So it Sunday...my first weekend working on the unit (I'm into a second week of orientation) Census low,quiet,a guess typical "slow" weekend day on the unit...so my preceptor gave two patients (I'm on two patients now) My first patient assignment went smoothly although quiet chalenging;a lot of PO meds,2 insulin shots,one lovenox shot and a antibiotic to hang...(my preceptor was walking me through hanging the antibiotic)..well minutes later I'm on my second patient assignment not quiet as overwhelming as the first one but still chalenging enough;a lots of PO meds and one shot...so I double checked my meds at the pyxis,and also before entering the patient room,I recognized that one med had to be cut in half so I was thinking to myself ok I do that at the bedside,so as I was opening the meds and putting in the cup I forgot to cut it in half (I didnt triple check my meds,which I usually do but I guess I was so overwhelmed and lost with so many meds that I forgot!! Plus being observed by preceptor doesnt help) Well my preceptor caught me right before I was about to administer the med I was to split in half,thank God she was there to watch over me...I felt so bad since I never made medication error back in school,now I worry my preceptor will hold this "incident" against me....I have a feeling she arleady thinks I know nothing.Yes I do realize that I have a lot things to work on since I never worked in acute settings but I'm trying hard to be the best I canI'm also realizing how important is to triple check meds,no matter how fearful,teary,overwhelmed one can get (especially new grad) This incident totally screwed my day and I'm beginning to doubt my ability to be provide a safe care for the patients.
PS.ups sorry I meant ERROR in the title of the thread! heh!!!
From a piece of mind point of view, I think you should take heart (no pun intended) that with that particular situation I'm 99% sure you wouldn't have hurt your pt, not that you should just blow this off, but rest easy about it. It sounds like the stress that you are feeling is from: 1) being pigeon holed as a "bad nurse", and 2) the fear that you might make future mistakes.
1) Everyone has looked stupid before. Bad on your preceptor if she treats you poorly for your mistake, but do your best to remain humble and stick with it.
2) This is what I do to avoid errors, I have a spot on a table in my patient's rooms where meds go when they are COMPLETELY ready for admin. Nothing is given to my pt unless it goes in this spot first, and nothing goes in that spot unless I have checked it. Don't get in the habit of OVER-checking yourself, this will waste your time, frustrate you, and make you more error prone. Get a system and stick to it.
When I pull meds from pyxis I set aside any med I need to split. I split it before I leave the med room, place it in a med cup and the place another med cup with the other unopened meds on top of the split pill. This helps assure I have the correct dose and by nesting the other med cup on top it assures I don't accidently tip the cup and drop the pill on the way to the room. Having said that, I agree with others about not being too hard on yourself. Even if you had given the full med, as soon as you realized it you would have kept an eye on your pt to make sure the B/P didn't drop too low and made sure to notify the MD. You will remember and not make this error again and for a while you will be overly cautious but that will get better as you gain experience. Good luck and welcome to nursing!
I am a new grad 2nd week working as a nurse of a psych unit. We pass alot of meds there. I enjoy the unit and the staff they are very welcoming. Feeling uneasy I think I gave a whole pill of Ativan one mg at 3pm (that was the only med. scheduled at 3pm). instad of half a pill. THat pt. fell that day earlier and I had alot going on This was my first day with 3 pt.s maybe I should decrease my pt. load back to 2 pts. I feel so incompetent. I don't know if my mind was playing tricks on me when I got home but I could sworn I double check the med I will have to look at pt.s MAR when I get back to work if so I will have to tell my Nurse manager. I guess you can say I was working at a steady pace but if it was a whole dose I gave instead of half. I'll be kicking myself in the butt for a long time.
Specializes in General adult inpatient psychiatry.
I am a new grad 2nd week working as a nurse of a psych unit. We pass alot of meds there. I enjoy the unit and the staff they are very welcoming. Feeling uneasy I think I gave a whole pill of Ativan one mg at 3pm (that was the only med. scheduled at 3pm). instad of half a pill. THat pt. fell that day earlier and I had alot going on This was my first day with 3 pt.s maybe I should decrease my pt. load back to 2 pts. I feel so incompetent. I don't know if my mind was playing tricks on me when I got home but I could sworn I double check the med I will have to look at pt.s MAR when I get back to work if so I will have to tell my Nurse manager. I guess you can say I was working at a steady pace but if it was a whole dose I gave instead of half. I'll be kicking myself in the butt for a long time.
Just a side note, I work on a psych unit and we regularly stock 0.5 mg Ativan. Did you not have that on hand?
If I'm giving 1/2 of something, I usually write "1/2" on the back of the tablet packet when I pull it. I always check everything again before I give it, and our computers tell us when the scanned dose is "incorrect" and needs to be adjusted....but the computer is not always correct, and I am not always correct either.
When I mess up on anything, I let my preceptor know what I think went wrong and how I plan to prevent it from happening again. That seems to make us both feel a little better
Yes, that's exactly what I always do and was going to suggest same. I've been doing that ever since single dose packets appeared... long before we expected pharmacy to adjust dose units for us. Some pharmacies will always send the exact dosage or even draw up injectables or elixirs to the correct dose. But other pharmacies don't and it's not the mark of a bad hospital or policy.
stephenfnielsen
186 Posts
From a piece of mind point of view, I think you should take heart (no pun intended) that with that particular situation I'm 99% sure you wouldn't have hurt your pt, not that you should just blow this off, but rest easy about it. It sounds like the stress that you are feeling is from: 1) being pigeon holed as a "bad nurse", and 2) the fear that you might make future mistakes.
1) Everyone has looked stupid before. Bad on your preceptor if she treats you poorly for your mistake, but do your best to remain humble and stick with it.
2) This is what I do to avoid errors, I have a spot on a table in my patient's rooms where meds go when they are COMPLETELY ready for admin. Nothing is given to my pt unless it goes in this spot first, and nothing goes in that spot unless I have checked it. Don't get in the habit of OVER-checking yourself, this will waste your time, frustrate you, and make you more error prone. Get a system and stick to it.