My First Med. Error

  1. today was my 3rd day of what i thought was orientation. the facility that i work at has 4 wings and the side they put me on today is pretty heavy. i found that out also today. the med pass is brutal. i didn't and still don't feel like 2 days on each unit is enough. i did fine on the first unit. no problems, buttttttttttttt, i keep telling them that i just passed my boards a few weeks ago, and med pass in school is totally different from the real world version. i am hearing two different versions of how long orientation is. i was told 6 wks and then i heard two weeks there is no way on this planet that i am going to be ready in two weeks!!!!! well anyways, the side i was on today and expected to pass all of the a.m. meds on has 32 patients, i kept saying i don't feel too comfortable, and i don't know these patients, i feel like i am falling behind. the supervisor said i was doing fine (which was a total lie, that is what my gut was telling me).one of the patient's i passed meds on had to have at least 17 different things!!!! that alone only took me forever and a day. the med error happened about half way through, when my preceptor was showing me how to go faster. that person knows the patients and was pulling out of order and doing not only my patient, but the one she decided she was going to do. well low and behold, i gave her meds to my patient. :angryfire . i feel like crap right now, i am upset with the way my orientation is going, and i have only been there for 3 days. i am ready to just say forget it and leave. i didn't give anything that would cause "real harm" is what i was told. now i am going to be up allllll night. but stilll, it's a med error!!!! after giving it, i told my preceptor that i was not touching anything else. i don't understand why they would want to start me out on a full med pass on a side where the meds are so heavy. please any advice from experience would be helpful. oh btw, half of the patients for what ever reason don't have name bands and there was no pic to identify the patient. i did ask which bed.
    Last edit by DarciaMoonz on Apr 28, '07
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  2. 19 Comments

  3. by   traumaRUs
    I totally agree with you - wouldn't do this job! My biggest concern is the patient who can't/won't self-identify. I refuse to pass meds unless the pt has name band on. I'd say get those resumes back out and get some in the mail.
  4. by   amc7791
    First of all, while your preceptor may be a good nurse, not everyone is cut out to be a preceptor. Is it possible to get a different preceptor? Perhaps you should talk to your director and let him/her know that you are not feeling comfortable and what your concerns are. Giving the meds to the wrong patient is serious and what is important is what you do to help prevent it from happening again. And while I am not saying med errors aren't serious, the majority of nurses have made some sort of error with medications at some point in their career. My first med error was milk of magnesia given on the wrong day . This isn't your fault, but I question the safety of medication administration in your facility if there aren't easy ways to identify the correct patient. It sounds like you work in long term care. Since the patients are there for a long time faculty that has been there for a long time know the patients well, but you do not. In my hospital we are required to verify patient name and birthdate on our medication record, the patient ID band, and with the patient. If your patient is coherent you could verify their identity with them. What you did well in this situation is reporting that you gave the wrong meds to the wrong patient. Moral of the story is to talk with your director. Good luck and hang in there!
  5. by   suzanne in hawaii
    How can meds be given if the patient has no armband? Especially if you do not know the person to know if he or she would answer yes to the wrong name due to hearing loss, confusion, not wanting to embarass the nurse for calling them the wrong name etc. Keep your chin up, but if this is not the best facility for you, consider working somewhere else. And dont compromise your standards.
  6. by   DolphinRN84
    I definitely understand how you feel. I made my first error like a month ago...I gave the meds that I wanted to give to my patient to another patient! I totally freaked out and felt horrible when I had to write my first incident report.....I felt just like you. But the environment you work in doesn't sound very safe. I agree with trauma...I think I would look for another job that doesn't give such a short time for orientation and patients not wearing some form of patient ID? I hope you feel better...you are definitely not alone. :icon_hug:
  7. by   DarciaMoonz
    I have been back on career and am going to call the facility that is like 2 minutes away from where I am currently staying. I was able to get a different preceptor, BUTTTTT there are still many people who don't have on name bands. The regular nurse knows who the person is, and since it is a week day, the majority of them have family members in with them. I am extra cautious now after the error. Today I had the pharmacy rep. or whatever he was watch me, and I can't tell you how nervous I was. Took me forever to pour/pop/crush 5 pills. There are some changes that need to be done on the kardex because he noticed what I noticed my first day of passing meds. The times aren't always where they should be when a change is made i.e. crossing out or writing over 9a, which makes it barely legible. I know I must have gotten on my preceptors nerves, but if I can't read it, then I am NOT doing it. Same thing happened when she wanted me to d/c a med. I could not read the doctors hand writing, so I waited until she came back before I did anything. There are shifts where there is NO documentation on patients for days. Basically, there is no consistancy in anything. It seems to be just on one unit. You would think that since they were just cited by the state about these very issues, they would have gotten their arse in gear to correct this issues. As for me, until I find something else, I am covering my bottom big time. Not only do I document in the chart and other appropriate areas, but I have a not book that I keep, a type of "work diary". I decided it was in my best interest to do so.
  8. by   gradRN2007
    i would be outta there..............from a lab perspective no id no blood draw period!! you need 2 identifiers at all times and if there is no bracelet why don't you get one and id the patient with the head rn..but i would be outta there in a flash! its your liscense that is on the line:uhoh21:
  9. by   saadia_s
    i suggest u quit that job and go better place. work in hospital where u have four and five pts. and do night shift.
  10. by   NJNursing
    I agree, 1:32 is a heck of a lot for a new grad who just passed their boards. I recommend getting a year of med-surg under your belt first at a hospital to really fine-tune your skills and then go to LTC if you really like it. Don't settle for the first job or the most money. Your license is just too precious for something like this. Keep your chin up!
  11. by   kstec
    Almost all LTC facilites around where I work do not put armbands or any type of identification on the residents. When I asked why I was told that these are their homes and should not have to wear them. I of course said as a new nurse to the facility how do you know who the person is. Well they have pictures on the MAR's and let me tell you, they almost all look alike, little gray haired people with glasses. I think it should be mandatory to have identification for their own protection. But it kind of goes along with not restraining residents, because they have the right to fall and not be restrained. Some rules are just plain stupid and dangerous and I think ultimately set facilities up for fines, don't you think?
  12. by   Spidey's mom
    This is an unsafe facility and you need to stand up for yourself and quit. And list the reasons why.

    Don't let anyone take advantage of your inexperience. You are the patient advocate.

    steph
  13. by   willdgate
    I think that it may be hard, but try not to listen to some nurses short cuts, b/c when the day ends it is your license you have to try to protect:angryfire .
    Many nurses give false hope to new grads, when things are different b/c they may have been doing the job for 20+ years, when you have been there for 3 days, that stuff makes me soooo mad:angryfire , because those nurses don't know your strengths and weaknessess.
  14. by   fmwf
    Quote from willdgate
    Many nurses give false hope to new grads, when things are different b/c they may have been doing the job for 20+ years, when you have been there for 3 days, that stuff makes me soooo mad:angryfire , because those nurses don't know your strengths and weaknessess.
    willdgate...your words are ringing true..but what do you mean when you say... (I want to hear what you have to say)

    false hope=?

    things are different b/c...20years=?

    b/c don't know your s&w=?

    Are you referring to the lack of synergy and cooperation between the precepting unit and appreciation for what the new grad's brings: didactic education and lack of practical experience?

    I felt like nursing school is a waste of time once I got on the floor.
    Assessment is the first step in the nursing process and adult education...planning is the second. New grads deserve some professional treatment!
    Last edit by fmwf on May 7, '07 : Reason: meaning

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