Making Mistakes

"Anyone who has never made a mistake has never tried anything new"  Albert Einstein

Making a mistake can be an awful blow to the ego.  Making a mistake in nursing can have life changing consequences.  Making a mistake in pediatric nursing can make you the most hated person for the rest of your life!!!  

Yesterday while teaching pediatric clinicals I made a mistake while supervising a student giving an IV antibiotic to a small child.  Yep, the earth stopped turning, my stomach did several somersaults and it kept me awake all night.  Thankfully it was not a huge mistake, I got the right drug, right patient right route (thank goodness) but I calculated the rate incorrectly resulting in IV was done and pump was still running end game.... in air in the line.  It was not me who discovered the mistake but an observant staff nurse.  However, she chose to take her wrath out on the student and when I stepped in and said its not her fault at all, totally me, I was supervising her.  I then encouraged the staff to make this a teachable moment and go step by step through how to calculate the rate so (me) and the students will hopefully not make that same mistake again.

The student was mortified but in post conference I reminded them that everyone makes mistakes.  Most nurses have made med errors and if they deny it they are lying.  I remember the first time I made a med error I did not sleep for 3 weeks!!  The point is we have to at all costs prevent mistakes through careful teaching and supervision but it's going to happen.  So let's create an environment of "no fail", where its only a failure if you don't learn from it.  I have made many mistakes as a novice and seasoned nurse and there is really no point hiding from it, or getting defensive.  You just have to swallow big, own the mistake and move on.  It still hurts though, spend the night asking myself how did I make such a simple mistake?  How arrogant!!!  It happens to us all, we all have an off day.  

If you see one of your colleagues making a mistake of any proportion say to yourself "there but for the grace of God....."  Embrace them, sympathize, empathize, learn and move on.

Have missed blogging for a couple of weeks, got totally caught up in that holiday called Thanksgiving.  Young adult college age children came home which also means their entourage arrived shortly thereafter.  I love having young adults in the house, spent my time making bacon everything, filling/emptying the dishwasher, folding laundry, picking up beer bottles....you get the idea.  It was heaven, I loved every minute of it. 

Now thankful for a day when I can sit in my office with my buddy (the puppy) and get stuff done as the snow falls heavily outside.......a perfect day.

So....know there is life after you make a mistake, it may even make you a better clinician.

Taking a Breath

Taking a breath sometimes..no often; is essential to create that balance in our lives.  It is something I always seems to be striving for but never quite attaining.  I recently was approached to act as a nurse consultant to a medical health care advertising company for a project they are working on for a major pharma company.   It would involve me stepping away from community health for a while.  All of a sudden that seemed like a very attractive proposition and I realized I needed a break more than I thought I did.  Like most women I think I am superwoman Mon-Fri, then your diet goes to hell in a hand basket because you have less time to organize the pantry, then the fitness regime you promised to follow starts to teeter, then the sleep pattern goes and well, then its all over, you may as well ask the men in white coats to come and take you away in straight jacket!!!  This epiphany came just in time, during a recent trip to see my college age children they informed me that when I am over committed (like all the time!) I range from nasty to an extreme micro manager......really.......and I thought I was handling everything so well!!!

So, I took the option not to renew my contract with the home health agency I have been working with for the past 3 years, put on my corporate clothes (dug them out from the back of the closet) and went off to my first meeting.  Intimidated?  Oh yes, these ad agency creative types are way above me in terms of creativity and dialogue, but during my first meeting I realized we were talking a similar language and our mutual link of health care gave us more in common than I thought.  I have really enjoyed working with this group, not sure where it will go as it is a contract position that could be short or long lived depending on the success of the project.  

I was also asked to pick up an extra clinical teaching day for a colleague who had to go out sick for the rest of the semester.  More students, mentoring and coaching the next generation of nurses, bring it on.  So far they have proved to be a promising and lovely group, I am enjoying them a great deal.  So even though I am still working several jobs, apart from 2 days of teaching I am at home telecommuting and I love it!!  I love the flexibility, I love the fact that I do not quite know what I will be doing after Christmas.  I love the ability to breath a little and recover from that burnout that we all experience every now and again.

Only a week until the kids come home for Thanksgiving, it has to be my favorite week in the whole year, hanging out in our pj's, eating bad food and lots of it and crazy hours of the day and night.  And then packing everyone off back to school with all the leftovers.  Cannot wait!!!  All I need now is a huge snowstorm and I will be extremely happy.

Nursing is like a Hurricane

We have just survived hurricane Sandy.  Compared to our neighbors in New Jersey our experience was the inconvenience of being without power for 48 hours and some minor cosmetic damage to the front of the house.  We are lucky to live in a community where we have close friends with power so at least we could get a hot shower and local coffee shops where we could plug in and stay connected.  But still it disrupted the week.  From a work point of view not much got done, although I did get a 1000 page novel read that I had been meaning to do all year!!  Sleep was not great as it was sooo cold, even with the dog in bed as a foot warmer!  And there was a general feeling of not being in control, of wishing, hoping the power would come on NOW!, and even a rumbling panic of what if the power does not come back for days and days.

When patients become a patient they must feel like this.  A loss of control, someone else is in charge of their destiny for the course of their treatment.  A patient is at the mercy of the medical team and their decisions of what/when care will be administered.  At pediatric clinicals yesterday this was highlighted for me.  A parent had been visited by her medical team at 6.30am (usual time for rounds!  really... busy days of clinic surgery mean an early start).  The team decided her child was well enough to go home.  Well, by 11am the discharge process had not even begun as the doc had not written the order.  Mom was going nuts, as she had other kids at home to care for and was being told if she just walked out ( I could see she was tempted) she would be leaving against medical advice, therefore risking the wrath of the medical team and social work (more aggro than she was willing to take on).  I could see the medical teams point, on a priority list this was low on the totem pole, especially on a week where staffing members were down due to inability to get to the hospital (I have lost count of the number of fallen trees on power lines around here).  But also I had great sympathy/empathy for this parent, we are here to serve her family, not just her child and I am not sure we were doing a great job of keeping her in the loop of communication and hustling the discharge process along better.

When a nurse joins a team she/he may feel like the power went out in the hurricane too.  So many unknowns, what is the culture of the team/organization.  Will people like me?  Will I be competent?  Will there be someone who will show me what to do (for weeks or months if needed)? Will there be that safe person I can ask all my stupid questions to?  Then there is the lack of control over work schedule and assignments, coming to work early, staying late to do paperwork, dealing with the difficult patient, family member, staff member!!  Dealing with the truth that we do not always make it all better and some patients get worse and die, and dealing with our own emotional grief and physical exhaustion throughout that.

Wow, I just reread that last paragraph and wondered if this is truth why would anyone want to be a nurse! However, many have had an incredibly rewarding life in this profession, myself included.  But it is OK to admit the rough stuff, to get it out of the closet of perfectionism.  Over the years you build resilience as a nurse, I am not sure if resilience can be taught but it certainly comes with experience. 

On the 48th hour exactly without power the lights came back on in my house, very very happy.  It was an rough week even though all we really experienced was some minor discomfort but it gave me a greater perspective to not dwell on the small things, I mean really, does it really matter if I cannot log onto Facebook?!!  And to dwell and prioritize the important stuff, family, great friends and work that I love and despite all the thorny points cannot imagine myself doing anything else but staying in Health Care.