tired_panda

I don't think I am shooting myself in the foot by accepting responsibility and perhaps inspiring increased awareness about a policy that isn't well advertised to new nurses on the floor like myself. I'm not reporting myself to the board, just putting in an incident report. My floor encourages this and I think it looks a whole lot better to accept responsibility than to wait for someone to notice and call me out on it. If I had called the doctor, she would have cancelled the med and ordered lopressor. No time wasted, no transfer necessary

To been there done that, I do know my meds. Labetalol (trandate), not lopressor. Both beta blockers, however one is approved and the other is not. And yes, in response to boomer, it seems like a silly rule and I'm sure when I bring it up to other more experienced nurses, they'll talk about how it is a little odd. But it is policy and I do wish I had remembered it. I know it's silly it came to me in a dream, but it doesn't change the fact that I did do something my facility does not agree with.

That is something I needed to hear. The anxious side of me feels wholly responsible, though the logical side of me knows it is a failure not just on my part, but on the part of the doctor who prescribed it and on the pharmacist who approved it, as well as an issue with the education on my floor. A lot of the meds we pull come with warnings and I feel this is one that should be flagged. So thank you so much for the validation

I'm good friends with a nurse who has worked there much longer and I sent him a message today asking about the medication. When I am at work I will access our policies to find out more but he did confirm my fears

This morning I had admission that came up from the ED. Her blood pressure was high with SBP in the 190s and the pulse was hanging around the high 90s/low 100s. The doctor saw her and put in a STAT order for IV labetolol and I gave it without question over the recommended 2 minutes for the dose I gave. She was on a cardiac monitor and I was watching the rate and rhythm closely. No adverse effects were noted, and the vitals were stable a half an hour, 1 hour, and 2 hours after administration. My shift ended and I left. I had no worries about the care I provided . I am still relatively new on my floor, and during my inevitable post-work anxiety nightmares, I dreamt I was being fired for administering this drug. Somehow, my waking self did not remember a comment that I received once, roughly 6 months ago in orientation, about IV labetalol, but my subconscious pulled it up no problem. We are not supposed to give it on our floor (though IV metoprolol is okay) and it needs to be administered in an ICU/CCU setting. When I am back at work, I am going to complete an incident report and inform my charge nurse but I am very fearful. I know med errors happen, but I just feel awful and cannot help but think of all the "what ifs" as far as the patient's health and my own job. I doubt any one has been in these exact shoes, but any input is appreciated. I am so worried and full of regret.

She had afib and was taking a po anticoagulant at home

After a crazy and frazzling night during a week that ended up being very emotionally trying for me outside of work, I had a patient who developed a really severe sinus headache, began dry heaving from the pain, and was refusing all medication as she told me that the only thing that helped with her pain was the steam from a shower. She was also on a heparin drip that was supposed to be stopped in preparation for a surgery later that day. I had falsely transcribed that the drip was supposed to be stopped at 5am, and in the craziness of the situation, I looked at my watch, saw it was 5am, and helped my patient with the shower, disconnecting her from heparin. I only realized my mistake during change of shift- learning that the drip was supposed to be stopped at 8. I did everything I could to reach the doctor, and the oncoming nurse found me tearfully waiting on the phone. She told me everything would be okay, and that she would take the call back from the doctor. She told me to go home, she would figure out the situation, and I could write up an incident report when I am back tonight. I just feel awful, especially since I was never able to reach the doctor. I know I should have double checked the time, but I felt so certain and so much was happening at once. I'm new, I understand the importance of heparin, but I am not sure of the weight of the error. Has anyone done something similar, or is anyone able to tell me how bad this is? I feel so incredibly terrible over it

Thank you! I'm glad to know it gets better. I'm working with my clinical educator to get connected with a mentor--just so I feel a little bit better about things!

Hello! I do work nights, so I did end up asking advice from others, but I ended up getting a lot of different answers. The doctor approved of all the interventions I'd done (stopping drip, monitoring patient closely etc.) and told me to keep doing what I was doing. Clinically, my patient looked fine, but I still felt uncomfortable because he was having pretty long pauses. I did take a basic EKG class and I've been studying a lot so I feel more comfortable, and though I lack years of judgment, it didn't look great. We do have a RRT team--didn't end up needing to call anyone, and his heart rate/rhythm ended up stabilizing a bit before shift change.

There are a lot of other posts like this, and though I know that there are so many other new nurses feeling just as lost as me, I feel so alone. I finished my 7 weeks of orientation on a cardiac floor and after my first week on my own, I feel pretty low. On orientation, I felt so much more confident, but now that I am on my own, I feel like I need validation for every decision I make. When I was on orientation, all the nurses told me to never be afraid to ask questions and to ask others for help. But now, I find myself asking the silliest questions just because I am so anxious about everything. All the nurses that told me questions were okay now give me these looks that imply I should know better, that I should feel more prepared and more comfortable with everything than I am doing. I've cried on my drive home every day I have been on my own, and whenever I am not at work, I am thinking of the things I should have done better, or worrying about whether or not I missed something important or made a mistake. I was feeling so safe and so comfortable on orientation, but now I'm feeling that I have regressed right back into that terrified, clueless nursing student I was so many years ago! Last night, my patient's heart rate and heart rhythm was all over the place with crazy random pauses and bizarre shifts in rate--outside of any treatment algorithm I learned in school or ACLS. I was terrified and asked for advice from other nurses (despite their apparent frustration with my questions) and called the doctor. When the doctor didn't get back to me right away, I started to get nervous. One of the other nurses said to me, "Well it's not like her rhythm is critical right now, I don't know why you're so concerned." The trouble is, I don't feel I have the experience to differentiate between what is acceptable and critical. I just feel like I'm doing terribly and I feel like I should know more than I do. Is this normal, and if so, when will I stop feeling like this?

I'm orienting as a nurse on a floor that I love. Naturally, 2 weeks before I was set to finish my orientation, I fell at home and fractured my fifth metatarsal pretty significantly. My doctor told me not to work until I met with ortho, but I don't meet with them until next week. My nurse manager was understanding and said I would actually be allowed to work light duty (on crutches, in a cast even) which is really crazy to me. My doctor was okay with that and signed me off to work. But, because I cannot do patient care I am going to fall behind on my orientation. I found out that if I miss more than 12 days in a year (which seems like a lot), I will be terminated. I am terrified that ortho might suggest surgery, which could mean days off the floor, or that they will give me a more strict work restriction. I am also afraid of how long I may be on crutches. If I am on them for weeks, I cannot imagine that my "light duty" will be enough of a contribution to warrant me staying on the floor. I love my job and I love my floor. I am too new to be eligible for FMLA or LOA or anything that could help me in a situation like this. I am terrified of falling behind--or worse, being terminated. I know I should wait until my appointment to start worrying, but I'm a worrier. Has anyone been in a similar situation, or does anyone know how these situations turn out?

Thank you so much :)

Nope, I was still too afraid! I checked for my name on my state's board this morning and my status switched from pending exam to active

Thank you everyone for helping me get my sanity back! I woke up this morning still prepared for the worst, and I passed!

Hi, thank you so much! This made me feel a lot better