In my last post, I mentioned that I was nearing the end of my preceptorship. I have been on my own for three weeks now and I just don't know how to think or feel. I dread going into work and have sometimes cried beforehand.
The other night, I made a mistake. I administered a medication to a pt who is allergic to it. The doctor prescribed it, pharmacy mixed the medication, it didn't alarm me when I scanned it. But I should've caught it. Luckily, the pt is okay and had no reactions. And the nurse who informed me about it was very nice and said that I'm new and learning, but to just check that next time. So you can bet that I'll be looking harder at allergies before giving medications and even asking the pts before I give them medication.
I also had another situation that I'm wondering if my assessment skills are lacking. I had a gut feeling about a pt and did not listen to my gut. I asked another nurse about it and she said to just watch the pt. The pt was fine the rest of the shift. However, the next day, the pt was sent upstairs due to a possible acute situation. Or to rule it out. I'm wondering if I could've done more.
Am I not cut out for this?
There's so much to keep track of. Labs, recognizing s/sx in pts, techs not reporting abnormal VS, paperwork, etc.
I feel so incompetent. I go back tomorrow and am dreading it.
I plan to open my books back up and refresh my memory on s/sx of disorders, etc. But what else can I do? People keep telling me that I'll get better and that the only way to get better is to do it. But it's just so hard.
Take a deep breath. If you don't mind, what was the medication and type of allergy? I ask because majority of allergies are in fact not IgE mediated allergies, just receptor responses and technically SE effects are part of the effects of the drug. For instance if a patient gets scopolamine patch and they end up with dry mouth or dilated eyes, that's not an allergy. It will be listed as an allergy however, which is nonsensical since that is an expected reaction of muscarinic receptors.
Thank you to everyone who has commented. It truly means a lot. I’m hoping with time that I’ll be better and more knowledgeable. I look things up in my off time and at work when I have a chance. Especially meds that I’ve never heard of. I’m currently sitting at work and I don’t feel terrible, but I think sometimes I have so much anxiety that it works against me and I can’t focus on things as much as I would like. I also don’t have the most confidence. I’ve always struggled with this. What other areas realistically could I eventually go into other than LTC? And I’m not sure about the contract. I was going to look into it. I’ve heard of them going after some nurses and not others to repay.
I think it's great that you recognized your BIG opportunities to learn and that no one was injured in any way. You got one big reminder to check for allergies. You also learned to always trust your gut! Sounds to me like your assessment skills are doing fine, just back up your gut feeling with objective data such as VS, labs, you know the drill ?
I'd recommended a book if you like reading: From Novice to Expert by Patricia Benner. Here's a 5 page teaser if you are interested https://www.medicalcenter.virginia.edu/therapy-services/3%20-%20Benner%20-%20Novice%20to%20Expert-1.pdf
There is absolutely nothing wrong with working in long term care.
Perhaps there is nothing wrong with working LTC, but for a new grad RN there are plenty of right reasons to work in acute setting first. I have seen some wasted potential in LTC pushing med carts without any reasonable upward mobility.
I understand your anguish! I've been off orientation for 6 weeks and some days are horrible and leave me feeling like I wish I was still in school? Thank you for posting this question; reading all these comments has made me feel better. Exercise has definitely helped with my anxiety and I ask questions whenever I'm unsure of things. It also helps me alot to remember that the first year of nursing is usually very difficult; that way I expect difficulty and know I have to stick it out. Good luck! Feel freel to send me private messages if you want to!
Experience only comes with time. The fact that you care about how you’re doing means you’re already a good nurse. Keep your eyes open and never stop learning. Hang in there. You belong.
Thank you again to everyone who has commented. Sitting at work on break and reading this helps a ton. I just tend to compare myself to others and I see these other nurses who easily catch things with their patients and just know things and I wonder if I will get there. I contemplate quitting a lot. But I know that I need to stick it out at least for a little while. Also that contract has complicated things a bit. I want to get a copy of the contract to look over, but I don’t want to seem suspicious either. I asked about going to PRN because I wanted to go back to school for my BSN but apparently I am not able to do that. I wanted to review my contract to see if that’s a possibility. Has anyone else done a 2 year contract with an HCA facility and left before 2 years?
Lots of great responses here! Nursing is a hard job. No one other than a fellow nurse understands just how hard. You're doing just fine. We all have made mistakes in practice and most are like yours, not causing harm to the patient. But you've learned from it and your asking the right questions. The dangerous nurses are the ones who don't learn or ask questions. Just keep moving along!
Hi, I am also a new RN here. I once did not flush a clysis line before connecting it, about five minutes later, I’m not sure of the time now, I got an alcohol swab wiped the port before administering the fluids for the patient. I totally forgot about it after that day, a while later I remembered, thinking back to the last time I saw the person they were fine (same baseline at which they were when I was with them at first), looking back I know the right thing to have done and I have learnt from it but I would like some advice.
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Take a deep breath. If you don't mind, what was the medication and type of allergy? I ask because majority of allergies are in fact not IgE mediated allergies, just receptor responses and technically SE effects are part of the effects of the drug. For instance if a patient gets scopolamine patch and they end up with dry mouth or dilated eyes, that's not an allergy. It will be listed as an allergy however, which is nonsensical since that is an expected reaction of muscarinic receptors.