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!

[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 or just before you go for break! Do you tell them if you decide you need to have an emesis you need to wait? Don't do it now because if you do, I will miss my break! Ooo, I got it, you have an awesome team which I miss on these rotation, who is willing to clean up your mess and says "you go, I 'll deal with this". Yes, I do have a great team as I said but not on these days!

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!(sarcasm, too, sorry, I am just getting tired of opinions like this, there quite a few identical here)

[Ruby Vee, BSN]

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!

You haven't shared anything that reaches the standard of bullying or abuse. Perhaps your charge nurse is too new at charge to have a clear vision of the role, or perhaps she's letting you develop without stepping in to save you or perhaps she's just a lazy person. We don't know. But YOU need to get a grip on your anxiety and self esteem, go to work when you're scheduled and accept that once you put something out there on this forum, you will get advice that you won't necessarily agree with. That doesn't make the advice wrong.

[klone, MSN, RN]

Part of being a good manager is knowing when someone needs help and when they need to learn to pull their own weight.

On the other hand, part of being a good team is when some nurses are done with their tasks for the moment, they offer to help out the others who are still scrambling around. That way, EVERYONE can get their tasks completed and be able to sit down and eat lunch.

[georgya3, RN]

You haven't shared anything that reaches the standard of bullying or abuse. Perhaps your charge nurse is too new at charge to have a clear vision of the role, or perhaps she's letting you develop without stepping in to save you or perhaps she's just a lazy person. We don't know. But YOU need to get a grip on your anxiety and self esteem, go to work when you're scheduled and accept that once you put something out there on this forum, you will get advice that you won't necessarily agree with. That doesn't make the advice wrong.

I am very tired of all of these, believe me, I can give you the letter seen by my union who decided is abuse, not me, but I cannot, it is confidential. So, in the meantime, that's all I can say!

I am going back to work next week when I work with very good/respectful nurses and I feel appreciated, I am not planning on wasting my time on this forum, believe me, I really miss my job! But I want to make sure I am not at risk of making other mistakes before I go! My very honest opinion about her is that she is very new, she told me she needs time and she cried during the shifts (months ago) when she started and I was one of them who comforted her. But people change and forget!!!

Thank you for your input, I love it! I forgot how it is to be on a forum, I haven't done it for over 10 years, I used to give just like-uri!

[JadedCPN, BSN, RN]

But I want to make sure I am not at risk of making other mistakes before I go!

We are ALL always at risk of making a mistake. If you ever feel you aren't at risk, then there is probably a good chance that is going to lead to a mistake. So all of your drama and blaming the charge nurse aside, if you want to make sure you do not make another mistake then focus on yourself (instead of what your charge or anyone else is or isn't doing), focus on your patients, follow your med rights, and pay attention.

[BeenThere2012, ASN, RN]

If you hadn't gotten to the notification yet, that might have been a better thing to say. When you say you "forgot", it makes it sound like you're trivializing the error.

And I always wonder ...how does someone so busy with their own work manage to keep track of what other people are doing all shift?

It.is.easy. Everytime I have to walk past the nurses station and see the same people sitting and obviously socializing over a period of time, like 1-2 hrs or off and on the entire shift, I can tell they are not as busy as I am.

[Sour Lemon]

It.is.easy. Everytime I have to walk past the nurses station and see the same people sitting and obviously socializing over a period of time, like 1-2 hrs or off and on the entire shift, I can tell they are not as busy as I am.

Seems that way, and yet, people do have misconceptions. One time in particular, a CNA told me about the "laziest" nurse on day shift who "never does anything". I loved getting patients from that nurse because everything was always always perfect! Very rarely was there so much as a single loose end, but she appeared to "sit around and talk all day" to some people.

I'm not suggesting that there aren't lazy, unhelpful nurses around, because I've worked with those too ...but I know one person's perception is not the whole story.

[MassED, BSN, RN]

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!

reporting a med error to the MD is first and foremost. You file an incident reports and you tell your charge immediately. You don't delay. This should be done before going on break. You also write "your second break" - that is a luxury MOST facilities do not have, so you might be living a bit the life of luxury. You lack of reporting in a timely fashion leads me to question you. I do agree if you're busy and others are sitting around socializing, that there is zero excuse and they should be helping. This is an issue to bring up, but I find this lack of work ethic is often something you cannot change in a person. People are either team players or they are not.

[Been there,done that, ASN, RN]

I tend to read these types of accounts with a grain of salt. What's "playing" on the phone? checking a text every once in a while (we all do that)? or playing that stupid Pokémon game? People who want to prove a point tend to embellish. And quite frankly, reading the list of wrongs done by the OP, a charge nurse playing on her phone (supposedly) isn't related to the price of tea in China at all. Something as basic as the 7 (or 8 or 9, I forget what we're up to now) steps med identification was completely missed! You can't pin that on the charge nurse.

OP made the MOST salient point that the charge nurse was using her PAD. "checking a text every once in a while (we all do that)" is not appropriate and we ALL don't do that. It is a not allowed on company time.. period.

The last floor nursing job I held.. ANYONE using a PAD was immediately walked out the door. In other words.. don't play on your phone.. when there is patient care involved.

[Kooky Korky, BSN, RN]

If you hadn't gotten to the notification yet, that might have been a better thing to say. When you say you "forgot", it makes it sound like you're trivializing the error.

And I always wonder ...how does someone so busy with their own work manage to keep track of what other people are doing all shift?

She said she was so busy that she forgot.

The Charge might be lazy and unapproachable. It's hard to know without the Charge's side of the story.

OP - you probably won't LOSE your license. And you definitely won't LOOSE it.

Switch to a shift when you won't have to work with her.

[Kooky Korky, BSN, RN]

reporting a med error to the MD is first and foremost. You file an incident reports and you tell your charge immediately. You don't delay. This should be done before going on break. You also write "your second break" - that is a luxury MOST facilities do not have, so you might be living a bit the life of luxury. You lack of reporting in a timely fashion leads me to question you. I do agree if you're busy and others are sitting around socializing, that there is zero excuse and they should be helping. This is an issue to bring up, but I find this lack of work ethic is often something you cannot change in a person. People are either team players or they are not.

OP has to learn to ask for help, not just seethe because other staff don't jump in without being asked.

[BeenThere2012, ASN, RN]

I am somewhat confused on the magnesium issue. As you are an RN, why do you need the charge nurse to intervene. Can you not notify the doctor on your own?

The incorrect morphine route and dose was, of course an error. You will not lose your license over this. I don't need to tell you to slow down and follow the 5 rights.

7 patients with one on an insulin drip is not manageable , and you never should have been given that assignment or accepted it. Next time refuse the unsafe assignment and notify the nursing supervisor.

That is all hindsight now. Certainly involve your union. Who know when and IF they will be effective in this matter. What was your manager's response in the meeting?

Charge nurse is not only not helpful, she is making it personal. You cannot keep calling in because of this.. you must deal. I would deal with it by documenting EVERY time she refused your request for assistance.. and beat the street for another job.

The situation will not change, soon enough remedy your situation.

Thank you! FINALLY, someone willing to offer some kind and helpful advice. I was going to read over the responses first in case someone has already said what I wanted to say.

It does sound like this charge nurse is not very helpful to this poster and sounds like she speaks to her in a condescending manner. There is never a good reason for this even IF the co-worker is annoying. (And I am NOT saying this poster is annoying, just using this as an example.). Sometimes we misunderstand a person's intent, but most of us can tell when someone doesn't "like" us or is treating us as though they don't want to be bothered.

OP- We all have to work with unpleasant people now and then. I know how stressful this can be. But like what another has said, I think having a sit down talk with this nurse and your manager to clear the air would be my advice as a first step if she is unwilling to talk with you respectfully as one coworker to another.

As far as reporting the med error is concerned, I don't think we need to berate you for forgetting the step of informing the charge nurse. You already realize how important this is. On shifts I have had that were horrible, I have forgotten an important thing here and there. Often, Ill remember it on my way home and then would call ASAP to report what I forgot.

I hope you get this straightened soon and can be at work more comfortably.