Am I in trouble?

[NurseLearningForLife]

Hello Everybody. I would like to hear you advice as a nurse.

I am a new grade. I just got this job about 5months now but it is just a per-diem position. Yesterday I got a bunch of new orders from Dr from 6 different pt. Dr wrote an orders and left around noon 1:30pm. I have to finish my afternoon med. and by the time i done with my med, i have to do the change shift report. than i start to write the orders. and by the time finish transcribing the orders it is around 5 o'clock already. I saw an order said give XYZ medication now. So i wrote an order at 5 pm when the medication order wrote since 1:30pm. Am I in trouble? As a new nurse, i am terrifying everyday. I go to work early and leave work late. By the time i get home I still thinking about my work. I afraid that i miss something. Some people are not really like new nurses because those people think that new nurses don't know what they are doing. I Really appreciate for all the reply.

Thank you.

[Asystole RN]

How is the patient? The first and last thing you should concern yourself about.

What kind of medication was it? If it was a pain medication and your patient was writhing in pain for four+ hours then I would be concerned. If it was MiraLAX x1 Now then I think you can relax. The nature of the order has a lot to do with how you follow them, so does facility policy.

I am more concerned about your writing to be honest, despite being a notorious grammar defiler myself.

[westieluv]

If the patient is okay and there was no undue hardship or suffering due to the late administration of this med, consider it a learning curve and in the future, no matter how busy you are, always, ALWAYS read doctors' orders as soon as they write them. any "now" or "STAT" orders need to be given as just that, and sometimes it is critical and literally life threatening.

As far as your writing, if you are new to the US and written English in general, then it is understandable. If not, it would benefit you a lot as a professional to take some kind of remedial English course. I'm not saying that to be snarky, just to try to be helpful.

[uRNmyway, ASN, RN]

How is the patient? The first and last thing you should concern yourself about.

What kind of medication was it? If it was a pain medication and your patient was writhing in pain for four+ hours then I would be concerned. If it was MiraLAX x1 Now then I think you can relax. The nature of the order has a lot to do with how you follow them, so does facility policy.

I am more concerned about your writing to be honest, despite being a notorious grammar defiler myself.

Although I agree with you that a good grasp of the English language is important in properly caring for our patients, at least in an English speaking country, I don't think it has anything to do with the question. I also agree that the degree of concern she should have depends on what the medication error was, because that is what it was, a med error.

I think what you need is help with your organizational skills. Because if you have a hectic shift once in a while, and leave later than shift change, that is normal. It happens to all of us from time to time. But if it is a daily thing, then maybe something needs to change with your routine. Ask more experienced nurses where you work for tips.

[NurseLearningForLife]

Thank you all so much. Yes my English is my second language and most of the times I will double check my writing because I know that i make a lot of mistakes in my writing. Anyway the medication is K-dur (potassium cloride). My pt is totally fine depite he has chronic diarrhea for a long time. Thank for the adivces. Next time I will remember Doctor orders first. I will go through them to see which one is Stat, and if there aren't any I will do what is important first.

[uRNmyway, ASN, RN]

Oops, yep, Potassium Chloride could definitely have serious repercussions. That would have been important to give, especially if the doctor felt the need to order it stat.

[Awesomemiss]

I agree that the biggest issue needing to be addressed is the prioritization of dr orders before passing that med then giving a report..... What if he wrote an order to discontinue that med you're about ready to give? What if this pt had an electrolyte panel drawn during this time, and the dr thinks they got their K+ before that lab draw, causing the dr to make further changes/orders??!! (ok, maybe I'm going too far here, I too am a fearful nurse, I can relate to u!)

Point is, dr orders are sooooo important to pt safety (and the nurse checking those orders for their safety too!!)

After pt safety, how about your own reputation/license? You pretty much made a med error.... Please don't take offense... I literally BEG for this kind of honesty from my peers. A NOW order should have probably been done within one hour?

Really, I don't do a thing with meds tx, drsg changes ect unless I see the written order first...

Having said all this, I don't know a thing about "transcribing dr orders" why cant they write down their own orders and u check them/fax them to pharm? Is it common practice in a place like yours to not immediately check new orders because of "transcribing?"