First Med Error as aNurse

[WeirdNurseKelly, BSN, RN]

I arrived at work yesterday for evening shift, noticed my communication envelope contained a few slips of paper and EEKS. One was a med error. I almost started to panick. Oh, this is an assisted living facility and I am a new grad (licensed June 22 new). So the first thing I did is go directly to DNS. I missed a scheduled benzo for a patient. I asked her if it was REALLY bad that this med error occurred. She said not really because I am new and learning the routine of passing meds and the residents.

So I start my shift and everything goes great! At the end of my shift I am going through the MAR to make sure I signed off on all the meds I gave and make sure I didn't miss anything. I found 2 meds I missed for a different resident. I think the meds were colace and prevacid (something for GI). The oncoming nurse thought nothing of it and to just write on the MAR that it was a missed med.

I work again tonight but am worried I am going to do this again. I now know why the 2 resident's meds were missed. Narcs are kept in a box (for the first res) and it was scheduled at an odd ball time so I wasn't looking for it on the MAR, the other residents meds were liquids and pretty much the same thing happened with this resident as the other.

Should I be totally freaked about that I made these to errors so close together? I have learned from the mistake by going back and checking the MAR to make sure I didn't forget anything after the first one. And I made a mental note that I wont forget the other 2 meds for the second resident.

I know I need to be aware of what is going on. The DNS made it seem like it was not much of a big deal. I think it is more than that. I know that being a NEW GRAD (literally, graduated June 4, licensed june 22) and only getting 4 days of orientation on meds is not an excuse but I just want to make sure that the DNS is NOT making it less of a matter than what it really is. I hope this makes sense. I tried to cut it down a little, I am just a VERY nervous new grad who needs a little advice and maybe some encouragement or a tongue lashing. Either way, I just don't want it sugar coated. I am a big girl and can handle the criticism.

[caliotter3]

You have been made aware and you are now taking precautions. Good. Don't freak out. Just calmly take precautions. But also be aware that in some workplaces you could have been canned, just like that, when employers go overboard and overreact.

[nurse2033, MSN, RN]

You are properly concerned and have a plan to prevent further errors. Everyone makes an error sooner or later. Just be grateful no harm came to the patient. Now you can see how easy it is, and you must never become complacent with med administration. Don't beat yourself up!

[dukesgal]

I also am a new grad working in a SNF and I make a list of all my residents meds, scheduled times, PM and HS meds and then note any oddball times a resident has a med scheduled so I don't miss them. I have a little cheat sheet I use and highlight any of those med times. I am still learning too, but I try to go over the MAR with a fine tooth comb at the end of every med pass to be sure I got everything.

[Forever Sunshine, ASN, RN]

Your residents aren't going to die because they didn't get their colace/prilosec.

Especially when you are doing a hallway you have never had before you have to pay close attention to the MAR. As you do med passes more and more you will memorize your patients meds and that's how you speed up, but always always always go by the MAR.

[WeirdNurseKelly, BSN, RN]

Thanks everyone. All of the input is really helpful. I am sure all of you say this but man there is not enough time. It feels like I am ALWAYS racing against the clock. I am confident that tonight will go much better but will be very cautious. Thanks again for all of your encouragment.

[Pistachio]

Any nurse who tells you they don't make med errors on occasion is a liar. That said having a plan to correct it is good. Any time you make a mistake you should brainstorm things to can do to prevent it happening again. You should always have more than one if at all possible. Don't rely on your memory, that isn't good enough for anyone, make other habits they will clue you in. You will do fine, don't forget that you are still human like everyone else.

[GRUNGE]

It happens. Just a bit more vigilance. But 4 days orientation for a new nurse is a bit rediculus. As long as you have a plan to prevent further errors i would not be concerned

[noctanol]

go by the mar and dont rush yourself, always sign the medication as you give it, if the patient refuses, you can circle the med on the mar and make a small note of why patient refused med

[iluvivt, BSN, RN]

I made a cheat sheet at the beginning of my shift with the med the dose and time due....if you need a shortcut...just write down the pts name and the time they have meds due and cross off the time on your cheat sheet once given. Also check with more experienced staff to see how they do it...take any of their ideas or part of their ideas and see if they work for you. The idea is to have a plan so it does not happen again. OK, so maybe someone misses a Colace and Prevacid but it could have been easily something else more important. Both incidents show you what you are currently doing is not working so you need to go about it a different way. I always made my own worksheets...now of course it is much easier with all the computer software we all have...so device your own..something that works for you. I have done this for our IV team to keep us on track and organized with all our tasks. If someone can not offer you a solution come up with on yourself