ARN1992

I'm just ashamed because I let all of these other things get to me and I allowed it to effect my job! I know as a new nurse you will have plenty of ups and downs, and in the long run these are foundational learning moments. Due to the accident I feel like I have had a major lack of focus. Just this morning I almost forgot to wash conditioner out of my hair !! I'm sure management is going to hear all about it, and they already know I have had one thing happen after another. If there is one thing that holds true, I care about my job and the people I take care of. There are just some days where I'm on, and last night just wasn't one of them

I know that this is supposed to be a day of thanks, but I just really need to vent. The last two weeks of November have been nothing short of awful. To start, I had a completely oriented patient who took a fall towards the end of my 12 hour shift. Mind you this patient was deemed AAOx3, for the past 18 hours! The only safety precaution I didn't have in place was a bed alarm. Management decided to call this a learning opportunity for me since I have only been off orientation for 6 months. On the way home I got into a car accident. Myself and the other driver were not seriously injured, but my car was destroyed. I had to miss work (I was seen at the hospital for minor neck and back injuries). On my first day back, I tried to put this all behind me, but it just snowballed from there. My vocera was lost in the accident, so I didn't have that on me at work, and I had a patient who was constantly pulling everything off Needless to say, that patients condition changed as soon as I gave report to the oncoming nurse. He has an ABG order sitting for a half hour (I just got 3 new patients. Long story short, he had to be placed on bipap and sent to PCU She was pissed, and now i feel like I will actually get in trouble with management. I am so upset by this and this is the first time I have ever questioned if nursing was the right career path. Far too many things happened at once, and I don't know what to do.

I think to assess for a possible developing stroke. His diagnosis before transfer to floor was a CVA, but CT showed no signs of bleeding. Idk why they made that call, maybe because of the history and headache and they wanted to just watch that it doesn't develop any further. The Ativan was given for anxiety, which the doctor told me to my face she wanted to give the patient that. The hospital it's determined he'd go to the stroke unit. But he swallowed the pill fine was was fine afterwards. If he was having neurological changes then I wouldn't have given it to him. If anything he was BeTTER than what he was when he initially came in.

If his only "stroke-like" symptom is a headache, but he isn't in any sort of acute distress and is speaking normally and is moving his arms and legs normally then I'd think he's okay. If CT showed no signs, an MRI is the absolute yes/no. But if he presents with no signs of a stroke, and he takes the po med and is fine, then it's not an issue, and I checked up on him right before I left and he was fine. The issue isn't the med itself, it's the route. I think she was just trying to scare me and make me more aware of the precautions you need to take for stroke patients.

So if he tolerated the PO med. The stroke nurses would just be annoyed and I won't get in trouble?

She was a stroke nurse, so because A "stroke" wasn't completely ruled out (with an MRI) that's why she told me that. The doctor spoke with me earlier in the night and she didn't seem concerned, and I wasn't too concerned either considering the patient was presenting fairly normal. I went in to check on him about a half hour after I gave the med and he was fine. I KNOW that if he was placed under a stroke protocol from the beginning we wouldn't give him PO Meds. But he is being sent to the stoke unit so that's what makes me worried. I didn't harm the patient, at least not in that time frame, but I'm still nervous

So I'm almost off orientation and I made my first medication mistake. A patient arrived with complaints of cardiac related symptoms, but has a history of stroke. The dr went in to see him and determined it was all anxiety. She order PO Ativan. Doesn't sound like a problem, right? Well the nurse I was orienting with knew this patient and told me I shouldn't have given to PO med because stroke units will usually make a huge deal of this and get jcaho involved. Because of his stroke history and the fact that he was being sent to a stroke floor. CT showed no signs of a stroke, and the patient had an NIH of 1. He seemed to have tolerated the medication, but it was the end of my shift so idk what the stroke floor will say. I'm so nervous. I know better than to give stroke patients PO Meds, but this guy was in the grey area. And I'm afraid I'll get in a lot of trouble. Anyone else have experience with this?! Please help