4 med errors in one shift... Feeling terrible - page 3

by NurseLoveJoy88 9,173 Views | 26 Comments

today the nursing supervisor wrote me up for 4 med errors i made in one shift. i feel incompetent, stupid, and sad at the same time. i don't believe the errors were life threatening but still nervous that it may cost me my job... Read More


  1. 2
    Quote from nurselovejoy88
    today the nursing supervisor wrote me up for 4 med errors i made in one shift. i feel incompetent, stupid, and sad at the same time. i don't believe the errors were life threatening but still nervous that it may cost me my job and possibly my lic. i'm distraught.

    here were my errors:
    1. i transcribed an order incorrectly
    2. i gave a prn med too early.
    3. i was accused of giving a pain med too early ( not sure this is founded as i remember having to explain to my patient that i could not give the med until the exact time it is due).
    4. same patient as # 3. the patient had a new order to decrease pain med dosage. i noted the order but then gave her the dose that was previously ordered.

    all four mistakes could have been avoided if i just would have taken my time and paid closer attention. now i'm faced with a write up and possibly loosing my job and even worse consequences. sometimes i feel like a great nurse who is competent and compassionate. then there are days like today where i question my ability to be a nurse. i pray that nothing went wrong with the patients and secondly that i still have my career.
    are you new? i am new been a nurse just under 4 months. i made a med error once gave two pain meds instead of one as md's order due to pressure (pt's screaming and yelling). i told my supervisor thought she would fix it while i was running around like a chicken with a head cut off. the second error was didn't call in x-ray lab during my shift and the third failed to do a complete assessment. i didn't turn the pt look under her bottom to ensure there is or isn't a skin breakdown. later they found she had a skin breakdown on her buttock. great! i didn't do it because pt was overly obese and was in so much pain to even lift her leg. i got written up by the don and got counsel. i didn't get fired but was told not to make these error again. what i have learned?

    i have learned to say "no" to pt who asks for pain med that is not due or more than prescribed. i normally do not give at the exact 4 prn. i turn every patient who i admit and check everyone of them from head to toe. i have learned to check all new written orders and take the ones that need immediate attention such as reduce or increase med dosage, stat lab and so on and so forth. for rehap written orders i leave them until i get to sit down and transcribe them.

    ultimately, what i really learned is that it is your license and your career. you cannot give in to patients who would otherwise cost everything you worked hard for. so, if you are not fired for these mistakes, learn from it and be careful next time. take your time making sure you cover everything. good luck! i know how it feels because i was there just two months ago.
    jtmarcy12 and Psychtrish39 like this.
  2. 3
    When I suggested you seek out the EAP, I wasn't suggesting that you consult them for career counseling, but rather that you should ask for help in identifying what has you so off balance and how to fix, or at least contain, whatever is troubling you. Like some of the others members, I recall earlier posts from you that sound as if you are experiencing anxiety/mental health issues and possibly ADD challenges, as well. Working in a stressful environment can aggravate and intensify any internal pressure you're already feeling.

    That isn't to say you should quit your job. Only that it looks like you're going to need help in managing your anxiety level, your thought processes, and the way you're functioning on the job.

    There's no shame in having problems. We all have our tender areas. But you do have a responsibility, both to your patients and to yourself, to make sure your practice is safe. If the job you are in is creating too much inner turmoil and pressure, it might be better to find something with a more realistic time frame and patient load.

    Then again, there may be ways to help you ramp up your ability to handle your current job.

    Either way, something is obviously amiss and it's making you unhappy and unsure of yourself. EAP counseling can help you identify what's causing this, whether it's mental health issues or ADD or a combination of the two. That kind of assessment is the beginning of getting help.

    You were fortunate that no one was hurt by the errors you made. Please, take care of yourself and start looking seriously at what you need to function well so that you don't ever have to feel guilty for causing real harm.

    I wish you the best.
    Last edit by rn/writer on Feb 23, '12
    mazy, Meriwhen, and VivaLasViejas like this.
  3. 9
    NurseLoveJoy:

    I'm going to be as gently honest with you here as I can be without sugarcoating the message.

    I can't overemphasize the need for you to pay attention to what's going on inside you, as so many others have said so well. Career counseling is not going to help unravel the mystery of confusion, agitation, distractibility, and inability to focus that is causing your work difficulties; eventually it may cost you your career if you continue to look outside yourself for the answers to your inner turmoil.

    You see, I know a little bit about what you're going through, because I myself have suffered greatly from repeated mistakes during the course of my life. In my nursing career alone, I've had 12 jobs in 15 years and been unable to settle down for more than 2 years, despite my best efforts. Thankfully, my primary care MD demanded a psych consult, and at long last I finally discovered what was wrong all these years: I have bipolar (AKA manic-depressive) disorder, which disrupts my brain chemistry to the point that I am sometimes extremely anxious, other times depressed, and still other times I'm alternately irritable, hostile, flighty, expansive, happy, breezy, energetic, and impulsive by turns......or sometimes they're all combined. And when that happens, I am horrible to deal with. I am a successful nurse-administrator only because I've learned how to channel whatever energies I have on a given day into doing what I am capable of, and not forcing myself to do what I cannot when I'm in that particular 'mode'.

    I'm also fortunate in that my job gives me some flexibility to do that. Your job, not so much. That is NOT to suggest that you should quit, and I would never presume to diagnose anyone with any sort of illness; that's far beyond my scope of practice! What I am saying is, I think you have a great deal to learn about yourself, and if you quit or lose your job now, it will be a lost opportunity to find out what really does make you tick. All of the problems you are having with this job will be carried with you into the next one, and the next one, and the one after that if you don't get to the bottom of what's eating you up on the inside.

    I know it's scary.......when you first seek help, it feels like stepping out into mid-air blindly and on faith, not knowing if you'll land somewhere soft or fall to your death. But believe me, you can't fix something if you don't know what's wrong. Knowledge is indeed power.
    not.done.yet, GrnTea, Epic_RN, and 6 others like this.
  4. 0
    Take a deep breath. We have all made errors, some worse than others. I do have to agree that is alot in one shift.
    If you are having anxiety, EAP sounds like an excellent place to star't. Also discuss with the DOn/HR about a change in position. Can't hurt and may help.
    Best wishes and keep your chin up
  5. 2
    Quote from VivaLasViejas
    NurseLoveJoy:

    I'm going to be as gently honest with you here as I can be without sugarcoating the message.

    I can't overemphasize the need for you to pay attention to what's going on inside you, as so many others have said so well. Career counseling is not going to help unravel the mystery of confusion, agitation, distractibility, and inability to focus that is causing your work difficulties; eventually it may cost you your career if you continue to look outside yourself for the answers to your inner turmoil.

    You see, I know a little bit about what you're going through, because I myself have suffered greatly from repeated mistakes during the course of my life. In my nursing career alone, I've had 12 jobs in 15 years and been unable to settle down for more than 2 years, despite my best efforts. Thankfully, my primary care MD demanded a psych consult, and at long last I finally discovered what was wrong all these years: I have bipolar (AKA manic-depressive) disorder, which disrupts my brain chemistry to the point that I am sometimes extremely anxious, other times depressed, and still other times I'm alternately irritable, hostile, flighty, expansive, happy, breezy, energetic, and impulsive by turns......or sometimes they're all combined. And when that happens, I am horrible to deal with. I am a successful nurse-administrator only because I've learned how to channel whatever energies I have on a given day into doing what I am capable of, and not forcing myself to do what I cannot when I'm in that particular 'mode'.

    I'm also fortunate in that my job gives me some flexibility to do that. Your job, not so much. That is NOT to suggest that you should quit, and I would never presume to diagnose anyone with any sort of illness; that's far beyond my scope of practice! What I am saying is, I think you have a great deal to learn about yourself, and if you quit or lose your job now, it will be a lost opportunity to find out what really does make you tick. All of the problems you are having with this job will be carried with you into the next one, and the next one, and the one after that if you don't get to the bottom of what's eating you up on the inside.

    I know it's scary.......when you first seek help, it feels like stepping out into mid-air blindly and on faith, not knowing if you'll land somewhere soft or fall to your death. But believe me, you can't fix something if you don't know what's wrong. Knowledge is indeed power.
    What you said. Beautifully written and so true.
    Epic_RN and VivaLasViejas like this.
  6. 0
    If medication is your problem, first are you using paper or emar???
    Emar usually flashes a warning sign that says....Its too early, are you sure you want to give this med???
    If your using paper mar, and you have someone that is calling you Q2-Q4 on the hour for pain meds, simply take your mar and a blank piece of white paper to the pt and make a time log so you and the pt are CLEARLY aware of the next scheduled dosing times.
    If the medication dosage changes, ALWAYS RBV.. be sure to tell the pt you have new orders and the times still remain the same, adding additional time for pending pharmacy review.
    Be sure to make intent known you are in the patients best interest and take time to double chk or have a charge or colleague dbl chk if you have ANY doubts. We are a team!! Good Luck ;-))
  7. 4
    (((nurselovejoy))), boy, you've been having your share of struggles these past (at least) couple of years.
    i echo the others who suggest therapy.
    while your errors were seemingly benign, 4 errors in one shift...well, that's serious stuff.
    it is imperative you get professional help, so you can find the root cause(s) of all your angst.
    this honestly cannot be put off any longer.
    you've been writing about it too long, and that's only the stuff you've willingly shared.
    we haven't a clue about anything else that may or may not have happened.

    please honey...this needs to end.
    you deserve to feel better.
    call you dr, and start with him/her.
    s/he will give you any/all referrals you need.
    i fear that should you continue, someone is going to get hurt.
    it could be you, it could be a pt.
    but i'm begging you to get the help you need.
    you have a great support system here.

    leslie
    Meriwhen, GrnTea, Epic_RN, and 1 other like this.


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