Hi, guys! I have to say, most of my posts to this site have been pretty negative. I dislike posting so many negative things, but what can I say, I'm a new nurse and incredibly unsure.
So last week was my 7th shift on a very heavy medicine unit. The day-shift ratio is 1:5 and I was up to 4 patients by my 5th shift. I am so afraid that I am going to harm a patient, because my nursing preceptor rushes me through things. She gives me a patient load, but then instead of letting me try to get into my own groove of prioritizing and organizing, she just commands me. It's odd. I really like her, she is a great nurse, but man, I do not feel like I am getting guidance from her at all. I am being taught to dole out medication, make sure the orders get carried out and am expected to have the knowledge of a nurse who has years of experience. AHHH!!
Anyway, last week I had a patient with low bp, which has been the baseline for awhile. Pt. was somewhat drowsy, but was saying "pain, pain, pain". Dilaudid was ordered PRN and I really did not want to give it, but my preceptor and the night nurse both urged me to give it. I explained my assessment findings and their response was "oh, it doesn't really affect BP, just give it. He needs it". So I gave it. The patient assignment was under my preceptor's name, not mine. Anyway, of course the pt's respirations went down to 10 and he was just knocked right out. I checked him every 10 minutes for the entire shift, I was so scared I had just killed the pt. The MD got angry with me (and I don't blame her). I approached my manager about this, because I was so upset that I went against my gut. she told me not to worry about it, and that she was happy that I conferred with the nurses before giving it, and assured me that this knowledge and judgment will come with time.
Well I had this patient a couple days later and gave insulin according to the sliding scale. He wasn't eating very well, but I managed to get cookies and a fruit cup into him prior to me giving insulin. I went home and realized "well, maybe that was another stupid move". And it was. He had a hypoglycemic episode that night. I read in the notes that he had another hypoglycemic episode, when I was not on shift.
I am an honours student. I am a smart girl. I've never screwed up so much in my life. I feel like my critical thinking skills, once pretty well developed, are completely out the window. I can't concentrate. I have asked my preceptor for feedback and she just laughs and says "it's fine, it will take time". Now, I am so freakin scared to give insulin to people that I practically cram food down their throats before I give it. I feel like I am the worst nurse on the planet and should never have gotten into this field.
