KyRN

Yes. A few other nurses have expressed their concern and often say they feel overwhelmed. Because I’ve been there a few months more than them they often ask me questions, which is great but feels very much so like the blind leading the blind. I just wish there was a way for there to be a more well rounded education, and less kind of on the fly surprises. It just doesn’t seem like it should be this way. I’ve also only ever been a nurse during the pandemic so I have no idea if this is normal or not.

I am in a little bit of a dilemma. I've been a nurse for a little over a year now. I started in the CVICU about 6 months ago after leaving my telemetry job once COVID had calmed down. This is a high acuity hospital and unit. I never really get any feed back from management, good or bad, other than apologizing for the assignments I've been given sometimes. They've given me paired devices (IABP, impella, CRRT, LVAD), placed in ECMO rooms pretty consistently when COVID was up. Which lead me to believe that I must be doing okay if they trust me with these patients. However, I just don't feel like I've gotten enough education on these actual devices because the unit has been so crazy. Our education days on devices are just when the reps come in for a couple hours and that's it. They don't physically show you how to work the devices, just how they work. I'm not sure If I just don't enjoy this area, or if I'm just not competent enough. Feed back from my coworkers are that I am doing well and that I am too hard on myself. I get sick patients. But I just don't feel that I know everything I need to know to care for these patients with these devices. For example, I had a low flow alarm d/t P2 level on an impella and had never seen it before (2nd-3rd time with an impella) and wasn't sure what todo with it. So I had just asked a more experienced nurse what to do with it to make sure I'm doing the right thing. The reaction to me asking her that was unpleasant lets just say that, and that I should have known. Before that, I actually started believing that I was doing well. I started thinking about all the other things I don't know, or don't feel comfortable with. I've just always been okay so far. Even trouble shooting an LVAD I probably would have trouble with, besides changing batteries etc. Honestly only recently I feel 100% comfortable with IABP. Im trying to decide if this is worth all the mental anguish this is causing me. I HATE feeling like I may not be doing everything I can for my patients. I think about quitting all the time, I just had always wanted to go back to school but I'm not sure what for so I thought sticking some time out in the ICU would be the smart move. I also really wanted to do travel nursing, but can't do it if I change specialties again for at least another year. Lately I've considered some kind of NP but in an office setting. I think If I felt more competent and had more education I would feel better, I'm just so exhausted. It is difficult to get ahold of our educator or management to ask questions. I've even bought books and watched Youtube. My work environment can be pretty cut throat at times and at this point I don't even want to ask anymore. I also don't really feel like they would care to hear me, they'll just hire someone new. A few other new nurses to the unit have shared similar experiences without me even saying all this. In general, I find the CVICU stressful, and so far not as rewarding as I thought it would be for me. I'm proud of the skills I have now but its just a lot, and maybe not enough. Is it me, an educational problem, the unit? Im trying so hard to be positive on my unit but it is literally impossible some days and I don't want to be the Debbie downer of the unit, especially if its just me that is not the good fit for the unit LOL.

I am looking for advice for a coworker, yes honestly! So, she recently started in the last maybe 7-8 months and has done great on our busy ICU, gives great care etc. However, she just got her 4th narcotic discrepancy since she's started. It seems to be mostly forgetting to scan the med before administration. One time she pulled a med under the wrong patient in the Pyxis but gave the correct med and dose to the intended patient. Her last error she pulled fentanyl for another nurse in a covid room because the patient was bucking the vent. This nurse did not waste the remaining fentanyl so it is under her name. So, her managers told her the next time it happened she would be written up and it would go on her record. It's not consistently the same drug either. Now, we have nurses who have had 10 discrepancies on our floor over time and have been just fine, still work here no issues. How worried should she be? Tips for error prevention?