Should I stick with this?

[RiverNurse]

Hi all,

I've been in nursing for a year and a half now. At this point, I am trying to determine if I should stay in the profession. I like to write in to AllNurses for the variety of inputs I receive from new nurses as well as more seasoned nurses. I would appreciate your advice - again.

Here is a brief hx of me.

Spent 12 years in IT. The industry went bust, I was burned out and wanted to have a fulfilling second career. I chose nursing. I'd never had any experience at all with a hospital environment, so charts, doctors and the floor itself was all so foreign to me - and - LOL - so were some of the attitudes - given that I'd come from a more "corporate" world.

I went to a nursing school - an accelerated nursing track - finished with my ADN in 15 months. Clinicals were difficult - I had a hard time putting the pieces together. I never quite felt comfortable with my clinical experiences - and don't feel that I really had a firm grasp on that environment.

I finished nursing school, moved to Memphis and was immediately hired on at a large facility, working on a Tele/Med-Surg floor. This was my first exposure to the hospital "world". I was clueless. I didn't know it until after I was hired - but there was an internship program available to new grads. By the time I found out - I was told it was too late for me to enter the program. In addition, I was placed smack in the middle of one of the most difficult floors in the hospital. Call it being gullible or naive - I didn't know it was the most difficult floor there.

Eventually, I left that hospital. I wanted more experience - so I went to work in an ER at an inner city hospital. Halfway during orientation, I was told that I wasn't "fast enough" and that because I wasn't fast enough - there was a potential for patient safety issues. With that - I didn't feel comfortable staying - given the analysis by my preceptor - a seasoned nurse.

I went back to the original floor where I started.

I was doing well until several weeks ago - when I had a pt with a GI bleed. He should not have been on my floor - it is another story altogether on a previous post here. Needless to say - I was "counseled" - with the reason being that I failed to call the doctor in a timely manner.

This week I worked Monday and Tuesday night - Monday night I had a patient fall in her room. She was trying to get to the bedside commode - ambulatory pt - family at bedside and instructions to call for help if needed. Tuesday night - I had a pt that was confused - the same section I'd had the night before. He had a PRN order for Ativan. Tuesday night he was confused again. He received his order of Ativan - he calmed down and was more restful. After watching him - I'd placed my med cart outside his door - I saw that he'd fallen asleep. I went to check in on one of my other patients - a new admit with several needs needing to be addressed. I finished up with her and went back to my cart. I heard shuffling in my other pt's room. He was on the bedside commode, stating that he wanted his wheelchair (from his home) after he'd finished going to the bathroom. A co worker and myself were able to get him back to his bed. He was instructed to stay in bed and did so. I was able to get an additional 1 mg of Ativan ordered for him. I gave that and watched him. He settled down again and fell asleep.

By this time, I went to the other end of the hall to check a patient with restraints - to do her ROM exercises and resecure the restraints. I had just gotten one untied when I heard a huge crash and yelling. It was my pt, he had attempted to walk out of his room. He was in the doorway. He was assessed and found no injuries, neuro checks intact. He was placed in restraints at that point.

So - right now I am 2 for 2. I am paranoid! My manager says there's nothing to worry about and that I am too hard on myself - LOL - I'm a firstborn - so I guess that is correct. But - given these recent events over the last month - and the comments made by my preceptor in the ER - I wonder if she's right? Could it be that there is a "risk for patient safety" at my own hands? If so, I cannot, in good conscience do this work.

I have realized that I am a caring person and have wells of compassion for my patients - but I have also realized there is a distinct difference in "caring for patients" and "taking care of patients".

LOL - I seem to only write when I have problems. My hope is to continue to mature past these first two years of nursing and begin to offer more in terms of support for others.

I appreciate your support and honesty in helping me evaluate this for myself. Your input is appreciated.

Take care,

RiverNurse

[arelle68]

I think we all have days when we feel like you feel today. The profession can't afford to lose a compassionate nurse to a run of bad days. No human being can do this job perfectly. We are all just trying to do the best we can. You should keep trying. If they felt like you couldn't do it, they would have already fired you. Stick nursing out for a few more months. You are probably doing really well. I think your supervisor is right about you being too hard on yourself. Someone has to do nursing jobs. No human is perfect. No human is infallible. We all just have to put up with ourselves and each other.

[SFRN]

It sounds like you are doing fine, it is always difficult when you first start out. I work in a cardio-thoracic ICU and I still have difficult times, especially when you have a confused pt. We never have more than 2 patients! I can only imagine what it's like on a med-surg/telemetry unit. Keep up the good work and for Gods sake DON'T leave nursing. If you find you are not happy you can move to some other area of nursing.

[Sash123]

It sounds like you are a very good nurse and very thorough in what you do. Don't give up on nursing completely. There are so many different nursing fields out there. You just need to find your own little niche. Remember its all about the PMA (positve mental attitude). :)

[litbitblack, ASN, RN]

Dont give up. We need you. Maybe you should try a different floor but it honestly just seems normal. That pt has a right to fall. You did what you could it is not your fault.

[Delirious]

Where were your fellow nurses when all of this was going on? The thing that I love the most about my Med/Surg floor is the other nurses I work with. We all look out for one another and one another's patients. We were just talking this week about how nurses "eat their young" and it can be soooo true. I've told the nurses I work with on night shift more than once how much I appreciate them. I've been an RN in Med/Surg for six months now and have wanted to quit more than once; but they have encouraged me to stay and grow. After weeks of all of us having really terrible patients (similar to what you described--(I can even identify with the GI bleed pt--who went on to ICU and passed away the next day--that's the first time I cried on the job) ) I have finally had a week of truly manageable patients. If this is what you want to do, then hang in there. If it's not, your heart will tell you.

[rita359]

So, tonight you had some confused patients plus the others. You can never tell what confused patients might do. Without someone at their bedsides to prevent them getting up alone there is no earthly way to prevent them doing something you don't want them to do if they want to. So, forgive yourself for not being in all places at all times. You were engaged and working to help your patients doing the best you could. This is only one night. A night without all the drama will make this memory fade. Sounds to me like you are already becoming a seasoned nurse. It is always a work in progress. Even after many years I still have some shifts like that.

[meluhn]

Rivernurse,

One of the most frustrating things about nursing is feeling like you are never good enough or that you always could have done better. I dont remember a single day that I left after work not thinking about 20 more things I could have done or should have done instead of thinking about the one million things I did do quite competently. Please do not beat yourself up. As far as that ER nurse telling you you were too slow, that is just wrong. If you honestly think about it, were you really too slow or just slower than her? We are all very sensitive to criticism and one person should not make us feel bad enough to leave a job we just started, however I totally get that it could.

Also, with your backround in IT, you would be a perfect candidate for a healthcare informatics position, if you are that unhappy with hospital nursing. I know you said you wanted out of the corporate world but this is an up and coming field and might be a good way to combine your experience. Just a thought.

You did not describe anything that would hint to me that you are incompetent. Just a nurse feeling the usual insecurities that our profession sometimes brings out in us.