I'm in need of some advice...i'm a newbie nurse, 3 months young, and I've already made two med errors! all in the same night! I feel terrible and terribly depressed. i got written up for both.i spoke w my supervisor about it and she's told me the write ups were for "education purposes" and that i shouldn't think about it too much...BUT that three "pink slips" (as they're called) would warrant a write up! write up to where i dont know. i'm scare stupid now, for my license and not to mention my job. i love my job in the er even with all the vultures around me...
fyi the med errors were: giving toradol 60 mg iv rather than im, no harm done to patient, even got discharged w no pain and md notified, he said no harm and even took the blame since his order spelled out iv instead of im. and giving rocephin 2gm ivp, i got confused since the pt was in an emergency setting and all and it slipped my mind (not an excuse, i know), again no harm done to pt or adverse effect noted.
please advise me, idk what to do, my record's been tainted already and ive hardly even started, im so afraid to go to work now, im actually dreading going to work tomorrow because of all of this.
Rocephin can be given as a bolus over five minutes. But that's not the point. What route did the doctor order?
Any time you give a medication that you've never given before, or even if you've given it but not very many times, or maybe it's been a while, you should look it up in your drug guide. Had you done so, you would have noticed that a standard IV dose of Toradol is 15-30mg, and maybe that would have prompted you to question the doctor's order of 60mg IV. With the Rocephin, had you looked it up in your drug guide, you would have seen different rates of administration for different concentrations (IV bolus of reconstituted med vs. IV infusion of diluted reconstituted med), and you would have noticed recommendations for IM administration as well. This might have prompted you to recheck the order to make sure you were using the right route.
It doesn't matter that the doctor wrote "IV". You are the one giving the med, so the buck stops with you. As an RN, you are expected to notice orders that don't seem right for one reason or another, and to clarify such orders with the physician. This is why they teach us the "Five Rights" in nursing school.
I'm not saying this to make you feel badly. I can tell you already feel badly as it is, and I'm not here to rub it in. I just cannot emphasize strongly enough how important it is to do your Five Rights and use your drug guide religiously, and if ever in doubt, have another RN double check with you prior to administration. It will slow you down, but it will also decrease the chances of continuing to make such mistakes.
What will you do when the doctor orders Ketamine for a pediatric conscious sedation? Rocuronium and succinylcholine followed by a Propofol gtt for an intubation? I hope your answer is that you will look it up in your drug guide and ask for help from a more experienced RN!
Welcome to the wonderful world of Emergency Nursing!
Last edit by Anna Flaxis on Oct 9, '11