No room for errors?

[heartlover07]

I am a soon to be new grad (May) and I am starting on a tele/stepdown unit at a large hospital. I got to thinking that it would be nice to know from some seasoned nurses where exactly there is NO ROOM for error in everyday life as a nurse. I know that accuracy is important at all times, especially with meds, but after many years of nursing what are the times when you know you just can't make mistake?? I am thinking with BP meds and insulin, also when administering blood products. In other words, what procedures/meds still scare you somewhat after many years?? Thanks this will help me so much!!

[Hoozdo, ADN]

ALWAYS ALWAYS ALWAYS double check any drips you might be infusing! Heck, even triple checking them wouldn't hurt!

I've heard of some dangerous mistakes being made w/ drips running at the wrong rates. Wouldn't it just suck if you entered the "volume to be infused" number as the "rate- mL/hr" number? Oooops

But... Mistakes DO happen. Just check yourself and know your limits!

And congratulations to nearing the end of your nursing school experience!

Good luck to ya :)

Ditto to this one. In the past month I have discovered 2 major problems with drips. Yesterday the pharmacy mixed the wrong concentration of a Nicardipine drip and the previous shift did not catch that it was a different concentration. :smackingf

No wonder the pt's BP was uncontrollable at report!

Another was a PCA pump with Dialudid that was programmed for the wrong concentration that had been running that way for 2 days. Good thing the pt was getting less Dialudid than planned instead of MORE.

Moral of story---always check and recheck the drug concentrations on your drips. :monkeydance:

[burn out]

Many times have found lasix drips infusing 100 mg/hr instead of 10mg /hr. Then the nurse kept calling the doctor because the cardiac output kept dropping. DAH...go figure

[LucyLu]

Mistakes scare the crap out of me!! I made one yesterday and today I'm questioning my decision to stay in hospital nursing!! Patient wasn't harmed but could have been. (Fluid overload). My unit was extremely busy---five telemetry patients, call lights, pain meds., routine meds., assessments, phone calls from family members, the list goes on and on, but the fact of the matter is I MADE AN ERROR. That mistake won't happen again but can I continue to do this crazy job?? I love bedside nursing but sometimes the patient load is too much and there's nothing I can do about it except deal with it day to day (and complain to my manager).

I'm still relatively new--less than two years experience (part-time) so maybe it's normal to still be questioning whether I made the right decision to go into hospital nursing. I don't know. Ironically, this happened two days after I received an Excellence in Nursing Award from my peers. Sorta took the wind right out of my sails.

[Cobweb]

We had a couple of new girls on our ward and us old warhorses were telling war stories...topic turned to patient deaths and I said, "Oh yeah, I'm a nurse, I've killed lots of people." You never saw such horrified faces in your life, lol. I'm so mean.

I was thinking of things like, giving morphine to a patient for excruciating pain even though you know what it's gonna do. I don't think that's what they were thinking of though!

[Tweety, BSN, RN]

My med pass still scares me. I'm paranoid of making a med error.

Cardiac monitoring bothers me, when I see a rhythm I think "why are they on the monitor in the first place" "what can this rhythm potentially lead to?"

I worry sometimes I'm going to miss some telltale sign in my assignment. When a patient crashes I go over and over "what were the clues that I missed? Should I have done something different".

[incublissRN, BSN, RN]

I've heard of some dangerous mistakes being made w/ drips running at the wrong rates. Wouldn't it just suck if you entered the "volume to be infused" number as the "rate- mL/hr" number? Oooops

We all know that can happen! I'm just now starting to not feel horribly guilty about my mistake and its been about a month. Once you do something wrong you become determined to never, ever do it again.

(Please refer to Med Error thread started by me in First Year of Nursing forum.)

[caroladybelle, BSN, RN]

Many years ago, a paramedics instructor once told me that in a crisis (either self-made or one that is thrust upon you due to circumstances) remember to take a breath. He meant to 'step back' when you feel overwhelmed, take a deep breath, and go to work.

That is actually taken from the book, "The House of G-d".

In the book, there were "The Rules of The House of G-d". One was:

In case of a code, always take your own pulse first.

As an onco nurse, my favorite was:

Don't take a temperature unless you want to treat a fever.