Anyone else have this problem?

lrs

I have to tell all potential employers what happened (which is something I have no problem with)and am constantly getting back things along the lines of “thank you for being honest and upfront…but we don’t have the support system in place to help you”

How do I get employers to realize that although I have made errors previously (and I do tell them what I have done further along to change my practices), I am fully capable of doing the job at hand and that I would be a welcome addition to their facility/ward??

It’s getting frustrating to know that there are places screaming for nurses out there but that I, a fully capable and qualified nurse, am basically being stopped before I can show what I am capable of.

I am an RN who has been licensed since 1990. In 2008 I got arrested for petite theft, a Class 2 misdemeanor.  I went through pre-trial diversion and later had my charges nolled processed.

I researched every day for hours trying to find peace of mind that I would regain my license.

I moved from Florida to Arizona and applied for an Arizona license. I self-reported the arrest to the board.  I was worried for months.  I had to send in the arrest record and all the court depositions; I even had to meet with a board investigator.

I was so scared and stressed for months.  I even took a voluntary drug screen for the board.

Let me tell you some good news: I got my license in Arizona with no discipline, but it took much longer than it does for most (4 months).  Follow my advice, don’t lie to the board! If you don’t self disclose then you violate the Nurse Practice Act and will at minimum get a civil penalty; this is a discipline against your license.

Always cooperate with the board and be honest. It may work out for you like it did for me.

Generally, though, when I make mistakes, I realize I have the best intentions and am able to forgive myself.

But there was one mistake I made in nursing school I can’t get over. I was one of the few nursing students that had been a CNA before school, working at a nursing home for two years. During our first year, I had a post-op hip patient. We were responsible for oral meds and ADL’s at this time. This patient needed to have a BM so I asked the new-grad nurse taking care of her how she had been using the bathroom. She handed me a bedpan (I didn’t know what a fractured bedpan was).

I asked if I needed to help the patient, and she told me the patient had been helping turn herself. So I went in the room and the patient asked me if I should get some help. I had heard this comment a lot at the nursing home, and said my usual joke: “I’m short, but I’m stout.”

I may have pre-planned for this patient, but I did not think about making sure there was a hip abductor between her legs. The patient rolled over with my help and did well, but had some discomfort. I thought this was normal, but after I put the bedpan under her and we rolled her back to her back, she was crying in pain. I ran to get the experienced nurse for help. She came immediately.

After we had the patient comfortable, the experienced nurse told me what I did wrong and what could have happened (how her new hip prosthesis could pop out). She asked me not to take care of that patient anymore. I agreed, but still went into the patient’s room to own up to what I did.  She didn’t say much.

I also told my instructor, who tried to make me feel better. But I couldn’t stop crying. I just can’t get over it because I always wonder if I was trying to impress someone. (Who knows – maybe I was trying to prove something to myself.) I was always told how good of a caretaker I was. I never considered how cautious I should be.

I know what I did was wrong-and I just can’t stop thinking about the pain that woman was in. I still cry about it now.

It won’t stop me from trying to be the best nurse I can, but GOD I wish I could take it back!

I spent some time reviewing what the “hot topics” have been.  We certainly have covered a lot of ground–that’s for sure.  We’ve talked about drug addiction, the NCLEX exam, impossible co-workers, and delegation.  We’ve covered making mistakes, insecurities, and being let go after only a few weeks of orientation.  I, myself, have written about goal setting, facing our fears, relieving stress, and being “perfect enough.”

I have a few thoughts after re-reading some of our community’s comments:

1) We’re serious about what we do.

2) We are encouragers.

3) We have a stressful profession.

4) We’re all doing the best we can.

5) Some of us like to swear a little too much.

All said and done, I’d say we’re a pretty amazing group of people.  I count it a privilege to be one of you.

I want to hear from you: What were the highlights of your year of nursing? And what do you look forward to in 2009?

I landed a job at a teaching hospital because I love to learn and felt it would be a good place for me. But I feel like I have bitten off more than I can chew.

Every day I make at least one mistake. I’ve already made two medication errors which resulted in my having to write incident reports. I am afraid they will not let me stay past the probation period if this keeps up.

This is so not like nursing school. It seems like 50 things are happening at once and you have to keep all of them straight in your head. I am having a hard time remembering everything I am supposed to do and have yet to get through charting on time.

While my preceptor makes it look so easy, I am terrified – feel like I made a terrible mistake and should go back to school, or find another career.

I have wanted to be a nurse for about the last five years and finally decided to take a chance. I never thought I would get accepted to nursing school but here I am: an RN.

Still I have no confidence and I’m always afraid I’m going to kill somebody because I don’t know enough.

Am I crazy, or do other new grads experience the same kind of feelings? What’s your advice?

One afternoon I was napping in my cabin when someone came in screaming for me. They said there had been an accident in the kitchen. As I arrived seconds later, I saw a teenage boy lying face down with his hand clenched in a big floor fan, which was lying beside him. I checked to make sure the fan was unplugged before I touched him. I unclenched his hand and rolled him over. He made some noise as I turned him, but soon realized he wasn’t breathing. Nor did he have a pulse.

The other nurse arrived, and we started CPR. Ten minutes later the ambulance arrived and took him away. We heard an hour or so later that he had died. Electrocution. He was seventeen.

It was a pivotal point in my life. I spent weeks rocking myself to sleep doing the CPR count in my head: One and two and three and four…every night. I couldn’t get his face out of my head. I was tormented by the fact that everything I knew had failed me. Failed him. I thought maybe I had picked the wrong profession after all. It was my first encounter with losing a patient, and it hurt like hell. It will be 25 years this July–and it still hurts.

We go into nursing to help people. We want to save lives. We want to make a difference.

The first time we find out it doesn’t always turn out the way we would like, we have to re-up. We have to make a conscious decision to stick with it and try again. It can be a painful process. But the truth is, people die. Sometimes way too young. Sometimes in horrible ways. Sometimes because we screwed up. It’s all a huge load to bear.

A couple weeks after the accident, I had to teach a CPR class to a group of high school campers. It seemed like a cruel joke that I would have to pass on this skill that had failed the only time I had ever used it. However, I did my best to be positive about all they were learning as I shared my own experience. I had five kids in the class, and I knew two of them from home.

That fall one of them saved a choking child she was babysitting, and the other did CPR on her own father when he had a heart attack! To me, that was the affirmation I needed to keep going. I can’t save everyone, but I can impact everyone. My own story didn’t end well, but I changed two other peoples’ stories. And theirs ended great.

1. Sharing too much of your own story. I’ve done this several times. Once when I was assisting my doc with a Pap smear, the patient mentioned she occasionally felt a hot, stabbing pain in her rectum. I jumped into the conversation, stating that I suffered from the same problem. (I had never told anyone about it and had never heard of anyone else having it.) The doc stopped the Pap, looked up at me and said, “Do you really?”

It was totally inappropriate of me to say anything in the middle of her exam. The focus immediately shifted from the patient to me. We walk a fine line between establishing a good rapport with patients and sharing too much of ourselves. Our goal should always be to keep the patient the center of our attention.

2. Dressing too cutesy. Scrubs have come a long way since I started nursing, but I’m not sure they’ve taken us in a professional direction. If you wear Betty Boop to work and expect people to give you respect, think again. New nurses establishing credibility should stay away from all the cutesy stuff out there. You need to feel and look confident. Even if you’re on a Peds unit, resist the urge. It’s just as important to gain the parents’ confidence in your skills as it is to appear friendly to the kids. Hello Kitty will not do that for you.

3. Flirting. Okay, it happens, but if you do it regularly, your reputation will suffer. It shouldn’t happen with the docs, other staff, the patient, the patient’s family–anyone whom you encounter in your work setting. You may garner someone’s attention but not his/her respect. When you’re wearing your uniform, control your coy looks and banter.

4. Contributing to the anxiety. There will be lots of opportunities to blow it on this one. When a patient is upset and starts to rant, we sometimes add fuel to the fire instead of being a non-anxious presence. We escalate the situation rather than defuse it. I remember one phone conversation with a gentleman who wasn’t getting what he wanted–his attitude was nasty. Instead of stepping back, I engaged. In the end, he called me an ax murderer, and I hung up on him. He may have been the ass, but it was my job to be the professional. I think he found a different doctor.

5. Disrespecting other professionals. Even if you disagree with a co-worker, you need to treat him/her respectfully. That seems pretty clear, but somehow, we all tend to fail at it now and then. As I tell my children, “I’m not concerned with how they are treating you; I’m concerned with how you are treating them.”

Though your mistakes say, “I am not a professional,” remember you are human. Try to learn from them and not repeat them. We all want to be treated like the nursing professionals we are. We just need to work a little harder at acting like one.

Now, what are some things you think make us look unprofessional?

Avoid mistakes in the first place.
This is a statement of the obvious, but it’s better to avoid mistakes than to learn how to deal with them. So stay focused and don’t rush. Remember the basics you learned in nursing school; you’re better prepared than you think. Trust your instincts and use common sense. Ask for help when you need it. Get over your fear of looking stupid if you ask a question—because it’s smart. Especially during your first few years, you need to double- and triple-check everything.

Don’t cover it up.
If you do make a mistake, very simply, don’t cover it up. Immediately report it to your preceptor or supervisor – and rectify it. If someone tells you what you should have done or reprimands you, don’t get defensive. You’ll benefit from listening. If you can learn from the situation, you’ll know how to avoid letting the same thing happen again. But don’t be too hard on yourself. Everybody’s human.

Also, keep in mind that the patient is your first priority. If you cover up a mistake, you could be jeopardizing patient care and safety—and even your employer’s reputation. There could be legal issues involved, as well.

Don’t blame others.
When someone in authority comes in and asks who made the mistake, it’s easy for a nurse to blame another nurse. Shifting blame is a classic defense mechanism that humans use when they feel threatened. But you have to own your mistakes, learn from them, and move forward. That’s how you grow and become a better person. Each of us should be a work of art in progress.

On the other end, if a nurse is ever falsely blamed, he should stand up for himself.

Talk it out.
I know a nurse who made a mistake at work. It did not result in harm to the patient, but she had a great deal of difficulty getting over it. She carried a huge amount of guilt around with her. I recommended that she speak to some competent, experienced nurses about it–people she could trust and who would be able to reassure her.

Sometimes you really have to talk to another nurse. Your spouse or a friend might say, “Oh, don’t worry about it.” They mean well, but they don’t really understand what could have happened. Nurses have a unique understanding of other nurses. That’s why so many nurses forge such close relationships with each other. You speak the same language. They might even say, “You know, the same thing happened to me once.” And that helps to put things into perspective—nurses need to know they’re not alone.

Also, don’t rule out professional help. It’s not common for nurses to need it, but sometimes people have trouble keeping things in perspective. If something happens and you can’t work through something, there’s nothing wrong with getting help.

Mistakes happen, but don’t make the mistake of not learning from your goof-up. Accept critique, grow from it, and share your experience with others. You might help others avoid the same pitfalls.

Through talk therapy, though, I learned I was expecting myself to be perfect—always. Now I realize, and I probably knew then, that I couldn’t be perfect.  No nurse can be perfect. No nurse can remember everything. They can just do the best they can.