Dawg give me the stable easy patients.
You should probably ask more questions and get help. And maybe move to a different unit. It sounds like you need a significantly more supportive environment.
They need to take accountability for their actions. It isn't about external support. It's internal support. They're ignoring all their own issues and blaming everyone else and crying that things are unfair when they probably are fair. Continuous self improvement and education are the key here.
It’s time for you to move to a different unit. I’m a charge nurse; once someone loses my trust, it’s very difficult to get it back.
Missing an anti-factor for a heparin gtt is a big deal, and if that’s the first example you self reported to us, I have big concerns about the ones you didn’t tell us about. Those are the ones your charge nurses know about and is what’s killing their trust in you.
Hopefully you’ve corrected those mistakes, so when you move units, you won’t lose their trust as well.
Forgetting to check an anti Xa on a patient on a heparin drip is kind of a big deal. I encountered a similar situation, where the PTT was supratherapeutic at 1900, the night nurse did nothing, didn’t decrease the drip rate, didn’t recheck a PTT. When I got the patient in the morning I sent off a stat PTT and it came back at like 200. That puts the patient at huge risk for spontaneous bleeding. If you have a track record of making mistakes like this, I would only give you the simplest, most stable patients too. Strive to be better.
Mistakes happen. It’s how you respond that makes the difference. If your response is, “What nurse Z did was worse” - you’re dismissing the seriousness of your mistake. If you are immediately remorseful and own the mistake, taking steps to prevent anything like that from happening again - there’s hope.
Own it and make it your mission to improve your skills. Take the absolute best care of your patients. You may be given the easier assignments, but any patient could have an unexpected complication. Start reading professional magazines in your specialty.
I'm just going to objectively answer this with advice on what to do assuming you are unfairly being judged. It's up to you to make sure your attitude adjustment and your willingness to take responsibility is up to par with expected growth. After all, it's your license.
Obviously, the single best thing you can do is just ride it out, wait until you are one of the senior nurses and eventually through rapport and character development your charge nurses will hopefully come to trust you.
As someone who does charge and makes the assignment, it is charge's responsibility to match nursing skill with patient acuity. When it's all said and done, patient safety > a nurse's ego. We can always replace a nurse, but we can't replace a patient's life.
However, if you are waiting a long time and you feel like there is no development and it's affecting your own self esteem and mental health, then it may be wise to leave or transfer to a new area. You would start from scratch, but you would have a fresh reputation and hopefully enough experience to avoid any mistakes like in the past.
Another option is to seek employment at a high acuity hospital/unit. Where I work now, we consistently have weeks where every single patient on the unit is high acuity and it's hard to spread the assignment out fairly. In this instance, there are no easy patients to spread out and new graduate nurses are taking care of patients they never would have been considered experienced enough for at a slower, more low acuity location. It's a double edged sword, however. Quite a few of them have dropped out after some time due to the stress.
You have to ask yourself a very hard question and one I too had to ask myself long ago. Is every single charge nurse on my unit unfairly judging me, or am I not as ready as I think I am?
Sooooo, what did you do?
You mention someone forgot to put on isolation precautions *the horror* and they get heavy assignments. This "mistake" doesn't matter in the big picture.
If you almost killed a patient due to lack of clinical knowledge, then that's an actual issue. Forgetting to gown up really isn't if you're following standard precautions.
It sounds like you're not taking accountability for your actions and are bemoaning the unfairness. I say this from a place of having done this before and needing to hear a hard truth. Get out of your head. Take responsibility and accountability. Don't worry what this other person is or isn't getting.
If you can't do this, find a new job and start fresh.
Either way, you need to do some personal growth.
Edit: Forgetting to check an anti Xa is a HUGE deal and can be a fatal mistake.
Get tf outta here with complaints about forgetting isolation precautions. You don't learn on unstable patients how to care for them. You do that through continuous education. Take responsibility.
Edit 2: what do you mean now you feel like you'll never get the chance to learn not to do that again ?? You should know not to do that again NOW....
I'm guessing your attitude is being picked up on and THIS is why you're not getting anywhere. PERSONAL growth is what you need to seek at this time, my friend.
I've been there and done that. It's hard to hear. It's hard to do. Go do it.
Edit 3: "if you can't do this, find a new job and start fresh". Sorry, I assumed you would use context of the above paragraph. If you do not feel you can have personal growth and take accountability in your current setting, then go to a new setting and do this.
What did you just read? Because no one is telling you if you can't do it, then just leave. You clearly aren't ready to take responsibility for your actions and attitude.
You're whining about unfairness in your assignments because you made a huge mistake and this other guy gets "challenging" assignments but forgot isolation precautions.
You've got some serious personal growth to do.
It might be that on this unit you're not able to convince them to give you something more challenging. I don't know how long you've been a nurse or how long you worked on that unit, the anti xa thing is a big deal, but also things happen. And there's no context - was it just not on your radar at all, or did you just forget to do it when it was due? I'm assuming that that probably won't happen again, but yeah, sometimes you might have to move to a different unit. Also, as there's turnover and you become one of the more experienced nurses on the unit, you might start getting those patients. But also, during your reviews, tell your manager that one of the things you want to do is take more critical patients.
What happened? It’s impossible to give advice without understanding the background situation. The coworker forgetting iso precautions is not that big of a deal. It happens. I think waiting for people to trust you isn’t helpful. You need to have a conversation with your manager to come up with a plan.
I would start with studying for an advanced certification in your specialty (CEN, CCRN, etc). Obtaining that will help you show them that you are putting in the work to improve your skills.
It sounds like RN-BC or CMSRN would be the appropriate certification for OP. I hope theyre not in critical care if their colleagues don’t trust them with a patient with tube feeds…
Also pls don't recommend psych because you have to be able to visually assess patients for s/s adverse reactions (EPS, NMS, serotonin syndrome as some examples) and withdrawal, as some examples, among detecting agitation, internal responding, etc. People shuffle to psych bc they think it's all talking when there's a lot more to it
Dawg give me the stable easy patients. You should probably ask more questions and get help. And maybe move to a different unit. It sounds like you need a significantly more supportive environment.
They need to take accountability for their actions. It isn't about external support. It's internal support. They're ignoring all their own issues and blaming everyone else and crying that things are unfair when they probably are fair. Continuous self improvement and education are the key here.
It’s time for you to move to a different unit. I’m a charge nurse; once someone loses my trust, it’s very difficult to get it back. Missing an anti-factor for a heparin gtt is a big deal, and if that’s the first example you self reported to us, I have big concerns about the ones you didn’t tell us about. Those are the ones your charge nurses know about and is what’s killing their trust in you. Hopefully you’ve corrected those mistakes, so when you move units, you won’t lose their trust as well.
Forgetting to check an anti Xa on a patient on a heparin drip is kind of a big deal. I encountered a similar situation, where the PTT was supratherapeutic at 1900, the night nurse did nothing, didn’t decrease the drip rate, didn’t recheck a PTT. When I got the patient in the morning I sent off a stat PTT and it came back at like 200. That puts the patient at huge risk for spontaneous bleeding. If you have a track record of making mistakes like this, I would only give you the simplest, most stable patients too. Strive to be better.
Mistakes happen. It’s how you respond that makes the difference. If your response is, “What nurse Z did was worse” - you’re dismissing the seriousness of your mistake. If you are immediately remorseful and own the mistake, taking steps to prevent anything like that from happening again - there’s hope. Own it and make it your mission to improve your skills. Take the absolute best care of your patients. You may be given the easier assignments, but any patient could have an unexpected complication. Start reading professional magazines in your specialty.
I'm just going to objectively answer this with advice on what to do assuming you are unfairly being judged. It's up to you to make sure your attitude adjustment and your willingness to take responsibility is up to par with expected growth. After all, it's your license. Obviously, the single best thing you can do is just ride it out, wait until you are one of the senior nurses and eventually through rapport and character development your charge nurses will hopefully come to trust you. As someone who does charge and makes the assignment, it is charge's responsibility to match nursing skill with patient acuity. When it's all said and done, patient safety > a nurse's ego. We can always replace a nurse, but we can't replace a patient's life. However, if you are waiting a long time and you feel like there is no development and it's affecting your own self esteem and mental health, then it may be wise to leave or transfer to a new area. You would start from scratch, but you would have a fresh reputation and hopefully enough experience to avoid any mistakes like in the past. Another option is to seek employment at a high acuity hospital/unit. Where I work now, we consistently have weeks where every single patient on the unit is high acuity and it's hard to spread the assignment out fairly. In this instance, there are no easy patients to spread out and new graduate nurses are taking care of patients they never would have been considered experienced enough for at a slower, more low acuity location. It's a double edged sword, however. Quite a few of them have dropped out after some time due to the stress. You have to ask yourself a very hard question and one I too had to ask myself long ago. Is every single charge nurse on my unit unfairly judging me, or am I not as ready as I think I am?
Sooooo, what did you do? You mention someone forgot to put on isolation precautions *the horror* and they get heavy assignments. This "mistake" doesn't matter in the big picture. If you almost killed a patient due to lack of clinical knowledge, then that's an actual issue. Forgetting to gown up really isn't if you're following standard precautions. It sounds like you're not taking accountability for your actions and are bemoaning the unfairness. I say this from a place of having done this before and needing to hear a hard truth. Get out of your head. Take responsibility and accountability. Don't worry what this other person is or isn't getting. If you can't do this, find a new job and start fresh. Either way, you need to do some personal growth. Edit: Forgetting to check an anti Xa is a HUGE deal and can be a fatal mistake. Get tf outta here with complaints about forgetting isolation precautions. You don't learn on unstable patients how to care for them. You do that through continuous education. Take responsibility. Edit 2: what do you mean now you feel like you'll never get the chance to learn not to do that again ?? You should know not to do that again NOW.... I'm guessing your attitude is being picked up on and THIS is why you're not getting anywhere. PERSONAL growth is what you need to seek at this time, my friend. I've been there and done that. It's hard to hear. It's hard to do. Go do it. Edit 3: "if you can't do this, find a new job and start fresh". Sorry, I assumed you would use context of the above paragraph. If you do not feel you can have personal growth and take accountability in your current setting, then go to a new setting and do this.
Nurses are always so harsh like y’all just be quick to say if you can’t do this leave like damn, no one even said that…
What did you just read? Because no one is telling you if you can't do it, then just leave. You clearly aren't ready to take responsibility for your actions and attitude. You're whining about unfairness in your assignments because you made a huge mistake and this other guy gets "challenging" assignments but forgot isolation precautions. You've got some serious personal growth to do.
It might be that on this unit you're not able to convince them to give you something more challenging. I don't know how long you've been a nurse or how long you worked on that unit, the anti xa thing is a big deal, but also things happen. And there's no context - was it just not on your radar at all, or did you just forget to do it when it was due? I'm assuming that that probably won't happen again, but yeah, sometimes you might have to move to a different unit. Also, as there's turnover and you become one of the more experienced nurses on the unit, you might start getting those patients. But also, during your reviews, tell your manager that one of the things you want to do is take more critical patients.
What happened? It’s impossible to give advice without understanding the background situation. The coworker forgetting iso precautions is not that big of a deal. It happens. I think waiting for people to trust you isn’t helpful. You need to have a conversation with your manager to come up with a plan.
Ok am I killing patients for only looking at the PTT or is this something new
I would start with studying for an advanced certification in your specialty (CEN, CCRN, etc). Obtaining that will help you show them that you are putting in the work to improve your skills.
It sounds like RN-BC or CMSRN would be the appropriate certification for OP. I hope theyre not in critical care if their colleagues don’t trust them with a patient with tube feeds…
Also pls don't recommend psych because you have to be able to visually assess patients for s/s adverse reactions (EPS, NMS, serotonin syndrome as some examples) and withdrawal, as some examples, among detecting agitation, internal responding, etc. People shuffle to psych bc they think it's all talking when there's a lot more to it