feel like an idiot

Ruby Vee, BSN · Aug 16, 2011

im a new grad working on a med surg unit, im at about 4 wks in to orientation and just got put up to 4 pts. one pt got percocet prn and i gave it to him earlier in the shift..well me being so smart decided to just peel them out of the packages and into his hand..well one went flying onto the floor..just on there for a couple seconds and he insists he'll take it while i was saying ill get another one..it all happened fast and he ended up taking it...feel like punching myself in the face afterwards and thinking he's going to get some hideous infection..will never again happen...well later on he was due for it again...same thing when one fell on the floor (im so graceful) this time i insisted and said no i am getting you another one..put that one in the sharps and got another but it didnt even occur to me to waste it with another nurse! i was so focused on getting the replacement it just didnt enter my brain. only when i got home and realized "crap! itll show i pulled three!" i informed my manager this morning via email as i have the day off today and wont be in..she said to let my preceptor know and to read up on the policy and said what to do next time...she is very nice and has never been the intimidating scary manager so i appreciate her understanding..she wants to talk with me tomorrow (but had a smiley face next to this statement in her email so i think it's just to see how im doing)...bottom line i just feel like an idiot! a. about the pill on the floor and then b. not wasting the other one when it happened again...it's just hard for me right now to think of each thing on a busy med surg floor when im trying to adapt to handling 4 pts...im worried about the dropped pill and i feel bad about the mistake with the waste...i just want feedback and ...not going to lie...some comfort if possible...i really beat myself up over things like this and i know neither thing will happen again...i know i have to look at it as learning...but i still feel crappy about it. learning and remembering everything in a fast pace environment like this is challenging for me..but i know those two things wont happen again.

everyone makes mistakes, and this one is pretty minor in the greater scheme of things. next time you'll remember to have someone waste it with you.

if i had a quarter for every pill i've dropped, i'd be able to retire on a beach somewhere . . . .

katygw · Aug 16, 2011

thanks for the replies...I realize in the scheme of things there are much more major errors that can be made...I have to mention it to my preceptor and I hope she is okay about it...she's very nice and helpful...honestly my brain just kind of skipped to the next step which was getting a new pill...whereas I should have first wasted the other one...in no way was trying to make it quicker or easier..and the fact that it was unplanned made my brain kind of skip that step...Ive wasted narcs before when they come in the syringes and have done it correctly..I guess this being my first run in with an unintentional situation where a waste was needed didn't really jog my brain into doing that...if that makes sense to anyone lol. I just hope everyone is okay about it and can move on...and yes trust me from now on ALWAYS into a cup...he was a young pretty healthy guy so I figured I'd just pop em into his hand..wrong idea on my part lol.

Kooky Korky, BSN, RN · Aug 16, 2011

thanks for the replies...I realize in the scheme of things there are much more major errors that can be made...I have to mention it to my preceptor and I hope she is okay about it...she's very nice and helpful...honestly my brain just kind of skipped to the next step which was getting a new pill...whereas I should have first wasted the other one...in no way was trying to make it quicker or easier..and the fact that it was unplanned made my brain kind of skip that step...Ive wasted narcs before when they come in the syringes and have done it correctly..I guess this being my first run in with an unintentional situation where a waste was needed didn't really jog my brain into doing that...if that makes sense to anyone lol. I just hope everyone is okay about it and can move on...and yes trust me from now on ALWAYS into a cup...he was a young pretty healthy guy so I figured I'd just pop em into his hand..wrong idea on my part lol.

Why do you have to tell your preceptor? Stop guilt now.

katygw · Aug 16, 2011

my manager said to let her know :eek: I'll just explain it as I did on this board which is the God's honest truth...I just wasnt expecting the pill to fall so I didnt really think it through and just thought about getting another one...wasnt expecting to have to waste so my brain didnt really realize it and consider it. Sometimes I wonder what I look to to my preceptor and manager...like a crazy chicken with my head cut off not knowing all of this stuff...I just hope they can see where I'm coming from and understand...Im just overwhelmed and trying to do the best I can. I want to get alot out of med surg so I can have the experience and gain the knowledge and then go into a specialty...right now it just seems so "task" oriented and like Im not using my brain..hopefully that changed with time.

1hotnurse08 · Aug 16, 2011

Everybody has dropped a pill or two throughout their nursing career. I have been nursing for 10 yrs now and I still drop pills!! U r only human and everything will be okay. We all get into a hurry at times when u have patients/residents all calling for meds at the same time. Just prepare your medicine at the cart over a medicine cup!!

Jenni811, RN · Aug 17, 2011

ahhhH!!!! same exact thing happened to me when i was new. Except it was with a Lortab. I dropped it on the floor (ew) and i threw it away in the garbage. I was in a hurry, not even thinking. I threw other medications like that away before, so it didn't even cross my mind the need to waste it with another RN.

Difference being is my manager came up to me and asked for me to explain what happened because 2 were pulled and 1 was given. She was basically like "I know you wouldn't take it and there is an explanation for this."

I was told the exact same thing. We let my preceptor know and i had to take a 20 minute education review on wasting narcotics. That was it, nothing came of it again.

It's a simple mistake that any new grad can make :) Don't sweat it. I still cringe at the thought of what i did, but i feel much better knowing i wasn't the only one! Thanks!!! :)

christinacub · Aug 17, 2011

I love the story a nurse educator likes to share. She put on a blood pressure cuff backwards and pumped and pumped and it exploded off the patient. She said something like "oops, that one's not working" then prayed..."Lord please don't let me kill anybody!" That one still makes me smile

katygw · Aug 17, 2011

Good to know Im not the only one either, thanks as well lol..yes it's like you described it..I just didn't even think about it because with other pills you dont really think twice (if a vitamin were to fall on the floor..no problem to just throw it away)...it's not like I said in my mind right then "oh I should waste this but eh whatever"...I legitimately just didn't think to do it...dont ask why I just didnt! Sometimes I get ahead of myself and I think it's what happened here. I just want to tell my preceptor, hope my manager is okay and move on. I have 3 classroom days starting tomorrow and then the weekend off..I'd like to enjoy this mini mental/physical break from the floor without worrying about this the entire time...I'm like that at times unfortunately..I tend to dwell on things...but I know only I can control that.

Jenni811, RN · Aug 17, 2011

Good to know Im not the only one either, thanks as well lol..yes it's like you described it..I just didn't even think about it because with other pills you dont really think twice (if a vitamin were to fall on the floor..no problem to just throw it away)...it's not like I said in my mind right then "oh I should waste this but eh whatever"...I legitimately just didn't think to do it...dont ask why I just didnt! Sometimes I get ahead of myself and I think it's what happened here. I just want to tell my preceptor, hope my manager is okay and move on. I have 3 classroom days starting tomorrow and then the weekend off..I'd like to enjoy this mini mental/physical break from the floor without worrying about this the entire time...I'm like that at times unfortunately..I tend to dwell on things...but I know only I can control that.

Exactly!!! like you described me. I would not think twice if it was a vitamin, just to toss it and get a new one. I have NO interest in taking narcotics, nor will i ever. so things like that just don't cross my mind. I was in a hurry, i had a lot to do. it was going on 3pm and i havent had one break since i started at 0630. So i really do understand. It's a mistake that did not cause any harm to anybody. You learned from it, and it won't happen again.

Try not to dwell on it. I did for the longest time, and to this day everytime i have to waste a medication i just cringe thinking about what i did. But...it's over, nobody got harmed by my mistake. We are human...we make mistakes and we learn from them.

If your manager makes you take a drug test (mine almost did), or do an education thing do NOT be offended by it. they are protecting themselves and you. If JHACO came, this could turn on you and they would say "What did the hospital do about this situation?" Hospital needs to prove they did something, such as making you take an education course, like mine did. Or they did a drug test to make sure you didn't take it.

Your hospital wants to protect you, and these policies are there to do just that!

Don't sweat it. It will probably never leave your mind, but given time it won't be a big deal anymore.

katygw · Aug 17, 2011

thanks for the comforting words, didn't sound like my manager wants a drug test...she said to read over the policy and let me preceptor know..but as you said if anything needs to be done I know it's for everyone's safety...as for giving a dropped pill..I just dont even know why that happened..Im a germophobe so it shouldnt have but it was so quick and unexpected and he was adamant that he didn't care so he just took it...dumb on my part..still punching myself (figuratively speaking) about that...it just happened so fast! Im so paranoid that he's going to get some infection or something..he's a younger guy (compared to the majority of geriatric pts we get) with a very good appetite when I had him so hoping the pill was digested and broken down and eliminated quickly. the whole thing was just a mess..bottom line always in MED CUPS...I usually use the med cup but for some reason I wasnt on these occasions...learned my lesson!

Jenni811, RN · Aug 17, 2011

thanks for the comforting words, didn't sound like my manager wants a drug test...she said to read over the policy and let me preceptor know..but as you said if anything needs to be done I know it's for everyone's safety...as for giving a dropped pill..I just dont even know why that happened..Im a germophobe so it shouldnt have but it was so quick and unexpected and he was adamant that he didn't care so he just took it...dumb on my part..still punching myself (figuratively speaking) about that...it just happened so fast! Im so paranoid that he's going to get some infection or something..he's a younger guy (compared to the majority of geriatric pts we get) with a very good appetite when I had him so hoping the pill was digested and broken down and eliminated quickly. the whole thing was just a mess..bottom line always in MED CUPS...I usually use the med cup but for some reason I wasnt on these occasions...learned my lesson!

yea, there has been a couple times where i haven't used med cups. In my situation, i used a med up, i just knocked it over when i was pouring her a glass of water. She too insisted on taking it. My case was a tiny little old lady, so just infection control wise i too didn't want to give her a pill off the floor. Ew.!!

You did the right thing though by telling your manager what had happened. Now you know for next time!!

I honestly don't think he has at risk for getting an infection. Think of all the crap we touch during the day with our hands, and somehow it ends up in our nose or mouth. Look at all the stuff little toddlers get in their mouths and they end up fine. Unless he had open sores in his mouth, i wouldn't worry about infection. That would be least of my worries.

nsue · Oct 22, 2011

Canesdukegirl, I like what you said about the hurry up and fix it getting us in trouble. Last night I felt like all night long I was in that mode because it was one crazy thing after another. Basically I felt so overwhelmed and behind I was in panic mode. I did end up making a mistake because I was in a hurry. Fortunatly not a serious one, but the point is if we take some time and think about what we are doing it can prevent some serious errors. Appreciate the good advice...THINK before you act!