ER medication errrors

[servant]

I have ADD and have had four medication errors in the last 5 years. I am considering going back to work in the ER (I was an ER tech for 6 years) but am very nervous about the possibility of making an error. I hate Med/Surg and my errors occured when I had 6-9 patients. My skills are excellant, however it is sometimes hard for me to slow down and see the details of medications while busy on the floor. All I have ever wanted to do was to go back to the ER. It is a marrage that seems suitable, but I wrestle daily with the fear of making another med error. Please, what are your thoughts?

[veetach]

HAHAHA!!! how true how true....

Servant, dont let those med errors stop you from making a department change, I dont know any good nurses who havent had a med error in their past. Including myself. We are all human.

Good luck, I wish you well.

[jrda328]

lol 'dis one's gud stuff.

...up up for 'dis post haha!

[Larry77, RN]

In our hospital it is easier to make a med error in the ED than on the floors because all our meds are "overrides" in our Pyxis...our patients do not have "profiled" meds like the floors...basically means you can pull out ANY med for ANY patient at ANY time. I have been very careful in my career and still have made a couple minor med errors...it happens to all nurses eventually, don't take it as a failure but do continue to do your 3 checks of the 5 rights (yikes I remember that...lol). And yes, welcome to the crazy world of emergency nursing ;-)

[canoehead, BSN, RN]

Most of my errors and near misses are wrong patient issues. Especially the ER, where people get shuffled, and they're getting new meds all the time. I've made it my practice to ask for a name whenever I walk in the room to do something. It's saved me from making a stupid mistake many times.

[8jimi8ICURN]

The ED is often hectic, and that may be as bad as having lots of patients. Last year we started a procedure whereby the nurse takes the MAR, or physician's order, into the room with the patient and reads the med as it is being administered. That makes it harder to give the med to the wrong patient. I hope an ER nurse can give you some pearls. It is impt, to me, to be working where I want to be.

A MAR is not necessarily going to save you. MARs get changed and updated, especially if you are too busy to check your meds in the computer before you pass them... after you have printed off all of your MARs for the day.

I haven't ever taken 7-9 patients, but there is no excuse for not checking your patient's name before you give them medication, especially if you have 7-9 patients, right? I'm not trying to appear harsh, condemning, or holier than thou, so please don't read any of that into this electronic context. If you know that your problem is rushing while you are giving meds, slow down! It doesn't take that long to read the medication you are giving, or tell yourself in your mind "why am i giving this med?" If you don't know what a med is, you should look it up before you give it, right?

Sorry, I just got out of school and the 3 checks and the 5 rights and the "know your meds" rationales really DO make sense to me. The first rule of medicine is to do no harm :) So, slow down. Be careful when you give your meds and your ratio of med errors will accordingly go down :).

To date with 2 years of nursing school, I have only made 2 medication errors: 1st one was in 2nd semester - I gave a medication without talking to my instructor about it (nitrobid -paste) I knew what it was for, how much to give and I checked a BP before I gave it. My teacher said, "We didn't discuss that one," and I said, "...You are right..." and she said, "What does it do?" and I told her and she said, "Make sure you discuss them with me first," and smiled at me. My second error was a misidentification of a medication (i thought it was the generic name for a different medication) in my last semester. I caught my error on the 2nd check.

Good luck with your change to ER! :) :)