First real screw up


One of my pts had Roxenol ordered. I had never pulled it, and in doing so, I counted before pulling it, but instead of where it asked how many were taken (should have been 1) I thought it meant how much I was giving (5mg) so I put 5! But it looked like I took 50 mg instead of 5!! Ack! I explained it to the charge nurses at the end of the shift when they were counting (I didn't know it was an error until then). Ugh. Now I'm paranoid that I'm going to be watched :/ I made sure to pay attention the next shift (had the same pt) and pulled it 3 times for the pt but made sure to put 1 was taken!

iPink, BSN, RN

1,414 Posts

Specializes in Critical Care, Postpartum. Has 10 years experience.

You shouldn't be paranoid about that unless you were truly guilty. I've done it before by just accidentally pressing the wrong number. I usually tell the CN sooner than at end of shift, but as long as they were told and the count was accurate. We are human and make mistakes, just be more aware next time and all is good.

If I'd known it was a mistake sooner I would have told. It was the only time I had taken one out that night, so didn't know until they saw it at count time. But I knew for the next shift to put 1 instead of 5!

Specializes in Critical Care, Education. Has 35 years experience.

No worries - apparently this was a documentation error due to misunderstanding. The patient received the correct dosage. I'm sure you will be much more careful in the future now that you understand the process more clearly.