One year in, yet still making errors -- stupid ones!

[SoundofMusic]

Today I had a PCA pump and totally documented it all wrong. I KNEW how to do this, but just didn't remember. We don't do them much -- I probably haven't had a PCA pump in 4-6 months.

I know I should have asked someone, but didn't. Why didn't I? I have no idea.

Also made another error in which I passed on meds to another floor (in trying to keep my pt. safe by not giving digoxin w/ a low HR,) but the nurse on the other floor wrote me up for it -- why I don't know.

At any rate, I felt so confident a while back -- now I feel as if I'm losing confidence for some reason. Is this a common thing in the 2nd year?

[nursemike, ASN, RN]

One of the things I always did during my first year was making sure to check for a pulse before starting an IV. By my second year, I was getting fairly decent at sticks and even had favorite veins I'd always look at, first (I like the cephalic vein, about midway up the forearm. Seems to hold an IV well, and since we never know when we might need to push Dilantin, I try to avoid using the hand, and a site on a long bone won't make the pump beep every time they bend their elbow.) So one night I could find any of my favorites, but their was a nice big one on the inner forearm. Lotta resistance going in, though, and when I finally got it, blood came gushing out even with my finger occluding the "vein" above the canula. Squirt, squirt, squirt...oops! No real harm done, but I was embarrassed, even though no one saw me. Well, pt was awake, but pretty confused.

Made a few other boo-boos due to haste and maybe a little overconfidence that year, and probably the next, but I'm beginning to learn how to hurry carefully. Swore I'd never stick another artery, and I haven't, but I gotta admit, after the next few times, I still don't always check for a pulse if I'm using a site that isn't near one.

I kinda agree that a documentation error isn't nearly as big a deal as an error in the actual administration. I mean, obviously, it's something to avoid, but it can be fixed. Holding the dig wasn't even an error, although I've seen it ordered to give if HR>50. (Happily, for me, the HR was well above 60, because I'd have been nervous.)

I'm sorry I don't have any real advice. By now, you're aware that you aren't immune to errors just because your first year is over. Of course, you never will be. So, I guess try to allow a moment to think, and try to focus on one thing at a time, because I can tell you for a fact it's pretty embarrassing to have to page cardio and tell them to ignore the labs that just came up because you put their patients label on blood drawn from the dialysis patient next to them because your neuro pt was staggering down the hall, trailing blood from where his Foley used to be.

[boggle, ASN, RN]

Oh Sound of Music, you sound like me and most nurses I have known. Oh why can't we be perfect all the time! :) We forget that we do good stuff day in and day out. Do you pat yourself on the back for all the hundreds and thousands of good judgements you make every shift? Do you smile over all the competent documentation you do?

You will make mistakes, we all do, just don't let them define you as a nurse. Do what you can to correct and learn from mistakes.

Now, take care of yourself. You have to be taking care of you in order to have the energy and concentration to manage busy shifts. Are you eating and sleeping in a healthy manner? Are you managing your outside of work stressors? Are you working in a toxic environment? As you know, Nursing is an emotionally and physically stressful job. You need all the help you can get to be on top of your game at work!

I wish you all the best. and don't let the *****get you down!