elixRN

um, I think I have something in my eye... or both eyes for that matter. this is probably the most touching story I have read on this website. thank you for posting this beautiful story.

This should be it's own article on allnurses.com. it was very informational. thank you for the info.

If this happened at my school I would be furious. My class of nursing students happened to take grades and quality of teachers very seriously, we spoke our minds when something wasn't right, and you should too. Advocate for yourself so you can have the strength to advocate for your patients in the future. Like everyone else said, get it in writing and go to a higher up. Be Profesional and you will gain respect, when these issues or others like them come up again you will be prepared.

- don't let " I have a million things to do in a small time frame" freak you out. You are only one person and you can only attend to one thing at a time. Stop, think, plan out your next few moves, and proceed to the next task, its better to be late than unsafe. Also bundle tasks, this will help a lot with time management.

In Hawaii we have some funny ones Shi-shi tube= Foley Doo doo bucket= bed side comode There are more, but I can't think of them right now

It's commen to be confused about these issues when you are a student, but the best thing you can do is communicate with your patients and with other staff. Explain what is going on to the patient " I am going to put my stethoscope on your back so I can listen to your lungs, it will just take a minute. Take some deep breaths in and out, good job. " when you describe exactly what is going to happen and how long it's going to take, the anxiety associated with the unexpected is diminished and you will find that people are much more likely to be compliant with your requests. If they continue to refuse after you have explained fully, then you can respect their wishes and chart "pt refused". Same thing with the urinal guy. Ask more specific questions, "can you hold the urinal by yourself?" Communication is key! Also be confident (or just act like it) know that you can do it (even if it is just listening to lung sounds). Good luck!

The way it worked at my school was in our final semester we followed one nurse through that semester, so we just followed her schedule. The students were separated into severall different hospitals so the clinical instructor only had to show up for a few of our shifts to check up on how we were doing. My instructor was not there that day. I did try to contact her at work and on her cell after the event. I don't know how she was punished, or if she even was... They wouldn't tell me.

The managers put together a nice breakfast for us!

Well my preceptor (let's call her Pam) got the bag from the pharmacy in-box. It was the only thing the pharmacy had sent up for this patient. The bag that they had sent up looks exactly like any other pre-mixed antibiotic bag from the pharmacy. Pam (who has about 30 years of nursing experience) quickly looked over the bag and handed it to me, it the dark patient room. I quickly looked over it too, made sure the name and birth date of the patient were correct. I do remember glancing over the name of the medication and thought, "that's an odd name" but I didn't think anything of it as I was sure that Pam had looked it over. So I then proceeded to hang up the bag with Pam in the room. We didn't use a pump, just the roller clamp to regulate the rate. It was all hung up so I left the room for maybe about 15 min while Pam and I monitored the baby's heart rate (which never went south). When I got back into the room, I realized that it was the wrong medication. I quickly stopped it, and ran to get Pam and a syringe of D50. Pam was written up, and the pharmacy was too. And I was also written up, and I didnt graduate on time. There was a meeting about medication administration with the big head hancho's at the hospital that I did not attend. It was a big mistake that could have happened to anyone. Never again will I administer a medication without triple checking it myself.

As you can see in my previous post I have admited that there was harm done. What I probably should have said in the original article is that there was a c-section done, and this was a major surgery that should not have happened, and it is my fault. As far as c-sections go this was a successful one, the baby had a good APGAR score and mother was breast feeding shortly after. I honestly don't know what happened to her after my shift ended, it was my last day on the floor and it would be a HIPPA violation for me to even try and find out. So congratulations irishIzRN you have won an argument on the internet. And I apologize for not explaining further on my already lengthy article. But it seems you have missed the point of the article completely. We must forgive ourselves of our mistakes just as I forgive you for being judgmental of me. Without forgiveness we cannot make progress, especially in our nursing practice.

I was 24 years old.

Thank you for bringing this up, and yes you are right, there was an enormous amout of harm done, and i do recognize that is was my fault. please excuse my venacular; i did not mean to offend. And the story still haunts me today, that's why I want to share the story, because it was an atrocious mistake. But that's the thing, if I would not have learned from and moved on from it, I would still be a blubbering mess sitting on my mothers couch. The point is "to err is human" but we must learn from error and be strong enough to move on. P.s. I accidentally posted my rough draft (as you can see by the blatant editing note and the end of one paragraph) and I initially wrote this article for a general audience, not a nursing one.

On certain weekends during college I would spend the entirety of the time that the library was open studying; I would get there at 9am and not leave until 11pm, and still I thought this wasn't enough, especially if I had an exam that week. I got good grades (not great), I was no over-achiever compared to some of my classmates. That's not to say I wasn't academically competitive, I was and I still am. I honestly think it's the only thing I have ever been competitive about. On my last day of clinicals in my last semester on the last week of college, I made a mistake A BIG ONE. I was on the Labor and Delivery unit for my preceptorship. I was just getting over a cold so I almost got sent home that day, but I insisted that I wasn't sick anymore and it was my last day so I really wanted to stay. I had a high risk patient with maternal Diabetes and an STD. She was already in labor but the possibility of an emergent c-section was high due to her risk factors. We had to infuse an antibiotic quickly so that the baby wouldn't get an infection on its way out of the birth canal. She was also allergic to penicillin which prompted us to use a different antibiotic than usual. My Preceptor (RN) gave me the bag to hang, she said "just open it wide up." The antibiotic we were supposed to use was 100mg of Unasyn, the bag that the pharmacy had sent up and put the patients name on was 100units of Humilin (a fast acting insulin). I hung the bag only checking the patients name and birthdate. Neither I or my preceptor checked the name of the medication, and there was no electronic medical record at the time. This resulted in the patients' blood sugar dropping to 40 and an emergent c-section. In the end neither the mother nor the baby were injured in any way, but that's not to say this error wasn't damaging. I was initially told that it would just be a ding on my record, nobody would even find out.... On the morning of my pinning I got a text from one of my instructors saying "hey did you check your email?" Of course I hadn't since it's the week of graduation and everything is done already. So reluctantly I opened up my email and it stated that I would not in fact be graduating, and I would have to repeat my last semester due to this one mistake. I finished reading the email, and when I had finally realized what it entailed, I screamed... I cried bloody murder so loud my roommate thought my mother had died or something. To me it was the worst thing that could have happened, and to top it off my boyfriend at the time broke up with me that same day. I felt like I hit rock bottom, things could only get better from here, right? Despite having the worst morning ever, I did in fact walk the stage that night, and as soon as I started the next semester, things were starting to look up. During my final semester I got to precept under my idol (the president of the nursing program at my college) in a pediatric oncology unit, I participated in the California gubernatorial debates, and I presented my research at the pediatric society of nursing conference in Las Vegas. It was an exciting and challenging time in my life. After I graduated, I spent 5-10 hours a day for a month (yes every day) studying for the NCLEX (the RN licensure exam). When I took it, the computerized exam shut off at the minimum amount of questions: 75. And two weeks later I found out I passed the test. As a kid you are told that you should "work hard, go to college, and get a good job so you can be successful". And there I was; I had worked hard my whole life towards being a nurse, and now I was...sort of. So after getting my license I started applying for nursing jobs daily. In the mean time, I worked as a waitress at Outback Steakhouse. I probably applied to over 200 jobs over the course of a year. The amount of applications per day that I was submitting would wax and wane depending on how I was feeling. After months of applying for nursing jobs, and not hearing back from any of them, I got really depressed. No one wanted to hire me; I was living in my parents' house, working a job I could have gotten out of high school, and realizing everything I learned as a kid was a lie. I didn't understand why nobody wanted to hire me; I graduated cum laude, did extra projects, and even had a job working as a student aid in the nursing sim-lab. How was I not a prime candidate? What's so awful about me that you can't even give me the time of day to respond to my email? I often glorified the past in my mind; I missed college, when everything was exciting and challenging, and now that was all gone. I was at a stand-still. I realized I was never going to get a nursing job in California; not as a new grad anyways. This was my defining "now what?" moment. My friend, Colleen, who I went to nursing school with, was living in Hawaii, and she had just gotten a job in a new-grad nursing program at Hilo Medical Center. I saw this as my opportunity to get out, even if I couldn't get a job at the hospital right away, at least I knew they were hiring nurses in Hawaii. And on top of that I was tired of waiting around in California for "my life to start." So I dropped everything, and bought a one-way ticket. When I first got to Hawaii, I got a job as a waitress at a local restaurant called Cronies. Even though I didn't have a nursing job yet, the change of scenery made me happy; I had minimal responsibilities, no one to call home to, and plenty of time to spend on the beach. After about a month I got hired at a clinic, it wasn't the ideal nursing job, but beggars can't be choosers right? The job was only going to be part time, so I kept my job at Cronies. And thank the flying spaghetti monster* I did, because I actually only ended up working at the clinic for about a week. I got hired on Monday and fired on Friday. They gave me a lot of silly reasons why they fired me that mostly added up to "people don't like you." It hurt my feelings that people didn't like me, but it hurt even more to think that if I couldn't even keep a stupid clinic job, how was I gonna keep an acute care job? It was worse than if they had not hired me at all. Once again I felt like a failure, I felt incompetent, stupid, not-worthy and I was a stranger in a strange land. I felt so bad I was paralyzed; I couldn't get myself to open a computer and look at a job application for months. When I finally did, I got hired at a long term care facility. Four months later I got hired at Hilo Medical Center in their new-grad nurse program. I have now been living in Hawaii for over 2 years, and I just completed my first year of acute care nursing. The most important thing I learned during this time was that failure is an option, in fact it's likely, but I also learned that I have the strength to get back on the horse and try again, bruised and battered as I may be.

And I also use the nursing process, its just happens to be rapid fire nursing process...

Epistme: thanks the response. How do i make my plan? Well thats a loaded question because things NEVER go as planned, but how my day goes is as follows: usually during report I find out the most important info about each pt, then I write down what time meds are due for each pt, and if they have any procedures that day that I have to do, such as paritoneal dialysis or if they need a blood transfusion. Any extra tasks that can be done at any time such as getting a consent signed, I write on the side, so I can cross them off as I do them. Then I go along and assess each patient, usually in order of acuity or just in room order if they are all fairly stable. If there are any issues i can deal with immediately like a high blood sugar, or a sky high BP i do that first, before I even assess other patients. At this point i know what each pt needs for the day; and if they are lucky I write that on their white board. Then if all goes well I start my med pass at 8am. I try to get that done by 10am,. There are always interruptions; doctors, lab techs, PT, OT, patients needing pain meds and so on.So I am always re-prioritizing basically minute-to-minuite. After dealing with the distraction, I go back to what needs to be done within a time limit, just going down the list. Once I have my morning meds passed I can do other tasks, making sure I check for new orders constantly and charting every chance I get. And that's basically how it goes. Every day is different and every patient is different. When I comes to care plans I guess I do actually do them, because I do have goals for each patient during the day, even if its just " give insulin to bring down high blood sugar"