A medication error was discovered when we were counting narcotics at the end of the shift yesterday. What happened was that I administered Oxycontin 80mg, which was scheduled at 12pm instead of Methadon 5mg at 10am. This happened after I found out that the resident was getting ready to go out, and I rushed and pulled the medication according the EMar but failed to check with eMar if it was the right drug or not. The Md was then notified and ordered to hold the 4pm scheduled Oxycontin and to do Q2 hours vitals until midnight.
Right away I checked the resident's condition, didn't notice any respiratory distress, and vitals were, Bp 100/52, RR 12, po2 92% and pulse was 86.At 10:30pm I call the night shift R.N to follow up on the condition of the resident and he told me she was doing fine. I went in the morning she a signed me new patients, we did our morning med pass and we took a break. when i came back from break I caught he sinking in to my folder to see my report and I wasn't crazy about it, instead I showed her what I wrote she said good i thought you would hid it.
Then when the instructor came they chat for an hour. Then my instructor ask me about it but before I finish she told me to I need to meet with director of nursing. When I went there they were both in in office as walk in I saw the anger in the director's face. I told her she is right to be angry because I didn't do what I my instructors thought me. I took full responsibility for my mistake. But it didn't stop her from blocking me from my graduation this semester which was the next day. I ask her if can retake the clinical again she said to call her when the registration starts. I called and left a message and wrote email after two days she called to tell me I am kicked out of the program.
What am I going to do? I don't think any school will take me for just a clinical or for only one semester.
Whoa!! Your school has you out at clinical sites with NO instructor present? What kind of facility wants to take on that kind of responsibility? I get a little more frightened with every post you make =(
LittleCandles on the last clinical we were on our own with nurses of the facility, my instructor was coming only once a week to see how we were doing. My report from my regular preceptor who had me for tree weeks was all positive but she took two days off. the nurse that came to work those two days was with a part timer. Anyways I administered Oxycontin 80mg at 10 am instead of at 12pm, Methadon 5mg was the one scheduled at 10am and because we didn't find out early enough she took another Oxycontin as scheduled at one o'clock so she could be overdosed but she was doing fine. I don't know if they going to approve my appeal but i will try.
I'm surprised so many are surprised that she was at the facility without her instructor? At my school as well, for the very last "clinical/practicum" we would go to the facility alone with an assigned nurse who we would work beside... the actual instructor showed up maybe a total of 3 of the 12 shifts required to check in on our progress. I thought this was a standard practice? This poster was a day away from being able to take her LPN exam.
Nope, my instructors were there every minute of every clinical. We were not ALLOWED to be at a clinical site without an instructor. She would divide us up, some would go to same day where there were lots of IV starts, some to ER, etc, but she was ALWAYS in the building with us.
Def not standard practice. In both my LPN and RN schooling our clinical instructor was with us from the beginning of the day to the end. During LPN school for me we couldn't even go to the floor unless the instructor was with us. In RN school we were able to go to the unit and look up info of our patient but we could NOT touch, see or talk to any patient unless our instructor was actually ON the unit (not just in the hospital).
I am still dumbfounded that any student (regardless of whether being watched over by their school clinical instructor or a nurse that they are following) had the ability to pass meds without anyone double checking! Especially narcs! Why did the 'preceptor' not notice the error before it happened??
There's a lot of "after the fact" advice here. You know you made a mistake, you took responsibility for it, and I'm sure your heart dropped to your toes when you realized what happened.
If you find a single nurse who hasn't made a mistake, you've found a liar (or someone who doesn't know they made a mistake which is scary). None of us want to make mistakes and some are more severe than others, but none of us are immune and just hope that WHEN we screw up, it's minor or caught quickly.
I'm sorry this has happened to you, OP. I am 7 years out of school and I still am afraid they'll come back and say I didn't pass a class or there was a glitch or something. I can't imagine how heartbreaking to be that close. Unless there is more to the story, this seems like an overreaction on the school's part. I hope that things work out and you take this and use it to make you a better nurse as a result. Please keep us updated.
Thank you for your kindly response, but the good news is that after i wrote a letter to the dean about what exactly happen, they said they will allow me to return if I write a well researched 10 page report about med error.
Thank you for your kindly response, but the good news is that after i wrote a letter to the dean about what exactly happen, they said they will allow me to return if I write a well researched 10 page report about med error.
I think the problem as others posted, you should have never been allowed to give this med without your instructor being present. In my state a preceptor for a capstone course has to be approved and sign a contract ( and only for BSN). In the PN program there is no extra clinical time for a proper orientation.
Ok, you made an error, it sounds like you did not even know what you were given and why ( problem one). Second, you did not notify your instructor - immediately. Third I did not see where the MD was notified, an unlicensed person should not have access to narcotics. In some states your nursing license could be revoked. Sounds like the facility was using you for cheap labor, all not your issues.
That's great news! You'll probably be more well-versed than your instructors at the end of that paper =)
Thank you for your kindly response, but the good news is that after i wrote a letter to the dean about what exactly happen, they said they will allow me to return if I write a well researched 10 page report about med error.
I'm sorry to hear that happened to you. People make mistakes even the most experienced nurses. Is it possible to take your credits and transfer them over to another program? Or maybe a Community College that has a lpn program?
BuckyBadgerRN, ASN, RN
3,520 Posts
Whoa!! Your school has you out at clinical sites with NO instructor present? What kind of facility wants to take on that kind of responsibility? I get a little more frightened with every post you make =(