Student Nurse Med Error - page 2
(plsppardon the double post asi also posted this under patient medications before realizing that was probably not the right place). l am a nursing student doing a preceptorship on a med/surgery... Read More
Jun 13Specialty: 5 year(s) of experience ; Joined: Dec '12; Posts: 579; Likes: 1,279Quote from Been there,done thatShouldn't be at clinical, period. I initially skipped right past that "Spacey comment." Yikes. Why were you Spacey?As you can see, THAT expectation is dangerous. In the U.S, students cannot legally pass meds without a check from a licensed nurse. You needed to realize that you were spaced out, and should not have been passing meds. I am not trying to beat you up after the fact, but in the future... know that if you are impaired like that... you should not be administering medication.
Jun 13Occupation: Registered Nurse Specialty: Cardicac Neuro Telemetry ; From: TX, US ; Joined: Mar '13; Posts: 492; Likes: 1,370There is no such thing as a student nurse med error. Think about that for a minute. When I precept nursing students who can give meds, we go over all meds together before proceeding. Your preceptor should have been watching you more closely.
Jun 13Joined: Aug '17; Posts: 112; Likes: 105Don't listen to anyone who said tell your instructor! You already told your preceptor. She will tell your instructor. Next time only give meds with your preceptor!
Jun 13Joined: Feb '18; Posts: 691; Likes: 1,374Quote from heallisEven seasoned nurses double check insulin, independent or not!Yes, if I give insulin it does need to be double checked. However there would be nothing to check if I didn't draw up any insulin and only gave the rest of her medications. We are expected to give medications alone during preceptorship as we should be independent by the end of this placement.
Jun 13Specialty: 1 year(s) of experience ; Joined: Jan '18; Posts: 12; Likes: 36What do you mean by "spacey," and why were you spacey? You post sounds as though you were indeed spacey while on duty. None of this is acceptable.
Jun 13From: CA ; Joined: Jul '17; Posts: 7; Likes: 9I saw on my shift tonight that I did give the insulin and t's co signed on the chart. I guess I was just having a panic attack brought on by general stress and it made it hard to recall.
Jun 14Occupation: Practice educator Specialty: 15 year(s) of experience in Done it all. ; From: GB ; Joined: Jan '18; Posts: 107; Likes: 197I intensely dislike the idea of a student giving out drugs independently. Glad you did give it, I've done night shifts gone home and been like did I do X or Y so don't take it too badly, but if you feel you're struggling on a night shift and feeling spaced make sure you tell you preceptor.
Jun 14Joined: Jul '12; Posts: 463; Likes: 485Quote from heallis,(plsppardon the double post asi also posted this under patient medications before realizing that was probably not the right place). l am a nursing student doing a preceptorship on a med/surgery floor... I worked a night shift last night and I was not myself at all, quite spacey all night. I am realizing after coming home this morning that I don't remember giving one of the patients her insulin!! Her insulin was high (16.9) so I remember thinking "gotta get her that!" Yet I seem to recall she did not have an insulin order sheet or something. I was so spacey that I can't remember clearly.. I know I did give her a needle... but that may have been lovenox.... I called the floor and told her RN for today that they should be on the lookout for that. When I called they asked if I had given that same patient patient PRN benadryl or gravol for her nausea. Even though I did my checks 3x before GIVING the med, I was not so thorough when SIGNING the med after and apparently signed for benadryl instead (I did describe the pill I gave to the RN and it was indeed gravol).
I am absolutely freaking out! This means that if I did indeed forget to give her insulin I made two med errors on the same patient in one night!! Though only one that actually reached the patient, but still... My preceptor is very nice but my course instructor is known for being a hardass. I feel so stupid and scared I am going to flunk out! My only relief is that I did call the floor so I know they will be watching her and she will likely not be harmed. Still, I am really anxious this could be the end of my nursing career. Is it common for students to get kicked it for things like this? Do you think I am doomed?
The fact that you were 'quite spacy all night' and don't remember give a patient her insulin, this alone would be grounds for dismissal. Why? You could be 'spacey' at home or forgetful at home, but not when you are at work. Good you gave it, but if you're a student I would believe you have to be extra careful.Last edit by fibroblast on Jun 14
Jun 14Occupation: allnurses Asst Community Manager, APRN Specialty: 25 year(s) of experience in Nephrology, Cardiology, ER, ICU ; From: US ; Joined: Apr '00; Posts: 53,365; Likes: 26,183Moved to General Nursing Student form
Jun 14Joined: Oct '16; Posts: 253; Likes: 280Which of these statements made by the nursing student indicates a necessity for further education?
A. "I am realizing after coming home this morning that I don't remember giving one of the patients her insulin!! Her insulin was high so I remember thinking gotta get her that!"
B. "Even though I did my checks 3x before GIVING the med, I was not so thorough when SIGNING the med after and apparently signed for benadryl instead"
C. "This means that if I did indeed forget to give her insulin I made two med errors on the same patient in one night!!
D. "I was so spacey that I can't remember clearly.. I know I did give her a needle... but that may have been lovenox.... I called the floor and told her RN for today that they should be on the lookout for that."
E. All of the above
Correct answer: E.
Jun 14Specialty: 28 year(s) of experience ; From: US ; Joined: Sep '05; Posts: 205; Likes: 124I don't know how common it is for students to get kicked out of a program for two med errors or forgetting to administer insulin, but I do recall during my student nurse days, another student nurse either failed to administer insulin to her patient or gave it late. Not only was the student expelled from the program, our school was no longer welcome to do clinicals at that hospital.
I know your post was about how common it is to get kicked out for med errors, but there was another important question here, and that was could you get kicked out for being spacey, which resulted in med errors.
Jun 15Joined: Aug '06; Posts: 1,016; Likes: 2,985Refine you 'brain sheet' Put an area on it for important information that you must check off before you leave. Sometimes running around busy and learning of or thinking of something important can lead you to forget. You might be involved in a complex, busy issue and forget the information you received. So what i do is write a quick synopsis on my brain sheet at that moment and make a square next to the task to be checked off. For example, if a patient is going to need Q 2 hour Neuro checks (which is out of the norm where I work), I'll place it on my brain sheet with check off boxes next to 2 hour intervals and if I don't have the time to chart real time, I'll make a note next to the checkbox to chart the results with the VS, time, and pertinent information for my note later.
Use your brain sheet to keep track of what needs done. I write all my diabetics down at the beginning of the shift with boxes for the blood sugar level and another for insulin information. I also put any labs I need to pull from PICCs or CL. Before I leave for the day, I check my brain sheet for any thing undone. It quickly lets me know that I've completed everything I needed to.
You don't need an excellent memory all the time with a through brain sheet. Box check offs are my lifeLast edit by dream'n on Jun 15