First Med Error
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I am so upset!! I made my first med error after 2 years of nursing. I am very, very diligent, I always double check my order, I always check allergies, I made a promise to myself as a student that I would never once get lazy with my med passing process. Well, I started working PRN at a psych hospital 5 months ago for some extra cash and started using a MAR for the first time. Well, on the children's unit it is hand written and the Dr. changes the orders every single day, so you end up with 20 kids, each kid as 6-10 pages of very sloppy MAR with everything crossed out, highlighted, switched around, you get my drift. Well, I always scroll down looking for my 20 meds to give and I skipped over a 20 and failed to give a pt. a dose of Adderall. This 20 was written on the wrong line, circled for some reason, and had the drug name written ON TOP of the 20. The thing that gets me, is I checked this MAR three times, my usual two times and then once again when the child said "where's my blue pill" I checked the MAR again, (missing this 20 AGAIN) then looked at all his meds to see if there was even a blue pill--well they are in the narc's box of course, so I didn't see it. I have never given Adderall at night before. Anyway, I don't want to sound like I am trying to place the blame on the MAR, but I am a bit of perfectionist and I take pride in my work, and I can't help but feel like maybe this is a dangerous place to work. Sure this time my mistake caused no harm, but it makes me so nervous that this sloppy MAR process has so much room for error, what if next time it is a big mistake? I am used to using the Omnicell in the ER one chart, one order right in front of me, not alot of room for error. Maybe I can convince them to adopt a better system, he, yeah right......
Would you quit this job?
Perhaps I am over-reacting--I am pregnant and a bit, ummm, psychotic!