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Discussion

please tell me it is

I am almost done with my first year as RN on a med/surg floor. I work nights and some mornings are so crazy. When I get home, sometimes I remember something I didn't do and can not sleep for days because of it. I had a problem with a pump the other night so I free flowed it waiting for a new pump to come. I left in the morning having forgot to hook up the new pump. I dread seeing the nurse who replaced me. I have lost serious sleep over this. I stress over everything, my great marriage of almost 20 years is suffering because of my stress. I need a less stressful job. I went into nursing for mother/baby but felt med surg would be good. Is mother baby less stressful, not L & D, but mother baby? Please, someone tell me it is.

Featured Replies

I don't know about L & D, but I just wanted to offer some support.

I'm also a newbie on med-surg (more of a newbie than you, actually), and I totally understand how you feel! I think you are being too hard on yourself. We all forget something sometimes, even seasoned nurses. Don't expect perfection - it's just not possible. If you get home and realize you forgot something important, call the unit and talk to the nurse who took over. More likely than not they probably already figured it out.

My marriage is suffering some due to the stress of my job as well. Recently my husband told me I was "just not there, like [i'm] sleepwalking lately". Boy did that make me feel bad! I've really been practicing leaving work at work. I take many deep breaths on my way out the door, drink chamomile tea when I get home, etc. Figure out what will work for you. You can't just obsess over your stressful situation and hope it gets better - stress must be managed! :)

Oh, and on the note of forgetting things that need to be done before your shift is over...find a spot where you can write such things down, a place you will see it. For me, it's my report sheet, as taping report is one of the last things I do on shift. If there's something I really really need to remember to do before I go, I write it in great big red letters at the bottom. It's not a perfect system, but we're not perfect people either.

Quit being so hard on yourself!

I agree with the above post -

Stop being so hard on yourself!!

If you do forget something, you just call. I've done it before. Just remember nursing is a 24 hour job, and you are only working 12 (or 8) hours of that. The next nurse will continue to work with the patient and if there wasnt something you could get to, just let them know.

Also, Kudos to you for sticking it out one year on a med surg floor. I know some nurses say you need a year of med surg before you specialize, and I do think this past year will be invaluable to you.

Start sending out the applications and the resumes now. If your hospital that you work at offers mother/baby, talk to the nurse manager about a transfer. You need to have a job that you love, and that you are comfortable with.

You need to find your niche in nursing. I can tell you, after 2 years I still havent truely found mine. I have applications out right now, and a few interviews scheduled so that I can find where I want to be.

Good luck :)

  • Experts

Things like this are going to happen. Hospital nursing is a stressful job and being extremely organized under the pressure is an awesome task to handle. Sometimes things get forgotten. It happens. Part of what you should be learning in your first years(s) of nursing, no matter what unit you work on, is how to organize your work. This will be an ongoing endeavor throughout your career. One huge fact of hospital nursing is that we are constantly inundated with little problems that we have to solve. I lovingly refer to it as "stamping out fires". Whether you work on med/surg or in mother/baby and no matter how well-organized you think you are, there are always going to be little fires that come along that will upset your organization and have to be addressed and stamped out. This is what an RN does no matter what unit he/she works on. After years and years of working and mastering all the various skills, I found that the one thing that I was still always learning was finding ways to better organize my work shift. This is not something that they address in nursing school. It's something that you have to learn on your own. And improvement often comes about through trial and error.

At the point that I remembered I had forgotten about the IV I had taken off the pump, I would have picked up the phone and called the RN who had that patient to tell her about what I had done and the problem with the patient's pump. Think of it as something that didn't get passed on in report. It would have gotten a lot of the worry off my mind that you are now experiencing.

Years ago when I started in nursing, we were only allowed to put IVs with certain types of medications added to them on pumps. Otherwise, all IVs were by gravity drip and we had to constantly make rounds on our IVs to make sure they were dripping at their correct rates or to make sure a new bag of fluids was hung. If a bag went dry, the IV clotted up and needed to be re-started unless the patient was alert enough to call and warn us. Patients sometimes fiddled with the roller clamps and adjusted their IV rates. IV's, depending on where they were located in the patient's arm, could be positional and the flow rate was interrupted. Part of our shift report was a IV sheet that was passed from shift to shift that listed the patients in the unit who had IVs running, the solution, the rate and how much we were leaving in the bag for the next shift. Believe me there were plenty of times when we found surprises--a bag that was supposed to have 800cc was found to only have 200cc, or even worse, had gone dry in the matter of an hour!

I used to carry a "brain" sheet with me each day I worked. As years went by I developed my own shorthand and use of symbols on it to indicate situations and things I needed to check up on to help me keep organized. Anything odd that came up that I wanted to make sure I had resolved before leaving got a big red circle (I carried red pens as well) put around it so it stuck out. When the thing was resolved I put a big "X" through it with black ink. Before leaving for the day, I looked over my "brain" sheet one last time to make sure I had done everything that was highlighted on it. That was how I learned over the years to double check my memory. Little things still slipped through the cracks, however, and like I said above, I got on the phone immediately and called back to my unit to tell the nurse taking over about it.

I hope that you find the area the is right for you

Maybe it's time for you to try mother and baby

being organized is what worked for me

I used to have a sheet on a clipboard - organized in columns and rows (each row labelled for each patient) - for things like meds, prns, dressings, etc.

In home visiting, I kept a binder with all my helpful papers, and on the first page was my daily list of things that must be done. I started every day by making that list. If something didn't get completed, then it stayed on the list for tomorrow. I always knew what had to be done, without having to rely on memory. It kept things contained in my binder.

If I forgot something, and it did happen, then I would phone to inform the next staff.

OH heavens, i still call back on occasion to make sure i told someone something,, or i did something. I dont live far from work so ive actually gone back to make sure i signed something off or done something. I know the next shift is going to be a mirror image of what i just went through so why call and put it on them. Sometimes i just want to make sure ive done this or that and want them to know it might be undone. Dont feel bad about it any more though.

That is part of being a concientious nurse. I would be more worried if you didnt have a concious. It will get better.

I am almost done with my first year as RN on a med/surg floor. I work nights and some mornings are so crazy. When I get home, sometimes I remember something I didn't do and can not sleep for days because of it. I had a problem with a pump the other night so I free flowed it waiting for a new pump to come. I left in the morning having forgot to hook up the new pump. I dread seeing the nurse who replaced me. I have lost serious sleep over this. I stress over everything, my great marriage of almost 20 years is suffering because of my stress. I need a less stressful job. I went into nursing for mother/baby but felt med surg would be good. Is mother baby less stressful, not L & D, but mother baby? Please, someone tell me it is.

Accept the fact that the situation on your floor is always going to be like this..and time will make you better. The Zen way of doing this is

1. ACCEPT: the unit is going to be like this everytime.

a.8 admissions for a 12 hour shift

b.each patient requiring special attention

c.you will not finish everything...just do what you can. Its 24 hrs.

2. Do something about how to adjust.

a. make a to-do checklist on your medcart

b. budget your time. (Save time by stocking up on stuff that

you will always need at the bedside like tape, alcohol swab, 2X2

gauzes, stickies for labelling, scissors, penlight, I make my own

blood draw kit since I work nights, and IV insertion kit for the

night. Some sugar (candy or gum)to fuel you if you cant eat)

c. Food: always make sure you have a easily digestible and

portable food to go

(chinese food is heavy and heavy meals will slow you down.)

d. mental check list...IV expiry dates, PICC and Central line

dressings, decub dressing, OR schedules and chklist,)

I also work in NY and I work nights so believe me I sympathize with you. People make mistakes, If I had to tell you about mine, we'd be here all day. But I'm still on the med-surg telemetry unit (the toughest floor in the entire hospital that no one wants to work in) and this is my 6th year going on seven.

I agree that the med-surg floor is very stressful. It shows and tells on me that I even argue this with my wife who is also an RN in THE SAME HOSPITAL!! Even she ....has been telling me to get out of there for the past three years!

Hope this helps

C

i work day shift and i always remember at 0200 in the am after i am in bed sleeping. i wake up out of a sound sleep and think.. i didn't tell them this? .. i forgot to do that.. or did i do that? i drive myself crazy .. i have called the floor at 0200 and the nurses tell me to go back to sleep..lol.. i worry about everything.. i just don't know how to stop this crazy thinking.. i worry about patients and if i did good care with them.. i wish i could just leave work and say the heck with it .. and not worry anymore.. but i can't.. i appreciate all your great posts.. any suggestions would be helpful...

i work day shift and i always remember at 0200 in the am after i am in bed sleeping. i wake up out of a sound sleep and think.. i didn't tell them this? .. i forgot to do that.. or did i do that? i drive myself crazy .. i have called the floor at 0200 and the nurses tell me to go back to sleep..lol.. i worry about everything.. i just don't know how to stop this crazy thinking.. i worry about patients and if i did good care with them.. i wish i could just leave work and say the heck with it .. and not worry anymore.. but i can't.. i appreciate all your great posts.. any suggestions would be helpful...

Kizzykat

nursing is a 24 hour occupation.

Here's a suggestion...

I've converted my worry into stickies! Do you remember when you are working, you get reminded by yourself to do this while in the middle of something? I take the time to write it and I choose different stickies. Now I've gotten collect 3M memo pads.

weird right? Yeah but it works.

Today green memo pad...for notes to MD on chart. (Renew this...Order not acceptable etc) "Sign here" stickies for MD to sign.

Yellow memo pad for reminders to myself and stick it my med book.

Hope this helps.

i work day shift and i always remember at 0200 in the am after i am in bed sleeping. i wake up out of a sound sleep and think.. i didn't tell them this? .. i forgot to do that.. or did i do that? i drive myself crazy .. i have called the floor at 0200 and the nurses tell me to go back to sleep..lol.. i worry about everything.. i just don't know how to stop this crazy thinking.. i worry about patients and if i did good care with them.. i wish i could just leave work and say the heck with it .. and not worry anymore.. but i can't.. i appreciate all your great posts.. any suggestions would be helpful...

OH and Kizzykat!?

One more important advice....

Make use of your sick/vacation time. There is such a thing called Mental Health Day!! Use it!!

OH and Kizzykat!?

One more important advice....

Make use of your sick/vacation time. There is such a thing called Mental Health Day!! Use it!!

thank you cross bow .. i guess our right we all have bad days and thats okay. your awesome... :balloons::balloons::balloons::balloons: i used mine and went to hawaii for 2 weeks .. now were heading to utah for 3 weeks... love those mental health days.. lol :balloons::balloons::balloons:

thank you cross bow .. i guess our right we all have bad days and thats okay. your awesome... :balloons::balloons::balloons::balloons: i used mine and went to hawaii for 2 weeks .. now were heading to utah for 3 weeks... love those mental health days.. lol :balloons::balloons::balloons:

Yes and I used mine today!! ...:devil::devil::balloons:

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