I made a mistake today and I can’t stop crying — NQN in ED struggling with the pressure

Hi everyone, I’m an NQN working in a very busy ED and the winter pressures are hitting us hard. I genuinely tried my absolute best today, but I still made a mistake and I feel sick with guilt.

I had 5 patients, 3 of whom were acutely unwell. One was on a VRII and needed hourly BMs and ketones. Another was an upper GI bleed who very quickly became a 1:1. He required blood, multiple medications, and constant escalation. I kept escalating because he clearly wasn’t appropriate for the area he was placed in, but I wasn’t being taken seriously until around 17:00 when he was finally moved. He was extremely difficult to cannulate and became increasingly unstable, so the majority of my attention and time ended up going to him.

At the same time, we had an aggressive 1:1 patient and my NA was stretched between multiple patients as the area next to us was short-staffed and needed support.

Amid all of this, I had a patient who is insulin-dependent. I checked her BM in the morning, it was low, so I withheld the insulin and assisted her with breakfast. Her BM picked up afterwards, so I administered her insulin. That was all before the shift spiralled.

During the chaos, I didn’t recheck her BM. It wasn’t until night staff took over that they found she had become hypoglycaemic again.

I asked my NA, but she had been overwhelmed as well and was pulled in two different directions. We were all absolutely stretched beyond capacity.

I’ve been crying since I got home because I know this will be datixed, and honestly, that part I don’t mind. What hurts is the feeling that I put a patient at risk, even though I was doing everything humanly possible. I didn’t get my break until after 5pm. I was mentally and physically drained and trying to keep multiple unstable patients safe.

I’ve written a reflection and I’m ready to learn from it, but right now I just feel disgusted with myself, even though I know the wider issue is unsafe staffing and unrealistic workloads placed on junior nurses.

I don’t know if anyone else has been through something similar, but I really needed to get this off my chest.