Medication Errors? How many are allowed?

  1. 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.
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  2. 22 Comments

  3. by   Aneroo
    I believe ours is like that too. We were told we would never make an error in nursing school, because our instructor would be there to witness our meds every single time. Most check our meds, make sure it's right dose, time, pt, etc. If we have heparin or insulin to give, they check it after we draw it up to make sure we drew up right amount. They came with us for IV meds. We haven't started doing IV push yet.
    As far as you case goes, I'm glad you filed a grievance, although I doubt it would go anywhere. Be glad you're not out totally, just set behind a year, although I am sure it's very hard to not graduate with your original folks. Keep us posted as to what happens. -Andrea
  4. by   BamaGirlRN
    Instructors could give 'Critical Zeros's' in our clinicals for what they thought deserved one. If you get two, then you fail. None of my instructors would have even given a critical zero for what you described happened.

    I'd check with the dean of your program, that doesn't sound right especially since other people you know made med errors and still graduated.
  5. by   caroladybelle
    If you were a patient under a student's care, how many mistakes would you think were acceptable?
  6. by   Aneroo
    Quote from TKD momma
    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)
    What med was it? The absorption rate could depend on if there is food in the stomach or not, and he could have absorbed this med way too quick b/c he didn't have food. Look at the insulin and food relationship...If I had given my pt insulin, but he didn't eat, I could have easily killed the pt. Again, keep us updated. -Andrea
  7. by   TKD momma
    Quote from Aneroo
    What med was it? The absorption rate could depend on if there is food in the stomach or not, and he could have absorbed this med way too quick b/c he didn't have food. Look at the insulin and food relationship...If I had given my pt insulin, but he didn't eat, I could have easily killed the pt. Again, keep us updated. -Andrea
    The medication was tamsulosin for indications of BPH.
  8. by   MandyInMS
    Many moons ago in nursing school they called errors of any kind "Clinical U's" (U=unsatisfactory)..you were allowed 2 clinical U's..the 3rd you're out.What was so unfair is each instructor had diff rules..grrrr..I almost got a U for not charting a bp on the mar beside a bp med(i had checked the bp prior, just didn't put it on the mar)...a diff instructor a few days prior had told me NOT to put it on the mar..frustrating :/
  9. by   justjenny
    Quote from TKD momma
    Is this fair? Is this what it is really like in other programs?
    Just wondering. Thanks for listening.

    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 actually do not know my schools policy on the subject, but in clinicals our instructor was 100% responsible for the meds and stood RIGHT next to us while they were counted and passed.

    I had a VERY scary experience (IMO) just a couple of weeks ago....
    My instructor and my clinical partner were preparing meds for a pt. and I went to get some supplies....they counted and prepared the pills without me there.
    I went back after we all passed the meds together and charted the med pass...and noticed that one med was supposed to be cut in half - and was not. It was Risperdol (sp?)
    I informed my instructor asap and she didn't even come down to my end of the hallway for at least another hour. I repeated the error to her, and my concern about the overdose. She stated she was more concerned about the pt. other problems....
    I was really confused and concerned, but she told me later that she would "check into it" and if an error was made she would fill out an internal report. I refused to sign for that med pass......and thought about doing more than that. All in all, the pt. was fine (a little more sedated than normal)
    But it was certainly an eye opener for me!!! :uhoh21:

    Jenny
  10. by   JimmyMallo
    tamsulosin is given with meals because food increases it's absorption by about 30%. Basically you could have slightly lowered his urine output for 24 hours on the typical qd dosing schedule. This is not the type of error that deserves the boot, at least not in my humble opinion. I understand the reason for discipline but one and out for the year on a first offense with a begnign mistake is harsh:angryfire even for a nursing instructor. Experienced RN's make mistakes from time to time, I have seen it, and it is one main reason Narcan is in floor stock at my hospital. One mistake should be allowed anyone unless it was a life threatening error like heprin etc.

    Those who can't do teach ....
    jk
  11. by   TKD momma
    This is not the type of error that deserves the boot, at least not in my humble opinion. I understand the reason for discipline but one and out for the year on a first offense with a begnign mistake is harsh:angryfire even for a nursing instructor. Experienced RN's make mistakes from time to time, I have seen it, and it is one main reason Narcan is in floor stock at my hospital. One mistake should be allowed anyone unless it was a life threatening error like heprin etc.

    Thank you, that is my opinion also! Everyone makes mistakes, it just makes us human! Hopefully I will win my battle! I keep you posted.
    JC
  12. by   1styear
    A nurse wouldn't be fired, it's odd that a student would be held to a higher standard especially in a so called learning environment with an instructor present
  13. by   RNinRubySlippers
    This infuriates me. What on earth makes anyone believe people don't make mistakes? I have one incident report(as they call it at my school, and you can get one for not signing off on the MAR, not charting pertinent info...) at the end of my 2nd year. It was for not checking a lab value before giving a med. It was not critical because the med could not cause hypoglycemia and the pt was on it long term. BUT my instructor wanted to teach the importance of ensuring to look at labs ( and I have religiously) and I reflected on the situation. I welcomed this as I feel it has taught me to be very diligent about my meds. HOWEVER, no nurse, regardless on how long they have been practicing, is free of error. If they claim to be, I believe them to be "bending the truth". I am sorry this has happened to you. You will take with it a learning experience, but, I feel for your loss of the year you put hard work into.

    Good luck next year and in the future.
  14. by   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...

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