My first MED ERROR!!! - page 2

:scrying: :scrying: I feel horrible, I am in my 5th week of orientation and I made my first med error!!! I was asked to give a new admit some pain medicine while the nurse I was with was in a... Read More

  1. by   TallGirlAni
    Quote from ERNirs33
    I made a med error with a nitro drip, the dr. wrote it wrong, but I should have caught it and corrected it or sought assistance, asked or something. Fortunately absolutely no harm came to the patient, in fact, the higher dose I gave was the only thing that even touched his BP, it came down to about 130/88 rather than the 200's over 100 range, but still, man I felt like a really bad person and I have anxiety so bad when I get off work now, I lost sleep over this and now after a shift I come home worried that I have done something wrong, I don't know how to just let go of these feelings and know that I am trying the absolute best and doing the best I can, but I hate the fact I made such a mistake that could have been so serious! any advice?

    I have been a new RN grad for 10 months now and made my first med error a couple of weeks ago, as well. I had an order for 1-2 mg IVP morphine q4h prn. It was a busy day, and in my mind, I was thinking q2h prn. Well, the pt had pancreatitis and was asking for pain meds about q2h, and I would give him 2 mg IVP q2h. I did this 4 times in my shift, when he should have had only 2 doses according to the order. It was a busy day and that is no excuse. The MD made my charge nurse aware of this and I felt horrible the next day at work. I did write up an incident report and now I am extremely diligent and careful when giving meds, especially the prn meds. This was a medicine patient and I work on a post-surgical floor, so I am usually pushing morphine q1h on the surgical patients at times. So, my advice is that what is done is done. If you are fortunate that no serious harm came to the patient, one can learn immensely from this and just remember the 5-- Right dose, route, patient, etc. Also, talking about these incidents with your coworkers can remind ourselves that we are all human and can all learn from each other's mistakes. Keeps us on the ball! I think there is an element of shame when we make a mistake and we should really use the opportunity to learn from them so that we can avoid future ones. Beating yourself up for being human will get you no where. Now if you are making the same med errors over again and not learning from your mistakes, that is a differerent story......
  2. by   colleennurse
    Hey there. I know it is hard but try not to beat yourself up! The fact that you are concerned about it shows that you truly care. I am also a new grad, 6 months in. When I 1st got off of orientation, I had to hang a unit of PRBC's and I ran it in over an hour vs. 3 hours. When I realized what I had done, I got so upset, went to the charge nurse and told her. Luckily the patient was ok and frankly had no idea that I even made the mistake. I was LUCKY that she was young and I didn't cause her to go into CHF. You know what? I will never make that mistake again. Now, when I hang blood I ask another nurse to check the pump for me after I program it, just to be double sure. When this happened I had emailed my supervisor the next day (cause I was so upset) and she told me to learn from the error and just to be thankful that the pt was ok. The important thing is that you learn from it. I know how horrible you must feel, it is a rotten feeling when you realize that you could have really hurt someone. But you will get over it and it will just make you that much more conscience about what you are doing! look how many people on this forum have already replied telling you that they have also made a mistake and know how you are feeling. It happens, we just have to make sure that we learn from it! good luck!
  3. by   AuntieRN
    I made my first med error today...I totally understand what you are going through...luckily our pts are ok...
  4. by   augigi
    With regard to getting over it, the only thing to do is realise that EVERY nurse has made a mistake at some time, whether they realised it or not. We are human. It's a learning opportunity. As long as you learn from it, and examine WHY you made the error, and change your practice so that you never make THAT mistake again, it is okay.
  5. by   loriann
    I seem to have diffiuclty when all the sudden there are several things to do, and then I make a mistake. For example, yesterday I had 4 patients, one was off the floor, one was a new admission and just came back from a procedure and needed monitoring q15 minutes, another just returned to the unit and needed medications, and the other needed premedication before a transfusion. My preceptor was helping me with all my patients in some way and told me that the transfusion pre-meds were there. We got the benadryl out of pyxis and I just started drawing it up without looking at the amount needed. When I finished, my preceptor said, "Now look at how much you are supposed to give." I honestly would have done that, but when I'm rushing to do so many things, I get flustered. Unfortunately, this has happened before (the preceptor checked before and saw my error), and so my preceptor told me they are moving me back to 3 patients until they can be sure I can handle that caseload appropriately.

    I guess I wonder, should I even be a nurse if I can't seem to handle the caseload (which is actually 5 pts not 4)?, why do I screw up with medications when I am flustered and how do I stop?, am I on the road to being fired? I'm in my 8th week of orientation, so any advice would be helpful.

    By the way, for all the earlier posters, I know how you must feel
  6. by   colleennurse
    Don't be too hard on yourself. That is why they have orientation. It sounds like the place you work for is willing to help you out and not just get rid of you. Maybe you can ask your preceptor for tips on how to organize/prioritze your time. You can never be too careful with meds. Just this last week on my unit 2 different nurses made pretty bad med errors, luckily the patients were ok, but it makes me triple check what I am doing now, it is so easy to make a mistake, especially when you are busy! Maybe now that you had a close call, it will make you more conscious of checking the orders for the meds that you are giving. Good luck!
  7. by   dijaqrn
    It is great that you've worked through to the root cause of this error i.e. giving a med without knowing the patient or the route. You won't make this kind of mistake again and the patient sustained no permanent harm! You will be a great nurse!!!!!!!!!!!!!
  8. by   dijaqrn
    Quote from DolphinRN84
    It's ok to make mistakes. I am a new nurse myself and I can understand what you're going through. This will make sure you don't do it again. Don't beat yourself over it (hypocrite here! :chuckle ) I know it's difficult trust me! (((((HUGS)))))
    I don't think it's ever "ok" to make a med error and I'm sure that's not what you mean here......... Yes you pick yourself up and learn from the mistake but we need to remember that patients actually die from these mistakes. My nursing school gave med calc tests in every module and you had to be perfect to pass, this is imperative for the new and us old nurses to understand. Run through your six rights three times before giving a med, =especially a push!
  9. by   RN 4 U
    I can definatley relate to your dilemma. I made my first med error last Wed. I am a newby only 2 days into orient. on the floor and I forgot to check a pulse rate when giving digoxin. I was horrified. I had given this man this medication the previous day and checked it. I guess I was so used to giving him this medication that i just forgot. I did however checked the telemetry monitor and thank God everything was fine. I didn't tell anyone, because everything turned out ok. I felt bad though and it reinforced how important it is to check your critical meds and the prelims before giving a critical med. Don't beat yourself up. You are human we are going to make mistakes.Having made that mistake made me aware that I am capable of mistakes and have to be very careful in the future.
  10. by   DolphinRN84
    Quote from dijaqrn
    I don't think it's ever "ok" to make a med error and I'm sure that's not what you mean here......... Yes you pick yourself up and learn from the mistake but we need to remember that patients actually die from these mistakes. My nursing school gave med calc tests in every module and you had to be perfect to pass, this is imperative for the new and us old nurses to understand. Run through your six rights three times before giving a med, =especially a push!
    I think you misread my post..though I apologize if I worded it kinda weird, but I never said it was ok to make med errors. Of course its something really serious and patients can die from them, but I meant it was ok to make mistakes IN GENERAL. I had med calc tests too in school and we had to know the six rights as well. At work I always try and double check everything...if not triple check!
  11. by   augigi
    Quote from RN 4 U
    I didn't tell anyone, because everything turned out ok.
    That is a dangerous attitude. The point of reporting med errors or near-errors via incident reports is to examine what happened, why it happened, and how to avoid it in future. Not telling because everything turned out ok just obviates the point of this process.

    Having said that, I don't think I'd call not checking a pulse before giving digoxin as a "med error".

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