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DH1234's Latest Activity

  1. DH1234

    I made a mistake!

    So I made a mistake. I been a nurse on a cardiac unit for two years. And two of my patient were supposed to be going to have a tunneled dialysis catheter placed. Usually if I’m not 100% sure about anything I will ask. However, for some reason I thought a patient did not have to be NPO for this procedure. Also, there was no orders for them to be NPO. And now I feel so dumb because I know I should have known that. And now I feel like my coworkers think I am stupid and a bad nurse. How do I come back from a mistake like that. Because I feel like on our unit they make nurses make you feel real bad about making mistakes.
  2. DH1234

    How to come back from a mistake?

    I had a very rough shift last night and to top it off I made a huge mistake bc I was distracted in the sense of I was trying to do to much at once. I had a new admit come around 2200 for chest pain and headache but everything was negative so he was kind of more staying there for observation. And he did not take any of his night time meds. The pt at the time reports he was having 9 out 10 chest pain so my main focus and the pts was trying to get the MD to put in pain meds. MD only was willing to offer him tramadol which according to the pt does not help so I tried to get him some other po meds but the MD completely shut me down and MD would not even talk to the pt about the situation. And of course I had to be the one to get yelled at by the pt and the pt was threatening to leave. And while all that was happening I had a total care pt who called every second and had like 6 bowel movements on my shift and I really wish that was exaggeration but it was not. And that pt also chewed me out bc the MD would not give me Imodium and I asked 2x. Finally, when I had time to get the pts calm and process everything I realized the MD did not schedule the pts meds right. So the meds he needed to take for the night were scheduled to start in the morning, and that’s when I finally realized that the pt didn’t receive his night time meds bc I didn’t catch that the way MD ordered the meds were wrong. And the admit pt was super upset bc the pt didn’t even realize either until 0300 and was demanding to take them now. And of one the meds I had to give late was warfarin bc I should have catched that the doctor scheduled it in the morning instead of in the night. Even though the MD placed the order to okay for me to give warfarin at 0400 I feel like the pt should have skipped the dose and resumed his dose at 2100 later that next day bc inr levels were good. I know I’m going to get chewed out by the morning primary team and management but I don’t know how to cope with it bc I think this has to be biggest mistake I made so far.
  3. DH1234

    Forgot to unclamp chest tube?

    My pt is getting a medication through his chest tube which requires the nurses to clamp the tube for two hours after the MD administers the drug. Day shift said they unclamped it before they left. And I assessed the chest tube which has a pigtail attached to it with a stopcock and when I looked at it I thought it was unclamped until the doctor came to the bedside at 0400am to basically realize I had the stopcock facing in the wrong direction. So it was clamped basically most of my shift. I feel so bad because I made a huge mistake and I didn’t even realize it. I’m scared I could have completely messed up the pts treatment. I don’t know what to do. I know I’m going to get yelled at most likely from the MDs. Can I get fired for this?
  4. DH1234

    Job advice

    I currently been a nurse for a little bit over a year. My first nursing job was on a cardiac tele floor and I stayed there for year until I decided to move back to my hometown so I could be near family. Now I currently work at a heart failure floor and been working there for about 3 months and I am almost done with orientation. However, the thing is I want to leave and look for a non-bedside nursing job. I just gotten to the point where I am super burnt out and exhausted. I am pretty much miserable at this point. Basically my mental health is definitely suffering. I just feel super bad because the unit is definitely a step up from my 1st nursing job but I know in my heart I can not keep on doing this. My manager does not know how I feel at this point in time because I know she is going to try to guilt me into staying, and I know for fact that would not be in my best interest. At the same time I feel bad for wasting their time on orientation but I was trying to give it a fair chance. I guess what I am asking is it okay to wait until I find another job before I mention anything to my boss? Does leaving a job after 3 months look bad even if it’s for my mental well being?
  5. DH1234

    What Specialty should I try?

    I have been currently working on a cardiac step-down unit for almost a year now. The pts are typically have higher acuity than average med-surg floors, and our nurse to pt ratio is usually 1:5. It is a extremely stressful job and I feel like I have become burnt out. I am relocating to different area which means I will need a new job. My question is what area of nursing should I try next? Is there any area nursing that is less stressful? I been thinking about do Pre-op, PACU, dialysis or even an observation unit. However, I do not know what they really entail and if they are little bit less stressful. I am open to any area of nursing.
  6. I have been working as a nurse for 9 mos on a step down unit. All of a sudden I am making a lot small/big mistakes in my opinion. I am so frustrated with myself because my time management skills are not improving yet either and we have typically 4-5 pts each night. I try to do very thorough assessments, and pay attention to fine details, but I feel like I get interrupted every time whether it is a phone call or another pt calling out. I do not know what do anymore. I go to work anxious and leave work anxious. Let me give you example of my last mistake. My pt was on chronic TPN. When i got hand off report, I looked at the bag but I not verify the rate w/ the off-going nurse or the MAR. Fast forward to when I was leaving my shift and giving a hand off report we signed off. Come to find out it was supposed to be going 25mL/hr faster, and the nurse before me was supposed to change it bc there was new orders; however, I failed to catch the mistake during my 12hr shift so ultimately it falls back on me. The more experienced nurse who I handed off to must have saw by my face I was devastated but she quickly reassured me it was okay and we changed it to the correct rate. But now I am freaking out because I am thinking back now.... should we have filled out a MIDAS report? I do not even think the pt is there anymore. I just do not want the other nurses to get trouble too because I failed to ask someone if we needed to do a MIDAS report. I feel like I am an incompetent nurse at this point. Do you think it would be a good idea to talk to my nurse manager about these concerns? For instance, should I tell her that I feel like I am still struggling? Do you think that I am on a verge of getting fired?
  7. Basically my pt's BP was high like Systolic BP of 170s and her base line has been like in 150s-160s. And I was looking at the orders of when to notify the Dr. but it said not to call unless systolic BP was greater than 180. And her BP did come down to the 160s by the end of my shift but that's not an excuse. And I did not know until the next night when the off going nurse giving me report that she had PRN meds for high blood pressure above 170. I feel like a fool how did I not catch this, and being a new nurse 4 weeks off of orientation does not excuse this mistake. I pretty much put my pt at harm. I just got my license, and I am already making mistakes to were I can lose it. Be honest how bad of a mistake did I make? How do I go back to work, and face my manager and co-workers? Do nurses get fired for this action? I am just dreading going back to work because of this big screw up of mine. How do y'all get over mistakes.
  8. DH1234

    Did I make a med error?

    So basically I have two channels on my IV pump set up. One has the secondary infusion of antibiotics going through it and the flush bag or primary fluid that is normal saline is going at 75ml/hr. However since the abx are running for 4hrs he wouldn’t get any of the fluids for 4hrs. So the oncoming nurse told me to hang normal saline at 75ml/hr in another channel and y site to the infusion that’s already running. And I forgot to change the rate of the primary infusion for the secondary to something like 5ml/hr. Therefore once the abx is done running both primary bags of fluid are going to be running. No pt does not have CHF but the other may have pneumonia which scares me. Also, I just remembered my mistake after I came home and was getting ready so technically the 150 ml/hr will not be given right way because of the Iv abx going
  9. DH1234

    Did I make a med error?

    The doctor order 75ml/hr of Normal Saline to run continuously. Also, the doctor order an antibiotic, which requires it to be hung with a flush bag. I have seen nurses in the pass set the flush of normal saline to the continuous rate the Dr order, so they did not have to use more than one bag. Therefore, I hung the antibiotic, and set the rate of the normal saline flush bag to 75ml/hr. However, the oncoming day shift explained to me that since the antibiotics is running over 4 hours not just 30 minutes using the flush bag as the continuous fluids is not okay which makes sense. Therefore, I told her I would hang another bag of normal saline to the IV pump and Y site it to the secondary infusion w/ the flush bag. However, I forgot to change the rate of the flush bag from 75ml/hr to a KVO rate such as 5ml/hr. I am terrified I made a medication error. will i get written up this. I am terrified that I will get in trouble
  10. Last night I experienced my first night off of orientation. And I felt like I had no idea what I was doing. I kind of was overwhelmed the whole night, but it was not too bad because I had co-workers who helped me pass my meds. However, I felt bad because I do not want to be known as the person who can not finish her tasks and needs help all the time. I called my charge nurse a few times with questions to double check that I was doing everything right. I just have a hard time feeling confident with my abilities. I am also struggling with simple stuff like the best way to change a person who incontinent, and I help my PCT change patients but I usually let them take the reign until I learn how do it more efficiently since they know the best tricks. But I also do not want them to see me as incompetent either. Also, my hand off report was horrible, and that has always been a big struggle for me since I have started. Additionally, day shift and night shift nurses have like an unspoken hate towards each other. Because day shift is filled with more experience nurses compared to nights. They always complain that night shift leaves their patients a mess and that they do not do anything. And I am just scared that day shift is going to give me a reputation of giving bad reports, and I honestly do not want to be that night nurse day shift hates. I am terrified to go to work every night because I am scared something bad is going to happen or I am going to make a serious mistake. Also, after my shifts I am always paranoid that I forgot to give a med or do an order. And sometimes I freak out because I remember that I forgot to document one turn or an output. Overall, I just feel like I am struggling, and some nights I already want to quit. But I am really trying to stick it out for 6 months because I heard it eventually gets better. Do you have any advice for me? or words of encouragement?
  11. DH1234

    Forgot to unclamp the secondary

    I am on orientation still, and I been making mistakes. No serious med errors or any mistakes that has caused harm to the patient. However, this morning I hung an IV antibiotic, and I am pretty sure I forgot to unclamp the secondary tubing. I think I made the same mistake two weeks earlier, but after that I never made that mistake again until today I think. I am pretty sure if it happened the day shift nurse caught it. But I feel so stupid. I do not know why I keep making this mistake. I do not want my preceptor and other nurses think I am incompetent. I honestly feel awful because I sort of delayed his care. Does this happen to experienced nurses sometimes? I know this a mistake, but is it something I should lose sleepover. Have you ever heard of a nurse getting fired for this? I honestly feel so awful.
  12. DH1234

    Forgot to document an output

    I am currently on orientation, and I came home to realize that I forgot to document one of his outputs. I am freaking out because he is on strict I&Os and do not want the doctors to think he is not urinating a lot. I mentioned in my hand off report how many total mL he produced last night, but I just forgot to document. And I know everyone says if you did not document it, it did not happen. I do not know what to do in this situation. Sometimes another patient calls out before I have time to document it, so most of the time that is why I forget. Therefore, I typically write a remainder on brain sheet to document it but I guess I overlooked it. I know in the future I should just take the time to document the output then and there, so I do not forget again. Do nurses get fired for this? Should I try to see if I can do a late documentation when I get to work. Or should I just let it go?
  13. DH1234

    New grad...forgot to document

    I am still on orientation, and I feel like I am still forgetting to document some important things. For instance, one of my patients had a PCA pump and we were supposed to document the settings and his RR every 2hrs. I stayed on top of my charting for the most part. But i forgot to document the one at 6 am because I was so frantic trying to get all my pts meds passed before shift change I seemed to have forgotten. However, I did get his RR with his vitals at 6 am and they were fine. Also, we have to a dual sign off on the pump during handoff. Do you think this is a huge mistake that I can possibly get written up for or fired for? Sometimes it just hard for me to keep up with assessments that are q2. Also, do you have any advice on how to stay on top of things like this?
  14. DH1234

    New Grad RN..made a mistake!!!

    I am on my 8th week of orientation, and I think I made a mistake. I am not sure how big of mistake it is, but I hope it is not. Basically, my patient from the ED came to my unit with an IV that had just a saline lock and not an extension. An older nurse on my floor said she needed an saline lock extension. Therefore, i screwed an extension on the saline lock that was an the IV catheter instead of attaching the saline lock extension to the actual IV catheter. I am now thinking I was supposed to remove the saline lock hub completely from the catheter then add the saline lock extension if that makes sense. However, the way I did it with the saline lock still in place with the extension attached to that it still flushed. I am honestly so embarrassed I messed up a simple task like that. Is that a serious mistake even though the IV stills flushes? I am freaking out because I don't if that is considered a big mistake.
  15. I am on my 7th week of orientation, and I am finally taking a full pt load meaning 4-5 patients. And I am not going to lie it has been hard to keep up. With that said I have trouble keeping up with the small things that are actually really important. For instance, two of my patients where Turn q 2. And I totally forgot one patient was Turn q 2, and I did not document anything. She kind of shifts independently in bed and had no skin breakdown, but I know that does not matter because she was at risk according to the Braden scale and per hospital policy that makes her a turn. My other patient I remembered who was a turn I would be busy with other patients so it would take me like 3 hours before I can get back in there to turn her. I like documenting my turns in real time, but I know a lot of nurses back chart it to make sure it shows that they were turned q 2 hours exactly even if it took them longer. I get paranoid about doing that because I am not sure if that is consider false documentation. Also, the aids usually handle the turns for the most part, and sometimes I assumed she would go in there and do the next turn but she never did, which once again that is also my fault for the lack of communication. Now I am freaking out that I can get written up or lose my job over these mistakes. Also, any advice on how to keep up with turns on your busy days.
  16. I just started working on a med surg floor and I am on my 4th week of orientation on the floor. I am currently taking care of two patients on my own with my preceptor looking over me of course. And each week it seems that I have a different preceptor which kind of sucks in my opinion because I really wanted a person to see my growth over the period. That is beside the point. I am always leaving work with major anxiety. I have thoughts such as what happens if I put my patient in danger, and something happens during night shift and it was my fault. Or what happens if I forgot to chart something or I charted something wrong. Or what happens if I missed something in general like a order or missed giving something in hand off report. For instance, I had do my first admission and I was all over the place. But my preceptor helped me but she kind of rushed it, so what happened if I missed a question. And when I got home I realized I forgot to document his height and weight in the chart which is crucial because he is a CHF pt. And I just remembered I needed to get him wristbands that id he is a fall risk and has allergies. I probably forgot other things too but everything was happening so quickly at the end of shift , and I am so slow it took forever do things. And I felt bad because I set my preceptor behind because she had to help me which set her behind. Another incident that happened is I had a pt fresh from cath lab, which means I have to document his groin sites every so often. I was doing good following the orders of when to assess it but when my new admit got there I forgot to assess the site of this pt. Therefore he probably went about 2 hrs without getting his site assessed. Even though his site has been looking good, I just feel like I neglected to follow orders. Oh and to top it off I had to give hand of report and I was so flustered and my brain sheet was so messy the night nurse almost got the wrong report ( so embarrassing for me), but thank god my preceptor was there to correct me. Do you think these mistakes can get me fired or worse can I lose my license because of these mistakes? I do not want to be this incompetent of a nurse? Also, do have any advice on how not to forget things like this?