First medication error- I am quitting nursing

  1. I had a horrible week at work. I had a prisoner who tried to hit and kick me everytime I tried to touch him to do am assessment. He refused all his care and he called me allsprts of wonderful names for 3 days. Crazy thing about this whole situation is that I was told by risk management that we could not send patient back to jail because he was confused because he didn't know where he was and that if I did anything invasive I could be charged with assault yet he assaulted me for 3 days. And then I made a medication error the week prior that was not caught for 3 days the week before on a patient with PE who did not get his lovenox because pharmacy said they never got the order even though I scanned the order well 3 nurses missed it. But it's my fault because the order was first seen by me and I should have checked more thoroughly. Anyways I'm quitting. I am going back to school to be a vet because I think animals are more civilized and decent than humans.
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    About tolerantgirl

    Joined: Aug '08; Posts: 214; Likes: 146

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  3. by   Purple_Scrubs
    So sorry you are going through this. Try not to make any decisions while you are still emotionally upset, those spur decisions can come back to haunt you. Keep in mind that although we are expected to be perfect, we are human and therefore imperfect. We all make mistakes. Do a search on this forum for med errors and you will see what I mean.

    As far as being assaulted by the patient, you should not have had to deal with that. Sure, sometimes people with physical/mental illnesses cannot control their behavior, but your safety counts too. If your hospital has internal incident reports or something along those lines, I would file one immediately to try to see that procedures are put in place to make sure it does not happen again.

    And if all else fails, remember that dogs bite, cats scratch, and horses kick In all seriousness, I have a dream of going the DVM route too, so I hear you there. In my case it is mostly financial reasons that keep me from it.

    Hang in there!
  4. by   morte
    Quote from tolerantgirl
    I had a horrible week at work. I had a prisoner who tried to hit and kick me everytime I tried to touch him to do am assessment. He refused all his care and he called me allsprts of wonderful names for 3 days. Crazy thing about this whole situation is that I was told by risk management that we could not send patient back to jail because he was confused because he didn't know where he was and that if I did anything invasive I could be charged with assault yet he assaulted me for 3 days. And then I made a medication error the week prior that was not caught for 3 days the week before on a patient with PE who did not get his lovenox because pharmacy said they never got the order even though I scanned the order well 3 nurses missed it. But it's my fault because the order was first seen by me and I should have checked more thoroughly. Anyways I'm quitting. I am going back to school to be a vet because I think animals are more civilized and decent than humans.
    could you explain how the lovenox is your fault? and the nurses should have been looking for an anticoag on a PE patient anyway....geesh
  5. by   chare
    and then i made a medication error the week prior that was not caught for 3 days the week before on a patient with pe who did not get his lovenox because pharmacy said they never got the order even though i scanned the order well 3 nurses missed it. but it's my fault because the order was first seen by me and i should have checked more thoroughly.
    people need to get away with assigning fault anytime a medication error occurs. while there might be the rare occasion where it is entirely the result of one person's actions, medication errors usually result from a failure of the system, and this is a classic example. as i am unfamiliar with the process at your facility i can only speak generically, however i can think of several questions that need to be answered to determine the cause.

    1. after sending the order to the pharmacy did you leave a copy of the order in the medical record per your facility's policies?
    2. did you transcribe the order onto the mar?
    3. did your relief conduct a chart check reviewing all orders and ensuring they were transcribed properly?
    4. did your relief validate the mar when the new mar was delivered?
    5. if you know that you processed the order correctly, what happened in the pharmacy?
    6. did anybody question why a patient with a pe was not on any anticoagulation?
    7. did the md follow up with the nursing staff to ensure that the lovenox was started?
    did this cause further harm to the patient? it is highly unlikely that missing 3 doses of lovenox caused the patient any harm. remember, lovenox is only going to prevent new clot formation, it is not going to do a thing to either the pe that is there, or the clot from which is came. also, you don't mention if the patient was started on coumadin or not, however this should have been started with the lovenox.

    don't let this drive you from nursing. medication errors are going to happen. when they do, learn from them and don't make the same mistake again.
  6. by   vanillavirtue
    Quote from tolerantgirl
    I had a horrible week at work. I had a prisoner who tried to hit and kick me everytime I tried to touch him to do am assessment. He refused all his care and he called me allsprts of wonderful names for 3 days. Crazy thing about this whole situation is that I was told by risk management that we could not send patient back to jail because he was confused because he didn't know where he was and that if I did anything invasive I could be charged with assault yet he assaulted me for 3 days. And then I made a medication error the week prior that was not caught for 3 days the week before on a patient with PE who did not get his lovenox because pharmacy said they never got the order even though I scanned the order well 3 nurses missed it. But it's my fault because the order was first seen by me and I should have checked more thoroughly. Anyways I'm quitting. I am going back to school to be a vet because I think animals are more civilized and decent than humans.
    Well, just thank the Lord you didn't kill anyone off with the med error! Now, with the patient hitting you, you might want to consider working somewhere else. I don't know if you are a female/male, but those patients that are mentally ill could be strong and dangerous. You might want to consider working in a different facility or another area of nursing. I had a aunt who was in a psych ward, and it was really scary going in there to visit her. Those patients were scary, and I was a young child when I went on those wards.
  7. by   jjjoy
    Quote from Purple_Scrubs
    Keep in mind that although we are expected to be perfect, we are human and therefore imperfect. We all make mistakes.
    I find the messages surrounding making mistakes incredibly frustrating at times!!!

    When someone says "you should've done X" they often aren't clear if they mean that "you didn't know this but now you do" or "you should've *already* known to do X"... my self-critical mind tends to interpret the latter unless I'm other assured that it was a *reasonable* mistake I made given my own experience to that point and not something I really *should've* known to do differently.

    And while it's true that we learn from our mistakes, I can find it disheartening when someone says "Well, you'll never make THAT mistake again!"... actually, I might! Of course, it depends on what it is but the fact that I could make a mistake once that means that I COULD make it again... probably not EXACTLY the same... but it might be similar enough that I feel like a hopeless idiot because now I've failed in two ways... making the mistake to begin with AND having it be similar to a previous mistake that I was supposed to have never done again!

    There often IS an expectation of perfection, which is, of course, impossible to meet. The only way to get as close to perfection as possible is to have lots of redundancy and double-checks... and that costs money, lots of money in order to have more manpower to allow for the degree of overlap needed to ensure close-to-perfection processes (like for rocket launches, complex medical operations, etc).

    Of course nurses are bound to make mistakes! They can't just check off one task at a time; instead they are bombarded with distractions and are juggling several different demands all the time. And due to tight budgets, the type of redundancy needed to further minimize errors is rarely every implemented. So things regularly get missed, but usually nothing bad comes of it, no one notices, and the assumption is that no mistakes were made. Yes, we'll just assume all is well until a mistake comes to our attention and then we'll assume that all the mistakes we catch with a more thorough review simply indicate a horrible lack on your part instead of reviewing EVERYONE to the same degree and perhaps seeing that there's a more pervasive problem.

    Sigh! This is a touchy area for me! I really need to learn some alternative ways of dealing with the reality of the possibility of mistakes without becoming overly paranoid!
  8. by   kapl70
    You are HUMAN!!! After all, three other nurses missed it too. Don't be so hard on yourself. Just be careful. I'd just find another job. You don't sound happy in that one anyway, right? So just move on and count it all as experience No one should have to work in fear of being attacked by a patient.
  9. by   Bobylon
    Quote from chare

    Don’t let this drive you from nursing. Medication errors are going to happen. When they do, learn from them and don’t make the same mistake again.
    Amen !!!!! This was stressed frequently while in school (March grad, here). Instructors stressed that every one of us WOULD make med errors over time. It happens, and as you said, learn from it and don't make the same mistake. Hopefully any errors will be minor and/or correctable. I've come close a couple of times due to changed/new orders not having been confirmed and our computers acting up - comps are wonderful assets.....WHEN THEY WORK !!!! I know my time will come, and I hope it's nothing significant.
    To the OP....don't beat yourself up over it (although I would feel the same as you do, being as that's the way I am)....as chare said, learn from it and move on. My nephew is out of college and going back to school to become a vet ........ a noble profession, in my eyes - I love animals....all animals. I wish you the best of luck with whatever path you choose
  10. by   libbyjeanne
    Maybe the problem is your work environement. I am assuming from your post that you work in a jail or prison. That is a rough patient population to work with and it takes special motivated nurses to deal with a work environment like that. Nursing may be for you...you just have to find the right work environment. Don't give up! Try again! What could it hurt?
  11. by   NickiLaughs
    As far as the abusive patient, you have the right to protect yourself as well. If the patient wasn't in restraints or proper measures taken to protect staff, sounds like the facility is lacking.
    The med error: We ALL make med errors. The nurse educator for our training program 20 years in will admit she's made med errors during her practice, and she knows of one for sure that took a patient's life. I will admit I've made some, luckily nothing major, but it happens.
    Furthermore, I worked somewhere where an insulin order didn't get in, the nurse who didn't follow up with it had nothing happen, I got written up because I worked the 3rd day it wasn't available, and even though I called the pharmacy twice and left a message with a physician, that "wasn't good enough."

    Sounds like you need a job change more than a career change.

    Good luck!
  12. by   sissiesmama
    First of all, let me start by saying that I have been a nurse for almost 18 years, and there is NO, I repeat NO WAY I could work the job you do. NO WAY!!! You are a saint to do it. I would cry before work, after work, probably while at work.

    I remember when I made my first error. It was within my first 6 or 7 months of nursing after graduation, and I thought the same thing you are thinking. Please don't make any decisions in the heat of the moment, give it some time and make any decisions you need to make calmly.

    I do hope you decide to stay in nursing. You are needed, and you are working in a place where every day is a challenge, to say the least. Like I said, I couldn't do it.

    Anne, RNC
  13. by   ghillbert
    Don't think you'll avoid people by being a vet - there is more people management than animal management with mommy's darling little pookie!

    Agree with others - you sound frustrated, and your work environment does not sound safe or supportive. Take some time, relax, and look for another job. Even if you go back to school, a part time position would be good as a backup.
  14. by   hotshot12345
    1. If the prisoner is in that mental state, then he should be in restraint. If he refuses care, then what can you do? Prisoners still have rights. If you know he is physically abusive, then don't touch him anymore. Verbally abusive? Who cares.

    2. Pt with PE not getting lovenox is not a medication error. You never even gave the med, how could it be an error?

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