Not labeling the bag with Vanco was a huge error.
"Administering" the medication properly (by that I mean verifying 5 rights) might have changed the outcome and it might not have, since 500 ml boluses are a fairly common order in EDs, so that one could've checked a 500 ml NS bag [which, unbeknownst to them included unlabeled Vanco], checked the order to see that there was a 500 ml bolus ordered, had the right patient and all of that. However, had you administered the bag of fluids properly in the legal sense, you would be uninvolved in the erroneous portion of it - that would fall to no one other than the RN who added something to a bag and then didn't label it.
However, as you have acknowledged, your actions were negligent and it is correct of you to let that sink in a little, as you are doing. You basically hooked someone up to something without completing a legal medication administration. Lots of patients are indeed getting fluid boluses in the ED, but not every patient is. It isn't my intent to rant at you
- but the idea of having someone on my team who has been given privileges to hook someone up to an IV but then operates as if "hooking up IV" is a task and not a legal nursing function is frightening and makes me a little edgy. I would think, "Who the H goes into a random room of mine and hooks up an IV solely because they see some of the related equipment near the patient?!" That's basically what you said you did.
The other thing (which wasn't "the" problem here but will help you in the future) is to communicate. The second there is uncertainty about anything,
excellent communication is necessary.
Okay, this next part is hard. Based on your statement about "just basic NS" and your misunderstanding about legal medication administration - I recommend that you ask your manager for some remediation/extra education about IVs and medication administration. I despise making waves at work, discussing concerns about coworkers, and the like - so I do it very rarely. But based on what you have told us here, if you were my coworker I would pursue with management my belief that your role should change for now (either the amount of independence that you have or the skills that you are allowed to perform or both). Although not doing the 5 rights was the main problem in this one incident, there's a lot more underlying this error than just that.
You could choose to be proactive about these deficiencies and I think it would be in your best interest to do so. I mean absolutely no ill will when I say that the alternative very well may be a shortened stint in acute care and/or someone getting hurt. So ask for help! Your knowledge of what you're doing in your role is deficient and simply committing to not making this
mistake again will not solve the problem.
Best wishes proactively going forward ~