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Discussion

Delaying of abx

Two weeks ago I made a mistake and locked someone’s IV instead of changing to to gravity while they were receiving abx and at a scan. I was thinking they needed the iv line for the scan. It was turned back on as soon as they returned about 20-30mins later and nothing changed with the patient but they did end up being sent out with early stage of meningitis.

I’m a new RN at a small hospital in California.

I’ve felt stressed ever since. I feel like I should have known better and that I completely failed at my responsibility as a nurse. Any advice.

Featured Replies

1 hour ago, Janie10188 said:

[...]

I’ve felt stressed ever since. I feel like I should have known better and that I completely failed at my responsibility as a nurse. Any advice.

Any advice? Yes, quit stressing over this and relax. The antibiotics were still completed in a timely manner. And, while there was a 20 to 30 minute interruption during delivery this had nothing to do with the patient being diagnosed with meningitis as this was already present, and most likely the reason for the patient’s visit to the ED.

View this as a teachable moment, and in the future consider calling to verify whether they will need the line during the scan.

Best wishes.

  • Experts
2 hours ago, chare said:

View this as a teachable moment, and in the future consider calling to verify whether they will need the line during the scan.

Or dropping a second one if it won't completely torture the patient. You have to get cultures from 2 sites anyways.

Agree with both of the above.

Probably would've wanted another line.

It's great that you want to do your best for the patient. Now you'll always remember to consider whether the best thing is to lock what's running or make a different plan.

Also, if you want to get a little bit technical in critiquing yourself, this didn't end up being less than ideal because of the patient's eventual dx/dispo. Rather, it might not have been the best choice based on the presentation, the r/o diagnoses of concern and the treatment that was underway. Does that make sense? In other words, if it takes an hour to get an EKG on someone with chest pain, that doesn't become wrong only if they're found to be having an MI...it's wrong because one of the the main concerns is that they could be.

^I mention all of this only because it helps you prioritize in real time. Try not get in the bad habit of to just performing tasks until someone tells you what's going on. One of our primary operations is to understand what is being ruled out and to plan and prioritize interventions accordingly.

Sorry if that is more info than you need.

No harm, no foul here, though....

Keep learning! ??

  • Author

Thank you for the replies. I am trying to move on as I know I can’t change what happened only learn from the experience. I love working in the ER but I’m often wondering if I can handle it. I like the pace and I find it interesting. I also learn something new everyday which keeps me stimulated though I am struggling with my anxiety. I have never been diagnosed with an anxiety disorder but I definitely believe I have one. I think I am doing well and catching on but I leave stressing about details of my day or if I could of, should have done things differently. Should I look elsewhere?

  • Experts
8 hours ago, Janie10188 said:

Should I look elsewhere?

Why? You'll just be stressed out in a different environment like every. single. new. nurse. before. you. Give it time. You'll be fine.

given what you've told us, that is not a *** up. very mild mistake and these are the best - if you turn it into a learning moment these "mistakes" prevent the big mistakes. take a deep breath, be thankful it wasn't worse and on to the next one 

I’m an ER doc. They are right. Stop worrying about it. This isn't a big deal.

The fact that you worry so much over every little thing isn’t a bad sign necessarily. That’s what I did, when I was new. It’s OK to worry, but then it’s OK to look for evidence or look for back up for if you should or shouldn’t worry about something. And this is something you shouldn’t worry about!

 

you have high standards. That’s good. Keep it up.

This is not a mistake. Maybe someone else would have done things differently, but just locking the line thinking they would need to have contrast is reasonable. Yeah people could pile on and make you think you screwed up, but you wouldn't get that from me.  It's a 1/10 on the mistake scale, and sometimes work is so busy you need to make a decision that isn't p[erfect.

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