Medication Errors? How many are allowed?

[TKD momma]

How many medication errors are allowed in nursing school? Does anyone know? Is it consistent with each program? That is the question of the day. I was in my last semester, the week before graduation when I made a medication error. It was not life threatening, I gave it, but not 1/2 hour after the patient had eaten which is when the med was supposed to be given. (he didn't eat) It was my first and only med error in my entire two year program. I didn't have any other problems in school, no unusual occurances, no tardies, no absences, nothing. The instructor failed me from clinicals. :angryfire In my program if you fail clinical then you fail theory and have to retake it all! So I was not allowed to graduate with my class! I have filed a grievance with the school and am still waiting for a response. I just think it is unfair to fail someone for one mistake(especially from the whole program)!

The program prior to mine a previous student had 2 med errors, one in the second semester and one right before graduation like mine, and she passed and graduated. Is this fair? Is this what it is really like in other programs?

Just wondering. Thanks for listening.

[shape0fmyheart]

I had a medication error in my med-surg clinical this past semester and I didn't fail... In fact, my instructor had nothing but positive comments and gave me a better evaluation then I gave myself. I think she felt just as responsible as me and could tell I was having a bad night and was very upset and worried. She was the nurse manager of the floor as well so she went right into action and told me the doctor said it was "nothing to worry about".

Everyone makes mistakes, I really don't think you should be failed for it especially since it IS a learning experience. But maybe I'm biased just because I'm thankful I didn't fail, I don't know...

[CarVsTree]

As a patient, I think it is completely fair - you could kill someone with a med error!!

As a student - I don't want to give an opinion....because I know how difficult and unfair clinicals can be.

My own personal concience, however, would EXPECT that I fail a clinical for a med error!

I think we are being quite harsh on OP. Yes med errors can kill patients, however they ususally don't. Especially if they are caught right away. Where was the clinical instructor when she was giving the med? Did OP realize the mistake after she gave the med?

Nurses make med errors in real life. We all will. We all definitely will at some point. So to can a student for making a human error makes no sense to me.

OP, does your school have a student handbook (for nursing students). This should spell out the rules and regulations and consequenses. I hope you get somewhere with your school and are able to graduate. Let us know what happens.

If you have to repeat the course, don't give up!

Good luck.

[Rapheal]

I think remediation is in order. But not to fail and take the whole course again. Since you were accountable for the error- you do not appear to be unsafe on the clinical floor. You are a student, you should be accountable (as you were) but not to a higher degree than a nurse.

I do not understand the expectation of perfection in nursing or in nursing school. IMHO it is this expectation of perfection and the consequences of commiting an error that lead people to not expose their mistakes.

Yes we are dealing with people's lives and need to be very careful. But we are fooling ourselves if we think we have never made and error and try to crush those who admit to theirs. Only be acknowledging our mistakes will we learn how to prevent them in the future. Any climate that dishes out severe penalties for mistakes just creates an environment where people will try to cover them up. IMHO this is something that is wrong in nursing and in healthcare in general.

[HisTreasure, BSN, RN]

I think remediation is in order. But not to fail and take the whole course again. Since you were accountable for the error- you do not appear to be unsafe on the clinical floor. You are a student, you should be accountable (as you were) but not to a higher degree than a nurse.

I do not understand the expectation of perfection in nursing or in nursing school. IMHO it is this expectation of perfection and the consequences of commiting an error that lead people to not expose their mistakes.

Yes we are dealing with people's lives and need to be very careful. But we are fooling ourselves if we think we have never made and error and try to crush those who admit to theirs. Only be acknowledging our mistakes will we learn how to prevent them in the future. Any climate that dishes out severe penalties for mistakes just creates an environment where people will try to cover them up. IMHO this is something that is wrong in nursing and in healthcare in general.

AMEN!

My sister just graduated. She told me of an instance where a young lady (a pretty good student, I was told) was in clinical and made a medication error. Her partner knew, and wanted to report it, and the young lady left the floor and went home crying. Of course, the incident was reported, but the lady was already gone and failed due to leaving... just because she was so afraid of the reprecussions of her actions and the response from her instructor. If her partner had not been there, she could have easily not said anything and exerbated the problem. My sister said her instructor took over an hour (that's a LONG time in nursing classes :rotfl: ) to lecture the class on the importance of being careful and responsible... and reporting their mistakes immediately.

[Tony35NYC]

TDK,

Actually, you're not allowed any mistakes. From what I'm reading in the nursing journals, medication errors are increasing rather than decreasing, despite all the additional training and awareness programs.

Sorry you have to take the course over, but don't feel too bad about it. They're just as tough at my school. They just want to make sure we're safe practitioners before they let us go.

[Loribabble]

Wow - I do think that is a bit harsh. I made a doozy of a med error my 3rd semester of school. To make a long story short - everything turned out ok with the pt. While I had to write papers, watch videos, have conferences etc -the school was extremely supportive to me becuase 1. I reported it as soon as I found out and 2. I took FULL responsibility and followed through with the pt. I was scared to death and it took me a long time to get over it - But I also learned a very valuable lesson.

While I think we need to do our best to avoid them - we are human and things happen. Instead of dropping students for "minor" issues - why don't they take a look at staffing and acuities - if we nurses weren't always running like chickens with our heads cut off - we just might have more time to really do some thinking and processing decreasing the risk of errors!

[SKM-NURSIEPOOH, BSN, RN]

i'm so sorry what happened to you - but you're not allowed to make any med-errors while in clinical. the time to make any sort of errors (if allowed) should've been during your school's lab area. unfortunately, schools aren't willing to take the risk/liability anymore. this country is regulation & sue happy!

i'm curious though....what are the policies regarding medication errors in your school as well as the hospital's? what's your sbon's policy/guideline in this manner?

the policies/guidelines should've been covered with all students before stepping a single foot onto the hospital unit. if the policies were all reviewed & you knew, agreed, & or signed to them prior to starting clinical (as many schools will have students sign a contract)....then i believe you'll have to abide by their rules. however...if it's a manner where the instructor was negligent in anyway in their supervision of your med pass....i believe that should also be taken into consideration when it comes to returning next year. my former lpn school wouldn't even take anyone back if they were deemed unsafe...even if a mistake was performed in the lab on dummies! my former bsn school would allow re-admittance to their program...depending on the error made & with certain criteria that may involve remediation.

again...i'm sorry to hear about what happened to you. a word of advice from the late & beautiful aaliyah..."if you don't succeed... dust yourself off & try again." no words are more truer or more comforting in times like this. trust me...i've been there...done that...several times over & in many ways!

cheers!

moe

[Chaya, ASN, RN]

I wouldn't call that an error as such. If the patient didn't eat at all would it then follow he shouldn't get the med, period? All you could have done would be to alert the MD and get a formal order either to give it or to hold the dose- and then DOCUMENT-bigtime! (As for giving insulin in similar circumstances- we do alert the Md; a common action they order for a scheduled insulin dose is give half the insulin dose and check/ recheck blood sugar in an hour or two).

[Chaya, ASN, RN]

I think remediation is in order. But not to fail and take the whole course again. Since you were accountable for the error- you do not appear to be unsafe on the clinical floor. You are a student, you should be accountable (as you were) but not to a higher degree than a nurse.

I do not understand the expectation of perfection in nursing or in nursing school. IMHO it is this expectation of perfection and the consequences of commiting an error that lead people to not expose their mistakes.

Yes we are dealing with people's lives and need to be very careful. But we are fooling ourselves if we think we have never made and error and try to crush those who admit to theirs. Only be acknowledging our mistakes will we learn how to prevent them in the future. Any climate that dishes out severe penalties for mistakes just creates an environment where people will try to cover them up. IMHO this is something that is wrong in nursing and in healthcare in general.

ITA. I have worked in environments where an error is dealt with by dismissing the person who made it before the end of the shift. I firmly believe that we should be looking to improve the process of med administration so that there are fewer opportunities to make errors. Ideally, we should learn from them, correct them, and prevent similar errors from occurring. I find I never make a mistake twice-even one someone else has made! So does that make me more or less safe as a practitioner?

[RedSox33RN]

I'm curious after reading this thread:

For all that have made some kind of med error, can you tell how it was made? I'm just wondering if it is stuff like the pharmacy sending the wrong med, illegible writing, unclear instructions, not double-checking, etc. I'm not asking this to embarrass anyone - really - I'm just interested in how they come about sometimes. I know we are all God's creatures and are imperfect.

I was the recipient of an "almost" med-error once, for the sole reason that the nurse would NOT listen to me and check with the physician. I know how much insulin I need, but she insisted I needed more, not taking no for an answer. So I refused the insulin, telling her I would call my doc myself. She got huffy, thinking she knew more than I did, and never said a word when she came back in 30 min later with a new syringe after confirming that I was right. I don't care now, but I hope she learned something by it (and I'm not saying that in a snotty way, I know I'll make mistakes along the way also.).

Only because I ALWAYS ask the med and dosage I'm getting was this caught. I know not all pts. have the knowledge and ability to do that though, but it's my right to know what is going into me.

[Chaya, ASN, RN]

Whitney:

Some of the med errors I know have happened at our facility:

-similar sounding med, as temazapam/oxazapam

-similar appearance of med; ie; tablet of same color or vial with same-colored label

-wrong dose with two separate dose tablets in med drawer (we don't used the computerized cart although we have started to use bar-coded unit doses)

-wrong dose because either tab not cut in half OR single tab given but 2 or 3 needed for dose