Survey: Do you believe the nursing shortage is contributing to medication errors?

MQ Edna · Feb 18, 2003

At 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.

TiddlDwink · Feb 18, 2003

I 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!

IRISHBREAD · Feb 19, 2003

it 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?

lateblumer · Feb 19, 2003

I can't speak for everyone, but where I work, med errors aren't related to staff shortage. It is mainly due to transcription errors and failure to properly read the MAR's. Regular ole human error.

justanurse · Feb 21, 2003

psychonurse · Feb 24, 2003

I don't think that it has to do with a nursing shortage either...I just think that nurses are always working short, to many patients and not enough staff to take care of them properly. I also think that many of the errors are also made on the pharmacy. They are understaffed also cause the powers that be think that they can work short staffed just like nurses.

In the area that I work we are sometimes pushed by the management and by others to do our medication lines quickly so that the officers can do thier other duties and the med lines too. I think that as understaffed as we are we hurry through to many duties and mistakes are made because of that.

So I don't just blame it on the nursing shortage....I also blame it on the powers that be :D :roll

MikeLPN · Feb 25, 2003

My primary wing is where I have made all my med errors. It's busy all shift every shift (AKA "The Wing From H***). The interesting thing is that when I get floated to a different wing (when day clinical coord. wants some OT) I don't make mistakes. I know these wings are less busy than mine because I have been rotated to all of them until previous primary quit d/t busy-ness +/ day clinical coord and I as a new LPN grad with long legs, good grades and strong arms got assigned. It's been downhill from there. Mostly it's with uncommunicated changes but last night I showed up after just getting over the flu (almost called in sick- wish'd I would have) and gave NPH 2hr late (5u) - Accuchecks usual. And let's not forget the time I found a missed oxycontin on days, spoke with day nurse @ this (didn't do a write up) and then she wrote me up to cover the count. Oh, right - back to the subject - I believe the question is misstated but very accurate. I believe that med errors are caused by too much information being processed on too many levels with too much proactive and retroactive interference, in other words, "Just Give Me 5 Bloody Minutes To Think, D*** It!!!"

nursejudy15209 · Feb 28, 2003

Here's what I think. The "powers that be" are too busy keeping cost down. Did they forget that the nurse's role is to give the best patient care they are capable of?

There is a nursing shortage, but there is also a shortage (imposed or actual) of Certified Nursing Assistants. Without them doing the "hands on care" it makes a nurse's job that much harder. How can a nurse manage families, doctors, answer the telephone, give meds, and in the midst of all that be expected to be perfect.

There are errors, there are decubiti, (direct result of not enough time to provide basic nursing care), and there are falls. All this is factored in to the amount of paperwork each situation creates. We would have less paperwork if there were more staff available to care for our patients. Long term care is hit hard with having to do more with less. It's a shame!

Thanks for letting me share my thoughts. Is it any wonder that you will find once-upon-a-time nurses working in other occupations?

MoJoeRN,C · Mar 17, 2003

"When you're up to your butt in alligators, it's hard to remember your here to drain the swamp"

Old Cajun RN proverb

K O'Malley · Mar 18, 2003

Constantly being interrupted while preparing meds is mistakes waiting to happen. Anyone remember the days when the med nurse prepared meds in a quiet little room and was not to be disturbed or interrupted? That was a nursing principle. We have allowed the present system to ignore nursing principles to the peril of the pt. Pharmacy is way short staffed also. Many times meds are hours late getting to the unit. And no one has the courage to force doctors to transcribe their orders into the computer to eliminate chicken scratch that is easily misinterpreted. Instead everyone dances around the problem. Can't get the docs upset!

MikeLPN · Mar 20, 2003

:chuckle alligators :chuckle

I'm gonna remember that one.

Furball · Mar 21, 2003

There's a problem in nursing? Huh?