June 19, 2008

Feeling inadequate

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.


Mrs. Spit said...

You know what, every time I read your blog, I think, wow. This woman has a brand new baby, (here in Canada, you wouldn't even be half way through your leave), she's nursing and she is working. And, um, oh. . . She has other kids too.

I don't think you are slipping, I think you're wonder woman.

Honestly, the nurse who came in my room the day I was discharged and announced that she didn't need to check my carseat, tell me about shaken baby syndrome or post partum depression. Didn't even tell me how long I would bleed for, or what to do when my milk came in (thank God for the midwife!)

That was a rotten nurse. ..

AtYourCervix said...

We all have our "off" days or moments, where we forget things. It just goes to show what an excellent nurse you are, for feeling so bad about missing things!! It shows you care! Give yourself a pat on the back - you're doing great :-)

Anonymous said...

You have three kiddies under 5 years, are still breastfeeding and working 12-hour shifts? You deserve a medal!! I'm just a nursing student (hoping for L&D upon graduation) but I can see by your post you are one of those nurses who really cares. What did you do in nursing school to make sure you didn't forget things - charts, flash cards? I'm sure you can delve into your past and pull up something to help with your sleep-deprived and energy-deprived self. :)

2nd year nursing student in CA

Anonymous said...

i know exactly how you feel. you couldn't have described it any better. we all have our off days and if you are like me you obsess about everything either on the way home or while your trying to fall asleep. or you forget things and a day later you remember that you forgot to sign the MAR for Bicitra you gave your pt at 2am. sometimes i feel i am on my game and then sometimes i feel so incompetent. keep your thoughts coming because they validate my feelings and make me think I am normal.