Worst night ever

[beeker]

I had a horrible shift last night. It was the worst one I have had so far. I finished my orientation mid April and have been on my own since then. I am still slow but feel like I have been getting better and I have had some good shifts and some that have been hard and hectic. Last night I had drowned completely. I just don't know if I can do this.

Right at the start of the shift I got an admission from ER. I already had one patient that was on close watch for having went downhill during the dayshift. But the admission, this patient was a train wreck. I was not at all qualified to care for her. We do not normally get this type of patient on our floor, and she had a lot of medical issues going on, and procedures and drips I have never done. She was too large for our bariatric beds, and not feeling well, she was less than pleasant to us. Her family was also very difficult. But I could not move her or reposition her without a team of people, and she was not comfortable because she did not fit on the bed. I had to ask the charge nurse for a lot of help because of all the drips I have not done before, and she was getting very irritated with me. The pts condition was declining, slowly at first and I was in over my head and asked for help. When she started going downhill faster I wanted to page rapid response. The charge nurse said no she would handle it, and another supervisor came down to help. Next time, I will just call RR. I ended up calling the on call doctor several times for orders, respiratory therapy came to help (they were awesome) and I ended up spending the entire shift in that room. Between her and the other patient, i feel like I completely neglected the rest of them. I ran in and out of their rooms so fast, I doubt they could pick me in a lineup.

Towards the end of the shift the charge nurse, at the nurses station, told me I had the easiest patient load on the floor and that at this point I should not need so much help. She gave me a loud long lecture on basically how much I suck at everything and how I ruined her night. I have never felt so incompetent in my life. I cried and as I was leaving the station I heard everyone laughing. I wanted to die.I though I had been doing ok so far. I was just starting to feel like I was doing ok on my own. I guess I do ask a lot of questions. A few of the other nurses later came to tell me I have been doing fine and reassure me, but I can't forget hearing them all laugh. When the day shift arrived the charge nurse pulled me aside to ask what had happened, I guess you could tell I had cried. She came in to see the patient and immediately called to have the patient transferred to CCU. She said next time just call rapid response regardless of what the CN says. She helped me finish up and made me feel slightly better. I am thankful for her being so nice. I was a mess. I am still a mess. My supervisor left me a message today telling me I did fine and that it was a hard patient, I have not called her back yet.

I am still a mess. I am not normally a crier, but I cannot stop. I am DREADING going back to work. I don't know if I can do that again.I still feel like there is so much to learn. It is overwhelming. I think the combination of being new and working nights is making me tired and emotional. The stress is really building up.

[ashley024]

I read this and wanted to hug you. I'm so sorry you had a bad night. I think people often forget they were once in that place especially when it comes to new graduates.

I used to be incredibly frantic during clinical. I'd think of 20 things I needed to do but be so worried about getting them done I would be overwhelmed. I eventually learned to calm down, prioritize and learn that things will get done when they get done. By the end of my precept experience my preceptor said that she was really impressed with my ability to stay calm when things got hectic and things started to add up.

I can't really relate to your experience but it doesn't seem fair that she spoke to you that way. I would think that she'd rather you ask for help that try to do tasks that you weren't familiar with. Just go back in there with your head held high knowing that you belong there. And as for them laughing shame on them! I'm sure they had days just like yours.

[skny]

I'm sorry u had such a bad night. I know how u feel. They treat us, new nurses like garbage. I always walked on. My floor has no manager. The night ANCC's are horrible. They don't do anything, just give me their pts. I hate it so much that I'm actively looking for another job and have an interview on Monday!!

[sauconyrunner]

Hang in there. Yes, Just call the Rapid Response team next time. Your Night Charge Nurse is a fool. See, the Charge Nurses job is to HELP things FLOW. Sooooo, there is NO WAY a nurse who is trying to take care of a patient (who you CORRECTLY identified as not belonging in your unit) can ruin her night. And really, she had a bad night? That is her own fault for deciding she could "handle it without rapid response". So essentially, she used some very bad judgement. As far as you having the easiest assignment...how many other patients were transferred out to the CCU? So, some big information was learned....you can not trust that charge to help you with decision making in the future. Because she sounds to me like she is not the brightest, and she is also a B%^*&.

You had some great support from the Day Charge and also the Supervisor. But of course, you will have to go back to work with the night Charge, and that is not going to be fun. As Charge, if she was concerned that you are having a problem, she needs to bring it to your mgr, not loudly call you out about it in public. So she is not only not very good as assessment of pts, she is not professional, and she just plain is not nice. Even though it won't be fun, I suspect given that the patient was immediately transferred that she will probably leave you alone about it. She was clearly incorrect...and should have been able to determine as well as any Day shift person that the pt needed to go to the unit. There is no way she can come out of the situation looking good, given that she refused Rapid Response and then the pt was transferred within minutes of Day shift arriving.

You are just barely off orientation, not even 3 months! So yes, you can do this, and you are going to do well! You are not incompetent. You are supposed to need help and you are supposed to ask for it- especially with things that are new. Just hang in, and do not let her attitude ruin you. :hug:

[tcvnurse, BSN, RN]

I am sorry you had such a terrible night. When it comes to calling the RRT, I really believe it's better to ask forgiveness than permission. When I am the primary nurse, I feel that I know the patient better than the charge nurse. I will call the RRT and THEN inform the charge. At my hospital they are there specifically so you don't have to spent a whole shift one-to-one with a patient when you may have four or five others to care for.

Also I find transfers to the ICU happen a LOT faster when you have involved the RRT. It's hard, but take this as a learning experience. Fortunately, horrible, awful, no good, very bad shifts are the exception rather than the rule.

Take care.

[Bec7074]

That sounds like a really bad night I'm sorry that happened to you. I think we have all felt that "are they talking about me? does everyone think I'm a bad nurse?" feeling at one point or another. Any admission is time consuming, let alone one that is doing really poorly. When I was new I dreaded admissions. My guess is this CN of your is going to get in some trouble and rightfully so. She's an idiot. I was told once by a wise nurse that if you have to even think about calling RR, you should probably just do it. In a few months when you are feeling more confident, you'll be able to stand up to people like that CN.

Keep your head up. I completely understand your feeling of not wanting to go back. Heck maybe call in and take a breather because if you're not emotionally ready, you won't feel like you can do your job tonight. But you are capable of doing your job, or you would not be off orientation! :) My biggest advice is to be completely honest with your manager regarding what happened, but don't make a big deal of it anywhere else. We all know nurses unfortunately gossip. I hope you post back soon with what happens and that hopefully the CN apologized to you!

[jennilynn]

I'm sorry you had such a bad night. I am a new nurse, as well, so I can appreciate your frustration and humility. I am also so grateful for each of the charges I work with. I had to call the assessment team the other night, but called my charge in while waiting on them. When all the excitement ended, I felt stupid for calling the AT, but she told me that I had done good.

Now, I am just starting out, so I know I will probably have my share of less than desirable coworkers, but for now, I love the crew I work with. If one of us has a heavier load we lend a hand and always have each other's backs.

Just take what you learned and apply it to the next situation. If you think you need the RRT, then that is your call to make. Good luck and we will be fine!

[netglow, ASN, RN]

Well one thing you now know. You know what type of patient you need to RR on, and that you won't "ask" if you can call it. I read a lot of this kind of post, and you know it appears your night folks need to be unemployed. If you did not seek help, that would be ammo they'd have against you, and because you sought help - that is ammo they have against you. So, where do you stand? I'll restate that you now just call a RR and ignore your CN. The RR will facilitate that patient to move to ICU where she should've been. Seems some CNs don't ever want RRs to occur, no matter what. That is their problem tho, not yours. You decide what your are needing to do, and then do it. All the chatter surrounding it, you can just ignore as chatter.

[NurseCard, ADN]

:hug:

That's all I can add. Keep your chin up. You can do this. :yelclap:

[sapphire18]

Sounds like a truly overwhelming night. It was definitely unprofessional of your charge nurse to speak to you that way, especially in front of everyone else. I understand the wanting to listen to the charge nurse and not calling the RRT, but it sounds like you had better judgement than her in this case. I respond to RR's where I work, and believe me, we would much rather have someone be safe than sorry, than to be responding to a code instead, a couple of hours down the line. It sounds like you learned from your experience. You did good:)

[turnforthenurse, MSN, NP]

:hug:I am so sorry you had a rough night, OP. That CN was WAY out of line. She was very unprofessional and maybe shouldn't have assigned that patient to you. Next time, just go with your gut and call RR. Better to go ahead and call and then it end up being nothing instead of waiting and having to possibly code a patient later on. It doesn't matter if you have years of experience - there are some nights where you will be running because of the patient load. Keep your chin up...

[♑ Capricorn ♑]

I just wanna give you a :hug: You did the best you could considering your circumstance. Give yourself so credit and not be so hard on yourself. I'm sure you are a great nurse. Good job and keep it up. :kiss