Please help me, I am at the end of my rope

Rustyhammer · Jan 17, 2004

First of all, take a deep breath and relax...

Everyone makes mistakes once in awhile and the best way to

not miss something is to complete a task before starting a new one. If you going to multi task (and really you will be doing this) keep in mind what you need to do and do it!

Am I making any sense here?

-R

gwenith, BSN, RN · Jan 17, 2004

one of my favourite possessions is a fridge magnet with a picture of a mouse on a rope and it says.

"when you have reached the end of your rope tie a knot and hold on!"

now don't waste your time about what might happen focus on the here and now and work to the best of your ability every day that you are there. you may end up in a lawsuit but that might or might not happen regardless of what you do or don't do worrying will not stop it from happening. just think you best defence is always "i tried my best".

RN-PA, RN · Jan 17, 2004

I can relate to much of what you wrote, RealNurseWitch, and can empathize with all you're experiencing. I've been a fearful person my whole life and have struggled to overcome fears and anxiety with some success.

I've had counseling for anxiety and low self-confidence, problems for me pre-nursing, but especially troublesome as a nurse because there truly ARE a lot of "what if's" and stress that feed into our anxious tendencies. I recommend counseling to get more understanding of the triggers and process of anxiety, and medication can be helpful as well. A good therapist can help replace the negative "tapes" playing in your mind with more positive ones and arm you with tools to cope better.

I'm a Christian and have found much help with my faith on the job through prayer and being aware of God's help and provision throughout a shift.

Also, having as balanced a life as possible outside your job can help anxiety: a nutritious diet, aerobic exercise, time spent with friends and loved ones (and hopefully, someone who can listen to your struggles and be compassionate as you go through this time), and the ability to cry (or laugh) out your stress can be very therapeutic.

If you really want to work with children, you should go for it, but I would suggest working first on your anxieties and coping strategies because I've found that it doesn't necessarily get better at another job.

I wish you all the best and am sorry for all you're feeling since I still struggle with some of it even after being a med-surg nurse for 10 years.

Speculating · Jan 17, 2004

Originally posted by RealNurseWitch

Hi. I am posting here because I really don't know where else to post. I am looking for support and possibly advice. Actually, I really need to vent just a little.

I am a new nurse, eight months out of nursing school. I work on a med surge floor and see ALL SORTS of patients; mostly adults but some children. I am very unhappy, miserable actually, and I really don't know what to do or where to go from here. I feel very stupid. Things happen all the time that I feel like I don't know how to handle, and I forget things that are crucial and important.

Okay, case in point. This morning I get a phone call from the nurse that I gave report to. She says that one of the patients that I took care of has reported that, all night long, she has been having bloody diarrhea, and this morning her H + H were low. I WAS NOT MADE AWARE OF THIS AT ALL. However, I DID know that she went to the bathroom around midnight and had some slight red blood. I called the doctor to tell him about this and about the diarrhea. However, I don't think I ever charted that I had called him. I charted that I called him the FIRST time about this same woman, earlier in the night, but I don't think I charted on the call about the diarrhea. We have computer charting so I could go back and make a late entry tonight, but how would that look?????

I am constantly scared, CONSTANTLY scared of screwing up. I'm constantly scared of situations popping up and not knowing what to do. I'm scared of getting sued. I'm scared of losing my license. I'm just SCARED and STRESSED and I don't know what to do!!!!!!!!!! I can't go back to being a counter jock at a convenience store, fer chrissakes.

I just really don't know what to do. I really need to find an area that I'm more confortable with. I love kids, and I have a huge heart for taking care of them. We have a large children's hospital nearby that has job openings, in med-surge and ER. But the FEAR, the ANXIETY... it's still there!!!!!!!!!!!!!! I also like mental health patients, but the state mental hospitals don't pay very well I don't believe.

I just think I made a huge mistake, going into this field. I get so frustrated. I get impatient. I feel trapped. I constantly feel like an idiot.

I feel stupid just typing all of this. You can tell that I really have zero confidence or faith in myself. I really would like to take care of kids because I love them and I enjoy taking care of them much more than adults. But there's that fear again, of screwing up, badly.

What am I going to do????

RealNurseWitch I guarantee you that things will get better with time. You're still very new in the world of nursing eight months is nothing. Now that you're out of college you're learning what real nursing is and how to do it. Nursing school was fine and dandy but they fail to teach you what real nursing is all about. Nursing school teaches you how to find the answers to the questions you come up with throughout the day. Witch give yourself some time. A lot of your day is filled with doing new things for the first time so your proficiency is not what it will be. Until things begin to balance out with increased expertise you'll remain a little stressed out. And, I promise you the fear will get better too like I said everything is new and for the first time. All of the students coming out of college are feeling many of the same things you are if they didn't that would really frighten me. So hold on tight you worked way to hard to get were you are to be second guessing your career decision you made the right one and things will definitely get much better with time. Beam me up Scotty.

bellehill, RN · Jan 17, 2004

I understand what you are feeling, after being out of school for over 2 years I still ahve shifts like this. Take a deep breath, remind yourself that you are competant and you do know what you are doing. Everyone makes mistakes and misses things, do you have a good support base on your floor? Is there someone you can talk in the hospital about your feelings?

I saw a saying on a shirt a while back that made me laugh but it is true...don't remember the exact phrase but basically said "Fortunately for us it takes a lot to kill a patient". Put things in perspective (a low hgb is easily treated and no testing can be done in the middle of the night to determine the cause of the bloody diarrhea) during the shift and walk out the door saying "I did a good job today". :kiss

Noney · Jan 17, 2004

Okay, case in point. This morning I get a phone call from the nurse that I gave report to. She says that one of the patients that I took care of has reported that, all night long, she has been having bloody diarrhea, and this morning her H + H were low.

Why do some nurses feel compelled to call others at home and tell them everything they felt the other nurse did wrong? Sorry that is a pet peeve of mine.

Calling you didn't change the outcome whatsoever, you could have been notified when you went back to work, instead of worrying about it on your time off.

Med surg is hard. It takes time to really get the hang on things. You can be the most brilliant nurse out there and still miss things occasionally.

If you really want to work with peds, go for it!

Noney

oramar · Jan 17, 2004

Most med/surg nurses have way toooooo many patients. Most people who respond to your post will advise you to take a deep breath or say a prayer. This is a good idea up to a point but believe me the problem is not just you. The problem with overwork is system wide no matter how many years you have been a nurse.

Alabama belle · Jan 17, 2004

I felt exactly like you do now when I was in nursing school. I did not feel like nursing school had prepared me to work on a medical/surgical floor or pediatrics. One day, toward the very end of the last semester, our med-surg instructor walked into the classroom and said that the local medical center was looking for OR nurses. They didn't expect us to know anything and would train us for six months. Since I was very worried about working as a nurse, this sounded like a dream come true for me. I accepted a job in that OR and loved it from the minute I walked in. I now have about 10 years total of OR experience. I would highly recommend that you look into working in a surgical dept. in your area. It is a totally different environment. You will also earn more money because most places pay a speciality rate and also you will probably make a great deal in overtime for call back. You should also be paid for taking call. I hope this information helps you and good luck!

NeuroICURN · Jan 17, 2004

Ok....first of all, let's just stop, take a deep breath and relax for a minute there!

As a new grad (also 8 months out), working in a Neuro ICU, I can identify with the stress that you feel!

I've found that when I'm feeling stressed and I feel that I'm not doing as well as I should....I try to go back to the "basics". Let me explain..... I was fortunate enough to have a VERY good preceptor. So when I feel like things are getting out of control, I step back for a second, take a deep breath and handle things exactly as I was taught. So, I start by checking my charts, and then basically going about things as "by the book" and as systematically as possible. That way I don't miss anything! If I have anything that seems off, I let the docs know...and I ALWAYS chart that they were notified, and what they were notified about, then if they gave any orders or not.....that way, it's well documented and it's out of my hands. (Granted, there have been times when I didn't get the answer I wanted and I have to go above that resident's head, but that's another story.)

Here's the other thing. With that situation that you mentioned, the only thing you could have done different is to perhaps give that pt. a "hat" so that if they would've had a BM again, they could go in there and then you could have heme tested it! But, if you didn't know that they went other than that one time, what could you do??? Clairvoiance (sp?) is not a trait that many of us possess! Also, follow your instincts...if something seems wrong, and you can verbalize why you feel it's wrong, then something probably is wrong!

And if all else fails, know that it is pretty hard to kill someone!

Keep your head up and keep trying! We all have those days.....even seasoned nurses have them!

allnurses Guide · Jan 17, 2004

Thank you all so much for your heartfelt replies. I am so glad that I found this place!!! Many nights when I know that I'm going to be busy I try to use the mantra "One thing at a time... one thing at a time...". I mean, I can STILL multitask, but... I'm actually dealing with one PATIENT at a time. And I may be dealing with a certain problem that the patient is having at that time, but I can still clear their pump while I'm in the room, or give them their scheduled medication while I'm there, or whatever.

Anyway, I do have problems with severe anxiety that I know I do need to deal with. To get a little personal... I was on Paxil for two years, and decided to go off of it after I finished nursing school. I didn't feel like I needed it anymore, and now that I was finished with school, and not having to both work and go to classes anymore.... anyway, I feel like stopping that medication, at least at the time that I did, was a huge mistake. Now I am on Lexapro, but I really want to try to go back on the Paxil. It really worked wonders for me. I feel like therapy is a good idea as well.

But anyway, there's still the problem that I didn't chart that I had called the doctor, although now that I think about it, I think I DID make a note of it somewhere; in my assessment.

And I DO feel sometimes like I'm supposed to read the patient's minds!! But I'll chalk this up as just another learning experience. Next time a patient says that she's bleeding from down there, I'll be sure to put a hat in the commode, tell my aide to watch the patient carefully for bloody stool, AND call the doctor. And CHART it! More careful charting!!!

Thanks y'all! :kiss

Tweety, BSN, RN · Jan 17, 2004

As you can tell from your posts what you are going through is entirely normal. I sometimes have days I feel exactly as you do. But I felt that way every single day for a long time after graduating and starting.

You did what you needed to do for this patient based on the knowledge you had and you did a good job. It's not you're fault that the patient had a low h&h and a GI bleed.

Relax, you're doing a good job, you're "normal".

Hang in there, good luck!