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Need solutions to nursing problems!!

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1 As a new nurse, just into my 3rd month, I find myself annoying my co-workers, doctors, patients, and MYSELF, by either doing or NOT doing things that I should. I know I'm new and I have to learn, but I hate the looks and attitudes of annoyance I get from others when I screw up.

One example of my many missteps- I had a patient today who had a foley placed last night. It was draining brick red urine and the MD was aware. About 5:30 he started moaning and yelling about pain, but whenever I would ask where the pain was, he would just say "everywhere!!" He has a hx of osteoarthritis and was in the hosp for that. Meanwhile, he had bloody urine leaking out from around the foley, saturating his gown (3 changes!) I told the MD and he just said "I know" and carried on.

I thought maybe it was constipation because he had not pooped in a while, so I gave him an enema, and it relieved him for a while, but come 9 he's screaming and yelling again. I tried pain meds, but it wasn't touching it. More bloody urine on the gowns. I call the hospitalist and she says "not my problem, call urology" I call urology and he yells at me for waiting until 9:45 to call him and what can he do. He sends the surgeon who put the foley in.

Here's the part that kills me. My charge nurse comes in while I'm waiting for the surgeon, and looks at the cath. She takes a syringe, flushes it, and whoosh, out comes all this urine!! Patient is relieved, surgeon isn't needed (though he shows up anyways, though at least he was nice about it!!) and I'm left looking like an ass because it was something so simple that I didn't even think to do.

I thank my charge nurse and say that I wish I could absorb knowledge. She gets a bit snotty with me and tells me that I should use all my factualities to figure things out and that I need to watch what I say to doctors. That it wasn't "bloody", it was serosanguineous.

In a passive aggressive way, she is always alluding to the fact that I'm a moron who doesn't think things through. The thing is, being a new nurse, I don't KNOW what to do in many cases, and I hate always asking because people get annoyed (no matter what they say)

My main point or question here is -Does anyone know of a website or an app that you can type in a question and find a solution to it?? Like "foley not draining" "IV occluding", etc? Agh, I hate this feeling of useless stupidness!! I forget about 10 things a night, and the night shift always complains and questions why I didn't do things, or I did them the wrong way. BLAH.

Sorry for the long post!! Thanks in advance! :-/
I would continue to ask the old, wise nurses. As you go through the gamut of questions, you will find yourself asking less and less. Don't know of any websites that you ask about; I would just do a general search but be careful with the search results. Would think that there are some PDA applications that would cover this type of question.

Comment:
You are just fine. Three months out..you are a BABY nurse still! I think the problem is the lack of support you have. When I was 3 months out (and still to this day sometimes!) I was asking questions of my charge nurse or other more experienced nurses constantly. The difference with me however is the nurses I worked with never acted annoyed at me. They were all sooooo understanding and helpful. Do you ask questions of them or do you just wait and guess? It is SO much better to ask then to not ask for fear of looking dumb. Hang in there and if you dont get more support I'd suggest looking elsewhere for employment.

Comment:
Awe, dang I hate that you are going through this. It's hard enough to be new the first year, then to have no mentor is even more difficult. Even so... before you start paging doctors next time, get the charge, or a senior nurse whom you trust clinically (not just the "nice" nurse) and have them look at the situation and help you gather your ducks in a row before calling any doc. This will help you critically think. If this group doesn't help you, it just doesn't magically appear, so hound them anyway. I know you're looking for an easier way to avoid this, since they haven't kept their feelings to themselves, but your patients need you to do it anyway.It will help you grow the brass ones that you need to anyway.

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I have only been nursing as a RN for about a year, and I still forget things and get the foul looks, snooty doctors. Think everyone does still. I try to jot everything down so I don't forget (but you do cos some shifts are crazy busy), & I write stuff down I've learned for next time.Anyway, I always tell the senior nurse/shift coordinator if anything is wrong with a patient. Tell them before the doctor & let them handle it - that is their job in most cases. They shouldn't really mind, as they do have more experience.I know you feel like a dummy, but try not to take too much to heart, we all make mistakes & to be honest, they will have forgotten about it all a few weeks later in any case.

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You are not a moran, and I'm sure that these experiences are teaching you valuable lessons. In fact, you just taught me a lesson, so thank you.

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Relax smokeynight. You cannot be expected to know much of anything at this point. Many of us went through the "rites of passage" hazing. Snooty, upidity holier-than-thou's running us through the gauntlets of insecurity and self-doubt. Busting our chops for not knowing is their favorite sport. Don't take it so personally. Continue to believe in yourself and the rest will come with time. Nursing school is like learning to drive a car by reading the operators manual. Trust me, learn from these experiences and you will be a fine nurse.

Comment:
We all struggle with this. Nursing school sucks a lot of the critical thinking skills out of us, with all the "right" answers and black and white thinkings. I know I was never encouraged to think outside the box. Next time you have a problem, try to think of every possible scenerio. Be creative. Problem - bloody urine not draining through a foley. Explanation - a clot occlusion. Seems obvious, but when the patient's fussing at you, your charge is fussing at you, and you have five other patients to worry about, it's hard to come to that conclusion because of all the other distractions. A lot of this falls on the doc. Why a urologist wouldn't order CBI or routine flushing is beyond me. Don't be so hard on yourself. No one, even your cranky charge, was born knowing all the answers.

Comment:
Hang in there. It does get better. Ask your unit director about having a resource nurse that expects to be asked questions from new nurses. I love to help our new nurses. After all, none of us were born nurses and no nurse knows it all. We should all be learning everyday.

Comment:
How come no one else that you asked thought to flush it? Hmm????Was there an order to flush it? In some places, I'd bet you need an order.Your supervisor and the other staff who are giving you a hard time should try remembering what it was like when they were not yet gods and goddesses. The ascent to Mt. Olympus is steep. I'd say just keep doing your best, don't expect perfection, don't believe that they know everything there is to know. Sorry I don't know any sites, apps, but I'm sure they're out there. Don't be overly sensitive, either. You might be perceiving annoyance where maybe it doesn't actually exists, at least, not from everyone. And once you have some experience, be nice to other new nurses.Keep on giving it your all and do not let anyone run you off - although if they're as nasty as you describe, it would serve them right for you to leave after they teach you a lot.

Comment:
yep, as everyone said, keep knocking on those solid doors that are your peers. I'd hope that their patient care standards are high, and they want that for you as well. But please include them, prior to calling docs and then they have ownership and are less likely to snicker when you get a tush reaming,,,, they then will step up and have your back. If not... you are in the wrong place.. we never ever let each other drown or get ripped if we agree an intervention is warrented.consider my infamous line..."look, If I'm waking you up, looking for more work for me... your patient needs you to order something!"and my second favorite.."when you raise your voice at me, I'll be hesitant to call you the next time I think your patient is in trouble... do we really want that situation?" 'now, back to our patient.......'

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I've been working for about 10 months and am just starting to feel comfortable about remembering to do all the small things and about knowing what to do in a lot of situations. It just takes time. And I am the queen of questions--it's the only way you can learn! There will always be some nasty doctors and nurses and otherwise around, don't take it personally.

Comment:
I firmly believe that you will never know everything. I answer all questions that the new nurses ask of me and I try to help them reason things out so they get the answer for themselves. I have 14 years of bedside nursing behind me and I still ask questions. "The only stupid question is the one not asked"
Author: peter  3-06-2015, 16:37   Views: 1015   
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