Nurse Managers in LTC

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I need to find my niche! I take so much pride in being an RN, but beat myself up all the time. I worked in a hospital for a few years as an RN. My last day I was treated poorly by having the worst assignment I could have. One patient ended up with a PE. I suspected it when I first saw him, but just kept an eye on him. The surgeon (one of the best) really didn't think it was a PE. I ended up calling him later in the day and the surgeon STILL didn't believe the patient had a PE, but wouldn't you know THE PATIENT HAD A PE! I kick myself for not using my instinct and pushing the surgeon earlier in the day. I had four other critical patients. I asked for help with this case load and got no where. I was determined to never go back as it was a floor having a hard time keeping help. I was told I gave the patient great care regardless of the PE, but I've yet to forgive myself for it. While he didn't present himself as a patient with a PE, I just had to wonder about the possibility. He ultimately went on a heparin drip and went home a few days later. THANK GOD!! I continued to work as an RN in a different area of the hospital, but always felt like a failure. I just kept being pulled in a million different directions - worse than usual.

I'm thinking about looking into a nurse manager position at a LTC facility. I'm going for my Masters now and will soon have it. While I'm thinking of different areas, I would love to work on a skilled nursing floor. I just lack some confidence. Maybe I should never get that involved in nursing again! I do know I'm not being fair to myself to be so hard on myself. I was given an assignment that turned bad and realize it could have been much worse. I've since left that hospital and work in a different area of nursing, but still miss being on a floor. I realize nurse managers have a lot of paperwork to deal with, but that doesn't bother me. I'm at a point that I'm considering leaving nursing all together or doing something like this. Any thoughts??

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Specializes in acute care and geriatric.

I don't understand, what makes you think you are responsible for the mans PE...you informed the surgeon and did all within your ability and scope of practice...if anyone should feel guilty its the surgeon.

Sounds like you carry around with you a lot of guilt and lack of confidence.

You must first work on forgiving yourself - we all make mistakes - and I'm not saying that you made a mistake with Mr. PE- but even so- you gotta let it go,

you gotta build up your confidence by improving your skills,

You probably don't realize what a good person and nurse you are and how valued you are as a team member.

In hebrew we have a saying: If I could give you one present- it would be the ability to see yourself as others see you- cause your a terrific, amazing and important member of society.

Finishing your Masters is an amazing accomplishment, I can already tell that you are a caring individual who is sensitive, talented and intelligent, don't let one incident (where you were not to blame) ruin your life.

Good Luck in all your future endeavors!!!

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Thanks for your reply. I suppose you're right. It was just that when I saw him, I was surprised he was still on o2, second day post op, should've been off by then. The surgeon wasn't worried because he felt he had the patient anti-coagulated being that he was getting high doses of Coumadin. He really did not think a PE would or could happen on that much Coumadin. Even at the end of the day when I got the order for a CT, the surgeon said to tell the patient he really didn't think it was anything, but wanted to rule it out. Bet he was surprised as the patient didn't present as a text book PE. The patient was never very nice, on everyone for everything, so it made me feel I wasn't jumping high enough. Obviously, I'm thankful the way it ended because it could have been far worse.

As far as confidence, it's always been something I've lacked. Not sure why. I've always done well in life which is probably a miracle. You're so right though, I need to move on. Thanks for your input!! I appreciate it.

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Specializes in acute care and geriatric.

BTW, I personally know a successful Psychologist- noted author, speaker, successful practice, founder and administrator of many amazing programs ,father of a large and wonderful family,

He writes an advice column in a local paper.

He writes how he grew up with a doting family and constant accolades for his successes in life - and yet still he is haunted all his life with feelings of low self esteem and self doubt- so you are in good company- If you are interested I would recommend his books, they are easy to read and helpful.

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I'd love to read some of his work. What's his name? Thanks!

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Specializes in acute care and geriatric.

Dr. Rabbi Abraham Twerski

He wrote many books but try "Lifes too short- "

check it out 2nd hand at :

http://www.alibris.com/search/books/author/Twerski,%20Abraham%20J.

or:

http://www.alibris.com/booksearch?qwork=3940696&matches=16&author=Twerski%2C+Abraham+J.&browse=1&cm_sp=works*listing*title

or new at:

http://www.milechai.com/product2/books/Twerski.html

He has other books - all are great.

Good Luck

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Specializes in ICU, CM, Geriatrics, Management.

Yeah, Lisa. Good advice given already.

Without regaining your confidence, delving into management would be ill advised.

Congrats on the educational accomplishments!

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Specializes in LTC, Hospice, Case Management.
One patient ended up with a PE. I suspected it when I first saw him, but just kept an eye on him. The surgeon (one of the best) really didn't think it was a PE. I ended up calling him later in the day and the surgeon STILL didn't believe the patient had a PE, but wouldn't you know THE PATIENT HAD A PE! I kick myself for not using my instinct and pushing the surgeon earlier in the day.

Don't be to hard on yourself. I did nearly the same thing, but it was with my Dad! He had had a pacemaker put in a week or so before, kept complaining of difficulty breathing and rib pain. At the time, I was an LPN. I pushed him to call his Dr (one of the best around) & he did. The Dr. insisted the chances of PE after pacemaker was very small and kinda blew off the whole thing. WRONG! Ultimately, Dad was OK, but I will always regret not pushing harder even tho I was only LPN vs surgeron.

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