So this is the same anon from before, who posted about being in a NICU nurse residency program. It has been an awful, awful week where I felt so clueless and did a million stupid things at the hospital and I would appreciate any words of encouragement. Please? @_@
I’m sending you a virtual hug right now. Here, sit on my internet couch, with a cup of nice coffee or tea, put your feet up and let’s have a chat.
Let me share a story with you.
One time, when coming onto shift I was told by the outgoing nurse that although the infant already received a PRN Fentanyl dose that he was still agitated and she thought I should go ahead and give the PRN Ativan as well. I assessed the baby, agreed with her opinion and quickly drew up the Ativan, had another nurse do my double check (5 rights and all) and administered it to the infant.
Within 30 minutes of administering the dose, my patient had two significant brady/desat spells requiring me to bag him off the ventilator. He then became hypotensive. I was so confused. He hadn’t had this type of reaction to Ativan before. I decided to research the half-life of Ativan in conjunction to when I gave it to see how long I should keep monitoring for an adverse reaction. I pulled up the computer charting and saw IT. The prescribed amount was 0.025mL. I gave 0.25mL. Ten times too much Ativan.
Heart, meet stomach. I paged the NNP, my charge nurse, and used our self-reporting system to make the error known.
The next day I had the same patient, and in an unrelated issue he had a serum potassium level of 8! The team decided to give bicarb. An hour passed and the NNP came around again to check on him. She asked when the bicarb was started. I stated that I was still waiting for it to come up from Pharmacy. She looked at me quizzically and then stated that there was always bicarb in the Accudose on the floor. (Which the order also stated.)
I know what you’re thinking, “Oh gosh! What an awful couple of orientation shifts!” I felt so dumb… so incompetent… especially since this happened after being a NICU nurse for 18 months.
Anon, we are always learning and unfortunately that learning process is laden with mistakes that we have made. My preceptor once looked me square in the eyes and said, “You’re going to make a mistake one day; one that will really affect your patient. You just have to hope that it doesn’t hurt them.”
We are human. One of my favorite quotes is, “I myself am made entirely of flaws, stitched together with good intentions.” (– Augusten Burroughs) We try our best. We read articles and books about NICU nursing. We watch how more experienced nurses perform clinical tasks and talk with families. We confer with NNPs, and doctors, and RTs and countless other people because we cannot do this alone… we are never always right.
All I can really say is keep at it. Try not to make those mistakes again. You’re learning. So learn. Be okay with the fact that you are not an experienced nurse nor experienced in NICU care. You’re working in a field that nursing school really does not prepare you for, for a hospital that you’re still getting used to, with co-workers that you’re trying to forge new relationships with – all while processing the emotions of what it’s like to be a new nurse, in an ICU with babies who are very, very sick.
Relax just a little bit – forgive yourself for when you feel silly, or stupid, or like you should have known something. Imagine one of your friends going through this same situation. Repeat the kind words you would have for him or her to yourself. For every negative that you’re focused on I bet you could come up with at least one or two positive things you’ve accomplished.
You are a registered nurse. You save lives. You provide comfort to those who need it. You are a rock star!
For all of those nurses and nurses-to-be who keep asking, “How do I know if NICU nursing is right for me?”