tears and more tears

CASTLEGATES · Oct 26, 2009

Yes, I was watching you and I saw you put some coagulant into that patients artery and gave him a PE...you BAD nurse! And that one you admitted gone to the ICU? How could you have? You should have denied care outright and let him die at home! How dare you give a patient oxygen with low sats or call the doc for it? Were you trying to help the patient? Are you insane? Allllllrighty then!

You've GOT to relax and realize people come to the hospital to die. Did you smoke for 40 years then have chest pain and come to the hospital...and it's something YOU did to kill him? It's normal to feel how you're feeling (just so you know); we've all been there and felt that way.

Now you've got to separate yourself from the situation and just work. If it's meant to be you'll carry the robe and the sickle and it will be "your" fault but in reality we're just going through the motions of life and try the best we can with the tools we have. Hospitals and illnesses kill people. We've got to get over this culture of being terrified of death; it's not a big deal! We're all going to die and there's nothing we can do about it. How do you think the population renews itself? Where are your great grandparents? They likely went to the hospital to die and these people are doing the same. Think how many thousands die who don't make it to your hospital? Death rates are just death rates and they have to happen somewhere. I know it bugs you to see it up close but remember people screw themselves up with food, booze, smoking, drugs, noncompliance and if they're lucky (or unucky) they'll die of being old. When it's time it's time so play your part on the stage of the world, practice your lines best you can and when the show's over, don't relive your lines and stay up over it.

It takes some time but I'm sure you'll make sense out of this chaos you feel you've been introduced to. Codependence is not a healthy thing for a nurse to feel. Separate yourself from it and trudge along :redbeathe

classicdame, MSN, EdD · Oct 26, 2009

agree with above post. The only reason we see people in the hospital at all is because they are SICK and many will die and some will get better, or become stable, then go home. Your job is to do the best you can with what you have, and that includes what the patient brings. If they bring a body that is too ill to survive, then you do what you can, make them comfortable and take pride in your work. I felt like you in the beginning, and suppose many nurses do. Time cures some of this. Stay in there! Better yet, talk to a mature nurse.

tewdles, RN · Oct 26, 2009

Clearly you learned in school that your work can significantly impact the health of your patients. They instilled in you a sense of responsibility for your patients and accountability for your actions. Of course, you can make a misjudgment that can have serious implications for your patients. However, what you are describing sounds more like the normal "come and go" of a hospital unit. Trust me, if you were making serious errors in practice or judgement that were resulting in deterioration of patient status, your immediate supervisor would be meeting with you regularly...you wouldn't be wondering...your peers would be talking to you...you wouldn't be worrying...you would be on some sort of a performance improvement plan.

Think of it this way...you reported to the nurse correctly (our report needs to alert them to the things that are problemtic and of concern, right?) so she discovered a critical value and the plan for the patient changed...AND...you discovered a hypoxemia on assessment and took appropriate action, possibly keeping that guy out of ICU for a few hours or days...

So...my point is...don't consider yourself a typhoon Mary...consider yourself a young but good nurse who is caring for some really sick people. No matter what you do, a certain percentage of your patients will end up in ICU. Discover what that stat is for your unit and then look for "those patients" in your daily assignment. There will always be future ICU patients who look uncomplicated but then take the abrupt turn for the worst in the middle of the night. There is, however, a real percentage of your population who are simply "staging" up to the ICU. Put your brain to work figuring out who those people are rather than using it to accuse yourself of bad nursing.

JobsearchingRN · Oct 26, 2009

I agree with the post I have seen . ONly thing to add is if you have done everything in your capablities and learning then you can be proud. I have seen many patient admitting on a lesser level when they should of been admited for ICU. Has more to deal with money then. The more experience you get the more you will learn and be able to recognize. Its your concern that will keep you learning and on your way to becomming a great nurse. Because you care. Alway reflect and review and then move on. Never be afraid to ask questions. . Just keep learning, stop looking for fault, and good luck to you.

squirtle · Oct 26, 2009

you didn't tell us about the pt's you admitted or cared for that got better and went home

mamamerlee, LPN · Oct 26, 2009

I read nothing in your post that indicates any of these pt's problems were related to something you did or didn't do. Someone went to the ICU while you were off for FOUR days!! You need to understand that YOU cannot possibly control what happens in your absence, that you seem to be very aware of your pt's conditions, and there are a myriad of things that can go wrong (or right!) despite your best efforts.

Please find a mentor who can help you through this difficult adjustment phase. I do not mean this to sound bad, but you are not G-d, and cannot possibly control every outcome for every patient! All of the other posters have been right.

RNperdiem, RN · Oct 26, 2009

I remember feeling that way when I was a new grad too.

There was a patient I took care of and then I had a couple of days off. One of those days I saw her obituary in the newspaper and my first thought is that I missed something at work.

The above posters are correct.

SuesquatchRN, BSN, RN · Oct 26, 2009

You're a nurse, not a miracle worker.

Virgo_RN, BSN, RN · Oct 26, 2009

Ah, the crippling insecurity of being a new nurse. I remember it well. It wasn't so long ago that I would go home from work and lay awake at night, remembering things I had forgotten, convincing myself that I had surely killed a patient and that I would be fired when I got to work the next day, and fantasizing about leaving nursing to get a job flipping burgers at McDonald's. I remember watching the Environmental Services (housekeeping) staff with envy as they pushed their vacuums, spritzed their surfaces, and went about their days so carefree....~sigh~.

Did I cry? You bet. In the bathroom, in the med room, in the car on my way home from work, at home in bed in the middle of the night....

But, I stuck with it. I kept going back, asking questions, learning from my mistakes, and vowing each day to do better.

Then one day, one of the experienced nurses, who I had always looked up to, asked me a question. ME. And I noticed other nurses were coming to me with questions too. How in the heck did that happen?

Well, I just kept going back. That's how it happened.

Then I got a wild hair and decided I needed a change, so I transferred to the ED. Now, I'm only 2 months in and I feel like a new grad all over again.

And each day that I have to work, I start to get those butterflies in my stomach and that sense of "Oh no, what's going to happen today?". And you know what I do? I just go to work. I just put one foot in front of the other. I do my best. If I don't know something, I ask someone that does know. If I feel like I screwed something up, I talk to someone more experienced, and usually, they say I did just fine; either they once made the same mistake, or I didn't really screw up at all, it's just my insecurity making me question myself.

At the end of the day, were my patients safe when I left? Can I look at myself in the mirror and know I did my best? If so, then it was a successful day.

nurse grace RN, BSN · Oct 26, 2009

You are doing the best you can for your patients. I remember the self doubts I had as a new grad-- it isn't easy to be a nurse. The fact that you show concern for your patients long after your shifts with them have ended, tells me that you are a great and caring nurse. We can help them to the best of our abilities and then the rest is in Gods hands. I'm sure you can tell us about many patients that had positive outcomes and I bet they would say that you are a great nurse! :)

jeslynhatRN · Oct 26, 2009

I'm a new grad and have been on my own for almost 2 months now. I have been struggling with the adjustment, and hate work most of the time. I feel like some patients I have taken care of, went bad, because of something I did or didn't do. i had one patient who i admitted, but didn't take care of for 4 days that transferred to the icu??? could i have done something to prevent that four days earlier???? I had another patient who I took care of for 2 days that had to transfer to step down for a possible PE that the nurse I gave report to found a Sao2 of 88%. Did i not catch something???? I had another pt who's o2 was inthe 80s, called the doctor, got some orders to increase oxygen... reported to the next shift...come in the next day find out he went to icu for respiratory prob...i was devastated...what did i do wrong???? maybe i wasn't meant to be a nurse...

I know how you feel... totally. Tomorrow night I start off on my own after close to 3 months of precepting. For the past week, I have been so teary and depressed and I constantly am telling myself, "I've picked the wrong field... I am so stupid, why did I choose this?... " I want to quit - period. But I can't because I don't want to disappoint anyone including myself. I am at the most miserable I have ever been, even my husband has noticed how miserable I am. To top it off, I hate the floor I'm on (the people are nice and I can ask many of them questions, but it's a cardiac step-down/tele/med surg unit) and I've decided this is totally not for me. I miss being able to see my friends and family (as I work nights) and I feel isolated and alone. Sometimes on my way to work, I think how great it would be to be in a little fender bender or something so that I don't have to go in (nothing that will kill me, just enough to not be able to go in that night). I have decided I need to call my PCP and try to get back on anti-depressants because of all of this. I feel your pain, but I read eveything on here and it starts to make feel better... a little... very little, lol!