Has anyone made a medication error and *not* get fired for it?

[pinkiepieRN]

I screwed up tonight, plain and simple. I had meds pulled for two patients and started giving meds to one patient. I pulled the pills in their packages out of the cup and told him each med and their dosage. The second after he put the cup to his lips, an "oh ****" comes out from under my breath. I realized that what I had given him was intended for the other patient and that I had made an error. I walked back to the nursing station, told another nurse, told the charge nurse, called the doc, got an order for Benadryl to prevent any undue reactions, however unlikely, filled out an occurrence report, documented in the chart (without saying it was an error) and made it through the rest of my shift. Everyone was telling me that it was okay and I did the right thing, but I'm terrified. I'm thinking about calling my supervisor in the morning and admitting my screw-up before she gets the wrong idea. Is this nuts?

[Isitpossible, LPN, LVN]

yup, made med error, informed my DON- she advised me to call physician,call family, and file incident report. that was all, her response, "im sure you'll never make that mistake again."

[KelRN215, BSN, RN]

I've not personally known anyone who's been fired because of a medication error. I'm not sure why you would need to make a separate call to your supervisor though... you filed an incident report so she will get that.

[GeneralJinjur]

Isitpossible said:

yup, made med error, informed my DON- she advised me to call physician,call family, and file incident report. that was all, her response, "im sure you'll never make that mistake again."

I agree with your DON. Med errors are painful, but the lessons you learn stick like glue! I also work in a facility that is non-punitive for med errors. We fill out a form identifying contributing causes and if you have continued problems, there is a tiered system of education that could potentially lead to termination, but it takes a lot of failures and I haven't seen it happen to anyone.

[nursel56]

I know two nurses who made life-threatening errors and neither was fired. The idea is to create an atmosphere where nurses aren't afraid of being fired and thus share honestly the circumstances that led to the error so it can be deconstructed and examined for systemic factors that raise your facility's error rates as a whole. Unfortunately, I seem to hear more and more that they are being used as a punishment.

[drowningdaily]

I made a colossal med error as a newer nurse. Thankfully, patient was fine. Just remember that terror you felt, and do everything you can do to prevent mistakes in the future. And no, I was not fired.

[TiffyRN, BSN, PhD]

RNsRWe said:

've seen the liars....and the ones too stupid to know what they messed up

Absolutely! I followed a nurse who accidentally mixed a bag of fluids with exactly 1/2 the needed vials, but that's okay, cause they ran the rate at twice the ordered rate, so in the end, the patient only got a few extra ml's of fluid but the correct dosage of medication. But I wrote that up for sure.

I can only think of two nurses that I know of in my 20 years that have lost their jobs purely on medication errors. One may not fully qualify; the nurse was agency, and they weren't fired, but our facility put a "do not return" on their file. The offense was that they completely skipped giving the AM meds, but signed them all off when I pointed out they weren't signed off thereby falsifying the documentation.

The other error was severe, the patient suffered a near fatal reaction (wrong medication given) and it will be years before it is known if there were any long-term consequences. I am intentionally being very vague as pediatric patients apparently have 21 years to file suit for medical malpractice. The nurse lost her job and had to go before the board though I don't know the outcome from the case to the board.

Medication errors happen, administering medications is serious business, never become cavalier. If you have bar-code scanning available, use it religiously. But for the most part, one does not lose one's job for the average medication error.

[Vespertinas]

VivaLasViejas said:

Unless the error was a particularly egregious one, e.g. allowing a full IV bag to run wide open in a CHF patient who's already drowning in their own fluids

Did it! (not all the way, but enough to see a response before my eyes)

Some of the things I'm most careful about are those which I had to learn the hard way.

[Multicollinearity, BSN, RN]

I've only seen one RN fired for a med error. She was supposed to give an immunization and gave another kind of med IM instead, by mistake. The patient who was outpatient had to be hospitalized.

Otherwise, I've seen/heard of quite a few coworkers making errors, and nobody else has been fired.

[pmabraham, BSN, RN]

Good day:

dolcebellaluna, you did a number of right things.

1. You acknowledged you made a mistake.

2. You quickly took actions to fix the mistake.

While only your place of employment's policies, procedures, and whether they give credit for doing the right thing (vs. lying or otherwise covering up) will determine what happens next, we (as a society) need more with your courage to acknowledge and quickly make right.

Everyone makes mistakes; and while, we all want to avoid mistakes (especially deadly ones), those who take responsibility quickly often learn their lessons the quickest.

Thank you.

[bebbercorn]

The important thing is that you owned up to it, I have heard of nurses getting fired for making med errors knowingly "Sure, I double ativan doses all the time, somebody will sign the waste for me..." or that sort of thing. Everyone is human and the fact that you acted to prevent harm in the patient says loads for your character. Proud to know you are an RN! :)

[caringfornurses]

I have never worked with a nurse that has not made a med error. I say learn and move on. Always remember, the first time it is a mistake. The second time, it is a choice. Oh, by the way, your boss will definitely know.

This is my new motto:

Good choices are based on experience. How do we get experiene? Bad choices.

[PeepnBiscuitsRN]

I've made 3 in my two years- smallies, yes. 1mg Bumex instead of 0.5mg and that was on my first day of orientation (I was supposed to cut the pill in half) and then I gave someone liquid ibuprofen instead of the tablet (right dose, right time, wrong form- pulled from a different patient's file on pyxsis) then one time gave ibuprofen 2 hours too soon. Excusable? No. Preventable, yes, inevitable for any nurse, YES! Never even a slap on the wrist. Found a seasoned nurse had hung straight D5....on a diabetic. Was she fired? No.

The only thing I can say from 2 years experience as an RN and 5 as an LPN, if you pull meds/draw up vaccines for more than one patient at a time, it is almost guaranteed you will make an error down the line. Just my experience.

If you feel like telling your boss, I think that's fine. She'll probably be surprised that you'd be so forthright.