Where to go from here?

[hbrn2010]

Hi All,

I frequently read posts on this site and thought it maybe helpful to reach out for support.

I have been a nurse just over 2 years now. Started my nursing career in a level 3 NICU with a great residency program. I had a wonderful preceptor and the team work on the unit was always great. We had 19 weeks of orientation and the nurse educator met with us frequently to see how we were doing etc. The first several months were hard, time management and prioritizing, etc. but I slowly got into the grove of things. I loved the nicu, working with the babies was very rewarding and enjoyable. I did find working with the extremely premature babies (we had babies 23 weeks and up) stressful, HFJV and lines with multiple drips, definitely was challenging and very intense.

Almost a year off of orientation I made my first real mistake, I messed up my TPN and lipid rates. I was devastated and so upset with myself when I caught the error. Fluids were a 2nd rn double check when hung and I did have a second rn check with me when I hung the fluids but somehow we both missed it. The rates were correct but I had the lines in the opposite channels. I called the doc immediately when I realized the error and we stopped the lipids and I checked a blood sugar which was WNL thank god. It was an overwhelming night on the unit; we were short staffed, had several admissions and assignments were very heavy, I had 3 babies a 24 weeker on sipap, a withdrawal baby and a 32 week feeder grower. There is no excuse for the mistake but I definitely felt stretched to the max that night.

I submitted an incident report and met with my manager about the error who was very supportive but I was so upset and angry with myself. I stayed for several months after this, I watched that baby grow strong and get to go home. But the idea that I could have caused harm to this precious baby was so scary, I would have never forgiven myself if there would have been a bad outcome as a result of my actions. My anxiety escalated after this happened. I was so afraid of making another mistake, I worried so much when I would leave and it became unbearable so I decided to look for a different job. I was sad to leave but knew that it was for the best.

I decided to cross over to labor and delivery at that time and started at a different hospital which was also closer to home. The orientation was 12 weeks, and we manage labor patients, antepartum and post partum. It was a big change. I was with 8 different nurses during my orientation which made things confusing because we all do things differently. I realized this was an issue and made my schedule specifically around the preceptor who I found to learn the best from towards the end. I have been off on my own now for several weeks and I am finding that I just can't shut off from it when I leave. Most of the nurses are very helpful on the unit with questions. I find the strips stressful, especially when they start going down hill. I have had several bad strips (prolonged decels etc), a prolapsed cord, chorio, a baby with a unknown heart defect. The post partum assignments are a lot as well, especially 4 couplets. Most of the time if I have a post part assignment the babies will have blood sugar checks or have NAS scoring, the moms will have HPTN or something else going on. I feel like I run around all night from room to room trying to get everything done educate the parents, help with breastfeeding etc.

I leave and I feel so defeated. I have gotten great feedback from the other nurses on the unit and they have said that I have just had a lot of difficult situations, but I should hang in there because it will get better and that I am doing a great job. But I really feel the specialty might not be for me. Post shift I worry all the time, what if i missed something, did I do this, how is that pt, did I chart that, etc. My husband is also a nurse so it was helpful having him to talk to. He is so good at compartmentalizing and leaving work at work, I really struggle with this.

I feel so discouraged and have thought on several occasions that maybe nursing isn't for me. I have been trying to figure out what to do. I do see a counsellor and I do take medicine for anxiety, but I don't think its helping. I don't think I have really ever forgiven myself for the mistake I made in the nicu and I don't know how to grow from that instead of beat myself up for it. I know we all make mistakes but the idea that as a nurse a mistake could be detrimental is terrifying.

I decided to hand in my notice this past week and I spoke to manager who was very nice and understanding. She did ask if I would be interested in transferring to another unit but I just am not sure the hospital is the best place for me. I feel dreadful leaving but I just think I need to really work on getting my confidence back and leaving work at work. I would be sad to leave bedside nursing altogether but I think I need to take a step away from it for awhile. I love caring for my patients but I find the hospital very stressful. I have looked into several other areas of nursing that may be a better fit and have had several interviews which have gone well.

I am just feeling lost I suppose and looking for some advice. Sorry for the short book lol.

[ItsThatJenGirl, CNA]

I'm sorry you're experiencing this.

I see that you're medicated for anxiety, but have you tried therapy? Getting to the "root" issue and learning how to reframe it or let go seems like it would be highly beneficial to you.

Best of luck to you.

[NurseCard, ADN]

Bump.

Agree with JenGirl.... you have got to move past the mistake you

made in NICU, and perhaps indeed, therapy is warranted. ((hbrn)),

you WILL make mistakes as an RN. You will. The key is to learn from

them and move past them. You didn't hurt that little baby. I suspect

you came no where close to really hurting that baby. In fact, that

baby got well and got out of there and it was likely due partly

because of YOU! :)

Hugs ((HBRN)) again! Good luck!!!

[guest52816]

First, I am very sorry about your experience in the NICU.

But as NurseCard stated, you didn't harm the baby! You discovered your mistake and took steps to correct it.

From your description, L&D seems like it can be quite stressful. But I think you quit a little too soon. Of course, I am not you, and trust you made the best decision for yourself at the time.

I just wish that you would have fully resolved the after effects of the NICU issue before resigning your position.

Best wishes. You've got support here.

[hbrn2010]

Yes, I think getting to the root cause of the issue is a good plan. I am going to really work on this and also meet with my counselor on a more frequent basis so I can move forward.

Thank you all for your advice. I am

feeling defeated. But I going to focus on getting to the bottom of this so I can be the best nurse I can be. These first two years as a nurse have been hard. So many ups and downs, moments of happiness watching patients succeed knowing you played a part and than moments of doubt questioning what's the purpose of it all.