Survey: Do you believe the nursing shortage is contributing to medication errors? - page 3
Here are the results of last months survey question Have you ever consulted with your facility's ethics committee about a patient? : Please feel free to read and post any comments that you... Read More
Feb 5, '03Sure working short has an influence on how well we can concentrate on what we are doing, remember what we have been taught, and preform our job correctly. Just because there is a shortage of nurses doesn't mean there is less for us to do, usually more. I can see Matt'smom"s point too I also have seen and heard supervisors send people home when we could use them at work in fact I have been told that if we keep the extra people they will just goof off. I also think there is cooperate greed involved, the cost of 1/2 of a room at our geriatric facility is 3,000 a mon and that doesn't count in laundry, meds, treatment supplies the furniture, beds, dressers are not even that good. I can't say the shortage is our only problem but it doesn't help. Where I work if there is not an availabe RN they have the LPN's supervise whether they feel comfortable with it or not and it is within their scope of practice as long as their is a RN they can call. deb
Feb 6, '03I voted yes. Some days it is total chaos at the med cart, the chaos coming from too much to do and not enough time. And I don't care if we are "appropriately staffed". If we are running around, barely keeping up with everything, we are NOT "appropriately staffed". There is a very good article on medication errors in the January issue of "RN" magazine. According to studies, 39%-49% of errors occur during MD ordering, 26%-38% during nurse's administration, 11%-12% during transcription, and 11%-14% during pharmacy dispensing. In my general area of the country, there is a frame of mind that it is the nurse's responsibility to make sure that everyone alse is doing their jobs right. We are the "last line of defense" against an error occurring. I have even heard it said by a hospital educator as part of "advocating for our patient's safety". We have to figure out the MD's scrawl for the unit clerk, and then the pharmacy will call us to decipher the same order, all the while there are visitors standing at the desk asking questions, the phone rings and has to be answered, and one of your patients is calling out for help. Like we can really concentrate on everything at once. OK, so I understand that we are most likely to catch a med error before it happens. What I DON'T understand is... if we are given this responsibility, why aren't we allowed to enforce the solutions? IE: remedial handwriting classes for MDs, implementation of computer order entry system(which has been proven to reduce errors), more staff available. That is what is MOST frustrating about being a nurse these days, not being able to "fix" the problems. At the end of the article there is a web site www.rnweb.com They ask the question, "Does your facility still view med errors as a 'nurse's problem'?" You may want to make a copy of the article for the communication book on your unit.
Feb 13, '03Being responsible for proper medication administration at the final "check point" of PT care is attainable. Not giving a med is as harmful as giving a wrong med. You would have to have the ability to think accurately in the future. If a med is not available it has to be ordered, timely. Find out exactly what to do if a medication is missed. Set it all up in your mind ahead of time, and try to realize before a pt safety is at risk.
Feb 15, '03I would also add that those darn med labels just keep getting smaller......Or is my eye sight really going? I am the "aging nurse population" ....maybe I'm not as sharp as I used to be....At this point it does not matter if I die in duty-they'll duct tape me (if they have any left after they cover the windows and vents with the plastic mattress covers) to the med cart and set me to rolling...on my unit the residents won't know the difference.....
Feb 17, '03originally posted by altomga
too many inexperienced staff that you have to follow-up on
yes, i realize that the new nurse, namely me, fresh out of college does not have the experience that is oh so valuable in this business. However, all of us had to start somewhere and at some time and I don't believe that all new staff,nursing or otherwise, are so bad that they make more work for the others.
Sorry, didn't mean to get off the subject, but it's a bit of a sore subject with me, probably only because I fit the description.
Anyways, I agree with the majority here that the staffing shortage is a large factor in med errors as well as any other errors that occur.
Feb 17, '03God yes!
Shortages of qualified R.N.'s and the subsquent employment of EN's ( in Australia not trained for medication and i.v. adminstration) means more pressure on R.N's to do more work!
Feb 17, '03I think it will definately helps cause errors.There is only so much one person can handle at at time!!!
Feb 17, '03Most of the mistakes I've seen made have happened because people get in a rush OR because they're not paying attention.
Our risk management dept. studied this a few years ago and found the staffing numbers made no difference, which surprised most of us because we were just SURE it was inadequate staffing. What I think happened was that the numbers didn't accurately reflect what was occurring; how many times have we started out with adequate staff, but then get slammed in the middle of the shift w/admissions, surgeries coming back, dismissals, the phone, the families, the dr.'s, more admissions, and then somebody down the hall has a crisis or codes? (Sound familiar?) And as several people have pointed out already here, no matter how many willing nurses you have, administration is not willing to pay for them. The almighty buck rules everything.
Feb 17, '03BTW, thank goodness for those "inexperienced staff"! You know the saying "see one, do one, teach one"--if we handle the teaching right, more of these individuals would be inclined to "hang in there" with us instead of bailing out. Attitude makes all the difference--we need to be realistic, but not overly pessimistic.
Feb 17, '03Of course! We are in such a hurry to get to all our patients/residents in our allotted time that we unfortunately rush through things and yeah that leaves us to make mistakes...now if we could only get this across to our facilities administrators and to the Government...but alas I'm dreaming there.
Feb 18, '03At the hospital I am employed at we have no Nursing shortage however we do have a great amount of medication errors. For us the answer lies in the acuity of the patients we care for. 10 years ago these people we in the ICU now it off to surgery and then off to PACU then off to either the medical or surgical floor.
Feb 18, '03I said "no".
Even if you're understaffed and have too much to do anyway...
It's like a doctor saying, "I had too many surgeries to do. I was too overworked to pay attention to handwashing before I did that appendectomy."
I am flexipool now, and no longer work 40/wk, but I heard a horror story from a colleague in Atlanta...
Her hospital has instituted some kind of auto-mat medication dispensing system that will dispense only the medications previously ordered AND at exact intervals... supposedly to prevent time-related errors. WELL... Her patient spiked a temp of 103.something and she called the MD to get orders. He ordered Tylenol, among other things... However, the order had to be sent to the pharmacy, checked by the pharmacist, entered into the auto-med system, cleared (whatever that means) and transferred from the pharmacy computer to the floor computer. This process normally takes about an hour. In the meantime, someone had tylenol in her purse for the patient, since it could not come from the system... but the whole process threw my friend 20 minutes behind giving her 9pm meds... Guess what!! TOO LATE! Can't get the meds out of the system now! Med errors on all 6 of her other patients, mostly because it takes ANOTHER 45 minutes to get the pharmacist to override the time thing...
NOT a question of nursing shortage, but an automated system that does not take into consideration nursing care or needs of an individual person!
In my heart, I believe that careful nurses are careful nurses... busy or not. .. IF the "system" cooperates!
Feb 19, '03it is not only the nursing shortage but the pharmacy as well. they are short staffed and rushed as well. i have received the wrong med for patients or the wrong dose for a patient. what scares me is the premixed iv meds. i have to believe what is written on the label. it is an accident waiting to happen.
one md asked me why anyone would go into nursing. his quote--
poor pay, poor hours, working weekends and holidys, being harassed by patients and their families, bullied by physicians.
i couldn't give him a good answer except i love doing what i do. he happened to be one of the good guys.
something has got to be done to entice good, intelligent people to enter this profession soon! remember most nurses are in their 40's who is going to take care of us?