I think I made A Med Error

[RaziRN]

I had a patient the other night who had IV depakote ordered for 24 hours. I checked the pyxis and the patients medication bin and there was no IV depakote to be found. I even checked the main pyxis which has most of the meds. Nothing. So I called the house supervisor and she brought me two vials up from the ER. I can't remember if the dosage was supposed to be in micrograms or milligrams. Either way it was 1000 mg or mcg. Well, I gave it IV push. I didn't realize until report that this may not have been the right thing to to do. The nurse I was reporting off to questioned me. So I came home and looked up Depakote. Apparently if it's given IV it's supposed to be mixed in D5W and infused over an hour with no more than 20 mg/minute. So, I messed up big time. I just assumed that because it was in vials that it was to be given IV push. I just sent a text to the nurse I reported off to asking if the pt. was ok. This nurse was one of my preceptors so I trust her. Anyway, I'm not sure what I should do. I'm assuming I should go ahead and file an incident report. Have any of you heard of giving Depakote IV push? Any words of wisdom for this overwhelmed new grad? I feel like the worse nurse ever!!!

[RaziRN]

Ms. RN, the order read: Depakote 1000 mg IV q12h x 24h. Pharmacy usually does write out the rest on the MAR. Such as: infuse over 1 hour at 50ml/hr or what have you. However, this order was hand written on the MAR by the secretary as is common practice in our hospital. I don't know if it's like this elsewhere. It was written exactly as the physician had written it.

As for other posters, it was the charge nurse who suggested I call the house supervisor. In fact, she was the one who called and then handed me the med when it came up. I'm not at all saying it was her fault or passing the blame. I'm just stating this for clarification. Calling the house supervisor for a med that needs to be given but isn't on the floor is also common practice at my hospital. I've had IV vancomycin brought to me from ICU. I mixed that with D5W and infused it over one hour. It was a case of not being familiar with a med and feeling rushed to provide patient care before my new admission (which was my 7th patient) got to the floor. We do our own admissions. I know I made a mistake. I took the necessary actions to own up to it and I've learned something. I really see no further reason to criticize me. I'm sure every one of you has made a mistake at some point or another. I'm only five months in, I have a LONG ways to go in terms of learning. I appreciate the replies that I've received that have been constructive. I'm actively seeking employment elsewhere, as I don't perceive the facility I'm working at to be safe. You just can't provide quality care with 7 patients, especially as a new grad.

[GooeyRN, ADN, BSN, CNA, LPN, RN]

Don't beat yourself up. You made a mistake. I haven't met a nurse who hasn't made one. Thankfully, the pt wasn't harmed. You learned. You won't do that again. We also call someone to get us the med if it is not available. We do our best to give meds that are scheduled for a certain time. If we can't get the med, we have to call the doc and request something that we CAN get. So I don't look down on you for calling around to see if you could get the med to give as scheduled. You did the right thing by reporting your error to the charge/sup. You know better now to look something up quick if you aren't familiar. 7pts is a lot when you are a new grad (one being an admit), I understand how it happened.