Am i fully to blame for this or did my mentor act complacement.

canigraduate · Jan 28, 2012

It sounds like the OP has recognized the seriousness of what happened and has a plan to correct her behavior.

It is very hard to admit your mistakes and just as hard to learn from them, so I congratulate you. I think that if you continue to learn and improve this way you will make a good nurse.

Meriwhen, ASN, BSN, MSN, RN · Jan 28, 2012

See the thing is, he is a student and therefore is practicing under his instructor's RN license. The RN and hospital would've been help accountable for any adverse events.

The nurse is the only one who works under their license. The nursing student is and can be held individually accountable for their actions in clinical. Here's one state nurse practice act's ruling--I bet the other 49 state it the same way or similarly:

Iowa Board of Nursing

I think OP received a LOT of reaction and outcry due to the flippant (albeit unintentional) attitude about the error in her first post. Now that she's responded we know more about what happened and how she feels about it...but to be honest, the way she worded her first post didn't exactly put her in the best light.

tinkerbell419 · Jan 28, 2012

Im not a flippant person, i do find placement nerve wracking anway and im a quiet person, it is easy to get the wrong impression.

Sparrowhawk · Jan 28, 2012

You realize you need to slow down? Oh I would say so. I'm so glad you've realized your errors because I seriously had a huge vent at this...and you better be glad that the mother took it well...very very glad.

I'm not usually mean....but you need a serious wake up call and pay attention!! You realize that now...so do it...double, triple check and just thank every being and God that you squeeked by this time and didn't get in trouble.

I need to slow down a lot too...but I have never ever ever just assumed at what a medicine was without checking, especially if it is the same color. Label things if you have to...

Altra, BSN, RN · Jan 28, 2012

Just to clarify i did know what the medication was, but pushed it through by accident.
What happened is that i was pushing in the other medicine that goes in the ng tube which is yellow and for the childs constipation and cramp, and then picked up the other yellow one (the tiny little syringe with the mouth stuff in it) in my hand, and because i wasnt thinking i accidentally put it into the ng tube too, like an automated action. Now i dont know how it happened, but i realised the error as soon as i flushed her off with water.
But i am aware of the medicine in itself, and my mentor did say that its no bigger than a blob, it is very mild stuff and wouldnt have harmed her.
However having said that, i should have spoken up. My fear and anxiety got in the way.
But ive realised that even in paediatrics, some medicines are very strong. The oral thursh stuff they use on the ward is very mild and the kids only have a teeny tiny amount to be wiped round their mouths. But ive seen and heard of stronger medications which can have strong effects.
Im still embarrased as to why i picked up the oral thrush medicine and pushed it into the ng tube, must have been an automated action where i didnt think as to what i had in my hand.
I am so glad it wasnt anything else. It has made me realise that i havent been as vigilant and on the mark as i should have been. Now i realise how easy it is to make mistakes when you get too used to a routine of doing something or through distraction.
I now have my own copy of the BNF, so next time i will read up on medicines given on the ward just so i know what meds im working with, and their normal route of administration. That way im taking responsibility for my own learning.

This is a very different story than your earlier post, which described the incident differently. You said the patient's mother recognized your error, and that is what cause you to stop administering the med through the NG tube.

I wasn't there, so I can't possibly know which is correct. But it's one or the other, and they are 2 very different scenarios.

But that's not even the point. In 4 separate posts, you repeatedly recount giving meds without knowing exactly what they are, and what the correct dose and route of administration should be. This should never, ever be ... whether you are a beginning student or a long-time experienced nurse. I cannot wrap my brain around how your school can possibly allow you to give meds without demonstrating the appropriate amount of knowledge related to their pharmacology and all of the procedures and safety mechanisms that go along with giving meds.

You don't do things - give meds, perform procedures, anything - to a human being without knowing exactly what you're doing, why, and what the possible outcomes are. Period.

tinkerbell419 · Jan 28, 2012

I havent given two accounts, the one i posted above is what happened. Am i being accused of lying or something? Im not a liar and i have no need to lie.

As i said earlier i knew what the medication was and the correct route of administration but as i said, as i was pushing the other one through, i picked up the one for oral thrush and accidentlaly pushed it through too, without thinking.

As i was clearing up, thats when i realised i made an error and said "oh no" and thats when the mother said "have you pushed the wrong one through, because thats supposed to go on a foam stick"

I have tried to explain what happened over and over, its hard to detail everything step by step, but i have gave a true account. Im not a liar thankyou very much.

Sparrowhawk · Jan 28, 2012

She's not calling you a liar. SHe's simply saying you've said two different things, and you have. First you acted like you didn't know which was which...then you do...

How much more of school do you have left?

tinkerbell419 · Jan 28, 2012

I have another year and a half to go, why?

And can i just say this mistake can be caused at any stage of training. However i have given the child the nystatin before on a foam stick and given all the medications by the correct route. I knew exactly which medication she was on and their side effects. As i said it was an automated action, and it can happen to anyone.

tinkerbell419 · Jan 28, 2012

But i realise now that i should have spoken up, which will not happen again. It was one mistake that i made.

Altra, BSN, RN · Jan 28, 2012

the child takes two meds both of which are the same colour. however one of them is actually for oral thrush and is to be given into the mouth on a foam stick. the other is by ng tube.
now my mentor never bothered to tell me which one is which. in fact i didnt even know until i made the error, which i think is quite bad. ive onyl ever seen the child have the ng tube medication, i didnt even know she had one which went in her mouth.
anyway, i was pushin the oral thursh medication down the ng tube and her mom looked up at me and said "hang on a minute, that doesnt go down her tube, its for her mouth"
i stood there and said "oh no!, your got to be kidding me, im sorry i didnt even know what this stuff is, however its only for mouth thrush, it wont hurt her and it will just pass out of her, and she is due more later. i didnt tell my emtnor, i was frightened to death.
...
but do you think my mentor is to blame in some respect???????

the medicine was yellow, now i know the child has a yellow medication that is given via ng tube so i assumed it was that medicine, so that why i pushed it through the ng tube.
now if it wasnt the same colour, i would have queried it.
as i have seen my mentor pushing a yellow medcine into the tube, i assumed it was the same yellow medication that is used to treat constipation but it was something else. the second yellow medicine was for oral thursh and i didnt realise.

i know the medicine isnt harmful, the child has a very teeny tiny amount in a syringe, so i knew it would not harm her, if anything it would contain a mild antiseptic, as she has it in her mouth, she is going to swallow it so it will be absorbed in her mouth when she digests it, and it will pass into her system.
as i say it was a small amount which is put on a foam stick and brushed round her mouth. to e honest i should have noticed by the quantity but didnt.

i knew what the medicine was but i thought it was administered by ng tube.

but i realise now that i should have spoken up, which will not happen again. it was one mistake that i made.

all we have to go by for this discussion is your own account of what happened, which has changed throughout the course of this thread.

and please, please recognize the multiple errors that occurred in this scenario:

1. lack of knowledge related to administration of meds

2. lack of attention to detail when performing a mechanical task

3. lack of recognition of the necessity of examining "what do i have in my hand, what is it for, and what should i be watching out for as a possible consequence of giving this?"

4. repeatedly iterating that the "mistake" was to withhold information from your mentor -- without recognizing that a medication has indeed occurred.

you can learn from this -- but it will require a significant mindset shift.

Meriwhen, ASN, BSN, MSN, RN · Jan 28, 2012

Im not a flippant person, i do find placement nerve wracking anway and im a quiet person, it is easy to get the wrong impression.

That is exactly my point: whether you meant to or not, your POST came as across as being flippant about the whole matter. There's a big difference in "I made a med error, help me understand" and "I made a med error, isn't it my mentor's fault too?"

mazy · Jan 28, 2012

It's been quite a while since I worked with an NG tube, and I work in geriatrics, not peds. So I'll throw this out to the more experienced nurses there. If I remember, you use the same type syringe to instill meds into an NG tube as with a PEG tube right? In geriatrics that's the 60 ml syringe. That's my recollection from the many years ago that I worked with an NG tube, although I could be very, very foggy on that. There have been a lot of G/J tubes in the interim so it's all blurred together.

So if that is the case, would it be typical to draw up nystatin into a 60 ml syringe?

Or is the set-up a lot smaller for peds nursing?