Stupid mistake when being observed

[Zippy83]

I have always, my whole life, had a kind of stage fright when being tested or supervised, even if I am 100% confident in the task and confident in teaching or training others.

Our home health is changing ownership and I was informed today that the new DON would join me on a visit so that I could orient her. I hadn’t met her at all prior to meeting up at the visit, so that made me a little anxious, and also I didn’t really see it as me orienting her, I’m not a DON. No matter what they call it, it still felt to me like I’m being shadowed to see if I’ll stay on board.

So I was afraid of making a stupid mistake, and I did! Even though she was a really nice and calm person, she didn’t personally make me nervous, but the situation did.

So I started an infusion and that went fine, the patient asked some questions and I knew the answers, but then during the PICC line dressing, even though I laid down all my supplies and double checked, and I thought I had everything, after the dressing and stat lock were removed, I realized that I did not have a stat lock! The shadowing nurse dug through all the supplies to look for one but there just simply wasn’t one in the supplies at all, and I do usually carry extras but I’ve done about five dressing changes in the last few days and have used up all my extra supplies.

So I looked like an idiot, and had to do the dressing without it and go back to the office to get one and then race back to the patient. The new DON was gracious about it but I’m sure she didn’t get a great impression.

And of of course the outgoing DON/owner is really not happy.

I am just kicking myself now, especially since it’s not a mistake I would have made if I wasn’t overly anxious about being shadowed. It’s such a catch-22.

Do any of you have this issue, and what have you found that helps you to stay calm and show your best self when you know that you are being observed?

[brownbook]

You're not human if you don't have some degree of performance anxiety in a situation like this.

I feel the tension in my shoulders. IF I can catch myself, I take a deep breath and slowly shrug my shoulders up to my ears then as far down as they go. Do this several times.

Acknowledge to myself that "yes I'm f***ing nervous" instead of fighting the feeling. (Swearing has been scientifically proven to decrease stress ?.)

Even telling the observer....in a jokey way ...it's hard to perform in front of an audience...or some phrase like that.

Ask the observer to help if that seems appropriate in the situation. I know she did try to help you out when you couldn't find a stat lock.

[myoglobin, ASN, BSN, MSN]

I wouldn't worry about it too much. To some extent it is a "systems issues" which is to say that the company could have "stat locks" included with the kit much like bio-patches usually are. Having said that having management shadow is a nerve wracking scenario and any manager inclined to be critical should have to undergo the same process themselves.

[Zippy83]

This kit actually didn’t have a stat lock or a bio patch included, whoever made it at the infusion pharmacy was probably not clinical. Luckily I noticed that the bio patch was not there and I did get a separate one for my own supplies.

And the irony is that I had another picc line dressing change today, this one had a comical overflow of stat locks in the bag.

When I keep thinking back to the incident, it was a domino effect, after I started getting flustered about the stat lock I am pretty sure I broke sterility a couple times and made a few other errors. It was not a good look.

I will definitely learn from this and acknowledge my anxiety ahead of time, I think my biggest mistake was that I was mentally trying to rush through it to get it over with, so I threw all of my training out the window essentially and acted like I had never done this before. Next time I’ll tell myself don’t rush, go slowwwwww. I’d rather have someone hover over me for 30 minutes while I do everything perfectly, rather than watch me make a bunch of errors quickly.

[Jory, MSN, APRN, CNM]

Oh, I understand your anxiety. If I am precepting a student, I am the super confident APRN.

Have a physician oversee me watching me do something and I instantly turn into butterfingers that drops everything and you would think I was a new grad.

So...I feel your feels. ?

[CrunchRN, ADN, RN]

Performance anxiety sucks. You just have to move on and try not to ruminate too much about it. I would sit down with her and just confess that it made you nervous and here is what I will do in the future to prevent it from happening again.... that way she knows you learned from it and did something about it.

[Hoosier_RN, MSN]

Look at it this way: your new supervisor got to see how you handle pressure and that you follow up and correct mistakes immediately, and gracefully at that. To me, that you didn't feel any discomfort from her says that you handled it well. I don't care what realm of nursing that you work in, things like this happen, it's all in how you handle it ?

[J.Adderton, BSN, MSN]

If pt was in hospital, you could just send someone to supply closet... you just had to go a little further.

I think you would really be in trouble if you didn't notice the missing stat-lock or reused old stat-lock?

[Forest2]

I just hate myself when I get overly self conscious. I tend to fumble even though I have done the task dozens of times. I do my best to pretend they aren't there and focus more. That seems to help.