i did so many errors today.*needing comfort guys - page 2

i'm a new grad and i've been orienting for about 8 weeks now.I should hve been starting my night orientation 2 weeks ago but i guess i'm not doing well so my preceptor suggested to my manager that it... Read More

  1. by   Imafloat
    Quote from chick_pea
    Thanks for the correction.It's well appreciated.Actually i don't really use ' dilaudid' very often i just usually use hydromorphone coz that's what comes up in the pyxis .
    I took this to mean the words. I thought she was saying that she doesn't use the word dilaudid, she uses the word hydromorphone, because that is what it is called in the pyxis and that is why she spelled dilaudid wrong.
  2. by   Mulan
    Quote from WeeBabyRN
    I took this to mean the words. I thought she was saying that she doesn't use the word dilaudid, she uses the word hydromorphone, because that is what it is called in the pyxis and that is why she spelled dilaudid wrong.

    I took it the same way.
  3. by   NotReady4PrimeTime
    Me three!
  4. by   Soup Turtle
    Me four :chuckle
  5. by   GardenDove
    TraumasRus, I think she meant that she is used to calling Dilaudid by it's generic name. That's how I read it. She wrote that she pulls it up in the Pyxis by hydromorphone, therefore doesn't use the trade name, hence her spelling error.
  6. by   Mags4711
    Quote from chick_pea
    ...Actually i don't really use ' dilaudid' very often i just usually use hydromorphone coz that's what comes up in the pyxis this was the first time i handled a pt with a dilaudid PCA...
    Sorry folks, I don't agree, read the line after "pyxis"
  7. by   Mags4711
    But in any case, every mistake we make is a good learning opportunity. I'm sure her manager is correct, she will be very careful in the future in giving her meds. I know making a mistake in my past (as I shared) made me even more diligent.

    I think she just needs a bit more time, a preceptor better suited to her learning needs, and some time to get more comfortable and learn her unit's frequently used meds.
  8. by   GardenDove
    So? She hadn't done a dilaudid PCA before, so what? She's probably given it IV. I've never done a dilaudid PCA yet because we haven't switched to that yet, but I give it IV all the time.

    Anyone can make an absent minded mistake like this once. She's new and has a nitpicky preceptor breathing down her neck. I'll bet she never does it again!
  9. by   GardenDove
    She had a hard day, it's extremely stressful being new, and many people perform poorly while being watched. I always did much better once I was on my own.
  10. by   kb12345
    Hi Chick pea,

    I'm sorry you had such a bad time. There's comfort in knowing that all of us nurses are not half bad. We don't all eat you guys and then spit you out. It will get better as you learn the ropes and become more confident about yourself and your capabilities. Don't let this "nasty" nurse ruin it for you. Ask as many questions as you can and when you mess up, report yourself to the manager before anyone else can, in the guise of asking for help/guidance, and understanding. Your new at this, cut yourself some slack your going to mess up, SOOO what.........even seasoned nurses like myself have had not so good days. I remember years ago when I first became a nurse, I was always so scared about forgeting things and as a practice (even now, though now I am a nurse practitioner) I still make a check list of all of the things I need to do for a patient. For example: I'm caring for Joe Smoe who is fresh post-op abd surgery....my check list would go something like this.....BP..P..R..T lung sounds, check for edema, check for bleeding at the site, monitor the wound, etc-Q4hours (rationale is that since the patient is fresh, if he develops a fever or the vs are grossly different than they were 4 hours ago that is indicative of infection or internal bleeding, and even acute pain and I want to be on top of that)...next is urine output. On my paper, I write UO and put a line next to it then yellow it so I can know that it needs to be done (indication is less than 30cc or no uo for a shift is indicative of fluid retention, amongst other acute issues being fresh post-op....next, I want to monitor pain and to do this I write down the type and amount and frequency of the pain med I am expected to administer and I ask the patient about pain at the times I wrote on my paper and again I yellow this out to distinguish what I still need to do ( I write my report from the off-going shift in black and the things I need to do in red, then yellow the blank area next to it, the I write what I actually did in blue or green so that I know it's done)....anyway I hope you get the point. Assess by patient true, but there are things your going to do for each patient that are constant (VS, lung sounds, etc...pain management, edema check, UO) then things that are specific to the patient based on your assessment, patient needs, and pateint diagnosis. If you find that you are having issues remembering to not leave meds at the bedside then put that on your list and put a little box next to it, yellow it out and when you give the med and have thrown everything in the trash, then put a red check mark next to it to indicate that it was done. I hope this helps...

    APRN
    Last edit by kb12345 on Feb 19, '07
  11. by   canoehead
    I't a huge no-no to leave any medication at all at the bedside, so keep your hands and eyes on them at all times until they go into the patient.

    Your preceptor may have been particualrly upset about the dilaudid because it is such a potent narcotic. If it had been lost and you didn't remember you set it at the bedside it would have been her butt as well as your own. There would be suspicions about diversion, and possibly police involvement. If I was her I would make sure someone knew about the error in case it happened again, so I would not be the prime suspect.

    The errors you made don't make you a bad nurse, but your coworkers don't know you that well yet, and they may be more cautious. Just take it in stride, and you will prove yourself in time.
  12. by   Mags4711
    canoehead brings up a good point bout why the preceptor probably reported it (a CYA thing).

    kb: what GREAT ideas! I also still make out a complete list of things I need to do, and I make an hourly sheet and put what I need to do at each time in the boxes, I generally write in red for meds (or highlight if I can't find the red pen).

    Chick_pea, kb has some great ideas. Hopefully these, coupled with a change in preceptors will make things go better for you.
  13. by   traumaRUs
    I'm sorry guys but I do stand behind my stance that not knowing that hydromorphone and Dilaudid are the same thing is very serious. Dilaudid is much more potent and has the potential to kill and quickly too. If you don't know what you are giving, you shouldn't be giving it. This is the issue I was discussing. Even now, with 15 years under my belt, I still check meds out prior to giving/ordering them. And...I won't even go into leaving two dilaudid vials in a patient's room.

    I'm not jumping on Chickpea because I do sincerely believe there is a problem with this particular preceptor and I did say getting another preceptor would be best.

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