Okay, so I graduated with my RN in 2013, I didn't work or take BSN classes for a full year after that. Now I'm working my first job as a hospice nurse, I have been for 5 months and I'm in my last semester of school for my BSN. With hospice I work as an on call nurse and I typically drive around to pts homes/facilities to make visits. In this past month I've made two big errors. The first was I had been accessing a pt's port to run in IVF, my first few attempts were unsuccessful and after two sticks with different gripper needles I placed them in the trash to take to the office and drop off in the sharp's container later. But I forgot to do this and the pt's husband got a needle stick. Luckily since it was the pt's husband who has already been exposed to her body fluids and he didn't complain or was angry it was okay. Now my next mistake happened this past weekend. I was having a particularly crazy on call day, I got a call about a pt that was having s/s of URI. I went out and assessed and decided to order abx, I didn't know which abx to order so I called my DON and he wan't available, so then I called the doc (who happens to be an ass) and said to go with zithromax, it was right then that my DON got in touch and said to order rocephin or augmentin. I reviewed drug interactions and everything and looked it all up in my drug guide and I decided to go with augmentin, I called the pharmacy picked it up and dropped it off with the pt. a few hours later I get a call from the facility that said the pt is allergic to PCN. I checked her chart and sure enough she is. At this point I had a panic attack, a real full on panic attack. I got the whole situation taken care of, new abx, assessed pt, benadryl. The pt was totally fine, no reaction whatsoever, the problem was that i just simply forgot to check her allergies, something so basic. I went in on Monday and spoke with my DON and administrator and I got a warning. I also had another panic attack the day after the incident. I have never felt so incompetent in my life. In nursing school I had way more bad days than good days, I never felt like I was doing enough or was good enough, and when I did it didn't last for long. I started this first job really optimistic and I felt like I wanted to be great nurse, and now I just feel stupid, worthless, and stressed out of my mind. I don't even think I want to be a nurse anymore. I am petrified of making another stupid mistake. I love taking care of people and blessing lives, but I don't think I have what it takes, I feel too stupid and incapable of being a great nurse and now I'm terrified of being on call again this next week. And on top of all of this I have been thinking for a while about getting a new job at a hospital, I told my employers that I've been looking. Right after I told them they called me and said they wanted to warn me that if I made any mistakes in the hospital that they would not be as nice to me about it. This just further reinforced my feelings of low self-esteem, its like they are expecting me to keep making terrible stupid mistakes. Any advice or thoughts out there??
I am not at all surprised you are making some mistakes, albeit rather large, dangerous ones. You do not have enough experience to be working in home care. I am really surprised that a home care agency would hire you without any nursing exp. As a home care nurse you have so much autonomy and need to be quick on your feet, there are no veteran nurses within an arm's reach to come rescue you. This does not mean you should quit nursing or that you won't be a great nurse. It simply means you need to get a med-surg or subacute care job for at least a year to get some much needed experience. Let these mistakes be a lesson as to what not to do. Good luck to you. All nurses make mistakes, and the ones that claim they never have are lying.
Specializes in Cardiac, Home Health, Primary Care.
It is situations like this that make me wonder WHY any agency who does home visits hires new grads. I work home health and see the occasional post on here from new grads considering it. As a new grad I was nervous and scared on the hospital floor with a dozen other nurses around me just a shout away. I can't IMAGINE doing home visits as a new nurse where I am at the mercy of getting someone via phone.
Get into a hospital if you can so you have proper support and can develop your skills and thought process. You can always go back to home care if you so choose but you need some experience with the acute processes so you can better understand things in home (and what to do when things go wrong).
You should also have a small sharps container in your car.
Specializes in Cardiac, Home Health, Primary Care.
I am not at all surprised you are making some mistakes, albeit rather large, dangerous ones. You do not have enough experience to be working in home care. I am really surprised that a home care agency would hire you without any nursing exp. As a home care nurse you have so much autonomy and need to be quick on your feet, there are no veteran nurses within an arm's reach to come rescue you. This does not mean you should quit nursing or that you won't be a great nurse. It simply means you need to get a med-surg or subacute care job for at least a year to get some much needed experience. Let these mistakes be a lesson as to what not to do. Good luck to you. All nurses make mistakes, and the ones that claim they never have are lying.
Lol. Apparently you posted while I was typing and we basically said the same thing! Still don't know WHY any agencies hire new grads for home care! It's not safe for anyone involved
Its not you...its the system...if you are getting stressed out a lot...its too much for you...best thing to do is leave..believe me I am trying to get out of this nursing job for years....I am shot to heck.....tired of nasty people and a disorganized Medical system.
Specializes in Pediatrics, High-Risk L&D, Antepartum, L.
I posted on this a little earlier...not necessarily outside the DON's scope of practice at all. Depends on the Hospice standing orders. ABX orders are within the scope of practice for Hospice certified nurses where I live.
But those orders allow for randomly picking an abx? Also, URI is usually viral so why would you have a standing order for that? Something is not good here.
But those orders allow for randomly picking an abx? Also, URI is usually viral so why would you have a standing order for that? Something is not good here.
And what happens when the abx that is chosen by an RN with no prescriptive education has an interaction with another med?
Good for you! Only problem I see is that most nurse residency programs, at least the one I graduated from, only accept nurses who have never worked as an RN. I think this is a requirement of the UHC, the entity that governs residency programs. Double check this with hospitals. However, this does not mean you would be precluded from getting a med surg position and getting a proper orientation. Just means you won't be taking residency classes. Not a major negative in my book.
Wouldn't be the end of the world, for sure. My first job (hospital floor) had a "new grad program," but it wasn't quite what I've heard a nurse residency described as. There was no competition for a spot; it's simply what all new-grad hires do, and essentially included some classroom time learning about labs, neuro, cardiac, respiratory, practicing skills...that kind of thing. But no months-long orientation w/ a preceptor. I think I only got 6 or 7 weeks on orientation ("only" compared to nurse residencies), but my colleagues were great about answering all the questions that I still had. I dunno, I think all of us new grads that I started at that hospital with turned out okay. :)
My point being, all is not lost even if you don't qualify for a Residency anymore.
EEEK...the antibiotic issue sounds a little iffy to me. But something I learned EARLY in my career, whenEVER I call a physician, I ALWAYS give them current vitals and note any allergies. some of the best lessons are learned the very hard way!!!! But, since 1983, I have had that info at hand, always!!!
Thanks everyone for commenting, these posts have actually helped me a lot. I went in today and spoke with my nursing administrator and mentioned that if they hire new grads for on call they really should have a better orientation. All I did was shadow one of the CM's for a few weeks and then was thrown into on call. I often had to do procedures on my own that I never actually did in school, I would go online and watch videos as to how to do them or read in my old nursing textbooks. Needless to say I am realizing that this is not a new grad friendly position. I also went into counseling today and was diagnosed with generalized anxiety disorder. Yay nursing! You are officially pushing me to the brink of insanity.
Wow sounds like the place where you work just needed a warm body to fill in the staffing holes. Sadly you were, essentially, set up to fail by not being properly trained nor given adequate resources to carry out your job safely and appropriately. I saw that you posted that your DON is your primary go-to, but he is difficult to reach AND doesn't want you contacting a doctor without his knowledge. This is unacceptable. Based on the additional info you provided this is certainly not a place I'd continue to work for. I hope you can regroup and find someplace more supportive. Take care of yourself, no job is worth your physical or mental health!
Still don't know WHY any agencies hire new grads for home care! It's not safe for anyone involved
Amen! I'm a new grad and I would be scared silly if I was my patient without supervision right now...just speaking the truth. You should be required to have at least 2 years experience before working for these agencies!!!! Patients deserve competent nurses taking care of them, not a newbie.
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JMF7755
12 Posts
I am not at all surprised you are making some mistakes, albeit rather large, dangerous ones. You do not have enough experience to be working in home care. I am really surprised that a home care agency would hire you without any nursing exp. As a home care nurse you have so much autonomy and need to be quick on your feet, there are no veteran nurses within an arm's reach to come rescue you. This does not mean you should quit nursing or that you won't be a great nurse. It simply means you need to get a med-surg or subacute care job for at least a year to get some much needed experience. Let these mistakes be a lesson as to what not to do. Good luck to you. All nurses make mistakes, and the ones that claim they never have are lying.