I was reading through my usual multitude of favourite blogs the other day when came across an interesting post from Steve Whitehead over at the EMT Spot. Steve writes a little about a cardiac arrest call that he was at that didn’t go quite to plan.
I would argue that he didn’t actually make a mistake, rather had a loss of focus for a little while (which happens to all of us at times), but the 4 points he puts forward to help us get past a mistake certainly struck a chord with me and made me think back 15 years and to an incident that virtually ended my nursing career before it even got started. I share this with you all to show how NOT to deal with a mistake and show that as Steve says, it very much does happen to all of us at some point in out working lives.
I’ll split this into two parts. First in this post, just the facts, then I’ll discuss what I think I did wrong and how I could have managed the situation better in Part 2. This is a pretty big disclosure for me but hopefully it may be helpful to someone out there…
I was a newly qualified registered nurse on my first ward from leaving nursing school. I had moved away, to work down the country in my ‘dream job’. Things seemed to be going really well.
I had always had an interest in palliative care and cancer nursing, so with 10 months left of my training I started to apply to various hospitals around the country for jobs on oncology (cancer) wards. I was over the moon when I got offered a position and looked forward to starting what was sure to be a prestigious nursing career………..
I had been on the ward for about a month, and at the time of the incident was the only qualified member of staff on the unit (the Sister in charge and other nurse had gone off for their breaks). On that day we had 27 patients on the ward in various stages of treatment or palliation of symptoms and I was in the middle of doing the drugs round. I was happily pottering around dishing out the medication and keeping an eye on a number of patient’s chemotherapy regimes that were running. I had been going for about an hour when I came to one of my favourite patients on the ward, Sam.
She had a fairly aggressive cancer but her treatment was going well ; she always had a smile on her face and I used to love sitting on the end of her bed and having a chat at various times of the day. The chemo that she was having was particularly nephrotoxic (which means that it really isn’t good to have it in her body for too long as it can damage the kidneys) and because of this she had to have a big dose of a diuretic both before and after the chemo (so as to get the kidneys working full out before the chemotherapy, then flush the kidneys out after the chemo). I had already given the chemo and was going to give the post chemo diuretic when I noticed that I hadn’t given the pre chemo dose.
My world stood still.
I felt sick.
I started to sweat.
I had that horrible feeling when you get that sickening feeling in the pit of your stomach.
All I could think of was Oh Shit! Oh Shit! Oh Shit!
Then the questions started to come…
“What should I do?”
“Have I damaged her kidneys?”
“How do I tell her?”
“How did this happen?”
The one thing that didn’t even cross my mind was “Do I need to tell anyone?”
I had made a mistake, and in my mind this one was a big one. I ALWAYS own up when I do something wrong. Some may say that this is a character flaw; some may say this is a good thing. All I know is that I cannot cope with the guilt of knowing that I have done something wrong which may impact on someone else. (Looking back, I know that this was the final trigger in a sequence of life events that started me on the road to OCD, which I have written about before).
I couldn’t think of anything else other than what I had just done, and I knew I had to do something straight away.
I shut the drugs trolley and went into the office, bleeped the consultant on call and called the cafeteria to ask for the Sister to return immediately. I sat in the office staring at the phone when the ring startled me back into the reality of the situation. It was the consultant.
I explained what had happened and waited for the onslaught of what was sure to be a major blasting……..However, none came my way. The Consultant was gracious, caring towards me, and told me that he would be straight up to sort it out. Shortly after I put the phone down the Sister and the other nurse returned looking a little flustered and asked me what was wrong.
I explained what I had done, and again, they were pretty cool about it and said that we could sort this out and that I should go and finish the rest of the drugs round. I went back out to the trolley and moved onto the next patient, but as I passed Sam, she stopped me.
“Are you okay Mark?”
“Yeah, yeah fine thanks Sam”
But I wasn’t, I felt sick to the pit of my stomach and if anyone was going to tell her what was going on it was going to be me.
“Actually Sam, im not ok, I feel dreadful”
I proceeded to explain what had happened and that her consultant was coming up to see her. I reassured her that everything would be ok and apologised to her. She was amazing.
“Don’t worry Mark, its ok. I’m sure everything will be just fine……..and….thank you for telling me”
The consultant arrived and had a quick chat with me to see exactly what I had and hadn’t given. He again reassured me that she would be fine and try not to dwell on it. He went off and took some bloods from her to check her kidney function tests. It turned out that she had to stay in hospital for an extra day so the doctors could keep an eye on her kidneys, but over all she was absolutely fine. I on the other hand was far off being fine.
I was left looking at the drugs trolley.
I couldn’t do it.
I couldn’t hand out any more medication. What if I made another mistake, what if my next mistake was more serious? How could I live with myself if my actions harmed some one else?
It may seem a big over reaction to you, but at that moment my world felt like it was collapsing.
What would I do if I couldn’t be a nurse?
What would I do if I couldn’t care for people?
I went into the office where Margaret, a lovely kind Auxiliary nurse was sitting. She asked if I was okay and I just crumbled. I cried and said I couldn’t do this anymore. The sister came in and tried to reassure me a bit then sent me home for the rest of the shift.
I was to come in for my next shift the following day and ‘get back into the swing of things’.
I struggled to sleep that night, and went into work the next day feeling more than a little anxious. I kept trying to tell myself that I was being too hard on myself and needed to get things into perspective, after all Sam was going to be fine and everyone makes mistakes right?
As I arrived on the ward, the Sister in charge asked to see me and asked if I was alright and said that she would have to write a report about what had happened but that it was absolutely nothing to worry about, just procedure. She would also see if there was anything they could do to help me if I felt I needed some help. Other than that I was to get back to normal and carry on with my duties.
It wasn’t long before I needed to do the drugs round again.
It felt like a nightmare. Every patient I went to, I ended up triple checking, then checking again and again to make sure I had the right patient and the right medication.
This wasn’t normal safety checks, it was the start of OCD and it marked the end of my ward nursing career. I seriously couldn’t handle the responsibility of doing something as simple as handing out some medication to my patients
I walked off the ward a couple of hours later, packed up my things in my room that I was renting and headed up the motorway to return home.
I ran away.
I never worked as a nurse on a ward again.