Made a mistake last night.

[ejmonroe]

I work as a tech on an orthopedic unit of a hospital. I am also working on pre-reqs for nursing school. Last night I had 15 demanding patients to take care of (the other tech scheduled had called in sick). I had nasty nurses barking orders at me, three incontinent patients, call lights ringing, people wanting to be taken to the bathroom....you know the scenario. No report was given when I came onto the floor. I accidently gave apple juice to an NPO (who was also on contact precautions). I had given him a quarter cup before I saw the sign on the door. I told the nurse and received a verbal lashing...she also made sure that as a pre-nursing student I realized what a huge mistake this was. She then proceeded to tell me that the poor guy was on a feeding tube, has diabetes and aspriation pneumonia and is a DNR. I am so upset. There is no excuse for giving an NPO a drink. I take full responsibility for that. But, I got no report from her when I came onto the floor. I work very hard and I love my patients. I enjoy them and their families. I take extra time and give extra attention to my dementia patients who are ignored on my unit. I am a good person and would never knowingly hurt someone.

I plan to speak to the unit manager today about what happened. I am so upset. Any advise?

[valifay]

Don't be too hard on yourself. Things like that happen more often than you think. You should suggest to your boss that if someone is NPO, to have all fluids and cups (or thermo's) and food items removed from there room when NPO status begins. I'm sure you feel bad now, but I know you will never make that mistake again!

[soon2bim]

That is a great point, about some not receiving report. I know that our AM shift aides receive a report, I work second shift and some of the aides will pass on report, others are hitting the time clock

I love that I do get report, residents that are antsy, disoriented, who has a cath, and even who isn't feeling well and will be a room tray it makes my shift easier because I have some additional ammo going into shift. I know additional precautions that will need to be taken for residents, and it makes me feel more prepared!

[niko1999 RN BSN]

Wow, I am very fortunate at the facility where I am. We do walking rounds. We're all in 15 minutes before the time we start, and in those 15 minutes, it gives us a chance to walk with the day shift (at least one of them)and get the lowdown on how everyone has been, who is OOF, whatever. BUt dont be too upset about it. 15 people is a ridiculous amount for anyone to do themselves, esp. when they have 3 inc, ect ect

[vampiregirl, BSN, RN]

I'm not sure if hospitals do CNA assignment sheets, but if so, can you grab one for the other patients or just your assignments? I know the nursing home I work at has them by units. If we were short staffed I knew I'd be helping in other units I'd grab one at the beginning of the shift for those units too, just in case.

[augigi, CNS]

First of all, we all make mistakes, so don't beat yourself up too much. I bet you'll never do it again!

If you're going to talk to your manager, make sure you take responsibility for the error, but do mention factors you feel contributed (short staffed, no handover etc). Make sure you tell the manager ways you will avoid this happening in future, and you should be fine.

Keep your chin up, we've all been there :)

[Ruby Vee, BSN]

i plan to speak to the unit manager today about what happened. i am so upset. any advise?

speak to your manager. tell her what happened, how you made the mistake, and make sure she knows that you understand the possible ramifications of your mistake and that you fell just awful about it.

give some time to thinking about the systems problems that may have contributed to your mistake and what could be done to prevent it happening again. better staffing, better report, bigger signs -- whatever you think will help.

and then forgive yourself. everyone makes mistakes. anyone who says they haven't is either lying or not smart enough to realize they've made a mistake.

[CrazyPremed, MSN, RN, NP]

I agree with everyone else.

I've worked in nursing homes and on busy floors and know how busy it can be. You may have cost this pt an extra day in the hospital because of a rescheduled surgery. You may have thrown off a whole OR schedule. You may have delayed pt care. You understand your mistake and take responsibility for your error. I appreciate that.

Unfortunately, no one else has. The nursing manager should have realized that being short staffed (short one tech) would predispose your team to an error. The nurse for the pt (whose license you are working under), should have told you, personally, of all of her NPO patients (even though the sign was on the door). You have addressed the broken links in your chain, but no one else has looked at her own.

I have recently learned to assert myself in situations like this. I argued with a charge nurse recently (in the ER) because I didn't have the support necessary to handle 3 traumas that hit all at once, and I needed help. I could have been quiet - and prayed for no mistakes - but I did not. I'm holding us accountable for potential mistakes before they happen. You should do the same. I respect what you have done, and I feel that this will help you to be a wonderful nurse.

CrazyPremed

[Scrubz]

We all learn from our mistakes. But you gave the guy an apple when he had a feeding tube in?

I've always said that if you can't take verbal assults then you'll have a tougher time being a nurse. I've never been chewed out by other faculty, or by patients, so I guess I'm lucky. I have been indirectly chewed out by patients before when they're complaining about the hospital in general, or chewing out the nurse while I'm right next to then, saying stuff like "this hospital is a peice of ****." Never really bothers me, sometimes I want to laugh but I know I cant. That's the tough one for me...

[Maverick80]

I'm not a tech, but as a CNA, I understand how stressful the job can be. However, we cannot assume that someone isn't NPO, or can drink regular fluids. At the LTC where I work, us CNAs have to read the careplan, where it explains each resident's diet. We are expected to know and follow this plan, even though we may be short-staffed, or the night is hectic. We never get this information in the shift report, unless it's a new admit, and I never heard of posting this info on a patient's door. You can explain to your unit manager what happened, and say that you didn't get report, but you could still be held responsible. At least you admitted your error, you are remorseful, and I'm sure you'll never do this again.

that's the one thing that you can say about working LTC. You know your patients and deal with the same ones day in and day out. Working in the hospital you could work one day, and come back and have an entirely different set of patients the next day. I am a tech and work in an ER and never see the same patient 2 days in a row, unless a frequent flyer. Very rarely do i care for a patient all day, they are usually gone by the time i leave with a new ones several times over. But the way i see it is EVERYONE is NPO until proven otherwise. Unless a doc or a nurse says they can drink they don't.

Being short staffed is horrible and it just sets you up for mistakes like these. this wasn't intentional, you didn't mean to do it, don't let that nurse make you think that you one day will be a bad nurse. Just remember when you are a nurse, Help your CNA's or tech's out. Don't set them up for these things. Good luck with school!!

[CJ777]

First of all. Giving an NPO DNR a few sips of apple juice is nothing to beat yourself up over. Nor the nurse that didn't give you report to treat you like that. Yes it was a small mistake. But I bet the nurse that gave you a hard time about it. Has made worse mistakes. So learn from it, then let it go....This is from a person that has been an RN for 17 years. LET IT GO...LOL

[UM Review RN, ASN, RN]

First of all. Giving an NPO DNR a few sips of apple juice is nothing to beat yourself up over. Nor the nurse that didn't give you report to treat you like that. Yes it was a small mistake. But I bet the nurse that gave you a hard time about it. Has made worse mistakes. So learn from it, then let it go....This is from a person that has been an RN for 17 years. LET IT GO...LOL

I think a far worse "mistake" would have been to walk past that patient and ignore him. I think it shows what a caring person you are. Click on this link and see that we all pretty much agree that mouth care is the one thing that we all tend to overlook, and it's really not good for the patient:

https://allnurses.com/forums/f8/what-part-pt-care-gets-overlooked-most-often-196583.html

So next time, you'll go hunt that nurse down and ask. You also have learned to assume that most people with G-Tubes are NPO.

Yelling at you was unprofessional and that nurse should apologise--I would, if I lost it like that--but she probably won't. Take that as a lesson on how not to treat people who make an honest mistake.

A better way to respond would have been to teach you (especially since you're a student) about this kind of patient, and how best to relieve the problem of dry mouth.

That's usually how I respond when someone messes up unknowingly. But some nurses just aren't good at seeing those teachable moments, and don't realize that an appropriate response can build a relationship and enhance communication between nurses and aides.

You'll be better than that, because you care and because you're coming here to learn from the pros.

Take care and keep us updated on your progess, ok?

[Tweety, BSN, RN]

I confess to doing the same thing. The patient had a peg tube clamped through which I was to pass meds, and I have had her take her meds p.o. I felt dreadful.

During your meeting your might discuss ways of dealing with "nasty nurses barking out orders" and "verbal tongue lashing". Sounds like you have issues there.

Good luck and don't beat yourself up.