Beating myself up - anyone else?

thatoneguy · Jan 27, 2006

I wasn't even THAT busy or stressed.

this is why IMO. if your anything like me. i work best when stressed or very busy. if its real slow thats when this could happen to me. i make it a point to stay busy and keep my mind alert during down times. for me this is when things are the hardest. give me 50 things to do right now and i will not forget a thing. give me 5 things to do and 12 hours to do it i will forget to do one of them.

How do you leave a mess up behind and keep doing the excellent nursing that you know you can do???

just that. leave it behind you . of course learn from it and set up things so it will not happen again. change your routine while giving meds. look back and think, not about the mistake, but about those times you are most vulnerable and likely to make mistakes. best way to deal the distraction at those times. you know get a plan and go with it. :cool:

Scooby · Jan 27, 2006

Thanks, and I think you're right.

As a student, I was taking a full patient load and I was fine. I almost feel like starting slower on orientation is regressing!

From now on, I will make sure I list ALL the meds on my "brains". I think that is where I went wrong. I often feel rushed in the morning when everyone is waiting to look at the MAR and I am writing down every med and dose. I know I can look at the MAR again, but I like having that info on my own sheet. This week, I was less detailed - I just put down abbreviations of each med at the time it was due.

Tomorrow, everyone will just have to wait for me. Yes, I'm slower. Yes, I might write down more than they do. But I will be safe for the patients.

Thanks again. I still can't shake this feeling of disappointment in myself. I guess that will come with time and with enough successful shifts...

nursemelani · Jan 27, 2006

I called my best friend, who is also a nurse, when I had made a medication error. I had been a nurse for several years, and this was my first serious error ( gave a med to the wrong patient!) I was SO worried that I would lose my job. She assured me that in med-surg it happens frequently. We are only human after all. I do check my MAR very carefully, even now that I am in homecare and have anly one patient at a time. As soon you feel over-confident, you make a mistake.

Fonenurse · Jan 27, 2006

Just take heart that this had no major effect on the patient, and was rectified so easily. We are all human, but with tasks like meds, it is so important to use the chart - not rely on notes or memory and be methodical to ensure we don't mess up. How can I be so hard - Easy I have made med errors too - in fact I don't think I have met someone who hasn't made a mistake - we are all human. The important think is with reflective practice to learn from it and move on - to being an even more amazing nurse than you were before! And it sounds like you are doing just that. Best wishes for the future.

bluestar · Jan 27, 2006

Forget about perfection, but strive for excellence.

GermPhobe · Jan 27, 2006

I read this yesterday, and didn't reply. TODAY I am beating myself up.

I had a mentally retarded adult patient last night, who'd had extreme pain issues for days. I was told at the beginning of my shift to make sure to get her pain meds on time. She had one scheduled pain med, and one prn med. She had a history of not asking for the prn med and letting the pain get out of control. So guess what I did? I kept up for the first half of my shift, and then dropped the ball. I didn't write down when the prn could have been given--so consequently she didn't get it until she asked. She got EXTREMELY painful. This sounds like something forgiveable, but I was TOLD at report not to do this! Yes, I'm kicking myself.

This poor lady has a terminal diagnosis. I hate to think of her continuing to deal with almost-insurmountable pain--especially if it could have been eased with better nursing care.

HeatherLPN · Jan 27, 2006

Meds get missed sometimes. It happens. Do you feel bad about it? Sure. But it does happen. I used to spend my whole drive home and then lay in bed going back thru the night wondering if I missed anything. I've even called back to work to check and see if I didn't do something. Every time it was done. I would get myself so worked up that I was making myself crazy. Now I can pretty much leave work at work. It's not that I don't care, it's that I'm more confident and relaxed about it now. It takes time.

scrmblr · Jan 27, 2006

Meds get missed sometimes. It happens. Do you feel bad about it? Sure. But it does happen. I used to spend my whole drive home and then lay in bed going back thru the night wondering if I missed anything. I've even called back to work to check and see if I didn't do something. Every time it was done. I would get myself so worked up that I was making myself crazy. Now I can pretty much leave work at work. It's not that I don't care, it's that I'm more confident and relaxed about it now. It takes time.

I still do this! I drive myself crazy.

Try not to let this throw you. Just be a little more methodical next time

perfectbluebuildings, BSN, RN · Jan 28, 2006

I made a couple of mistakes recently that still have me upset, even after talking them out with someone.

The major one, was a nonverbal patient, I work on a peds unit so lots of the little ones are nonverbal but this was an older pt with other issues. Well I hadn't taken care of her before and got in report that she "moved around" a lot in the bed. Well the first B/P and heart rate were very high and she was moving around a bit so I thought well what's going on here? But to make a long story short, it took some calling to a doctor, trying straight cath and trying stopping the GT feeds, which didn't help, before I thought to give the pt some pain meds even though the pt's mom had been saying "she's not usually like this at home" (the movement around in the bed, etc.). It makes me mad now, that I didn't realize at the start and try the pain meds right away. And that once I realized the pt might have been uncomfortable, I first tried to figure it out what was causing it and stop that, instead of going ahead and giving a med for it. Luckily the pain was able to be controlled within a couple of hours, but I'm still beating myself up over not realizing that.

Also, I think I forgot to sign off some meds that I did give, so that's going to be a major problem, since I'm not back till Monday. I usually ALWAYS check all my MARs right before I leave to be sure they're all up to date, but didn't this time for some reason, I was a little frazzled. I guess that will be a write up or something and rightfully so. Luckily, they were meds I checked with another nurse and I think they were all IV, so the amt of them is recorded on the I/O, so it's known they were given. I hope anyway.

And I've been a nurse there since end of June and still worry over sooo many things, and make "DUH" errors like this. I wish it would get better but I guess it will take a lot more experience!!!

(Edited for content/grammar mistakes)

Pocamom · Jan 28, 2006

I had this very same type of error, I totally missed one, it was a lovenox injection. I had given the pt their other 2000 meds but for some reason missed this one and didn't catch it until 6am the next morning at the end of my shift. I was absolutely sick about it. And so very pissed at myself.

I have learned from this mistake. I do not write down every med and time, that would be just way to time consuming for me but I do do this:

When I come on I get the 10 min early and look at the MAR's I write the time of each pts meds on my report sheet and circle it, then next to the circle I put the number of meds the pt is to recieve at that time. And then when I am getting the meds out and doing my 3 checks with the MAR I make sure that they are getting that number of meds, I haven't missed one since. It has been really effective for me.

Our vice president of nursing wrote an excellent article for us and in it stated: "We need to unmask the unspoken myth that if we are really good nurses, we won't make any mistakes. In reality, we don't go to work hoping to make errors, but the happen to ALL of us (yes, ALL of us) and we need to support when they happen."

This article came out one day after my error and it really helped me. I now have a copy of it in my locker and at home by my computer as a constant reminder. I hope this quote helps you also. :)

Scooby · Jan 28, 2006

Thanks so much for your input, everyone! I'm glad I am not alone (even though I KNOW this happens to everyone, it is hard to think about that when you have such an emotional response to your own screw-up).

I had a much better day yesterday. I felt like I was getting better at time management overall (of course I only have two patients right now, but I am working my way up). It was only my fourth day on the floor, and I'm lucky that they have a nice preceptorship/internship for new grads.

Thanks again all for sharing. I am feeling confident again, and all your replies helped tremendously!