I work on a busy cardiac stepdown unit. After a 3 month orientation, I've been on my own now for 3 1/2 months. I love my job, I love interacting with my patients and making them smile when they're going through a rough time. I try to keep a positive attitude, however, after several stupid stupid stupid mistakes, I'm wondering if I'm even cut out for this. I'm so scared that one day I'm going to make a mistake that is going to be fatal. Here's my list of mistakes thus far: Just got orders from a doc with notoriously horrible handwriting, thought the order said DC foley, which I did... only come to find out later on, the order said DC zosyn... Next mistake, had a patient with a wound vac for the first time, came in that morning and assessed, assessed the site where the wound vac was applied, and even thought I assessed the machine, WRONG, apparently the wound vac had died on night shift, was off my whole shift and it wasn't caught until the next nightshift... Ok, next mistake, had a CABG pt who was a walky talky, didn't need any assistance. Well apparently I forgot to lock his bed, and he fell on his butt while trying to get outta bed when I was not in the room.... All of these mistakes happened around the same time frame, and for a while I was starting to feel more confident since I was making less mistakes, wrong assumption. Had the day from hell yesterday, and don't even know if I want to be a nurse anymore. Had a pt who was in a fib with rvr, was running in the 110s, was on cardizem iv @ 10cc/hr, doc came in and ordered lopressor 25 po. Pt left the floor all day for tests, and the lopressor had not been administered, well the pt had converted to SB while gone, which I knew! but for some dumb reason, I gave the lopressor anyway!! His heart rate was in the 50s for goodness sake! So I got wrote up for that, of course. I leave the hospital bawling, because I have made mistakes, but never a med error like that, get home only to find that I had another pt's q 2 hr eye drops in my pocket. I call the floor to tell the pm nurse, only to find that I had forgotten to chart output on another pt who was strict I&O and the doc was up on the unit raising cane about it!!
Sorry so long, but after all this, I feel incompetent and am questioning why I ever went into nursing. I dread going to work, and bearly get any sleep before a shift (which could have something to do with all these mistakes) I just wonder now many more mistakes I can make before I just get fired...... Can anyone relate, or offer any advice, I'm desperate here!
CZBN and everyone else makes some good points for keeping track of what's going on with each pt.
I also make a to-do checklist for each pt, then review the orders to make sure nothing got overlooked. We're computerized so this is pretty easy and quick to accomplish.
Also can't overemphasize asking questions. Remember, the only dumb question is the one that wasn't asked.
I have been on my own after orientation 15 months - it does get a little easier, but I still have days where I feel like it's the first week after orientation on my own. I work on a similar floor as you do. I try to go in early and get as organized as I can before hand - and I tell myself it is OK to stay late and go through the charts one more time.
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!
Just an update: I now work in adolescent psych and I love it. The staff is really a team. I actually get to interact with patients- in fact it's my job to interact! I just finished orientation yesterday. One of the charge nurses (a very experienced nurse) sent a great e-mail to my manager and unit educator singing my praises. I really feel like I am finally in the right spot. I guess God wanted me here and not in tele. I have complete compassion for all the other new grads who are struggling! I will be thinking of you all.
feeling much better, off for a couple of days w/enough sleep to make up for the crazy days. I will definitely incorporate some of the things mentioned here and most of all, I will ask questions like there is no tomorrow, already I think the docs and PAs are aware that I will hunt them down and make requests or inquiries about my patients.
feeling much better, off for a couple of days w/enough sleep to make up for the crazy days. I will definitely incorporate some of the things mentioned here and most of all, I will ask questions like there is no tomorrow, already I think the docs and PAs are aware that I will hunt them down and make requests or inquiries about my patients.
Quilter - I think that was very wrong of them to insist you resign or be fired. It sounds like they botched your orientation and made you pay for it. I think that happens a lot because management does not want to take responsibility for mistakes. The only consulation is that you're out of that place - it sounds like a below par place to work, although, being a new nurse, I'm not sure what's more common, facilities that have good training practices or lousy facilities running like chaotic circuses and treating new nurses badly. I hope you found a better job with a better facility and got a good preceptor. They are hard to find!
dont feel bad the other day i had a copd pt who was stating in the 80's so the dr put her back on the bipap (which she hates) then my preceptor came in the room and realized her 02 wasnt hooked in the wall anymore.
and as far as the bed being locked i think ive accidently forgot to lower a pt bed back down at least once a day.
ive forgot to sign off on charts at eos
we are all new and theres so much to remember it will come in time
also did this stuff happen towrds the end of your shift? my mistakes are usually around lunch (no fuel no brain power) and around the end of my shift (im worn out)
Just a side note it's "sating" not "stating" as in o2 saturation. Just so you know :wink2:
lol, oh honey relax! we all make mistakes! maybe its the unit youre on? try home health or med surg, just calm down! when i first started working icu i would go home almost in tears cause i didnt feel i was cut out for it, and before work i would just about have an anxiety attack! just relax! take a deep breath, nursing is ALOT to learn when youre new, you will make mistakes and forget things, we're only human! we're people too!
would it make you feel better to hear some of my mistakes? hmmm well i gave a pt his po cardizem which was about 240mg (yep im serious) even though he was brady like in the 50's, it just didnt click, anyway, i had to call the doc later when his heart rate was in the 40's, yes he lived and i felt like crap but hey now i am more careful!
hmm during a code once we tried ambuing a patient and the sats wouldnt come up, it took a few minutes to realize that the ambu wasnt connected to the O2, we connected it and went on with the code.
what else...oh yeah this one is the worst...i transferred a patient out of the unit withOUT an order! the order said anticipate transfer in am, well the house officer had already given the night nurse a bed number so when i came on to my shift all i saw was transfer in am. my heart sank when the floor nurse called me and said the surgeon was throwing a fit cause i transferred his patient without an order! he never told me anything though, it was a mistake, if i had to i wouldve gone and brought him back, but the doc told the floor the pt could stay in med surg. thank goodness!
hang in there, just cause you make mistakes doesnt mean youre not fit to be a nurse, maybe you need to work a lighter unit or just get better at organizing your day! right after report read your orders and the previous days orders, make a note of anything that needs to be done like 'ct in am' or 'get consent for blah..' write that down! then look thru ur mars..all of ur mars! and write down times for each med, hell write down each med if you have to, look at ur prns so you know if you have protocols youll have to cover like k/mg/accuchecks, then check ur labs!!!!, if there are abnormals and you dont have a protocol, ask the secretary to page the doctor right at that time, then go look at everyones rhythms so you have a baseline and then go assess ur patient, tell ur patient what the plan for the day is and pass ur meds!
emtb2rn, BSN, RN, EMT-B
2,942 Posts
CZBN and everyone else makes some good points for keeping track of what's going on with each pt.
I also make a to-do checklist for each pt, then review the orders to make sure nothing got overlooked. We're computerized so this is pretty easy and quick to accomplish.
Also can't overemphasize asking questions. Remember, the only dumb question is the one that wasn't asked.