Thursday, February 4, 2010

sweating the small stuff.

Yesterday was probably my worst day in the ICU. And the worst part was that it had nothing to do with a patient being sick or me not knowing what to do, but rather--an extremely difficult (putting it mildly) patient. I cannot go into details, but let's just say he was out of his freakin' mind. He made me sick. I really could not muster compassion for this man. He was too manipulative and #$^%@#$^%$^&%$&#$!@#!!!!!!!!!!

My whole day was terrible because of this patient.

Also, I am beating myself up over a stupid mistake that I am afraid made me look like a goddamn idiot in front of people who I respect. The order read to give 20mEq of KCL over 1 hour times 3, but for some STUPID reason, I hung each bag over 4 hours. And his K+ was only 2.7, and he was on bumex and diamox. I just felt so dumb when it was revealed to me in front of the intensivist, my manager, med student, and 3 nurses. No one acted like it was a huge deal, but I'm sure they all thought I was retarded. I think I just did it over 4 hours because when I worked tele, everyone had peripheral IVs and you have to infuse it slowly. I know it isn't a huge mistake, but I'm still beating myself up over it. I just feel so dumb. I don't want other people to question me, either.


Anyone else have difficulty letting small things go?

 I'm trying not to focus on it today, but I'm still feeling pretty down about the whole day.


Unknown said...

Yep - and NOPE.
All great ICU nurses don't know how to let go of smallest things due to our overly zealous compassion for perfection.
You're going to make a great critical care nurse.
Keep it up!

Dragonfly said...

You have a very challenging and demanding job. Some days are hard. Hope tomorrow is better.

Eco Yogini said...

agree with sean and dragonfly- you will be ok. you ARE a fabulous nurse! and you will have terrible patients... patients who are sick and ill and don't want to be there. parents of patients who are upset that their child is there....

whenever i have parents and clients who are particularly difficult (and yes I have cried because of a few), i try to remind myself that they are usually upset because ________. No one walks through my door because their child's development is healthy.

Each experience really is a learning opportunity, as corny as that sounds. A full year after an Autism case family said terribly horrible bad things to me and made me cry for hours and then weeks after put in complaints with my manager (who supported me), i now feel 100% more confident that i have been through the worse, and have a set of alternative actions to take the next time a client comes through my door who is an ASD slam dunk.

you will benefit from this experience too.

Susan said...

Sometimes patients can make your days terrible...I totally agree and know what it is like. I try to remember that it's not personal and it's just how they are, but it's still hard to swallow sometimes. And I've cried plenty of times (people say it's normal for new nurses...everyone who isn't a nurse says, "your job shouldn't make you cry!!" haha walk a day in my shoes...), and sometimes it's the only way to let everything out so you can get your chin up and head back out there.

Wow that's fast for potassium! We always runs it over four hours so I would have to check the order seven times before running it over an hour. Although like you said, the situation warranted it! I always let silly mistakes get to me, especially when my manager "discusses" them with me (it's not so much a discussion as a "you're an idiot" matter what the situation is). I've spent days off crying about them! While that's a bit overboard, we learn from everything and "it won't happen again." Maybe it will, but we work in a profession where it is SO EASY to make a mistake yet we're expected to be perfect 100% of the time. As I have to tell myself, tomorrow is a new day!

Niki said...

Girl, don't worry about it! Every nurse makes mistakes! Just be glad nothing life threatning happened because of your mistake! I hate when patients ruin your day. I guess for me it was more if family members ruining my day since I worked in the PICU. Kinda hard to get mad at the kiddos!!