chipper_RN

I had a patient who was having right sided facial droop, right sided weakness, and decreased alertness. I called the doctor to get a CT scan and other orders for a potential stroke. The doctor says, "Hmm, let's just watch it for a while and see if it goes away." Umm, no?!? I had to call the nursing supervisor to get her to come evaluate the patient.

"Nevertheless, she persisted."

Only pick up overtime you WANT to work. Giving into the pressure to work excess amounts of overtime is a a recipe for burnout. Taking care of yourself is important for your own mental health and allows you to give better care to your patients.

That moment when your patient's family member tells you all about their "healthcare experience"

Our hospital overlooks a fairly busy highway, and one night we had an elderly, confused female patient. When we went into her room, she was flashing an imaginary man down by the highway. When we asked what she was doing, she said, "Well he flashed me first, so I had to flash him back!"

When nurse Jane said she needed a new hair product, this was not what she meant!

...the confused patient lying upside-down with their head hanging off the bed and blood streaming down their face...and all over the floor...and under the bedside table. Seriously, it looked like a scene out of Psycho and the Exorcist put together!

A few of my coworkers and I were discussing the idea of using our built up PTO to take a day of PTO each week and effectively work part time. Have any of you considered doing or actually done this? I'm not sure that I would actually do this, but it sure is nice to think about when I'm feeling particularly frustrated or overworked.

Sorry, I did not realize I had a few more responses to the post. After having some time to think and reflect, I do think there were a number of factors at play in that situation. Yes, critical thinking development was probably the main one, but like Nurse Beth said, I probably panicked a bit, and like RubyVee mentioned, it was the end of the shift and I was fatigued. Overall, I've decided to stop feeling frustrated about what I did wrong and choose to learn from the situation so I can do more right next time. They'll always be something I can improve on, but I did learn a lot from the situation, and the patient was not harmed by my actions, which is sometimes all I can hope for. Thank you all again for your responses and ideas!

Thank you all for your responses and encouragement. I am so very grateful for my team, who is nothing but supportive and I have learned so much from them! I just get a bit nervous because I work on a fairly high turnover floor and right now the most seasoned nurses on the floor during my shift only have 1-2 years more experience than I do, so pretty soon I'm going to be the one nurses are looking to for advice and to keep a calm head. But one step at a time, and I know that I'm way more competent now than I was when I started out, so I just need to keep learning all I can (especially from all the lovely allnurses people!)

I've been a nurse for about 9 months now and I had a situation a few weeks back that made me question how well my critical thinking skills are developing. My patient had a nephrostomy tube 2ish days postop that had been draining urine beautifully all night, when at 0630 (of course it would happen right before shift change!) they rolled over and felt a sharp pain at the insertion site. I went in to assess the patient and his neph tube was now draining frank red blood. Otherwise asymptomatic. My charge nurse was off the floor at the moment, but thankfully the day nurse (who I'd gotten report from the night before and was getting the patient back) was already there and clocked in. I knew that I needed to call the doctor and report what had happened, but it seemed like my mind went blank of everything else. Really basic stuff that I would have forgotten if the day nurse had not done it while I was paging the physician, like getting a set of vitals so I could tell the physician that the patient's BP was stable and the fact that the patient was on a heparin drip so I could get orders to stop it (important stuff!). I'm so very grateful to the day nurse who helped me, and as soon as he mentioned something (like that he was going to get vitals for me) I immediately agreed that he was right and remembered those interventions would be important. But I'm concerned about what would have happened if he had not been there and I forgot to tell the physician the patient was on a heparin drip. I got so focused on the immediate issue I completely blanked about all the related issues. I suppose what I'm ultimately asking is how long did it take for you to develop your critical thinking skills? I understand that I'm still a fairly new nurse, but should I be farther developed in my critical thinking skills at this point? And if so, what can I do to further develop them? Thinking back to my first few months on the floor, I know that I have improved a lot in this area, but I'm just concerned that one of these days it won't be enough.