Proving myself after making mistakes....

[Yenta7]

Hi everyone, it's me again. You guys were great in helping me out before, I decided to come back again.

Let me start from the beginning. During my first week on my own (following my orientation) my first three days were a nightmare. On my frist day, m pt coded. As a result, I finished late and was not able to finish signing off my MAR and my IV administration records. The incoming LPN just calmly reminded me to sign it. The following day, I got busy again and I again forgot to sign the same forms. On my third day, one of my pt's coded and I spent the whole shift trying to deal with a delirous pt who eventually pulled out his permacatch. Again I forgot to sign off on my MARs. This time, the same incoming LPN, began to give me attitude. She literally "gave me the hand" as they say, when I went to apologize to her. Still, I said to her, I'm really sorry, I'm still trying to learn how to deal with things during the shift. After that, she suddenly winked at said, "that's ok" as if she had never gotten angry in the first place.

My realtionship with her was strained at best. It always felt awkward talking to her, and I always felt as if I was making a complete idiot out of myself. It felt as if everytime I forgot something, I swear she was always my incoming nurse! I didn't blame her for being upset, but at the same time I eventually STOPPED trying to talk to her.

Yesterday, things were going relatively well. I had some crisis' at the end of the shift, but I thought I had managed to get things done fairly well. During this particular shift, I had a pt on a chest tube. The chest tube had come out during the previous shift, and the chest tube suction had been switched to an external suction Throughout the whole shift, the chest tube was drainin.g well, and the pt only complained of minimal discomfort to the insertion site. On two occassions, he requested his morphine, but immediately recovered after it was given. His sats were good, his breathing regular and his chest expension equal. The dressing at the insertion site was also dry.

As the shift was coming to and end, I had some minor issues, but I (suprisingly) was able to deal with them. As this LPN was coming in, I greeted her warmly and asked her if I could resite one of her patients. She laughingly said it was fine my her. We both got our tasks done and had a fairly light conversation. After I resited my patient, she suddenly came into the room, asking me why my other pt's chest tube was clamped. Confused (and frantic) I said, "clamped? but it was draining all shift?" She asked again, why is it clamped? So I checked my pt, and sure enough it was clamped. Confused, I tried to remember if it had been clamped during my shift. I frantically told her, that I wasn't sure if it had been clamped during my shift, but I was sure it had been draining. At one point I even assumed (in my what I call "dumb panic") it may have been clamped because the suction was changed to an external one. However she calmly informed me that the whole system would not work if the tubing was clamped (I know, I know you're all probably wondering if I was hit by the stupid stick to many times-but I seriously blanked for a second) then walked out.

Kinda freaking out at that point, I called my charge nurse who then calmly unclamped it and said the tube may have been clamped by accident when the pt was walking around. By then though, my confidence was shot out the roof. What made it even worse was that I saw the incoming LPN asking my charge about the pt's status. I heard my charge calmly tell her, that the chest tube was draining the whole shift and that the pt was ok.At one point I overheard this LPN say, that I had missed an IV resite (we have to resite pt's every three days) and looking over, I saw her give me the same dirty look she gave me that day I forgot to sign my MARs.

I suppose I should have spoken to her, but by then, all I wanted to do by then was crawl into bed and never come back. I swear I felt as if I had a big red letter on my chest signifying to the world about what an idiot nurse I was.

As I was going to my locker in my lounge, I realized the same LPN was also coming into the lounge. I barely even looked at her and didn't really chat with her as much as I usually tried to do. As I was putting my things away and she began making coffee, I heard her jokingly say to me, "I can't work without my coffee" I sorta laughed (suprised), but then she walked out before I could really talk to her.

Now I have to go back tonight and work graveyard with her. I've been really trying to prove myself but now I have a feeling it's to late for me to prove myself to her. I know she's only one person and I can't please everyone, but I've seen how the nurses there talk about other nurses with bad habbits or who are not dependable. In hindsight, I could have done a lot of things differently.

I've only been working at the hospital for a few months (three by the end of Feburary) and this is my first job. Can you guys give me suggestions on how I can "re-prove" myself to her and to the other nurses?

[Scrubby]

[i've only been working at the hospital for a few months (three by the end of Feburary) and this is my first job. Can you guys give me suggestions on how I can "re-prove" myself to her and to the other nurses?I've only been working at the hospital for a few months (three by the end of Feburary) and this is my first job. Can you guys give me suggestions on how I can "re-prove" myself to her and to the other nurses?]

From reading your post it seems that you lack confidence in your nursing abilities. This is perfectly natural in new grads and to be honest overly confidence grads make me worried. I don't see the need for you to 'prove' yourself to her at all, she has acted unprofessionally by giving you dirty looks and being unsupportive to someone who is new to the area. You are giving her too much power over you.

[EmmaG, RN]

As a result, I finished late and was not able to finish signing off my MAR and my IV administration records. The incoming LPN just calmly reminded me to sign it. The following day, I got busy again and I again forgot to sign the same forms. On my third day, one of my pt's coded and I spent the whole shift trying to deal with a delirous pt who eventually pulled out his permacatch. Again I forgot to sign off on my MARs.

I noticed this from an older post:

During the change of shift, the incoming nurse was giving me attitude because I hadn't signed off on all my meds on my MAR.

Are you referring to a separate incident than what you described on the earlier post?

In any case if you look at the bigger picture here, you seem to have problems with organization and prioritizing. That is not unusual for a new nurse, and it will get better as you gain experience.

My suggestion would be to go to your nurse manager and acknowledge your need to improve in these areas, and ask for her input to help you get a handle on this; if you work with experienced nurses who seem to be calm and well-organized, ask for their assistance. See if they can help you develop a 'cheat sheet' of some sort, to remind you of things you must get done within your shift.

Not signing MARs can be a serious problem, leading to medication errors (in fact, places I've worked consider not signing off on a MAR an error itself); they do need to be signed as you are administering the medications. Please make a point to do that every time without exception, even as you are working on other issues.

[Yenta7]

Actually, this was in reference to a previous post. I've realized why she was irritated in the first place actually and have made it a point to sign my MARs after I give my medications, no matter how "busy" I feel. In fact, this really isn't a problem for me anymore. I've gotten a lot better at ensuring all my MARs are signed as I do realize (after my first post) how much of a potential it can be for a med error.

I suppose I mentioned it to demonstrate my concerns.