Sick of making mistakes and questioning why I ever became a nurse to begin with!

Mahage, LPN · Jan 24, 2009

I am in the same boat -- about six months off orientation now and it seems I make a doozy about once a week!!! And I can't even tell you why. Of course, it's often always due to being rushed, over stressed and not EVER having enough help, or people who are WILLING to help. (Usually plenty of people around -- just none that seem eager to help). And I am STILL battling a never ending upward learning curve.
There are just so many zillions of details every single shift that a nurse has to keep track of. I've got my "brain sheets" but there's always something that slips past it -- I start out every shift telling myself I'm going to stay on TOP of things, but something always happens -a code, a fall, a crisis of some sort.
I also have questioned my competency many times and think I've made a mistake to go into nursing. I dont' know what to do. In many areas, of course, I've progressed, but I'm still making errors. There are times I feel my soul is just in distress and I so want to find a way OUT.
What is most frustrating are the few little ugly trolls on the unit who will glare at you for the errors -- as if they themselves have never made one themselves, even though you've CAUGHT them making those errors yourself! I'm not saying every nurse is like that -- many are super supportive -- but these are the ones who can really work on you mentally to make you NOT enjoy the job when the going gets rough. I really despise these types of nurses, down to their core.

Hey Music, As a second career nurse (actually third) I was talking to a younger but more experienced coworker about my similiar concerns early on and how I compared it to my competence as a Social Worker of over 30 years experience. He pointed out to me that as a new nurse we have to use our brains space and time reminding ourselves of the things that will become automatic, like the meanings of acronyms and the best time sequence of things and the definitions of proceedures and diagnosis and must learn to picture the patient and what is going on with their bodily process and how they are interupted. These are rudementary skills that must be practiced and developed under enourmous pressure of the moment when we are already feeling tons of pressure to just keep our patients alive. Crisis inevitably happen when we are trying to focus on our routine along with all these other issues. :grn:

One of the biggest things i have learned and it happened around the 8th month was that I should expect crisis and work them into my rhythem. I also gave myself permission to not be finished on time. I put the patient care first and the paperwork second, chores are last. If I am still busy stuffing charts when it is time to give report, I take my pile of stuffing with me and do it after I give each report. I will also stay late to put in my I's and O's or do progress notes when I must and don't give myself a hard time about it. I am not a failure just because I had a rough night. I have also gotten to the point that when an assignment seems unfair, I will try it for the first night in my rotation but if it proves overwhelming, I will go to the charge nurse and request a change. I used to would not do that because all my patients scared me to death anyway and would rather continue on with 3 super difficult patients that I had already had than to take a chance on a new one.

As far as needing help, I have learned who to ask for what. The newer nurses on the floor are super willing to help with things like repositioning and even clean ups. Early on I had a few mentors who would give meds for me and do trach care in a pinch if I would ask, not to mention difficult blood sticks when my tech wouldn't even try and I couldn't hit the vein. :yeah: If you don't already know, find out who your good guys are and ask them for help.

You will find soon that you start to have a bit of loose time and you can cut loose and help another nurse in a pinch. They will be surprised and will respond positively. Also, it is the charge nurses job to help you when you are overwhelmed. I honestly didn't know this for a long time and I noticed that one charge nurse was always helping me when she was on and I got behind. I told her how much I appreciated her support and she told me that she was just doing her job. That she was supposed to enter orders, and help the rest of us keep up in addition to her administrative stuff! Well, duhhhh! I hadn't a clue. She is a jewel. :bowingpur Others are varying degrees of responsive when you ask for their help. Sometimes you have to demand it. Frequently the other new guys are a great support.

The main thing is to understand that you are in a very stressful position in your most stressful time. :banghead: Do not keep telling yourself all that negative bull crap. You are experiencing what most of us experience. I promise you if you hang in there, go easy on yourself while striving for your ideals, work will get much better and you will get through a shift one day and think, "hey what is different? :tinkbll: I feel good about the work I did!" That means you are getting past the steepest part of that learning curve. You will continue to feel frustrated often times but in our current health care system, we are severly overtaxed and challenged. At best there are constant challanges and opportunities for learning in nursing. That is why I love it. I am so glad the trolls could not run me away. They don't give me much crap nowadays, and when and if they do, I can give some back. I let my inner dog come out! :flmngmd:Yaahaaahaaahaaahaa!

Mahage

ayla2004, ASN, RN · Jan 24, 2009

Not sure about all this yet i've made a few mistakes not seieing a drug wasn't presribed a time so it wans't given until the paharmaist reviewed the drug card days later. dealing with a ding patient and missing the x-ray card ordered for another. Getting stressed and anxious by everything, havinga patient fall out of bed because i let them have bed rails down (bed on lowest setting but lacerations to the head, buzzer given to patient). Getting stressdd means not being able to protoize get help delegate or put off tasks. I now try to recogize what importat and do it, listen to my own stress trigger and deal with them it may mean getting help or declining to help a collegue if i feel it will push me over my stress limit. I think more clearlt whehn i do this and don't try to rush care, assesments meds or anything and do a better more focussed job.

but my number one tip getting feedback both good and bad and makinga firend of an experinces nurse on my ward who reached out gave me her pohone number and said ring me.

i was

gruchi1 · Mar 19, 2009

I'm looking at your situation from a different perspective...I am still in nursing school and looking ahead at all the mistakes I will make. You have to ask yourself two things:

1. Is there ANY nurse on your floor (or that taught you or trained you) that has not made a boo-boo along the way? I will be willing to bet that your instructors used many mistakes they had made to teach you "what not to do!"

2. The mistakes you have made......honestly looking ahead, do you think you would ever repeat them? OR, will you hold them close and work to improve them? You obviously care and are concerned. You should be. So, smack yourself on the hand and get back to work. Yep, your co-workers will give you crap and they may watch you closely...but this is human nature. Fess up that you are human, don't make excuses and I'll bet the next time you have a patient off the floor with tests, you will take that 10 seconds to think..."okay, do I need to do anything for him? Has he missed any meds?"

The nurses I work under scare the crap out of me. I have found tons of mistakes that would cost them their licenses. You are a team, though. You are there for the best interest of the patients, not out to stab each other in the back. If it's not a "team" atmosphere, then you need to find a job somewhere that is. If it is, let them give you a little crap about it and move on. And stop doing this.....:banghead:You will end up on the mental ward, having nurses there taking care of you!!

SummerGarden, BSN, MSN, RN · Mar 20, 2009

hey everyone,
i just wonder now many more mistakes i can make before i just get fired......
thanks!

me too!!! it sounds like you have a supportive environment because the type of mistakes you are making has not gotten you fired. this is a positive! do not get me wrong, i am on a similar unit as you and i understand how hard it is...!!! however, i think i can help….

are you talking to your nurse manager, educator, etc. about these mistakes and how you can improve? may be you can have someone to refer too during your shift until you are comfortable? in my environment i have very experienced nurses i can turn to for help. for example, if i cannot read the writing of a doctor i will ask a more experienced nurse who knows the doctor to read the order to me.

i also have a time and task management system (it is not perfect yet), where i review such things as the chart vitals and i&os at the end of my shift before giving report. maybe you need help developing a system? if so, talk to some of the more experienced nurses and steal some idea that will work for you.

as for the patient who fell because the bed was not locked... guess what? you will never make that mistake again! some mistakes will only happen once. i am told by more experienced nurses (with a laugh) that it gets easier... and that someday we will know our jobs like the back of our hands... can you believe that? like the back of our hands!!!!

-new grad rn, who loves nursing but hates the learning curve of being a new grad!

ps. ooops.. i just realized that this was posted in december... no worries.. i still wish to help if i can. :nurse:

LovePurple · Mar 20, 2009

How many mistakes can you make before you get fired? That depends on where you are. I think my case is worse than usual. I was in orientation 12 weeks. At the beginning of orientation I had to be reminded to give insulin a couple times (it is on a separate diabetic MAR after the other MARs). In the middle of orientation I was in a big hurry and hung an IV antibiotic without flushing it first (pt. was saline locked) and forgot to wipe it with alcohol. At the end of orientation I had 2 pts. with crazy BPs-one high and one low. I checked the high one, only to find out it was a false high. I quickly gave her meds and did a quick assessment since I was already in there. Next I went to the pt. with the low BP. I called the doctor and got a 500 ml NS bolus. I got busy taking care of my other pts. and forgot to check the BP right after the bolus finished. When I checked it 45 min. later it was still low. He ended up needing another liter and a half wide open to get the pressure up. Two days later I was called in to the mgr.'s office and told that I had made too many safety mistakes and had 36 hours to resign or be fired. (During this time my regular preceptor had been on vacation so I was precepted by someone else who told me to pretend she wasn't there and ask the charge nurse if I needed anything). I had no written disciplinary action of any kind, and no warning at all that termination was even a possibility. I made mistakes, I agree, but my preceptor should have helped me more. I don't think I should have been fired. I resigned so that I wouldn't have a termination on my record. Now I am looking for a new job, but nobody wants new grads. Any thoughts on this, anyone?

Holy cow! I think they need to re-evaluate how they're precepting! I just left my new grad position because it just stressed me to the max.. especially being night shift, after 3 months and am on the job hunt again. I do get the "new grad" thing over and over even though I do have a little bit of experience now. I mean I'm not a complete moron.. and I don't understand why I need to have experience before going to some units because if it's where I'm really interested in being, I might as well learn from the start. I don't get how that works. I might end up being the best nurse they ever had, but they'd rather hire someone else who has experience in other fields of nursing just.. because?! Who knows.. anyway- I don't have any advice, other than I really hate your situation for you! That is crazy they gave you no warning or anything, but I guess on orientation they can terminate you (at least at my hospital) without giving any reason. Best of luck to you and I hope you find something fitting to you!

caribqueen12 · Mar 20, 2009

I am feeling this way and contemplating changing careers. I have been working for the past 5 months 4.5 months of which were residency. I am so scared that each day I go to work feeling nauseated and leave depressed and frustrated. I work cardiac as well and despite me mentioning how afraid I am about making decisions, everyone insists that you will be find and there is tons of help: here is the reality-everyone is busy or can't be found when actually needed, you're so confused you don't even know what questions you should ask. Doctors, ARNPs--I mean a Podiatrist yelled at me. I am thankful that my precepting nurse is usually nearby and will help but I am scared b/c my manager insists that I take more patients 5-6, and I feel still need to work on tying up the loose ends. Nursing is such a scary and demanding profession, I believe any day you know it all, you should probably retire---you will make a mistake. Despite me feeling like I hate my job and wondering what other career I can switch to---nursing is my second career, I still like the response from my patients and I enjoy when they smile, even as I"m screwing up everything else. I am learning to be humble and to accept the fact that I need to ask for help. I will start posting more as things change for me. :nurse:

caribqueen12 · Mar 20, 2009

Inner dog....it has surfaced already but I am generally a passive person but nursing has brought it out of me.

LovePurple · Mar 21, 2009

Inner dog....it has surfaced already but I am generally a passive person but nursing has brought it out of me.

haha! I love how simple you put this! Not that it's funny, but still! Straight to the point! I just hate to realize the fact that it seems like those who work best in the hospital setting under all of this stress are those who 'do not care' or have become 'desensitized' to the seriousness of each individual situation. So much for holistic care.. and caring for the person and ALL of their needs. It's more like do the basics to keep them alive during your shift and then go home and not worry about a thing. That doesn't work for me, nor do I want to become that person

Mahage, LPN · Mar 21, 2009

I am feeling this way and contemplating changing careers. I have been working for the past 5 months 4.5 months of which were residency. I am so scared that each day I go to work feeling nauseated and leave depressed and frustrated. I work cardiac as well and despite me mentioning how afraid I am about making decisions, everyone insists that you will be find and there is tons of help: here is the reality-everyone is busy or can't be found when actually needed, you're so confused you don't even know what questions you should ask. Doctors, ARNPs--I mean a Podiatrist yelled at me. I am thankful that my precepting nurse is usually nearby and will help but I am scared b/c my manager insists that I take more patients 5-6, and I feel still need to work on tying up the loose ends. Nursing is such a scary and demanding profession, I believe any day you know it all, you should probably retire---you will make a mistake. Despite me feeling like I hate my job and wondering what other career I can switch to---nursing is my second career, I still like the response from my patients and I enjoy when they smile, even as I"m screwing up everything else. I am learning to be humble and to accept the fact that I need to ask for help. I will start posting more as things change for me.

Caribqueen, Darlin', I know how you feel, believe me, but you are at the very worst point in the learning curve. Mark my word, things will get much better about 8-9 months, you will begin to see the light at the end of the tunnel and by 12 months you will be feeling much, much better. Then stuff will still happen that will set you back emotionally, but if you are like me (I'm third career) you did this because you really wanted to do it, so just toughen up, put on your big girl panties, and show em' what you are made of. You didn't get here without a load of sacrifice and you are here and more than likely, you are doing a great job. Take the full load of patients, we only learn by doing. Ask for help when you need it, keep putting your patients first and finish the paperwork last, you will make it. I can tell by the fact that you love the patients response that you are a great nurse.

Mahage

The fairly new nurse (1 year and 4 months) with 57 years life experience!:dncgcpd:

starletRN · Mar 21, 2009

I'm so glad I found this thread. I just started my orientation and I'm a new grad. It's nice to know I'm not the only one feeling overwhelmed.

I have been putting the patient care first and the paperwork last, but my hospital is big on the paperwork. I feel like that's the majority of what I'm having to focus my learning on.

But I still focus on my patient and remind myself to chart later. Only problem is that when I go to chart I find myself guestimating on what time I checked a patient's response to a med or what time I reassessed a patient.

Does anyone have a system that they use to keep track of these things until you get a chance to chart? I have a little notebook for reminders but sometimes forget to write it down in there. LOL

I just really don't want to make guesses about when I did something and then have there be a discrepancy later on. I want to do the best job I can with this. Any suggestions would be great.

Mahage, LPN · Mar 21, 2009

I'm so glad I found this thread. I just started my orientation and I'm a new grad. It's nice to know I'm not the only one feeling overwhelmed.
I have been putting the patient care first and the paperwork last, but my hospital is big on the paperwork. I feel like that's the majority of what I'm having to focus my learning on.
But I still focus on my patient and remind myself to chart later. Only problem is that when I go to chart I find myself guestimating on what time I checked a patient's response to a med or what time I reassessed a patient.
Does anyone have a system that they use to keep track of these things until you get a chance to chart? I have a little notebook for reminders but sometimes forget to write it down in there. LOL
I just really don't want to make guesses about when I did something and then have there be a discrepancy later on. I want to do the best job I can with this. Any suggestions would be great.

I unfortunately am not a great role model as far as keeping up with times. I do try very hard to jot down times that pt threw up, I called MD, MD called back, gave prn BP meds, etc. But I am not real consistent at putting down times that I checked or reassessed a pt. or his response to pain meds. Some of our nurses carry note cards, stapled together and put each time they enter a room on it. I plan to try that system myself, but haven't yet. We have COWS and I try to make computer notes on the biggies. Sometimes I have had to wait until after report to enter shift assessments and I hate that because the charges really push for us to get out on time, but its illegal to not chart your assessments and it is also unethical to clock out and finish charting. I won't do it. I have gotten chewed out about it, but that is just the way it is.

Sounds like you are doing fine.

Mahage

starletRN · Mar 21, 2009

I unfortunately am not a great role model as far as keeping up with times. I do try very hard to jot down times that pt threw up, I called MD, MD called back, gave prn BP meds, etc. But I am not real consistent at putting down times that I checked or reassessed a pt. or his response to pain meds. Some of our nurses carry note cards, stapled together and put each time they enter a room on it. I plan to try that system myself, but haven't yet. We have COWS and I try to make computer notes on the biggies. Sometimes I have had to wait until after report to enter shift assessments and I hate that because the charges really push for us to get out on time, but its illegal to not chart your assessments and it is also unethical to clock out and finish charting. I won't do it. I have gotten chewed out about it, but that is just the way it is.
Sounds like you are doing fine.
Mahage

Thanks Mahage! I'm glad I'm not the only one. Our hospital tells us the same thing about leaving on time. To clock out as close to the end of our shift as possible. Fortunately, the unit manager doesn't give us a hard time if we can't do that. It's not like any of us want to be there any later than we have to.