don't understand something ask right away, never be afraid to ask a question if something is not clear!

Murse1919 · Aug 19, 2014

Giving 1mg of Morphine when it was supposed to be 0.5mg.

Nothing big came of it and patient was fine :)

zzravizz · Nov 8, 2014

I hope this isn't rude, but I am a new graduate nurse similar to the user who posted this question. I have been trying to find advice on this site as a new grad, and it is impossible despite using the search function. It concerned me a little though that when I was looking for ways to be the best new graduate nurse possible that all I could find in this thread prior to filtering through were negative attitudes going back and forth about one person being inquisitive on how to be a better nurse. Isn't that one of reasons why this website is great? Despite trying to find the information, I guess maybe I don't actually know how to search on this website if I wasn't finding what I was seeking. Anyways, I wanted to thank those that did provide some good feedback on this thread for me on my journey as a new graduate nurse. Thank you, awesome nurses!

NurseKis, BSN, RN · Nov 21, 2014

Thank You @TNBUTTERFLY!

NurseKis, BSN, RN · Nov 21, 2014

@ GRADUATENURSE14 I agree with u!! This is how i felt when i joined!! I guess its true that Older nurses eat their young.

RNx8yrs · Dec 3, 2014

Let's see, 15 months in, on orientation for the job I'm currently at, and I make a med error for a partial package. The patient needed to be monitored, but no harm. I could have been terminated because I was on 90 day probation, but my manager fought for me. Apparently, there were people on the IR committee who *did* want to fire me. Now, I keep a pill cutter in my pocket, and cut the pill immediately after scanning it.
Still new at my current job, and I did not question the procedure for when a new dialysis order comes in. Thought the right people would see it. Near the end of shift, thought, "Why hasn't he been dialyzed yet?" Turns out I should have called our dialysis contractor when the order came in. Patient did get dialyzed that evening, but I should have facilitated it hours earlier. It's now one of the first things I mention to agency or other floats working with me.
Waited too long to do a discharge on a patient to a new nursing home. Thought everything was in order. Turns out they wouldn't take him because some paperwork was missing. If I had done the discharge earlier, the SW would have been in the office to fix it. The attending was ****** that he had to stay another day. Expensive mistake. Now I try to discharge immediately unless it's near a meal time. I don't discharge nursing home patients right before a meal because the facility will most likely not have a tray available.
Not life-threatening mistakes, but they still made my stomach churn. Wanted to give a variety of errors that could happen as a nurse, not just med errors.

I don't understand about the partial package, but I can tell you that the other stuff is people being mean. The question is: how do you know if nobody told you? In this computer age you had probably a 50/50 of getting a crabby response if you had called. They could likely have said "I.KNOW." Here's something I learned quickly, if ancillary staff, lab, xray or whomever call you and want you to call the doctor and question the order he/she just put in.....don't do it. Especially if you think it's a stupid question. Don't get sucked in. Their questions, they should ask them.