Quote from peaches88
Nursing home (all paper charting) and the med was a lovenox injection.
That's a hard one IMO. During report had there been some type of change with that particular resident... had they been to surgery etc... that's when the red flags go off. "But" with the paper MARs as I know they are in LTC if all orders aren't put on the MAR when processed that can lead to med errors.
Were you alerted to the fact that there had been a change in the resident? If not how could you have known. RNs who are passing meds don't have the luxury of going through every chart to check for new orders. Going through the charts and making sure all the new orders are processed in their entirety is usually night shifts side job (but not everywhere).
In my experience with LTC the primary reason lovenox is ordered is due to a post surgical procedure...did the resident just have surgery? If so then you got a fight on your hands in relation to who should have done what when etc... The experienced RN would have most likely caught it; the novice, probably not. LTC nurses who have the med pass from Hades don't have time to look up orders in the charts continually (not overlooking the fact that they're paper MARs as well).
My advice is to go through the steps in detail and see exactly where the break down occurred so as to avoid it in the future.
Every experienced RN who's honest has med errors on their record; it's unavoidable. No matter how careful we are we are still only human. You don't have to sign the document. In fact I would wonder why they are so casual for you to sign without some type of learning intervention.
It's definitely an error...whether you choose to accept any responsibility towards it is your own personal decision but I know you've learned something from all this. The question you need to ask yourself is should you have known a med could have been ordered for this resident due to what ever change occurred?
Let us know what happens