New RN, First Job and SCARED!! Help

MikeyBSN · Feb 5, 2011

What kind of job did you get? Is it at a nursing home? In a hospital? Those details help. If you are worried about med errors, there are a few good tips to go through but they depend on where you work. Generally, you should always double-check your medications. I have been a nurse for more than 5 years and I still bring my medication order sheet to the PYXIS with me (unless it is just a toradol or percocet order). Take your time with meds. Double-check to make sure that the medication you are giving matches that on the order sheet. Also ask, "why am I giving this"? Are you giving a beta-blocker to a guy with a cocaine habit? If so, double check the physician order vs. the MAR to make sure there was not a transcription error. If in doubt, call the doctor and double-check. I deal with a lot of doctors who know English as a second language. At first I was intimidated about feeling dumb, but now I have no problem with the confidence to just keep saying "I'm sorry, can you spell that? Or, can you repeat that order"; "Albuterol 2.5 q6h, is that right? Do you want that around the clock?". I have learned to not really care if the doctor is in a hurry because the patient's safety is more important. It's a hard but important step to take. Lastly, and I think most importantly, is the patient. I look at the medical record before giving medication. I look to see if the patient has an allergy band on as well. However, I try, without exception, to talk to the patient before giving medication. "I'm going to give you 2 mg of morphine, are you allergic to any medications". "No, good. Have you ever had morphine before?". "No? Okay, then, it might make you dizzy, that's normal. It might make you fell like you are going to throw up, that's normal. If it does, let me know and I can give you some medication to help those symptoms. Sometimes it can give people a rash. If you feel itchy, if your arm gets red or if you feel like your mouth is swelling call me right away, here is the call button".

Be careful, cover the basics, and know what you are giving and why. Understand the medication and that will help you with look-alike and sound-alike meds. At first, take your time until you know dosages. At first, you might not raise an eyebrow to a toradol order for 60 mg IV, so always double-check. When you gain experience, you will know that the order should be 30 mg IV. Until then, always check the order, ask why you are giving the medication, and ask the patient about reactions.

SummerGarden, BSN, MSN, RN · Feb 5, 2011

5 rights and 3 checks every time and you will not make a med error. btw, if you do make a med error, you should not be fired! med errors are to be written up on an incident report and you should receive counsel. the only time a med error should get someone fired is if that person either shows a pattern of safety problems or if he/she killed/harmed someone. fyi, a healthy fear of a med error should keep you on your toes so you need not worry too much.

as for hating your job, well the first two years of nursing is hard. there is no way around that.... some nurses are lucky to have a supportive work environment where co-workers are great. most of us experienced working with nurses who eat-their-young. thus, my advice is to come here for support and to vent. also, do not expect to learn all of what you need to know from working. you will find that nursing school taught you very little!!!! however, once you incorporate learning/studying on your days off with relaxing activities, you will see your clinical practice improve. gl!

jillpr · Feb 6, 2011

I'm right there with you GEM27. Starting my first nursing job and have an added language-barrier concern to go with my new-job anxieties. Love reading the support here to help calm me!

panurse123 · Feb 7, 2011

I think forcing yourself to create habits can keep you safe. FORCE yourself to ID your patients, FORCE yourself to verfiy allergies and say OUTLOUD - ok, you are Mary Smith and you are getting 2mg Morphine ( look at bottle/syrine as you say it) and 4mg of Zofran for your pain and nausea. You are not allergic to this drugs, correct? After a couple months, this safety net is in place and it can reduce the risk of a med error. Its like putting on a seatbelt before you pull out of the drive, just comes automatically.

GEM27 · Feb 11, 2011

Thanks to ALL the AWESOME advice. I start Monday and the area I am in is Psych. Which I do really like. So please keep me in your prayers and Thank you all!!! God Bless:)

hiddencatRN, BSN, RN · Feb 12, 2011

So, I'm only a couple of weeks in, but it really hasn;t been that bad. I have a great preceptor, ask a lot of questions, push myself to take on new challenges, and have been more surprised with how much I know rather than the opposite. Maybe I went in with super low expectations because of everything I've read on AN, lol, but I'm actually pretty please with how I'm doing.