Med Error...Now what?

[lchapman]

Well I am not a brand new nurse but feel like one. I started out of nursing school working nights at a behavioral health hospital. Mostly all we did was do chart checks, give the occasional or sometimes more than occasional prn meds during the night, and pass 0700 meds. Working nights was taking a toll on my health and when we moved to another state I decided to start working days! I still don't understand why night shift gets a shift differential because you are running your bottom off during the day. So I have been working 4 1/2 months on days in behavioral health with 4 weeks of orientation which makes me feel like a new nurse because it is totally different. The first part of Oct, I gave a pt too much of an emergent med where the pt got 4 times the amount of Ativan and Cogentin. I caught the error myself, because the supervisor wanted to know why the patient was so drowsy and asked how much Ativan I gave. I originally said 2 mg and she said that needs to be corrected because the patient is less than 5' and weighed about 79#. So I started looking at the order and remembered exactly what I gave her and realized I gave way too much. I told my supervisor right away and called the MD. I was so embarrassed and felt so inept as a nurse that I immediately told my supervisor to report me to the BON. We had the patient sent to the hospital next door as a precaution and I tried to continue working on the unit. I was so rattled that I was having a hard time working and the supervisor asked if I wanted to just finish the charting on this patient and I said yes. I didn't even get that far when they had me get a drug test and told me that I was suspended from my job pending investigation. The patient's VS were well within normal and she was okay albeit sedated. Of course, I went over everything that happened and remember just drawing up the meds on auto pilot because I had another patient that had started throwing chairs and my mind was preoccupied. I also had been stressed out because I had been written up for not scanning medications correctly into the system and not giving patients on another unit emergent meds in time before we had to call a code. I had PTO approved for vacation the following week and since I was suspended I didn't get paid. By the end of my vacation, I was called and asked to come in and meet with my supervisor. I suspected I was going to get fired and I was, but I feel so inept that I am even questioning my nursing ability. I have never worked in anything other than behavioral health and do not feel adequate enough to apply for a hospital job. I am looking into home health but have read the postings and see that there are trachs, IV, blood draws and the like. I have no experience in those except for clinicals in nursing school which was 3 yrs ago. Not sure where to go from here. Any advice? I feel awful and afraid to give anyone an injection now!

[GundeRN]

Working nights was taking a toll on my health and when we moved to another state I decided to start working days! I still don't understand why night shift gets a shift differential because you are running your bottom off during the day.

If nights are so much easier you can always go back I'm sure. Nights may not be as busy, but it has it's own challenges that you yourself first said where taking their toll on your health so you quit. We deserve our differential.

[lchapman]

Yes, I probably can go back but I was not able to sleep well during the day. I'm sorry if I offended you. I'm not saying nights has it's own challenges. I worked very hard at night and had to deal with management when errors weren't caught. Days is a different sort having to deal with not only patients, but families, doctors, telephones, and health team members. For me it was much harder work and we don't get a differential!

Sent from my iPad using allnurses.com

[GundeRN]

I just hear it too much I guess, how easy everyone thinks we have it on nights. Except I don't see too many people clamoring to work them.

[lchapman]

That's the main reason there is a differential because not a lot of RNs don't want to work those hours! Personally, I am a night person and I loved nights, my body just didn't like it!

Sent from my iPad using allnurses.com

[HouTx, BSN, MSN, EdD]

So, were you terminated or not? I don't understand why you were drug-tested. Did they think you were symptomatic or is it part of their protocol for dealing with med errors? That sounds weird to me, but anything is possible. Psych is not my area, but I understand that 'emergent' meds are administered under a medical protocol in the same way as we initiate emergency resuscitation drugs in the acute care setting, right? If so, your error was limited to miscalculating the dosage. I don't see how that would constitute a reason to fire you or suspend without pay. That seems very harsh since it was a dosage mistake and you owned up to it.

If you were not terminated and it is possible to go back to work at that facility, I strongly advise you to do so. You need to 'get back on the horse' in order to recover your confidence. If you don't want to go back, try to make some arrangements so that you will not be listed as "ineligible for rehire"... maybe agree not to take any actions against them for subjecting you to a drug test??

[determinedlpn]

I know exactly how you feel. I also was just recently fired for giving the wrong vaccine which did not hurt pt at all just gave him a booster on his Hep B but it was my second med error with given wrong vaccines. I also feel devastated and inept in nursing. I have 10 years in Mental health as well, I have been working in internal medicine for almost two years until I got fired from there. Maybe that is what you should try, out-patient clinics such as internal medicine, community health centers, DPH, etc. I also worked in methadone clinic for many years try those fields and see how it goes. Me in the other hand don't know where to apply, I have 12+ years experience in out patient clinics only, I'm afraid I have lost my nursing skills completely. Also what would I say if they ask me why I left my last employment, I don't want to lie by I'm also concern if they will hire me if I tell them the truth. Any advise from anyone please.