Re: First Medication Error.....feeling horrible!!
I'm re-reading this and trying to figure out what was wrong here- was it the dose? Was it to be adjusted if below a certain number?
Please, go easy on yourself. We all remember a med error or two in our careers. My big one was Decadron- always ordered at 6-2-10. Only this patient started his at 6 PM, not 6 AM, so it was due at 2 AM. I did not give it until 6 AM. I was on nights and got the 6-2-10 thing mixed up! Not a huge deal physically, they changed the schedule of his meds and went forward, but I was a new nurse and I was devastated! This was in the day where you had 1/2 hr before and 1/2 hr after to give the med, now it is usually an hour. So a 4 hour error was a BIG error.
Another time on nights I mixed all my IV's- we mixed our own then, and I had about 36 to hang that night. I passed the meds and made rounds a little later and I looked at the patient's IV label and it did not match his name on the wall! I stood there trembling for a second, terrified- thinking "what have I done? my God, what have I done?". Then I shut off the bag, checked the MAR, and Thank GOD, he was ordered the exact same med. Back then everyone was on Kelfex so I had mixed up the two Keflex patients. I learned why they tell you to check and check again, even when patients are talking to you as you make rounds. Never let anything distract you from that check. It was a real wake up call for me and I was much more careful to match the label with the armband every time.
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