Informing pts/families of med errors; consequences?

[WI,RN]

Greetings to all fellow nurses! My first time here so please bear with me. Looking for some input re: a life altering situation for me.

I had a granddaughter born @ 24 weeks d/t my daughter having eclampsia. She weighed in @ 12 ozs. She seemed to be doing fairly well, all things considered; even gained up over 1#. We lost her @ 12 days old. Two months later, my daughter & I were notified to come to the hospital for the baby's "preliminary" autopsy report. At that time, the dr. informed us of a medication error; Vitamin A was administered IV instead of IM. He tried to reassure us that "there was no high levels of Vit.A found". First of all, we were shocked at just then being informed of the error. Secondly, referring to several resources, Vitamin A given IV "will cause anaphylactic shock and/or death." You can imagine how I feel, hoping for some sort of closure yet realizing what may have happened!

Multiple questions in my heart & mind. Shouldn't families/pts be informed of med errors & by whom, the RN or MD? Should some sort of consequence be expected, possible depending on the severity of the error? Yes, I am a nurse & have made errors, which I feel horrible about & continue to learn from, but never with that type of consequence. Is this type of error "expected" to happen in a NICU? Aren't the nurses more specialized there? Should we consider legal action? It won't bring our little one back but could promote some patient rights issues?

I will look forward to hearing from ya'll.

Help this Grandma/nurse to heal.

__________________________________________

Do not fear death but of unlived life.

[Jolie, BSN]

Since there was no father involvement, staying in the NICU was difficult 24/7 since my daughter was trying to recuperate postpartum/ post-eclampsia too. Sometimes, as a nurse, I feel I failed to 'save'/advocate enough for my granddaughter.

Please don't allow yourself to think that you somehow failed your granddaughter! Deep down in your heart, you know that is not the case. You must allow yourself to grieve without placing guilt where it does not belong.

The nurse made an error. Even his/her co-workers were not aware of it, or they would have prevented it from happening. How could any of your family members possibly have recognized it in advance?

I had lunch with a dear friend today who recently lost her mother. She and I are both experienced nurses, as was her mom. She is blaming herself for failing to recognize an obscure condition that took her mom's life suddenly. There is no possible way she could have recognized this condition, but she still blames and questions herself.

I pray that both you and my friend find peace.