S. O. S. - page 4
For the first time since I started nursing (I graduated last June) I feel really discouraged with myself. It all started last week. I made a med error. I was waiting and waiting for a now order to... Read More
Mar 1, '02Dear (((((RN-PA)))),
I'm not sure why...but I felt the sadness all the way here in WA! Yes we do need that emoticon!!! What a joy it must be for your pts. to have you as their nurse! I like nurses who do the out of ordinary for their pts.
And Renee...lady...we will have to meet when I get to TX...which should be next month now.
You know I try to remember to pray everytime I go to work. Before I open my door...I sit in the parking lot...and say something like this.
Lord ...please give me a servant's heart...let me keep my mouth closed, and my heart , mind, and ears open. Let me find no fault in those I work with...and let them find no fault in me. Let me see you in each bed...and let them see you in me. Let those who I care for benefit from my care, and let me do no harm...Amen
Mar 1, '02Thank you for the hug and kind words, Brownie :kiss. I love this BB and wish it'd been around when I was in nursing school and the years following, but am thankful for it now and for all who contribute, teach, and sometimes confess here. The great stories and humor are indeed healing and so helpful.
Your prayer before work is similar to mine. (Don't worry, anybody-- I have NO intention of turning this into a religious discussion thread!) I pray to love my patients and co-workers, to please God and serve Him through my thoughts, words, and actions, and to be competent and safe. When the bad things happen, I wonder why God didn't protect my patient or alert me somehow, but I now have figured that if I HADN'T prayed, how much worse might the situation have been.
Mar 1, '02Dear RN-PA,
You absolutely, totally 100% correct , and I agree with you everything you have said... Have a wonderful weekend,..
Mar 1, '02All good posts here. I've been around 20 years or so, and as someone just said, there are days (or nights!) that are just going to make you feel s***ty! My reality check is two questions: 1. "Did anyone die?", and, 2. "Should they have?" If I can answer no to those two, I force myself to move on. I was lucky when I first started. Several of us would meet at a little pub and decompress. I think this is especially important the your first year of nursing. I will encourage you to not stand around more than a couple of minutes trying to figure out what an order means. Call the one who wrote it and get clarification. Not only do docs have bad hand writing, but they get tired and distracted too.
Mar 1, '02That's a deal, Brownms46! We're on base, so not hard to find that's for sure! Send me a "pm" here, and I'll let you know where to find us.
Mar 2, '02So right you are mustangsheba....but sometimes hard to get pass it when you're in the moment.
Great Renee....been a long time since I was there....but I have to come through there....so it would be a nice break in the drive to the coast. Thanks for the offer!
Mar 2, '02that reminds me of the time i called a code on someone who had died on my watch, and i got in trouble for "panicking". i thought i was supposed to push the button if there is no pulse or respirations. and me a CPR instructor for 10 years at that point (but new to nursing). always remember you are first human, then a nurse. good luck.
Mar 2, '02shavsha----:kiss welcome to the human side of it all.
Matt, Lake Wobegon, say hello to all the Norweign farmer guys would you? You must be an ok guy.
Mar 4, '02Howdy Yall
From deep in the heart of texas,
Dont knock yourself out because of a med error. Weve all done them at least once. No matter how good a nurse youare. Its a learning and growing pain we all go through. And if you ever work with a nurse who says shes never made an error then she is either lying through her teeth or she doesnt work with patients.
Keep it in the short grass
Mar 4, '02((((((BIG HUG))))))
Honey, we've ALL made med, and other, errors. The many posts above mine have shown that. Don't let it get you too down. I've given Ativan instead of alprazolam. Not a biggie, but still an error. And that's only ONE that comes to mind. I've made a few others, especially right after graduation. Nothing major, but still enough to make me feel like an idiot and wonder if I'd chosen the right profession.
Once, right after graduation, I was working on a rehab unit, and one of my elderly patients was very confused. I BELIEVED him when he promised me he wouldn't get out of bed if I took off his posey. I went to give him some meds and couldn't find him. AN HOUR later my co-worker and I found him down in the ditch next to the hospital. He said he was fishing (nary a pole, or fish, in sight). To top it all off, he was naked. I thought I was going to have a heart attack and DIE right then. Now I just have to laugh. Live and learn.
I've worked with a nurse who mistakenly set her pump at 800 cc/hr to run her Heparin in (thinking of 800 UNITS/hour, which would be either 8 or 16 cc/hr depending on your concentration). The patient got 250cc of heparin in just a very few minutes. My friend was HYSTERICAL! But the heparin, being what it is, was gone rather quickly and the patient suffered no ill effects. But it still scared the crap out of her! This friend of mine had been nursing for YEARS in ICU and was having a really bad night. Just goes to show it can happen to ANYONE.
I also worked in a hospital where a new RN gave 150 units of regular insulin SQ instead of the 15 that was ordered. She mistook the "u" for a "0". The patient died and the nurse went back for "pharmacological remediation".
SO, keep your errors in perspective, learn from them, and remember you're human.
Mar 4, '02I mad it al the way through nursing school without a med error. unlike many of my fellow students. my last rotation was critical care and it was the last week of clinicals before graduation, and my instructor was Corella Deville, my pt. had a primary line runnign with about 4 piggy backs. I hung something programmed the machin and walked away knowing I had done something wrong. when i figured it out i grabbed my preceptor and brought her in the room and explained to her what had happened,she corrected it and told me not to worry about it, I said I am going to call the res. on call, and tell my instructor, she said there is no harm done, dont worry about it. I went ahead and called the doc and hunted down my instructor and told her. She looked at me and said I was outside the door listening when you were telling your preceptor and had you not come to me today you would have been out of school. WOW---- we all make mistakes, just owe up to them, learn from them and go on. We are human, we make mistakes. xoxoxoxo
Mar 4, '02
I am a critical care RN and have been working in Quality Improvement for a while now. Medication errors are a focus nationwide because they are the most common error in medicine.
A medication error usually doesn't happen because one person or process failed. There are usually several failures along the was starting with how the prescription was written (legibility, correct dosing) to the nurse who actually gives the meds and the 5 rights. Unfortunately nursing usually gets the blame because we are the last protection to the patient. (We are on the "sharp end" of medical care. Administration is on the "blunt end" everyone else is somewhere in between)In our hospital there are 24 steps from the time an order is written to when it is given to the patient, and a mistake can happen at any of those steps.
So the message is, it's not all your fault, there were several failures along the way. If you want to do something, work on changing the SYSTEM- ie. computerized order entry, (with checks on dosing, allergies, etc), robotic filling of rx's. barcoding on the patient the pill etc., education and reinforcement to all involved in the medication process.
I would love for you to take care of me because you are consciencious and you care.
Mar 7, '02Have all of your learned not to say, "I'll never do that", ? I will try to learn from each of you, so that I can avoid making these mistakes. But, sadly I have had a lot of close calls with similar circumstances. The best thing you can do is listen to those little warning gremlins. Treat the narc. cart as if it is an enemy trying to trick you. My tolerance for insulin stops at 10 u. Anything higher I have to see written in the chart. Anything higher than than 15 u I check with the patient or sometimes old med records. 60u if not comfirmed by patient or old records would get a call to the doctor. All of this will sometimes still not be enough to make me fell comfortable. Oh, yhea, the big bo-boo, switching the lines for heparin and nitro. or something else. A lot of nurses tag their lines, good idea. Our profession should have coined the line,"BE CAREFUL OUT THERE!"