Am I unsafe to practice?

lifeisgood2012 · May 24, 2012

I have not gotten my first LPN job, so maybe this will mean nothing - but

I would love to meet a nurse, or anyone for that matter, who has not made

a mistake. It sounds like you learned from them too.

When I was doing clinicals I worked with LPN's and RN's doing med-pass

and there were times that they were early/late with meds and had to have it

in the certain window you are talking about - but they were still there

teaching me. They even knew it was wrong but things came up, they got

busy with other patients and just did the best they could to back track and

then chart it correctly.

From the limited experience that I have, isn't that all you can do? I will be

glad to see other responses to this thread. Please don't be too hard on yourself -

I can understand why you are feeling the way you are feeling.

catlvr · May 26, 2012

Unsafe to practice after these two events? I don't think so, unless you showed an attitude of unwillingness to be accountable, learn, and vow to do better. It is possible that for whatever reason, the facility no longer wants you to work for them. I would not take this as gospel that you are not cut out for bedside nursing; heck, if all of us who made a med error was removed from bedside care, there would be only liars at the bedside! If you can, find a new facility, or perhaps return to the one that you did well at for nine months. Shake off this experience after you have learned from it, and continue to be the best nurse that you can be.

javertech · May 26, 2012

I have been a nurse for about 8 months now and have only had one event report on me that caused a delay in the patient's procedure. I was under the weather but chose to go to work. I did not start IV fluids on a pt. going for a heart cath. I did everything else but that. My supervisor was very nice about the incident. This is how you learn is by making mistakes. I sure can tell you I will be more attentive next time when a pt. is going for surgery. There is not a practicing nurse that does not make some mistakes. I think you should just learn from it and brush it off your shoulders. Don't let other nurses make you think you are the only one making mistakes

xoemmylouox, ASN, RN · May 26, 2012

Please this doesn't make you a threat. You need to make sure you think things through next time. LTC is a stressful job. Perhaps you should try something else for awhile.

debkimt · May 26, 2012

Don't let this threaten your confidence in yourself as a nurse. I have over 25 years in nursing experience and can tell you that mistakes are just going to happen. We don't want or mean to make them, but we ALL make them. Even physicians make them. Of course, we try our best to NOT make them, but we are all human. Just take the mistakes as a learning experience. An "unsafe" nurse would be one that continually makes the same mistakes and doesn't bother to learn from them and is not bothered by making mistakes.

conroenurse · May 26, 2012

an "unsafe" nurse would be one that continually makes the same mistakes and doesn't bother to learn from them and is not bothered by making mistakes.

amen. i have been a nurse for over 30yrs, and can tell you that even the most respected nurses in the field for yrs. make mistakes. if nothing else it feels like the law of averages catches up with you.

i have learned if/when i do something wrong to sit with myself and figure out how it occurred and think of what i can do to prevent it. i have found that getting in a rush or being overwhelmed is almost 90% of problem area for nurses. if i feel at all overwhelmed or rushed either i stop everything for a few minutes and go somewhere, deep breath, wash my face, whatever to get a sm. shake it off session no matter if i am behind, or sometimes just ask for help. nurses sometimes don't remember to ask when they need to, and it can lead to mistakes too.

don't beat yourself up or stress over. just learn from it and jump back on that horse.

also i have found that those nurses that make statements like that are the ones that are the worst nurses and just like a bully say things to make themselves feel better abt the crap they do.

good luck.

nita

UpTheLadder12 · May 27, 2012

Wow! I am not working yet but in clinicals I saw these things happen OFTEN, and the nurses often had a careless attitude. In fact, this happened more in the hospital than LTC, which I would think is worse since those patients are acute. Did you have a touchy or tense relationship with your supervisor, or with a staff member that has some pull? I have seen some nasty backstabbing in clinicals and hearing from my friends who are currently working as LVNs.

This doesn't sound like you are 'unsafe' at all. You had a bad week. They should be supportive and help you find ways to avoid these errors in the future instead of putting you down. It's not like you gave the wrong med or wrong amount or wrong patient, which IMO would be wayyyy worse. And I know people who have done that and were not reprimanded.

Don't put yourself down, and next time you have an issue with a med being delivered from pharmacy or when giving a PRN, just approach your surpervisor every time so that it's in her hands and not yours. And in the meantime, look elsewhere for work! That sounds like a crappy environment to be working in, especially for a relatively new nurse.

Need2Care · May 30, 2012

thank you all for your kind advice. *update, i was let go from that job for these mistakes, in which i respectfully asked if i could resign instead. of course i was regretful and remorseful about my mistakes but in the end i was just not good enough to work there in their eyes. the don told me that my nursing judgement was way off and it was a unanamous group decision from the don, md, pharmacist consultant and risk manager that i am unsafe to continue working there.

i'm sad about it. mad about too it but cannot forget that i did in fact make these mistakes. i can't stop thinking about all the factors that were wrong in my mind working there.

and why yes - uptheladder12 yes there was someone there i worked with who specifically was involved at making sure to make a big deal of my mistakes. this person i went to school with, graduated with and told me about the job opening. one day she flipped a switch and i swear was out to get me. she and i disagreed about a tx order. there were numerous orders for this person however one night they ended up scratching at both upper arms and needed another order. it would not have duplicated any other tx order already written but this nurse, in her mind, in actuality did not want to write another order. she was working charge and should have written it. so i had off a couple nights and she worked in my place one night and discovered the tx hadn't been done. what does she do... goes and tells the shift supervisor i didn't do it. i come in to find out about this and point out that there's no tx order for it, and if there was how come the nurse the previous night didn't do it either (i didn't get written up for this). anyway she was livid with me for saying there wasn't an order and proceeded to bad mouth me to the other staff, in particular the cna's. she told one cna not to listen to me anymore... i found that very strange.

point being that this nurse, someone who i thought was a friend of some sort, complained and made a big deal out of my mistakes on the orig. post. i think the don may have felt a bit cornered into taking action because if she did not then this nurse might have reported it to the state.

i don't know if that's a correct assumption or not but i'm not there anymore and i know time will heal my broken heart and mind and i will certainly not forget to slow down and be more adament about giving medications and proper orders being written.

UpTheLadder12 · May 31, 2012

I'm so sorry to hear that it went down like that! But don't let it get you down too much. Did they OK you resigning instead of being fired? If so, it should be relatively easy to find a new job. You can always spin your choice to resign at future interviews to relate to a toxic work environment. If you don't need to be working STAT and can afford to be a little picky, start visiting LTC's or whatever type places you want to work and get a feel for it. You can tell pretty quickly if there is a lot of tension between staff or if the residents seem stressed. Of course no place is perfect but there are definitely places that have strong, capable management, where the DON knows how to take control and wouldn't let things get this bad.

You should have had a QA review right after your first mistake, where you could discuss with supervisors and peers how to avoid future mistakes. And all that stuff about not being suited for LTC and a previous career in accounting was totally out of line. That was none of their business to say that, it was unprofessional and had nothing to do with the situation. That's what caused me to ask about tension with staff.

Sounds like toxic management, and it all trickles down from the top. If the admin can't control troublemakers, good employees will suffer and the then the whole place will suffer. And if the admin themselves are toxic gossipers, run run run to the nearest emergency exit!

Good luck in the future! You made a couple mistakes, but your place of employment made some mistakes too. Learn from yours and be better for it!

Fyreflie · May 31, 2012

If you're learning from this mistake, and are able to identify why it happened so that it won't happen again, I think you'll be fine!

Last year, 3.5 years post grad, I gave penicillin to a woman who came in 5-6 cm dilated and was gbs positive (requires antibiotics in labor). It was shift change, she was still in triage and the report I got was that she "wasn't in active labor" so I thought I'd have a few minutes to introduce myself, then read through her chart, and then admit her to her room.

When I went to introduce myself, her labor was indeed well established so I confirmed with her that she was gbs pos and then started an IV and hung the PenG. She popped out her baby within half an hour and I got her cleaned up and fed and feeding baby, then finally went out to read her chart.

Right across her prenatal record it said "allergic to Penicillin."

I almost died. I went flying back in there to stop anything that might have been left of the bag and changed out the tubing etc (she had no signs of any reaction and probably thought I was a maniac). Then I had to sit down and tell her that I had given her the PenG by mistake and if she had any symptoms to let us know ASAP. THEN I had to call the OB on call, crustiest man alive and tell HIM what had happened, and then I had to inform my manager and fill out an incident report on myself.

Turns out she's one of many who had a "rash" when she was a child that they thought may have been caused by penicillin but it was never confirmed. I went to the break room and cried my eyes out after it was all over but I'll tell ya, I have never EVER forgotten to ask about allergies on any patient since. It was a better learning experience than any horror story they could have told me in school!

It sounds like the place you were working in wasn't a very supportive learning environment, but that doesn't mean you shouldn't be practicing! It just means you need to do some reviewing and move forward. The most dangerous practitioners are those that don't ask when they don't know, right?

Need2Care · May 31, 2012

my resignation was accepted. i still am uncertain with how to explain that 'it wasn't a good fit for me' at the next job but i'm sure the words will come to me if i'm asked. i've been out of work almost a week now and have been applying to jobs online. i went on one interview and didn't have to explain as it all was still happening that same day so i basically said i was still employed. i am still waiting to hear back hopefully for a second interview.

thank you so much for helping secure my mind into not giving up. i never thought i'd give up but this definitely shook me up quite a bit.

@uptheladder12 thank you and good luck to you as well. school was hard, the work even harder but it's all worth it.