Forgot to restart my patients fluids

[daniela095]

I gave an IV push med to one of my patients today and had to unhook them from the continuous lactated ringers infusion to do so. After I was done I forgot to hook them back up to the infusion. It was end of shift and I'm freaking out hoping the next nurse saw and hooked him back up. Has this happened to anyone before if so was it ever a big deal?

[Guest219794]

Not everything is compatible with LR. It's not like NS.

True enough. Oddly, some are incompatible with NS as well.

OP?

[Daisy4RN]

This should not be a big deal. Like others have said you could have just called the unit, we have all probably done that for a variety of reasons, I know I have. I would check and see if it really was needed to stop the infusion, you could be making more work for yourself and also risk forgetting to hook back up. I have been on both sides of these types of things and most nurses look out for one another, hope your unit is like that too!

[djh123]

We've all forgotten something. One of my 'favorites' was when an often-cranky resident at the LTC I used to work at, after I forgot to give her a PRN pain med she'd asked for, said "EVERY TIME! EVERY TIME you forget to give that to me". It happened once. Once. :^)

[murseman24, MSN, CRNA]

It's a very big deal, it's a medication error. Not clear as to why you had to unhook the main IV. But all of that will come out when you write yourself up.

LOL, omg, no. Not a big deal.

[Dodongo, APRN, NP]

Depends on how long the fluids were off and what they were ordered for in the first place. If it's a DKA/HHNK, hyper/hyponatremia, septic resuscitation, dehydration/hypotension, etc. I'll be pretty unhappy the fluids I ordered weren't running. That is a big deal. Otherwise, in a more stable patient, it's not a big deal. Just call the unit and tell them to restart them.

[Been there,done that, ASN, RN]

That being said, we've all done it, or something similar.

Yes, I have made a med error, but not that one in 30 years.

OP is a newbie and has several posts about med errors. In this case, s/he is not taking responsibility by hoping a fellow nurse will catch the mistake and not even knowing if it is "a big deal".

[Farawyn]

Yes, I have made a med error, but not that one in 30 years.

OP is a newbie and has several posts about med errors. In this case, s/he is not taking responsibility by hoping a fellow nurse will catch the mistake and not even knowing if it is "a big deal".

I agree.

[bgxyrnf, MSN, RN]

Yes, it is a med error but...

not all med errors are created equal and...

depending on the patient and the indication for the fluids, this has a high likelihood of not being a big deal.

That said, it is very important to get to the root cause of the error because it COULD have been a vital infusion that was left off which then could have led to a negative outcome.

There is no reason that I can come up with that would require disconnecting a fluid line for an IVP. Even if the med wasn't compatible with LR (which list has to be pretty sporifice), one would typically just pause the pump, flush w/ NS, push the med, and then flush again prior to resuming the infusion... the pump will happily and noisily remind you that you forgot to resume the infusion :-)

[RNinheart]

If I have to disconnect fluids for IVP, I pause it, unhook it, and if I forget to hook it back up, IV pump will start "screaming".

[JBMmom, MSN, NP]

I think that everyone here remembers that we were all new nurses at one time, and mistakes can happen at any time throughout a career. Daniela095, I think the thing that concerns me is that you may not have set yourself up with someone at work to whom you can turn for help and guidance. We are a bunch of random people on the internet, with varying levels of experience, competence, and different places of practice. You have had a few posts since recently starting your career about mistakes, I realize that some or all of the posts were things that you realized after leaving work so you turned to this board. However, I really recommend that you set up a meeting with someone at work, are you still be precepted? Do you have a clinical or education resource nurse on your floor? Is there someone that you can check in with regularly to give you support? In order to set yourself up for future success, you may need more time with regular check-ins with someone at your place of work. Good luck!

[Guest219794]

Yes, I have made a med error, but not that one in 30 years.

OP is a newbie and has several posts about med errors. In this case, s/he is not taking responsibility by hoping a fellow nurse will catch the mistake and not even knowing if it is "a big deal".

You make a good point. as a registered nurse, the OP should know whether or not this is a big deal. Bot the part where she forgot- we all make mistakes. But, as the nurse, she should know the impact of stopping the fluids.

[iluvivt, BSN, RN]

It is a medication error.It is an ordered IVF at a prescribed rate and was not reinitiated after the IVP medication. You should have looked at your IV set up and added a T extension type tubing or dual lumen extension set at the hub of the IV catheter.If its not set up that way you can prime your add on tubing with a normal saline prefill and add it on and redress the site as needed.You can also give it push at the closest Y site if compatible and if not you can also put the fluids on hold or pause ....give an adequate amt of Saline Flush...then your agent (the prescribied medication ) and another normal saline flush.Ypu also want to solve the problem for the next nurse so you lessen the disconnections.Much better to lessen disconnections and keep a closed system.