first med error and feeling burned out

Nurses General Nursing

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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?:bluecry1:

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Just hang in there. I'm orienting from LTC to med/surg and yes, it's remarkably different.

You'll get there. Really.

Now go take a long, hot bath and a nap.

:)

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Specializes in Psych, education.

We all make mistakes and we all have to ask questions, even after years of practice. I hate making med errors! Thankfully my patients were OK, like yours, and I could just use the errors as a learning experience. Bottom line: they happen.

After 8 months, I would be worried about you if you didn't feel bad after an error or if you didn't ask questions.

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I'm sorry to hear you had a bad shift and are feeling burned out.

First off... the med error. Clearly, you are a careful person or else this wouldn't be the first med error. Give yourself big pats on the back there. EVERYONE has made an error at some point. Each person deals with their human fallability in different ways. Some deny it (their falliability) otherwise they feel they might be lowering their standards - if you expect to make mistakes, you will make mistakes. Others accept it - if I expect perfection from myself, I get even more nervous and am more likley to make a mistake - so I have to look at the overall trend, see if the error in question is an aberration (due to a particularly chaotic day, feeling sick, etc) or part of a larger trend (have I started cutting corners?). If it's the former, I can assure myself that I'm doing fine. I'm human and humans make errors on occasion. As long as I dealt with the error appropriately, I have nothing to be ashamed of or feel guilty about.

The moment of discovery of the error can painful. The sinking feeling... one's mind trying to determine what the ramifications of that while at the same time fearing what that might be... what if it's something really terrible? For me, I imagine pushing through it, like pushing through a rain storm... do what you need to do... take appropriate measures to mitigate the problem, contact the appropriate people, be buffetted byone's own fears and perhaps others' scoldings (other people's fears)... and eventually, the storm passes, hopefully with the patient sustaining no lasting problems. Whew! You learned something, even if just how to deal with that kind of error... which is good, because someone else might make that error and you will know what to do... Now, go back to business as usual, being the good nurse that you are.

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Good. You have integrity and a conscience. You made a mistake, owned up to it, followed up on it. I'm willing to bet you won't make the same mistake again.

Now please stop beating yourself up. It's extremely unlikely that you giving a single dose of toradol would have an adverse affect on this patient. You're going to be ok too ;)

Now go take a long, hot bath and a nap.

Yeah, that too :)

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Specializes in onc, M/S, hospice, nursing informatics.

I only wish I followed people as consciencious as you! I know of people who have been in nursing for years and made several med errors in a shift.

Cut yourself some slack, take a deep breath, and keep asking questions! I never mind when people ask questions... what I do mind is the person who thinks they know it all, never asks questions, and then make errors. That's how you learn. You'll be okay!

:icon_hug:

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Relax it's over- no harm done. Bet you never forget to look at stuff like that again when you have a patient on Toradol. Good thing about mistakes - they teach you a lot. If we were all perfect there wouldn't be a reason to have the JCAHO.:lol2: Keep on with what you're doing. sounds like you're doing a great job.

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Specializes in LTC,Hospice/palliative care,acute care.
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?:bluecry1:

I've been doing this for almost 20 years and I made a med error a few months ago.Every med error is a learning experience-you learn and move on..Own the mistake and stay focused.It will get batter-then you'll have a bad day and feel like you could crawl under a rock...That's nursing...I love it....You are doing great

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A couple weeks ago I was on the phone with the on-call GI doc about my ulcerative colitis patient that had developed kidney stones. Out of kidney stone habit, I asked if we should try toradol. I'd mentioned it to another nurse, that knew the kid before I was on the phone with the MD, and they thought it was a great idea. He points out (very nicely) that with the ulcerative colitis, he'd like to avoid it. And it hit me, DUH!! I just asked for a toradol on a kid with active lower GI bleeding. I felt like such an idiot.

Point being, we all have moments where we miss the big picture or the small picture or whatever piece of the picture we need to be looking at. Because we're all overworked and human.

I'm willing to bet that the reason you were doing good and feeling like the last few weeks have been rough is this: You were doing great, so now they can trust you with tougher patients. Believe me, when assignments are being made, it may not seem like it, but generally, we're nice to the newbies. We give you patients with a little less to remember and keep up with. You've been doing great, so now you're getting heavier assignments, because the charge nurses know you can handle them. Try to consider the tougher time you've been having as a compliment to your skills, and that you're improving as a nurse, rather than as a sign that you're not doing well.

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Specializes in Travel Nursing, ICU, tele, etc.

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!!

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Specializes in Trauma ICU,ER,ACLS/BLS instructor.

Hindsight is always 20/20,,,,when one puts themselves in another humans hands,mistakes happen. You handled it better then most experienced nurses would have. I always say that when u make an error,u will never repeat the same one because a cautious nurse becomes more so. Chin up and go forward,tomorrow will be a better day!

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We are human, humans make mistakes. I have been a nurse for a long long time and I made a med error not long ago, not my first, and I doubt it will be my last. Each time I still get that sinking feeling in the pit of my stomach. None of my errors were life threatening, but errors just the same. You are doing great, the main thing is acknowledge it, learn from it and go on from there. We don't go to work planning on making mistakes, sometimes they just happen. You sound like a very good nurse so don't let this get you down. Hang in there. BTW, there is nothing wrong with asking questions either, I still do that too. I left LTC after many years and started working med surg, believe me, I ask plenty of questions. We never get to old to learn and we are never going to know it all. Hold your head up and go take care of your patients!!!

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