first med error and feeling burned out

[chuckc]

Well, I had my first med error last nite. I had a post op pt, she was going to have an H&H soon after she came to the floor, there was a concern about possible bleeding, in recovery they had ran an H&H, found it was down from preop, and she was treated for low urine output, good UO before she came to us. It was very crazy when I got her, I was very stressed, got the orders, MAR, reconciled med sheet, but I missed a written order that said to D/C Toradol. I gave her the scheduled dose. MD called to check on her, I was giving him update, mentioned the Toradol, he said "WHAT!?" I felt like I had been punched in the gut. In hindsight, I can see how I should have questioned the Toradol, in light of possible bleeding, seems so stupid now. I apologized, would call as soon as stat H&H back, etc. It was the longest 20 minutes or so till results. He ended up calling back himself, he called the lab, said H&H was stable for now. I apologized again, he was very nice. My charge nurse was so nice to me, she stepped in and gave some meds for a pt, made a MD call for me, another pt having problems during this time. I also got another fresh post op during all this. I have been a nurse for 8 months now, got thru orientation, was really sailing along, but these last couple of weeks have been so rough, I have had to ask so many questions of my charge nurse, who is new to our floor, I hate being front and center with my weaknesses. I have been staying late finishing charting the last few weeks also. And if I ever got thru a shift without missing something on the Kardex, I would faint. I feel like I am backsliding. Any words of wisdom or encouragement?

[Sabby_NC]

I am truly impressed by how well you handled your first med error. You took responsibility and kept doing your job. Even the Physician heard that from you. Great job!!

Well said and I totally agree. Hang in there do not beat yourself up, learn and move on in your RN career. I am sure you will do just fine. Run that bubble bath and CHILL. :)

[Elvish, BSN, DNP, RN, NP]

We all make mistakes. I have hung the wrong abx on a postop patient, given morphine to a pt that was ordered for someone else, and the lady who is now my NM gave someone 40 more units of insulin than was ordered for them!!! Fortunately no one was harmed in any of the circumstances, and we learned our lesson.

You did fine. You made the mistake, you followed the right procedure for afterward it sounds, and you will be ok. It is really scary. Your heart just drops when you realize what you've done. But you will be fine. Learn from it, go on, and DON'T THINK ABOUT IT ON YOUR DAYS OFF!

[leslymill]

The first med error I remember making was just as I was starting to gain some confidence. We were giving Nubain IV for comfort to a DNR patient with the family there 24/7. For the whole time I had been working there Nubain came in 10 mg ampules. This one particular day I gave the nubain and came back seeing the pharmacy had supplied us with 20mg ampules instead of 10. I didn't even know it came in 20mg ampules. The PA tried to reassure me I hadn't worsened her condition, but she was in mild respiratory distress before I gave it and his comfort and understanding didn't seem to help me much. I had been so confident on a lock up drug being what it had always been, I didn't even do one of the 6 rights. I learned a big lesson, confidence can betray you.

Half the problem why you hae eaten yourself up so bad is that you and the doctor were on pins and needles for a whole 30 minutes and you and the doctor had no rest for the entire time. You can quit biting yourself now nothing is broken that couldn't be fixed. My prayers go with you cause beleive me God is with you, relax. In a few days that adrinaline from that 30 minutes will be forgotten, but you will have learned something.

[Lynda Lampert, RN]

I just wanted to say that I have been a new nurse for four months and off orientation for a month. Last night there was another nurse orienting a newer nurse. I kept going down and asking her questions. In fact, I asked her more questions than her preceptee did! Did I feel small? Sure! But all of my patients were safe and cared for properly.

Also, everyone I have talked to -- on here and on my unit -- says that asking them all questions is the sign of a GOOD NURSE. I know, I know. It seems counterintuitive, and sometimes I still feel a fool, but people respect me for asking. I've even heard a nurse that has been there about a year track down someone and ask a question.

My new thing is this: "hey, I just wanted to run this situation by someone else. do you think I should do A or B?" That way I don't feel so much like I "don't know" something, but that I am collaborating with another professional . . . and then, of course, when they help me I give them my best smartalek grin and tell them they are my favorite charge nurse. Quietly, though, because other charge nurses have overheard. :)

I've made errors, too. Set up a piggyback pretty as could be. Programed the pump. Hit start, walked out . . . never connected the secondary tubing into the main tubing. Duh!

Had a guy with a sat of 85, slapped o2 on him, and never went back to check the sat. Needless to say they did not come back up and the next shift had to send him to a higher level of care. He was fine, but I CRIED over that one. I was miserable and unconsolable and kicking the stuffing out of myself for DAYS. I talked to every nurse -- charge, manager, staff, anyone -- and they all said it was part of learning. They certainly didn't encourage me to do it again, but it was a lesson learned.

It still hurts me that our lessons must be learned "in the fire" so to speak. A patient was put in the way of potential harm because of my error. I don't like this system of refining by mistakes, but I hear tell it is the only way. The only solution is to pray that our mistakes are small, caught early, and mere ripples in the otherwise healthy care of our patient.

Sorry to go on so long. Just wanted to let you know that you are not the only one. That sentiment has helped me many times and I am sure will help me in the future.

Iona

[chuckc, BSN, RN]

I want to thank you all for your kind replies. It was comforting to read them when I was feeling so down. Lesson learned, I am moving on!