Coworker and medication errors

[Jules A]

A nurse I work with constantly makes med errors. Fortunately they have been minor although imo that does not make it ok. Since I relieve her 3 days a week I keep finding them. I just correct what I can and when I tell her she is receptive but the same things keep happening over like missed medication administrations. At one point I reluctantly told my NM that there are quite a few issues being missed but nothing has changed and I don't feel it is my duty to be the nursing police and report her every misstep. She is very nice just not the brightest bulb in the box and it is really starting to wear on me. Any suggestions?

[Jules A, MSN]

Is she missing colace, or blood pressure medicine? IMO, the specifics of the errors DO matter.

It is more likely to be the colace hence my reluctance to make a big deal out of it but in the past two weeks there were 8 "colaces" and it really isn't about being too busy or lazy. I think it is more about a disconnect in the thought process somewhere.

[pagandeva2000, LPN]

I am the sort of nurse that will try and speak to the other nurse first, depending on how severe it is. It could have been that they forgot to sign, etc...(Jules, exactly what happened?). I tend to listen to their explanation, judge for myself whether or not this is a person who clearly forgot, doesn't care or is not that bright. If it is that it was an honest mistake (and we ALL make them) and no harm was done, a responsible nurse would try not to let it happen again. If it is one of the latter two, I would tell them that next time, it would have to be reported to for safety reasons and the protection of my license.

How long ago did you tell the supervisor? I'd be curious to know this because those actions can show me what sort of support would I receive if I had reported something. If there remains to be no change, then, this lets me know that the supervisor either spoke to the nurse, but she is too bubble headed to take heed, or that the supervisor doesn't care either (or they may be friends). Then, take the chain of command.

During this time while in wait to see a response from the supervisor, I'd probably tell this nurse one more time that this is a sincere problem that will fall on me, and I have to protect self.

[pagandeva2000, LPN]

I wish it was a matter of just forgetting to sign things off that were given although that happens every shift also. Most often it is missing new orders that never get signed off on or started. Again it hasn't been anything especially dangerous but if the order is for Cogentin IM either read it and give it correctly or get them to change the order before you give it PO and c'mon if the physician wants an antibiotic started this morning, start it this morning. If it doesn't get signed off the pharmacy doesn't send it to the unit and am orders shouldn't still be in limbo land at 7pm when I come in.

Thank you to everyone for writing with your insight and advice.

It is more likely to be the colace hence my reluctance to make a big deal out of it but in the past two weeks there were 8 "colaces" and it really isn't about being too busy or lazy. I think it is more about a disconnect in the thought process somewhere.

I was just about to ask if she is overwhelmed or busy. Do you still work in psych? Are you guys still using paper charting or are you all on line, now? Not making excuses for her, but, I can see a bit if there is difficulty comprehending the handwriting, etc... But I also know there are many bubbleheads working like that in my facility. They can be a nightmare, because it gets to the point where NO ONE wants to pull their coat tails any longer. I still say to watch the actions of the person you reported it to (in order to know what to expect from them later) and speak to her one more time to clear your conscience in case you do have to take it further. There is nothing wrong with wanting to protect yourself. And, I can understand the frustration of trying to clear up the mess from the previous night and have to also deal with the headaches of that oncoming day. That isn't fair, either.

[Jules A, MSN]

I was just about to ask if she is overwhelmed or busy. Do you still work in psych? Are you guys still using paper charting or are you all on line, now? Not making excuses for her, but, I can see a bit if there is difficulty comprehending the handwriting, etc... But I also know there are many bubbleheads working like that in my facility. They can be a nightmare, because it gets to the point where NO ONE wants to pull their coat tails any longer. I still say to watch the actions of the person you reported it to (in order to know what to expect from them later) and speak to her one more time to clear your conscience in case you do have to take it further. There is nothing wrong with wanting to protect yourself. And, I can understand the frustration of trying to clear up the mess from the previous night and have to also deal with the headaches of that oncoming day. That isn't fair, either.

Thank you so much for writing. From what I can gather she is not that smart because charting is eletronic. Absolutely everyone makes mistakes, Lord knows I have made plenty myself, and no one should have to be put under a microscope so that has been my hesitation in being too formal with it. I do ask her for clarification but I don't think she really "gets" that these are medication errors since most are glossed over by me signing off on the order, getting a rush from pharmacy and administrating the medications late if appropriate or just having it started the next day etc. Like you said I think I am just tired of it. Excellent point about the reaction or lack of from my supervisor who is very hands off with unit operations and yes she does like this nurse so perhaps there in lies my answer.