July 6, 2016 at 6:05 PM #103229
In desperate need of advice from some fellow professionals. I’ve been an RN for four years and have done mostly ER work. I have seen some rough things before, but one particular case, from roughly three years ago haunts me to this day. I had been a nurse for maybe a year, and worked nights at a very small rural hospital. At night we had two nurses and one cna to cover the 20 bed med surg floor and 3 bed ER. We had one floor patient who was maybe fifties or sixties, obese, diabetic, high blood pressure and was admitted with a diagnosis of acute renal failure. Absolutely zero output. Pt was not very compliant with meds and diet. Apparently, he had a buildup of metformin in his system that was unable to be excreted due to the acute renal failure. So as a result, every couple hours or so his blood sugar would tank to the 30s and 40s. He would present symptomatic with confusion, weakness and slurred speech. A shot of d50 would bring him right back to normal. Well this happened and I had given this pt d50 3 times during my shift. FSBS checks were hourly. In the middle of the night, myself and the other nurse were caring for an ER pt when the cna came back. She stated that “mr. So and so isn’t responding to me”. I immediately assumed his blood sugar was low again and he was exhibiting his typical slurred speech and confusion. I walked back to my med room for the d50 and pulled down my med book to chart the dose. At this point I became distracted by something on my cell phone( I know, huge mistake). I read some type of article on my phone for a moment. Long story short, I wasted anywhere from 5 to 10 minutes before getting to the pt with the d50. When I arrived at the room, I immediately knew something was wrong. Upon assessment, he was cold, clammy, and pulseless. I also noted hypoxic coloration around his lips. I slammed the d50 and called a code. Unfortunately we were unable to bring him back. For three years, this has haunted me. I can’t escape the feeling that this mans death was my fault. I feel that had I moved faster, perhaps I could have saved that mans life and prevented the code altogether. I should have taken the cna more seriously and not assumed I knew the situation. I’ve talked to my coworker on that shift, other RNs, and my old administrator at that hospital, and they all tell me the same thing-let it go, it wasn’t your fault, he was very sick and it was his time to go. However I cannot seem to accept that, and the guilt is overwhelming. It’s beginning to affect my focus at work, and I fear I will make another mistake because of this distraction. I even feel sometimes that I should call my board of nursing and report myself to them over the case. At this point I’m just desperate for advice. Was I negligent and to blame for his death, deserving my license to be revoked? Or should I do as others have advised and learn to move on? Have any others experienced this type of thing? If so how did you deal with it? I always had high hopes for my nursing career, in fact my plans were to attend Nurse Practitioner school by now. But the guilt is ruining my plans. Can anyone here help me? Again, I’m desperateJuly 6, 2016 at 6:45 PM #103230
I am not yet a licensed nurse (still in nursing school), but there was a situation in my life where I experienced severe anguish and guilt over something I had done and could not get over it. I would highly recommend seeing a psychologist, many of them are trained in how to handle these exact situations. You CAN get better. But it sounds like just hearing affirmations from other people is not enough to make you feel better. It wasn’t for me. It was a process, but I worked through it and you can too.
I know I can’t answer your question about whether or not you should report yourself, but you’ve made your desperation very apparent and I feel for you. I want you to know that you can get past this.
I have no idea if you have any religious views and if you have ever tried prayer, but my situation was helped enormously through prayer. It gave me the ability to forgive myself and move forward with my life. I hope this suggestion doesn’t sound silly or flippant to you, because I mean it seriously. Regardless of whether or not you might choose this route, please know that I will be praying for you.July 6, 2016 at 8:07 PM #103231
I’m so sorry this happened. Sorry for you and for the patient and family. I can imagine the guilt you are feeling and I think it is normal. But, you have absolutely got to let this go. You cannot keep going on beating yourself up over this. This does no-one any good. And I don’t think it does any good to ask if you were negligent etc – no one knows. But I can see you do realize the serious nature of the event. You made a foolish mistake with severe consequences, but that was 4 years ago and no one really knows what might have happened – if the patient was already so far gone, or not. No one knows. And don’t ask if others have had a similar experience – not many people will admit to it and people will feel very uncomfortable discussing such things with you.
You must let yourself move on. Let it be in the past where it is. Forgive yourself. I wonder if this was someone else, how would you council that person? I bet you would give them the same advice I’m giving you! So now, give that advice to your own self. Forgive yourself, and move on.
And whenever you notice yourself starting to think about it challenge the thoughts: tell yourself it’s in the past now, and that you don’t know what other outcome there might have been. And do not analyze the situation. Do not allow yourself to repeatedly go over the events of that night. (This is hard to do but you’ll get better at it).
Finally, do not report yourself! That would be foolish indeed. And I would not talk about it to anyone at work: boss, co-worker or colleague about it: keep this to yourself and perhaps a friend outside of work or a counsellor if you feel you need to. If there really was something directly linked to you it would have been noted. Just leave it alone and don’t let it happen again.
Time will heal this. All the best.
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