Anxiety about screwing up at work

[pinkiepieRN]

I've made several medication errors recently (totally different scenarios, but I am double and triple checking my med pulls now) and it's really doing a number on my confidence. I know that I'm great with patients, my charting is good and I'm always willing to help other co-workers and work as a team. I'm confident about everything except for my med pass. I'm mostly confident about it, but there's something holding me back. I check the kardex, go to the appropriate drawer, pull the meds and then compare them once again to the kardex. In distraction, I sometimes end up pulling an extra dose of something or the wrong pill. I'm good at catching myself and sometimes it's just because the wrong pill is mixed in there with the correct pill. How do I get over the anticipatory anxiety of screwing up? I definitely don't want to give the wrong meds and have every intention of double and triple checking things, but I feel like that's just not good enough!

I feel easily distracted and can't always focus. Note: I *CAN* focus and do my best to write everything down on my shift brains but I'm worried about forgetting to do something I was planning on doing if I get pulled into a situation with a patient or have an emergency. ARG!

Any advice?

[tbehlow, LPN]

I am a new nurse myself , and also have anxiety. My manger who preceded me one day .. He told me this.. " take a deep breath, and refocus on what your doing , just take it one patient at a time." Today was a crazy day for me.. I felt so overwhelmed . They haver a hard set.. I took his advise and my anxiety eased up.. We don't have Kardex, any longer, we have rolling computers . So I have the opportunity to take my computer to a place that has little distractions....

[FlorenceNtheMachine]

Do you have to scan meds before you admin them? If not, then I can see how you could make mistakes. It happens. I write my meds on my brain at the beginning of the shift and compare when I pull. I also have the last fail safe and can scan them in.

Try this: ask "WHY am I giving this [x-amount]lb. patient this med?" when you are preparing your meds. I always found when I knew the why, I could absorb so much more. Think about the patient too. Can they swallow? Peg or NG tube? Are the on the vent? Do they have IV access?

[pinkiepieRN]

I do not have to scan meds before I give them; but I was spoiled with that in my last position. I'm also used to a computerized MAR. Another confusing thing is that med times aren't in military - they're in AM/PM. It's very easy to skim down the kardex and see a whole page of BID meds given at 9a and then a random one in the middle for 9p.

As far as writing down all the meds, I'm in LTC with 16 patients and 7-8 meds is an average number. It's not the "easy" patients with 2 meds that I have trouble with; it's the ones with 8 different pills and a couple of liquids and then some medication that isn't in their bin but is floor stock. Of course, there are also cases in which the same med is ordered either Q day or BID, depending on the patient.

[xoemmylouox, ASN, RN]

Unfortunately you may always have a bit of stress when it comes to meds. Patients take SO many now (especially in LTC) that it takes double and triple checks to make sure you've got it right. All you can do is take a deep breath and refocus.

[elantra]

go slow and breathe