"Stupid" questions and working as new RN

[lillystarrn]

Hello,

I've got another question and don't know if it's considered a "stupid" question or not. I'll give you my background first (for those who have not read my earlier posts) and what had happened. I'm currently on my 8th week of working as a new RN, but I have only worked 2 weeks (2 shifts total) off of orientation.

I worked as the second RN last night, which consisted of 4 admissions, assessing 14 patients and giving IV pushes (the LPNs did the med pass and took care of the patients). I had a new admit around 1 am and did not know they were NPO until later and I did not even think to ask. I picked up from watching other nurses that you always check before giving anything to eat or drink. I was having so much anxiety because I still had to chart on all the patients and I was administering blood to another patient (they were already on their 3rd unit) so my judgment was not where it should have been. The LPN had already brought them ice (so I was assuming that they were not NPO. That's what I get for assuming).

Anyways, my shift did not end until 7:30 that morning and it did not even hit me until I woke up this evening that I had let them have ice and they were NPO. I'm freaking out because I made a mistake like that and called the nursing supervisor who had worked that shift. They kind of giggled and said that giving them ice would actually be the "best" thing (as in least harmful mistake) to have accidentally given them since they were NPO. The patient was fine and to not worry about it.

I asked if this would be considered a write up or something like that and was told no, but it would be if it happened again.

Here is my actual question: Am I stupid for "telling on myself" by asking about something like this? I've already made "little" mistakes that I've caught and once I calm down I realize that these are small mistakes, although still mistakes, that I shouldn't worry so much about them. Is this normal to worry like this as a new RN? I'm beginning to wonder if nursing is right for me because I stress so much about everything.

[Harrychandler]

I think you did the right thing by telling on yourself because what if that patient asked the current nurse on duty for some ice and she said no? Then the patient may say "well the other nurse gave me some" it's better to hear it from you than it is from a patient.

[Davey Do]

"Am I stupid for "telling on myself" by asking about something like this?"

I sense, at this time, you are motivated primarily by fear and anxiety in wanting to do a good job. Not that this is bad. I'm thinking that maybe you are just a real conscientious Nurse. And you will develop from this point, continuing to be meticulous, with time and experience, your anxiety will decrease.

I even applaud the fact that you told on yourself, so to speak. Had you said you were doing a scrupulous re-evaluation of your questionable actions, I would have applauded you all the more. Just because it sounds less self-deprecating.

"Is this normal to worry like this as a new RN?"

You know, personalities vary and some Individuals slide into their positions gracefully with obvious self-assuredness. Others stumble around in the dark and hit and miss on their goals appearing not have a clue. Some have a laisserfaire or devil-may-care attitude and go about their business with all the compassion of a Social Director on a Cattleboat.

I sense you are One who cares about your Patients and the care you provide. You may be a worrier by nature. If you can find a happy Medium and not be so hard on yourself, you will be (and that's not saying that you already aren't) a great Nurse.

The very best to you.

Dave

[lillystarrn]

Thank you so much. I get "advice" from people, some who are nurses and some who aren't working in health care, to not "tell on myself." As you can tell, I worry too much about what my actions could have done because I always picture the worst-case scenario with the patient. I agree with the other reply that I feel it's better for me to point out my mistake than to have the patient or another nurse to. I hope that after working for a while that my anxiety will go down and I will get better with everything.

[Hospice Nurse LPN, BSN, RN]

IMHO, Honesty is the best policy.

[NurseOnAMotorcycle, ASN, RN]

I think you did the right thing. Especially as you are establishing yourself as a team member. You don't want them questioning your every action because you were caught lying once AND I'm sure that the patient will be better for your coworkers knowing that they had the ice chips if there were some kind of problem from it.

Good integrity under pressure!

[ShayRN]

Lets get this straight? 2 shifts off orientation you had at least 7 patients, 2 admits and was hanging blood? I find it hard to believe that is the only mistake you made last night, you just don't know what the other ones are because clearly it was NOT SAFE. Crap, I need to go back to bed just reading that post.

[NightOwl0624]

I have been a nurse for almost 2 years and I have yet to have a completely perfect shift.

Even on a good night, I have given meds 5 minutes late, I have given a drink of water to someone 20 minutes after he was supposed to go NPO, I have been unable to get a blood draw, patients have fallen, left AMA, etc. etc. etc... You do the best you can, report what you need to report and don't beat yourself up.

(I would have mentioned the ice, too.)

[Whispera, MSN, RN]

I think if you have a concern about whether to report or not report, you should report. We must stand in our truth and accept consequences, which are probably going to be just information or help so we don't do the same thing again.

It's normal to feel overwhelmed as a new nurse. It's normal to feel overwhelmed at times, as a nurse with any amount of experience. There's a book I like that talks about the stages of development as a nurse. It's called From Novice to Expert, and is by Patricia Benner. I'd recommend it, to help you learn more about the stage you're in right now, and what to expect from yourself now and in the future. It might help you be less hard on yourself too.

I think you're a very caring nurse, and I'm proud to have you as part of my profession.

[OBJandro]

I have been an RN now for over 3 years. I started out as an RN in the hospital setting working Med Surg. and I now work in OB.

Honestly I was a wreck for nearly the first year. I thought the same thing you did, "Is nursing right for me?" I was worried I did something wrong, or missed something everyday. I made little mistakes often and beat myself up over them for weeks at a time!

Experience is what builds confidence. You have the knowledge to do nursing now, but it takes time and experience to build up confidence in yourself and what you are doing.

Things will get better I promise! Some of the things that seem stressful to you now will just be routine later. You are learning from all the little mistakes and you will turn into a very good nurse!! Be patient, and have lots of support during the first few months.

Hope things get better for you, and keep us posted!!

Hugs!!

[llm1987]

You did the right thing by calling and making sure that someone knew. One small lie can lead to many many more!! Your work load seems to be pretty extreme, though, and maybe requesting more orientation time would be beneficial.

[lillystarrn]

I have received replies from previous posts that my patient load is considered high. The usual ratio for where I work at is 1:5. The LPNs do the majority of the patient care as far as meds go, etc. Working as an RN, I am responsible for the patients that the LPNs care for, but I am doing the initial assessments and administering IV push meds mainly (+ admissions, etc.). I don't know what it's like at other hospitals for an RN because this is my first job since graduating nursing school in December. I've seen other hospitals have only RNs working the floor with maybe one or two LPNs. I'm guessing those are the hospitals that have the RNs doing the role of LPN also.

Whenever I am working as an RN and doing LPN duties, then my patient load has not been more than 5.

What is considered a typical RN workload? Also, I'm wondering what is a typical workload for a LPN?