Have you ever made a med error? - page 8

i'm a senior rn student & i made my first med error last week. the nursing director said if i make another med error i'm out of the program. Has anyone done a med error as a student? i know i'm... Read More

  1. by   pagandeva2000
    Quote from Teachingnurrse
    Imagine this: You are working in long term care. Your patient load is 40 They all take from 5-15 meds apiece. You have one hour before and one hour after to pass from 200-600 pills before it officially becomes a med error. I personally can't imagine NOT making some sort of med error when your patient load is that heavy. 40 patients seems the norm here in the state of Colorado.

    The first thing to do when you KNOW you've made a med error, be accountable. But what happens when you've passed meds to 40 or so people, done treatments, answered the phone, charted, supervised CNA's, among many many other things and you've made a med error and you don't even realize it.

    Part of stopping med errors, especially in long term care is for nurses to refuse to accept assignments with such large patient loads. I've worked for a nusing agency for years.....large patient loads are the norm, not the exception. I don't accept more than 20 patients anymore.

    I've made a few med errors myself during the years, but I've owned up to all of them. Then after all was said and done, I wanted to quit nursing.

    Judy
    The only thing I am wondering, is if the nurse really has a chance to challenge such an assignment with positive results. If, for example, you are an agency nurse walking into the facility and the agency does not tell you that this is the nurseatient ratio, and you chose to leave, then, where does that leave your license? What if they report you to the state for job abandonment? Or, even if it is your normal job, and you refuse, it may be handled in the same way...or lead to suspension, insubordination and such. In the ideal world, we can refuse, but, I have seen disasterous results to those that actually did challenge this. Now, I would say that if we all decided to take that stand, the results may be better, but there are always the nurses that are afraid to for many reasons, and this would allow such things to continue.
  2. by   pagandeva2000
    Quote from askaham
    Narcotics and other high-risk meds (ie. anticoagulants, electrolytes, etc) should always be double-checked independently by another licensed nurse.
    Many nurses refuse to check with others at my hospital. Protocol states that insulin and narcartics should be double checked with another nurse, but there is no place on the MAR that provides a double signature, so, even if you did, the only signature they see is YOURS. I think that they should have a form filled out where it forces both nurses to actually have to double check and sign it, to be added to the chart for better accountability and compliance.
  3. by   pagandeva2000
    Quote from kukukajoo
    Just wanted to say that this thread helped me pass my med admin lab with flying colors! Thanks to all who shared their stories and let me learn from you, it is greatly appreciated!
    Great to hear that. SOmetimes, sharing mistakes prevent other ones from happening.
  4. by   potatomasher
    Quote from dijmart
    i'm a senior rn student & i made my first med error last week. the nursing director said if i make another med error i'm out of the program. Has anyone done a med error as a student?
    i know i'm going to be totally paranoid from now on giving meds, since i know if i mess up again i'm OUT!....ugh!
    yikes...

    medication error is the scary. i did not have a medication error during my student days...i was sort a paranoid. when i'm the medication nurse for the day, i'd arrive 30 minutes before duty starts to check all the orders in the patients' charts and kardex...kind of saves a lot of time and give you more time to recheck everything.

    be careful, always observe the 5 R's in med administration.

    jan
  5. by   askaham
    Quote from pagandeva2000
    Many nurses refuse to check with others at my hospital. Protocol states that insulin and narcartics should be double checked with another nurse, but there is no place on the MAR that provides a double signature, so, even if you did, the only signature they see is YOURS. I think that they should have a form filled out where it forces both nurses to actually have to double check and sign it, to be added to the chart for better accountability and compliance.
    As an instructor, I would see this refusal to double-check alot. Even if not overtly, it was obvious b/c they were not really carefully checking independently. I agree that the nurse cochecking should have the responsibility to chart. I always charted next to my students who administered meds so why can't a coworker chart next to you on the MAR? In this day and age when JCAHO is so hot on preventing med errors, I would think that nsg mgt at your hospital would want to have that kind of double-check system in place. The old saying of, "if it's not charted, it's not been done", is still true today.
  6. by   askaham
    Oh...and PS...a great wealth of wonderful information on this very topic can be found on the Institution of Safe Medication Practices website
    http://www.ismp.org/Newsletters/nursing/default.asp
  7. by   pipersjo
    Quote from Noahm

    Once I gave a med to someone who supposedly was allergic to this med. I got a verbal order for the med in the middle of the night. I didn't see any allergies listed on her chart. She did have a bracelet on but I didn't see it. No excuse. It was a classic stupid nurse error. She didn't have a reaction but I sure did!! I was sick. I caught it right away and told the nursing supervisor/doctor. They said no worries, just be more careful. I never made an error since and hope I never do.
    I know this post was a couple of weeks ago, but it fits with my situation today. I did the exact same thing! I told my instructor and the nurse caring for this patient and they both basically blew it off saying that the patient would be fine, but I am still sick to my stomach. This patient had no reaction either while we were there, but I feel awful. I cannot believe that I did it! I thought I was doing something so good and then I mess it up! Thanks for letting me vent.....
    Last edit by pipersjo on Nov 6, '06
  8. by   RN1263
    Quote from pipersjo
    I know this post was a couple of weeks ago, but it fits with my situation today. I did the exact same thing! I told my instructor and the nurse caring for this patient and they both basically blew it off saying that the patient would be fine, but I am still sick to my stomach. This patient had no reaction either while we were there, but I feel awful. I cannot believe that I did it! I thought I was doing something so good and then I mess it up! Thanks for letting me vent.....
    i'm the OP & like i've said in other posts the "sick feeling" DOES eventially get better and where off somewhat. my error was about 4-5 wks ago now. I finally stopped beating myself up about it & have just taken what i've learned from the situation and moved on. Really that's all you can do. i'm extremely careful now and go as slow as i need to....PERIOD!!! i'm also very glad that i started this post seeing now that it has given many people somewhere to learn and vent about this issue!!!
  9. by   Teachingnurrse
    I've been an agency nurse for years. Before I start work I always check on the census. One time I had 72 patients! This was nights, however, the med pass in the morning had to be started very early for it to be accomplished successfully. One time I found that the nurses were "borrowing" narcotics from a resident who wasn't using them for a resident who was in pain, but didn't have pain medicine. I refused to take the keys to the cart. Don't take the keys to the cart if you feel that your patient load is too high or that in any way your license will be in jeopardy. If you do not take the keys, no one can accuse you of patient of abandonment. You will probably be DNS'd (do not send) at that particular facility, but you'll have left with your license, career, and self esteem intact. In fact, at that facility where the nurses were taking the narcotics and giving them to someone else I was DNS'd.

    Judy
  10. by   allantiques4me
    I have made a med error,and I consider myself very careful and concsiencious with my med pass,Remember your three checks against the MARand your 5 rights each and every time.When I made the error,I called the child to the med cart and another child came up and was speaking with me,I accidentally gave him the pills!!!I was horrified called the DR.and was crying,I was so upset.Luckilyno harm was done I just had to assess him for excess fatigue.Now,as you say ive learned to call the childs name repeatedly as I give him the pills.It also keeps me totally focused,free from disruptions.I only concentrate on the task of med pass only.Also the staff make the kids be silent and orderly during the med pass times. Which helps immensly.Medication administration is a very important nursing task and it must be taken seriously.Remember what you learned in school and try to totally focus on the med pass only.theres plenty of time for other tasks.
  11. by   chocokitten
    I think med Errors are a risk we take, as nurses... Very few nurses make it through their career without ever having a med error. And, imo, I think many of those few probably HAVE made errors but just don't know it (how can you ever REALLY be sure that you have never ever ever made an error, if noone, including yourself, caught the error and there was no adverse affect? even with checks errors can still occur)
    I know I have made a med error once, that I know of, when I was working in an assisted living facility and passed meds as unlicensed/uncertified staff (this is allowed in Michigan). Just to clarify I was not at clinical or anything, this was my freshman year of nursing school and this was my job, not clinical.
    Was pretty scary, and I have since them become quite anal about the checks I do on meds ^_^

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