No nurse is going to answer this honestly but here it goes........

[c_beshore_rn]

I'm the sort of nurse that has flown by the seat of my pants for many years. My first priority is making sure my patient is cared for...I hate paper work!!! What do the rest of you consider "med errors"??? I know there are times in a shift when I've given an ABT 30 minutes late, I forgot to lower the fluids from 100 to 75, I haven't been able to get the 9pm meds out until 1030pm. These are all true "med errors" that I should be filling out incident reports for everytime......am I horrible for just giving the meds and going on with my night????

I understand that if I gave someone 10mg of Ativan instead of 10mg of Valium that'd be a biggy to call the Dr about. I also understand if Im 2 hours late hanging the pts Vanc- thats a biggy, it'll mess up the entire trough/ peak thing. I also understand if I give kayexelate through a urinary cath- I'm just retarded and should surrender my license ASAP!! (lol did anyone else read that??)

Since I moved to med/surg it seems time management is a huge issue. (I had 20 patients on psych and could break up brawls, talk folks off of ledges, teach groups, etc and not blink an eye) We do total care at our hosital most of the time and I usually have 4 or 5 patients (which isn't that much, I know). But when you have 2 crawling out of bed, 3 incont of bm and 1 of those are on a colonoscopy prep, 2 fresh surg., 1 screaming in pain etc etc.....4 patients can seem like a MILLION!! ANY SUGGESTIONS WOULD BE APPRECIATED!! My ADHD is kickin my rear and my conscience itches.:bowingpur

[Aneroo, LPN]

I've always been one to write up more stuff than my coworkers, but didn't write down everything. To me, the incident report isn't there to get me in trouble (even though it might)- it's also there to alert risk management that there is a problem there. If an entire floor is writing up that they're having issues with a pump/bed or another department, flags will be raised and someone might say "Hey, there's a trend here. What can we do to make this better?"

ETA- How long have you been on the med/surg unit?

[Katnip, RN]

Having been a risk manager for a brief time it was my job to check the med errors. There was obviously a severe under reporting issue, and we knew it. Where we could see trends, we made recommendations to attempt to fix the process in order to reduce errors. And it helped.

However, if we didn't know the problems were happening, we couldn't try to fix it. That's what the reporting is for. If I saw a nurse self report, I went to visit and thank them. They were surprised, but we started to see an increase in self-reporting.

Mind you, if we saw a nurse who was consistently making the same error over and over-such as forgetting to write a verbal in the chart and administer the med so it looked like they were giving meds without orders-then we would talk to the CNO and

the unit manager who was responsible for re-educating the nurse. If that nurse still continued the errors, then they were put on action plans, etc.

Granted there are some hospitals that punish for med errors, which is extremely arhaic and unproductive, but most I've seen use reporting as a tool to improve safety.

[c_beshore_rn]

Ive been on M/S about 7 months with 3 days of orientation. Ive been a nurse for a long time and worked m/s out of lpn school in 1995??? We had aids then, a unit secretary, and 10 pts a piece. It went a lot smoother then. No census and cost are the bottem line. I don't mind doing total care its just different and I have to readjust my time management.

[Roy Fokker, BSN, RN]

"No nurse is going to answer this honestly but..."

Why?

What prompted you to make that assumption?

cheers,

Roy (Who is known for his skills in 'seat-of-the-pants' actions should the need arise)

[registerednutrn, BSN, RN]

I work med/surg and time management will always be and issue due to the nature of the patients you have. Where I work we have a policy in place that allows to give meds other than narcotics and hour early or an hour late. I know that sounds like a lot of time but when i have several fresh post opt all wanting pain meds or nausea meds it is a life saver. Where I work we have a 6 to1 ratio with techs which helps a lot too. Just keep up the good work and time management will get easier

[CoffeeRTC, BSN, RN]

Well...I work in LTC, if I wrote up giving meds late..I'd be doing it every single shift I worked.

[arelle68]

Well...I work in LTC, if I wrote up giving meds late..I'd be doing it every single shift I worked.

And then you'd be even more behind from writing up the reports, and that would make you late doing something else. What we need in healthcare is enough staff to do the job, not more paperwork about how it's not getting done.

[Tait, MSN, RN]

There are always days when I have trouble getting EVERYTHING out on time. The priority for me is patient conditions > abx. If I get behind I just send a message to pharmacy to have them retime the med.

As far as 2100 meds, I start with my most critical med patients (pain, abx, heart meds etc) and work down to the less critical (a sleeping pill and some Zocor). Plus if a med is a 24 hour I will tend to let that one slip a little later than say a Q6 ABX.

Tait

[NurseDiane]

Med-surg nurses are WAY overworked, WAY underpaid, and taken advantage of at every hospital across the country. If hospitals could figure out a way to have one nurse take care of an entire floor of patients, they'd do it.

[pinksugar]

I never get my meds out on time because pharmacy never sends them, or they are never in the patient's pyxis profile. Thankfully everyone has this problem so management doesn't care! *sarcasm*

[Ms.RN]

has anyone not reported a med error because they are afraid of whats going to happen and get into trouble?