doublecheck

i've been a nurse for just under a year, and you mentioned some things in your initial post that echoed inside of me: "i also have to wonder if i can take the responsibility that goes with being a nurse -- constant vigilance, no error, one mistake and you could kill someone, etc, etc. it just really shook me that i was caught, and that perhaps one day i could do it and it would have a dangerous result. it's just sent me into another round of looking at want ads again. i'm just not sure i'm cut out to do a job where there is so little room for error." i feel like i have been unhappy with my job as a nurse since i started. as with most nurses, i've been disappointed by the inadequate, and often unsafe staffing; i've been frustrated by the amount of responsibility i am "assigned" as a result of the rn shortage (i.e. i work on a medical oncology unit and because we often don't have adequate staffing, and even though i am not chemo certified, i have had pts who are receiving continuous chemotherapy), but this responsibility comes with the job; and, i don't like hospital politics. but in the end, these things aren't the source of my unhappiness and they pale in comparison to the patients and my love for patient care. i love being able to offer compassion, kindness, care, and knowledge when people need it the most. it's humbling to work with someone when they are really sick, and inspiring to watch them get well, recover, and hopefully be healthy again. i can't begin to describe the feelings and emotions i experience when caring for someone who is preparing, and actually ready, to pass on to whatever god has in store for us after this life. these aren't situations or emotions one experiences is a typical career, and i do feel very lucky to be a nurse and have these opportunities to truly help others and simply be present for them when some have no one else to support or care for them. unfortunately, there are aspects of this job that overpower the aforementioned positives and negatives. i am constantly struggling with the intense stress of being a nurse and the amazing responsibility that comes with dealing with a person's life - or death. nursing is a serious job, this isn't news to anyone. but what i never fully realized or appreciated as a nursing student is how just one slight oversight, or one slight omission can affect a patient in a major way. i've been told that with experience comes knowledge, and subsequently confidence in one's nursing care. i hope this is true, and i hope i reach that point soon. for now, i leave each morning worrying about my patients and hoping that i didn't forget some pivotal piece of care. wondering if i did everything right, and everything within my scope of practice to provide quality care. for those times when i know i could have done something better, or when i've had a "learning experience", i lie awake worrying that i caused undue harm to my patient or possibly did something that will get me written up. how do we, as nurses, new and experienced alike, come to deal with this? how does one get over the fear of this immense responsibility and accountability?

I would like to second your question of "what can nurses be written up for?" and also add, "what can nurses be sued for?" During my BSN program, I don't ever recall hearing about RN malpractice insurance or the possibility of being sued. Of course it is entirely possibly that both were topics of discussion at one point or another and I just didn't give it much thought at that time. However, having now only been working as a nurse for 10 months, these are two questions that are constantly weighing on me. I am concerned about what minor mistake or offense I might cause that can get me in trouble, either legally or internally within my job. Couple this with the innate fear of causing undue harm to a patient, and at times I feel like a nervous wreck. So what can/are nurses be written up for, and what can nurses be sued for? Can Unusual Occurrence/Incident Reports be used for legal reasons?