I have just finished my 5th qtr of ADN and we caught wind of a 6th qtr ADN student who was going through her preceptorship and made the near fatal mistake. She gave the wrong pt the wrong meds, multiple meds at that. The pt almost died and is still in ICU. She was kicked out of the entire program, and it is believed that she will not be able to obtain a licenses ever (not sure the license part is true). I don't know what happened, why she didn't check the 5 rights, or what her excuse was. At this point I don't think it matters what her excuse was.
I felt very sick to my stomach when I heard this. Many things ran through my head; how does she feel after going through all this hard work only to majorly screw it up, OMG what about the pt and their family, how could something like this happen, where was the nurse who was precepting her?
I just want to take this time to remind everyone that the nursing field is not a place to ever feel too comfortable and start to slack!!!
I didn't check one day, and I was actually kind of out if it that day, and I took the wrong patient's blood glucose. Thank GOD I didn't have any meds, because I know I would probably have given it to him. It was such a bone-chilling thing to realize that I WOULD have, even if I didn't, because I didn't do the 3 checks.
The 6 rights are important, but mistakes can still happen.
It's also imperative to look up each medication that you aren't familiar with, to check correct dosing, compatibility, adverse reactions, indications, etc, etc.
My instructor was just saying the other day, "you wouldn't believe how many times doctors mess it up." Referring to checking the drugs you aren't familiar with.
The rights are extremely important! And check more than 3 times! I almost made a med error by almost going into the room with 1 tab of Zoloft instead of the ordered 0.5 tab :uhoh21: That is what polypharmacy will do to you (seriously this patient had soooo many meds!) but my point is to check, check, check and then double check, recheck and check again!!!
I forgot to document that I had given milk of magnesia. My patient had many meds and it was one of my first solo med passes. I was on a roll naming the medication and explaining what it does, putting in the cup, and initialing when I watched the pt take it. I put on her new nitro patch, initialed. Handed her the MOM, and left. I gave the MAR back to the staff RN who also gave her MOM since it was not initialed. Obviously, there is no excuse. I messed up and I am so lucky it was not a med that would be life threatening with a double dose. Of course, I got an "unsatisfactory" and now I am damn sure to check, check, check, and initial!
My first day of clinical at a hospital, I was not passing meds. The staff RN emptied out all the pt's meds into a cup and brought them to the room. I followed her in to watch. The pt didn't want one of her pills and the RN had no clue which one it was. She was visibly irritated with the pt, saying "Well, now I have to go and waste all of these and it will be a while until i can get back here with the ones you do want to take." I think of that every time I see a nurse putting the meds in a cup in the med room.
She gave the wrong pt the wrong meds, multiple meds at that. The pt almost died and is still in ICU. She was kicked out of the entire program, and it is believed that she will not be able to obtain a licenses ever (not sure the license part is true). I don't know what happened, why she didn't check the 5 rights, or what her excuse was. At this point I don't think it matters what her excuse was. 
rainingwoman
66 Posts
I didn't check one day, and I was actually kind of out if it that day, and I took the wrong patient's blood glucose. Thank GOD I didn't have any meds, because I know I would probably have given it to him. It was such a bone-chilling thing to realize that I WOULD have, even if I didn't, because I didn't do the 3 checks.