as a new nurse, i want to avoid the most common (or stupid) mistakes...what are some mistakes that you have seen, that would be a good heads up for a brand new nurse?
make sure you check patients name bracelet before giving medicine and always check meds twice from mar before giving it. there are lots of threads about this topic. maybe you want to search the thread on this topic???
If you have any doubt about something, ask first. It may take more time to look up a med or disease process that you don't know about, but it is essential to developing real life skills in your practice. Sometimes, if you just need someone to be present and observe a procedure to make sure it is done correctly, it can be a great help. Also, use your orientation time wisely while there is an experienced person at your side. If you make a mistake, admit to it so that any potential damage can be lessened or avoided completely. That is all I can think of at this time, so good luck!!
ALWAYS make sure you get a COMPLETE order from the Dr. Remember pt name, drug, dosage, route, frequency. I lost my job over one of those items missing from an order. Don't let this happen to you, even though you might see the other nurses do it!! Also, I saw a co-worker get chewed out by the NM because when he was giving report on a previous shift, the CNA was in one of his pt's rooms cleaning the pt up and she hung the O2 cannula on the IV pole. He got blamed for the pt not having the O2 on even though he wasn't the one that done it. The next shift was kind enough (sarcasm) to write a variance on him.
I would bet medication errors are fairly common, based on my own (unfortunate) experience. I made one after two months, luckily no harm done, but I hadn't realized until then that similar drugs are put in the same Pyxis drawer in separate compartments. Now I won't forget though!!! Good luck!
I would say to follow your hospital or place of employment policies! They are there for a reason. They will include medication administration, blood administration and the works. Read over them while in orientation and don't forget about them!
Never do anything your uncomfortable with or unsure about without checking with your resources first!!,...ie med book,.another nurse, the doc, pharm etc. I agree with an earlier poster always check name braclet and allergies EVERY time you give meds. I always tell the pt what I'm doing,."Hi I'm RN-Cardiac, I have some medication for you,.let me take a peak at the bracelets on your arm,..ok Mr Jones,.your aren't allergic to anything right?,.ok here is med one for your BP and med two is for pain" I find that many people aren't familiar with the meds they take or perhaps we are giving something different than what they take at home,..but usually they will speak up and say "oh is my BP high,.I don't usually take meds for that." If there is ever any question at all I say "you know what let me triple check that order and make sure this is what Dr Smith really wants you to have right now",.another tip I learned the hard way over the years is that I NEVER take meds out of the original container until I'm at the bedside in front of the pt!
After asking "are you allergic to anything?" when giving the patient any new or PRN meds I then say what it is I'm giving them ("this is morphine, to help with the pain, and Maxolon, also known as metoclopramide, to stop the morphine making you nauseated") - I've had more than one patient who seconds earlier told me they had no allergies say "oh, I'm allergic to that."
Remember that the doctors are human. Therefore if the doctor writes an order that says one thing and your fellow nurses are saying "The doctor gave an order to do what?!... That just doesn't sound right ..." (especially if you have a gut feeling that something just does not sound correct) then go with your gut feeling and what your fellow nurses are saying (and of course call the doctor to double check his order).
DOCTORS ARE HUMAN BEINGS AND ARE NOT INFALLIBLE...
Ugh! I'm remembering "many moons ago" as a new nurse in Psychiatry, a tired doc, asked me to "divert" him some ativan, or whatever the sleep med. was at the time. Dummy me *did it* and got counselled. I think I was just too new and wanted to fit in. Lesson learned: don't be a dope or a stooge, hold your head up, and be the best you can be. That was +/- 20 years ago and now I'm an APRN heading towards a DNP. Its been a great profession for me, I never minded going to work!
One thing that I learned early on is always take one last peek at my pts before giving report. Make sure they look clean, tubes/lines are where they're supposed to be...and give the room a quick once-over, too. Clean up the counter by putting away any items left out. Every nurse likes to walk into a tidy room and see a clean patient at the beginning of a shift. Sometimes *stuff* happens right before/during report, but then at least you'll know that when you looked at your pt 10 minutes ago he/she was fine. Plus, it will sometimes jog your memory of any little thing you were meaning to do and kept forgetting because you were pulled in 100 different directions. I've avoided some mistakes by donig this....NG out, IV out...the next nurse might not be able to get to the patient for a while, but believe me, she'd rather wait for report (or help you before getting report) while you're fixing something than walk into a disaster.
Along this line....in ICU....check your pts immediately after X-Ray comes (or go in with them & help if you can)...many times IVs have been d/c'd by XRay.