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This is a discussion on Depressed and Lost in First Year After Nursing Licensure, part of Nursing Career Advice ... So, I have been a nurse in the same facility since June of '09....so I've been a nurse for a little...by Trying23 Sep 6, '10So, I have been a nurse in the same facility since June of '09....so I've been a nurse for a little over a year. I'm still a newbie. I think I'm pretty good at what I do. I get along with all of my coworkers and have never had a patient complain about me. I'm always on time, and I'm always willing to help others. My problem is medication error. Since I've started I've made six....today being my sixth one. None of them caused any harm to the patient. Today's error: Dilauded order was changed to 0.5mg q3 hours from 1mg q3 hrs. Well, it wasn't changed in our medication giving machine. The machine told me the order was for 1mg and that I would need to waste 1mg. So that means I would have to draw up 0.5ml....I saw the 0.5 on the MAR and saw that I had 0.5 and gave it....two times before I caught my mistake.
Another nurse was complaining that she had made her first mistake in the the three years that she has been working....I feel so incompetant. How can I have already made six, and she's only made one. I know a lot of people don't admit their mistakes, but I have...and I don't know what to do. I've slowed down. I triple check myself. I don't know what else to do.
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- Sep 7, '10 by nurse nessieI feel you on this one. I've made several med errors since at my hospital all of our charting and MARs are still on paper. We don't even has a PYXIS either so it's very easy to make med errors. My first error was giving a med after it's automatic stop date. I was so distraught over it even though it was minor. I wrote myself up. Then later I saw other nurses give meds after their automatic stop dates and not even care. I guess as new grads we're extra hard on ourselves. I just make sure I double check and triple check everything, and if I'm unsure I make another nurse witness with me that what I'm reading is correct.
- Sep 7, '10 by Little_MouseI totally understand.I've been working at the same facility since Feb '10 and I compare myself all the time to other new nurses, especially regarding errors. I've comitted a few (more than 1!) med errors since I started (none of them major or life threatening, thank goodness). It's a huge blow tto the ego, every time I feel terrible even go so far to think maybe nursing isn't for me? But the only thing to do is move forward and learn from it to prevent the same thing from happening again.
I admit, it's comforting to see that I am not the only one and that the so called "super nurse" is also human and not perfect either...
- Sep 7, '10 by terry-upstate-nyI have learned from experience that it is most helpful to check the actual Doctor's order on the patients chart before giving the medication if there is any doubt at all about the correct dose. You can even call the pharmacy or write them a note to update the pyxis if you find an error in the pyxis.
- Sep 7, '10 by RmorcartI just joined this site and I am so glad that I have. I come home and vent to my boyfriend on a daily basis about my troubles I am experiencing as a new RN. I graduated in Dec. 2009 and just started at my current place of employment/my first nursing job in mid April 2010. Every trouble that I read that someone else has posted on this site I can relate to! I too have had medication errors..one was an order that I had put a pain medication for a pt. as prn only instead of as routine and prn. The mistake was caught when the pt.'s pain still remianed the same three days later. I felt awful that it happened and am glad that it did get caught so soon. This pt. had been having pain for weeks and finally the CNP did something about it. I take responsibility for the error of course but it was not intentional and it makes me extra careful now when I out orders into the computer. The other day I floated to a floor and a pt, had an order for a diuertic and it was not available and I assumed it was on order and would be coming in. The order was for a pill form. It wasn't until the end of my shift until I found a liquid form in my drawer for the pt. I felt bad but I was not made aware from the regulars on this floor on previous shift of this. Next time I will pull from the pixis if I can not find a medication. I just get so
overwhelmed with the medication pass on the long term care units that I work on and feel that if things don't go perfectly as planned I have no extra time to take extra steps.
- Sep 7, '10 by llgI agree with the general tone of this thread being one of "not being so hard on yourself" and "forgiving yourself" when these mistakes happen. They DO happen to most people at that doesn't mean you are not all going to make fine nurses some day.
There is no need to wallow in self-punishment over it. However, there IS a need to learn from these errors so that you can avoid them in the future. Your thoughts should quickly go to the questions, "What lessons can I learn from this?" "How can I prevent a similar mistake in the future?" Each error should be reviewed in this way -- and eventually, you will be taking the safeguards you need to take to minimize your errors.
For example ... one common theme I see to a couple of the errors discussed in this thread is the failure to double-check something that changed (had a new order) or something that wasn't exactly perfect (not available in the form usually seen). Any time something doesn't seem exactly right, it needs to be double-checked from the original order onward. That's just one of those things an experienced nurse does. They don't assume anything. If a "red flag" gets raised, it gets investigated before anything gets done (or not done). That's a lesson that you can learn from these events -- a lesson learned the hard way that you never forget and never violate in the future.
I wish you all the best in your on-going efforts to be good nurses. I hope you stick it out a while and build on your current skills by adding these life lessons in a positive way.
- Sep 7, '10 by HouTxAll of the issues that have been discussed in this thread seem to be grounded in Process failures... like the fact that the Pyxis was not updated to reflect the med order change, or that the MAR format should be revised so that the form of a medication (oral or IV) is clearly apparent to the nurse who administers it. I hope that this is being noted by your facilities as part of the analysis that should be done for each med error.
It may be of very little comfort to anyone, but the ongoing Federal HITech initiatives, such as physician Computerized Order Entry (CPOE) will help to eliminate a lot of process errors caused by human errors. We should support these initiatives wholeheartedly. My hope? -- that the bedside nurse will not have to always have to function as a human safety net and shoulder the entire blame of anything that goes wrong because she/he "should have double checked" or traced back to the original order to ensure that no one else has caused errors because they didn't do their job correctly.
I applaud all of the posters - you all personify the integrity and diligence that should always be associated with the nursing profession!!!
- Sep 9, '10 by terry-upstate-nyDifferent facilities use different technologies. Where I work now, we do not enter orders into the computer, instead we fax the Doctors Order sheet to the pharmacy, and the Pharmacist enters the order into the computer. Then, as Nurses, our responsibility is to process the order, check the MAR sticker they send us for accuracy, etc..., the night shift nurses do a 24 hour chart check every night to make sure all orders have been processed properly. Really, every shift should check their charts before the end of every shift to make sure they haven't missed anything.
I worked at another hospital years ago that had unit clerks enter the orders on the Cardex, some places, only nurses do that.
- Sep 9, '10 by phatluckI too, am very concerned about med errors, it's terrifying! I too, am just like you, a new grad, got a job, went through orientation, got along well with coworkers, no patient complaints, my patients loved me! Six months and I still could not get past taking a load of four patients, and 3 med errors which thankfully did not harm the patients. I was crying almost everyday that I came home, lost weight. In the end, I had a meeting with my nurse educators and nurse manager. I submitted my resignation and they let me go. I feel like in a crossroads now, wondering if I should pursue nursing. If there is one thing I love about nursing is taking care of patients, but finding a job that will fill that is difficult. Maybe, med-surg in an acute setting was not for me. I hope you find yours. Thank you for posting your experiences.