Getting so busy and forgot to notify the charge nurse about a small med error

[georgya3]

Hello everyone,

I work with someone who is been treating me like "stupid" for a few months now when she is charge nurse and no other RN is on the floor (I work nights, sometimes is just her and me on the floor and 2 other LPNs). Whenever I go to report her something she makes comments ... like a while ago I told her about one of my patient's magnesium being low and she said "I am sure it was already addressed by the evening staff". After a long talk she called the doctor and we got an order for MgSO4 IV. Thus, the problem wasn't addressed by the evening staff!

We had many episodes when she made me feel embarrassed! The worst one was last month when I had 7-patient assignment (on a surgical floor) at night with patient on insulin drip, one post op, one MRSA iso, one waiting for transportation to a different hospital, one C-diff ...however, the worst night ever. The charge nurse did nothing to help except to give me directions and to ask me to do things, give and bring and etc... and she wasn't so busy! I missed my break because I wasn't ready to leave at 2 am on the first break, so she said I cannot take the second break (3:30 am) because she was going to and I was supposed to cover the floor (being the only RN there except her). Well at 6 am I was almost crushing ... and I still had things to do, so I asked her to let me go outside for 10 min and she said "do whatever you want" not that she cared about me. After that night I filled a PRC with UNA and I had a meeting with my manager. I thought I was ok with this charge nurse and it is a learning process, she needed more time to learn how to get involved on the floor while being charge nurse.

Well last Friday I worked my first night after the meeting. I made a med error. At 00.40 am I gave Morphine 10 mg po to a patient. I picked up the wrong MAR from another patient. After I gave it, I found the mistake, my patient was on 5 mg IV/SC. And she got Morphine 10 mg PO. I started filling and incident report right away and I was called by one of my patients whose tub feeding was beeping. I finished the incident report going back and forth to this patient. I was planning to go to tell the charge nurse about the error and I got busy with another patient who was slightly bleeding from the surgical site. Well, I totally forgot about telling her about my error and at 2 am I want for break. After I came back at 3 am the charge nurse came and told me about the error. I tried to tell er that I totally forgot and I did incident report and my patient was ok. She kept telling me what it could have happen with my patient and how bad is and kept repeating me a few times that this could make me loose my license. Later I told her how I feel around her, I am very stressed out and every time when I get to her she makes me feel embarrassed, stupid and useless.

Last night I called in sick and tonight the same because she is in charge and I am terrified to work with this person when no other RN is around. I cannot function! I am planning to involve the union!

Did anyone experience something like this? Please let me know what to do!

[roser13, ASN, RN]

And the OP should not have to run around trying to stay afloat while the charge sits at the nurses station playing on her phone. It's about team work. On my unit when we are short staffed we pitch in to help each other. In our contract it states we are entitled to breaks not to "down time."

We only have OP's perception of the charge nurse's behavior. I'm not willing to trust that.

[Conqueror+, BSN, RN]

When I was a nurse working on the cart and we had supervisors, I always heard the same thing from my co-workers the supervisor doesn't do anything. All she does is walk around with her clipboard and talk on the phone. When I was a CNA I also heard the other aides saying how the charge nurses didn't do anything but pass pills and sit at the desk. If I'm organized and efficient enough to have breaks and down time I am not obligated to donate it to someone who is less organized or efficient. I absolutely believe in teamwork. I don't believe in making up for someone else's poor skills or compensating for management not staffing enough nurses

[Steffy44]

when you see a charge nurse chatting and sharing pictures from the phone with other while you are running back and forth, what would you think? do you call this being busy?? and looking over on you many times??and the wrong route was given at 00.40 and at 2.00 I was on break!

I know exactly where you're coming from ref the charge nurse. When I worked nights everyone ended up being charge regardless of experience. There were only 3 experienced nurses assigned to night shift and everyone else was a new grad. We had one (new grad) who sat around after her meds and initial assessments were done. She gave the admits to everyone except herself despite her having 2 patients and everyone else had 4+. On our floor, on night shift, charge has basically the same number of patients assigned as everyone else. Her actions went against every rule on the floor per the experienced nurses. She was also a bully nurse. She sat around watching YouTube videos while everyone else was drowning. She was always putting her coworkers down. Finally everyone had enough and she's no longer allowed to be charge. She was nearly fired. She takes pleasure in seeing other nurses make mistakes. She lives for the gotcha.

One thing I try to always do is tell charge immediately when something happens. I write a sticky note and keep it with my papers so I don't forget to do the paperwork. It's helped a lot. You must work through this problem...unless you have a ton of vacay time you won't be able to avoid her forever.

[georgya3, RN]

well, I was trained in a different country where abuse is every where, you grow up with abuse and you end up by being shy and avoid conflicts because you are afraid of troubles. I immigrated here 10 years ago and I did a few courses I was asked for by the college and a few months of clinical (2-3 years in total) to get my RN license. They did not teach us anything about bullying and how to refuse an assignment if you feel unsafe! They did not say anything about harassment in school, they thought us the basics and stayed focused on therapeutic communication. I learned about harassement the way I go! I The last med error I made was when I was pregnant and I was taking diclectin which was making me drowsy (6 years ago).

I entered this forum to learn more about this world, but most of the inputs are not helpful, some of them are and I learn from them. I have been working in this country for 7 years (nurse for 13 years overseas where is a different world with different rules).

I have just started to stop blaming myself and to look after my kids after as I was supposed to as a mom because I was so messed up for the last 3-4 days that I hardly saw them. I see most of the nurses here blaming and I heard someone saying nurses eat nurses. Now I believe this! Guys, just kill me and the end of the story, the end of telenovelas!

I was planning to return to share my experience by going through this mess but I am coming back less and less to read your inputs as I am getting anxious again and again when I do it! And I learned something after all your lines: Life doesn't stop here, I need to keep going on for the sake of my family who needs me! With or without this license! I am not gonna let you mess up my days with all your accusations and things like "you should have done" or "you should have made", I made a mistake and I will pay for it and I will fix this mess and this situation! I realized I do not need your help if it's not constructive! My self esteem is already down and I am trying to grab the pieces left behind to build it back. Someone I don't remember who said somewhere: "If you cannot say something nice you'd better don't say it all!" And God bless all of you who are nice people and good nurses and the ones who are not and spend the whole day on this forum (probably while at work, the ones texting while others work hard) should keep their thoughts for themselves and their friends as I don't need them!

[georgya3, RN]

I know exactly where you're coming from ref the charge nurse. When I worked nights everyone ended up being charge regardless of experience. There were only 3 experienced nurses assigned to night shift and everyone else was a new grad. We had one (new grad) who sat around after her meds and initial assessments were done. She gave the admits to everyone except herself despite her having 2 patients and everyone else had 4+. On our floor, on night shift, charge has basically the same number of patients assigned as everyone else. Her actions went against every rule on the floor per the experienced nurses. She was also a bully nurse. She sat around watching YouTube videos while everyone else was drowning. She was always putting her coworkers down. Finally everyone had enough and she's no longer allowed to be charge. She was nearly fired. She takes pleasure in seeing other nurses make mistakes. She lives for the gotcha.

One thing I try to always do is tell charge immediately when something happens. I write a sticky note and keep it with my papers so I don't forget to do the paperwork. It's helped a lot. You must work through this problem...unless you have a ton of vacay time you won't be able to avoid her forever.

well this is a similar situation except the charge doesn't have any assignment and we are just 2 RNs (me and her) on the floor at night (and two LPNs). Probably this will be the result after the meeting (she won't be allowed to be charge nurse anymore) and after I get my pay back for my mistake. There were some senior RNs complaining about this charge as I know from a few of them.

However, thank you very much for your advice, someone else suggested me to use a sticky note, too after telling her the story. I love that idea. I will use it! It great especially when it's hard to talk with the charge nurse (communication problems).

[Ruby Vee, BSN]

"Forgetting" to report a medication error is a pretty big deal. It made you look stupid and careless, and perhaps that's why the charge nurse spoke to you as if you were stupid and careless.

Calling in sick because you are "terrified to work with this person" is just plain wrong. You're refusing to face up to your issues with this nurse, inconveniencing the other staff who now has to cover for you and you're being cowardly. Being brave isn't about never feeling terrified. It's about doing the right thing even though you are.

We're only hearing your side of the story; I wonder what the charge nurse would say about you. And I wonder how someone as busy as you had the time to keep track of what the charge nurse was up to. Perhaps she's trying very hard not to step in and do your work for you so that you can hone your time management skills. Or maybe they pay her just to sit around and bully you. (Sarcasm there, sorry).

[Ruby Vee, BSN]

Thanks for the comments.

Morphine 10 mg po instead of Morphine 2.5 - 5 mg SC or IV q2h. It was given at 00:40 am. The patient called at 2:15 am for another dose while I was on break. If you do some research you will see morphine 30 mg po = 10 mg parenteral. My patient said it did not even touch her. It was a pre -op patient. The doctor said in the morning when I reminded her about the error: "if the patient wants po, no problem, if she wants sc, no problem, no big deal, I will order it!"

On my unit someone gave codeine 60 mg instead of 30 mg and the charge notified the doctor in the morning, but we monitored the patient. I believe this was a more severe case. And of course it was another charge nurse (senior RN).

Possibly you're not getting the point. A med error is a med error. You don't get a pass on med errors. The correct response is to immediately report the med error and set about mitigating the damage to the patient. If it means too little pain medicine, that might involve informing the charge so she can call the doctor and get an extra dose.

[georgya3, RN]

We only have OP's perception of the charge nurse's behavior. I'm not willing to trust that.

I can put you in touch with that charge nurse to hear her side if you want! She might be already somewhere here, giving inputs!! I am getting sarcastic, sorry, just trying to deal with the situation!!

[Ruby Vee, BSN]

Hi Roser13,

I do not try to JUSTIFY anything, I am just asking if anyone went through this. I do not need you to blame me, I got it! I blame myself enough to not be able to function since it happened! And I have 20 years experience as an RN and it never happened to me. Do you know I am on Tylenol#3 for back pain because I broke my back in a stroke unit 2 years ago? Well welcome to my world! Maybe that's why it happened to me! I do not know!

You should just pray to not be in my shoes one day, you never know what future might bring you!

It actually does appear as if you're justifying your medication error and your failure to report it to the charge nurse. Your back injury has nothing to do with it. If you were working under the influence of narcotics, that's another issue and perhaps now we're starting to get to the real meat of the problem.

[Ruby Vee, BSN]

Actually it does. You stated at least twice that the supervisor was not busy and could have helped you. I gave my perspective on why that may be. And it's . not !

Chiming in to say that no one ever solved their time management issues when others keep jumping in to "save" them. And jumping in to save someone over and over gets old after awhile.

[georgya3, RN]

"Forgetting" to report a medication error is a pretty big deal. It made you look stupid and careless, and perhaps that's why the charge nurse spoke to you as if you were stupid and careless.

Calling in sick because you are "terrified to work with this person" is just plain wrong. You're refusing to face up to your issues with this nurse, inconveniencing the other staff who now has to cover for you and you're being cowardly. Being brave isn't about never feeling terrified. It's about doing the right thing even though you are.

We're only hearing your side of the story; I wonder what the charge nurse would say about you. And I wonder how someone as busy as you had the time to keep track of what the charge nurse was up to. Perhaps she's trying very hard not to step in and do your work for you so that you can hone your time management skills. Or maybe they pay her just to sit around and bully you. (Sarcasm there, sorry).

I got your sarcasm....however for your information, she is very happy when she is charge nurse and looks upset/frustrated when she is on the floor. When she was on orientation for charge one night they asked her to be at the bedside instead and she said she is tired and went home! She is been working here for 3-4 years. Time management?? you are funny! I am sorry, I cannot ask my patient to throw up at 8 instead of 7.30 am (shift change) or to leave him like that to the next shift, I cannot leave my patient in pain at 7.30 if he told me at 7.00 his pain was 0/10, I cannot leave a patient bleeding to death from the IV site at 7.35 am because his IV site got disconnected at that time and it was absolutely fine at 7.25 but he decided to walk to the BR unassisted! Or tell me how you are educating your patients to be "nice" and stay "still" between 7.30 and 7.40 when the report is given and the shift is over! When you work and need help you don't look around to see if anyone would be able to help you? Or hearing people laughing?? I am sorry, I should be blind and deaf but I am not!

[Ruby Vee, BSN]

After reading through all of these comments, I'm just at a loss of words....there's no way you've been a nurse for 20 years.

-A med error is a med error, own up to it instead of pushing the blame onto others.

-You (should) have the experience to know what is a safe assignment and what is unsafe - you shouldn't have accepted an unsafe assignment.

-Calling in because you don't get along with another coworker is only going to make things worse for you.

I can believe the OP has been a nurse for 20 years . . . She may have "worked" 20 years at a job where her co-workers did the heavy lifting for her and never managed to develop as a nurse. She still behaving like a new grad, possibly because someone else has always "saved" her.