June 19, 2008
Lately, I've been feeling like I'm not the nurse I used to be. I really feel like I forget to report off things, question my abilities, etc. The main reason I feel like this is I've done things I've not done before, and believe me, if I had, I would have known. For example, and this is actually the worst case of my forgetfulness, I admitted a patient for the RN working back in labor. She, unfortunately was trying to get a hold of the doc (for 2 hours) so I admitted a patient for her. I had her admitted, IV in, doc called, orders given, all that jazz. She was what we call a frequent flyer, so all her history was already in there. I'm pretty anal about making sure I cover all my bases, and I thought I had. Turned out I was wrong. An hour later, I go back to check on her and the nurse I passed her off to let me know I didn't tell her she was beta strep positive. I thought I could just die right there. After she said that, I remember seeing it highlighted on her prenatal record. I just didn't report it, or send orders down for the antibiotic. Luckily, it was her first baby, it had only been 1 hour, and she was treated 3 times before she delivered. But, still, I shouldn't have forgotten to tell that to her RN taking over. If that wasn't bad enough, Monday a.m., I had a labor patient who would have tubal ligation immediately after delivery. I can't remember if I told the dayshift nurse she was planning on getting the tubal. A couple years ago, I took report on a patient who delivered very quickly for me, but the evening RN didn't tell me she was a tubal. She actually didn't even have the mom sign the appropriate consent forms (something I did with my patient, and I even told anesthesia, something most people forget) and I remember being so incredibly pissed off because I ended up looking like a fool when the doc asked if the OR was ready. And then I asked "for what?". But, I think I may have forgotten to tell the a.m. RN. There have been a couple minor things as well that make me think I'm losing my touch. I'm known to be thorough, and a good RN. People look up to me, ask my opinion on things and even defer to me, waiting to see what I decide to do in an emergency. And, I've heard, the docs really think I know my stuff. But lately I'm not living up to that. I was even given a "bonus" for taking on a lot of responsibility long before I should have had to, and handling it a few years ago. Now I'm not saying I'm the worlds greatest nurse and that I never made mistakes before, but lately I'm slipping from the level I had been functioning. I'm so worried, I even had a bad dream about a RN I really look up to telling me I'm not doing as well as she thought and that I should really be working at a much higher level than I am, considering my experience. My stress/worry is spilling over into my sleep. Not good. I thought I was doing well with 3 kids and the lack of sleep and added stress, but I guess I'm not. No harm has been done, thank the Good Lord, but it's a lot of little things, and that bugs me. I'm actually really anal...I look over my work 3 times to make sure I'm not forgetting things, and I write down everything I want to tell the MD before I call. So this whole "missing things" is really bugging me. I guess I need to figure out a better system for myself to make sure I don't continue on this path.