Got fired for a medication error

[Sonyab]

Hi everyone

I recently got a job in a private hospital. Now the hospital i work with has different policy and procedures in administering medication. I made two medication error in the first two days. The first one was an error in medication dosage for someone else's patinet . I administered the wrong dose cause the nurse who told me to give it was not clear about the units of measurment and just gave me a number so i administered the med in ml where it should have been mcg. This happened in icu enviroment where nurses are allowed to adjust medication dosage within certain parameters .the second one i gave a medication which was in an incomplete order. This happens alot in where i work and most often the med team come and complete the order later on when doing rounds. I administered this medication for bp according to previous day dosage .

In both accident nothing happened and i acknowledges my mistakes and reported them.

This facility did not organise an orientation for me whwn i commenced working so i went with what i was used to in that enviroment from previous experiance .

My magaer said it will be fine and that i will hopefully get shifts . However after putting many shifts down and not getting any i got the hint that i will no longer get any shifts . Later on in 2 months time i recieved a call that i was fired .

I was thinking about making a complaint firstly bc i was never orientated and secondly they waited 2 months before letting me know .

I apologised to my manager after accidents and filled out an incident form .

Does anyone have any such experiance and should i make a complaint ?

[Daisy4RN]

Agree with the other posters. This was your mistake. You should not need "orientation" in order to safely pass medication. You should not have taken those liberties upon yourself. Please learn from your mistakes and do some homework/refresh on how to safely pass medication before you work again and possibly hurt someone. Just count it a learning experience and move on.

[Horseshoe, BSN, RN]

Even if someone reports off a dosage, you should be checking it yourself!

I agree. Even a most trusted co-worker can make a mistake if the order is not right in front of her. It would be risky to ever give a medication you haven't at least seen on the MAR.

[roser13, ASN, RN]

Good question. When I worked ICU, I would not have felt comfortable with anyone but another RN giving my patient medications if for some reason I could not do it.

Have to admit I missed the ICU part. Which makes this post even more frightening in multiple ways.

[djh123]

Administered a med in mL when it should've been mcg? Depending on what med it was (obviously), that could've been VERY dangerous. You don't just give something when the nurse 'wasn't very clear'. Whether it was your 'patinet' or not

[TheCommuter, BSN, RN]

Are you a nurse? Or a medication aide?

This OP is, in all likelihood, a licensed nurse. I have never heard of a medication aide administering meds in a high-stakes, high-acuity critical care setting.

I have seen medication aides in lower acuity healthcare settings such as group homes, assisted living, and long term care facilities. Nonetheless, I suppose the lesson is to never say never!

[Cafelattee]

I work different icu and er and the rule you may give a med for another nurse but you always read the order for your self and draw the medicine for your self. You never take someone's word or administer a medicine you did not draw up or obtain yourself.

This use to happen a lot when a LPN couldn't' do a IV push. I had LPN that wanted to help me so they would get everything ready. That's a big NO. yes it would of helped cause I was one RN with 54 pts but still have to do it myself.

Sorry but its sound like you don't get basic medication administration practice

THe only time this rule can get ambiguous is during a code.

[chacha82, ADN, BSN]

You've been given great advice from all the posters here. Count your lucky stars (in this case they are profoundly lucky) that nothing bad happened to the patient. I am sorry they let you go, but they have more than due cause here. In your next job, do not give another medication for another nurse without a check and independent check. I always have another RN verify with me, sometimes it may be intrusive but I try to do it with as little disruption as possible.

[Ruby Vee, BSN]

This is pretty damned scary! You administered cubic centimeters instead of micrograms! For the love of all that is holy, that's a really, really bad mistake! Did you not look at the MAR yourself? Shame on you for not looking if indeed you didn't look, and an even BIGGER shame on you for not knowing the difference between cc and mcg! I'm glad you acknowledged your mistakes, but you need some re-education before you ever give medications again!

[Here.I.Stand, BSN, RN]

Picture this: Fentanyl: 25 mcg/ml. Oops I gave 25 ml instead of 25 mcg.... that's 6375 mcg of fentanyl.

Giving ml's in numeric equlivalent of mcg is not a med error as a result of systems breakdowns. That is GROSS negligence. That's so negligent I can't even get my head around it. Be glad the only consequence was loss of a job. It could have been a charge of negligent homicide.

[Workitinurfava, BSN, RN]

Be glad you were fired and didn't kill someone instead. I am not saying this to be nasty to you. I am saying this because it was your hands that gave a med you were not sure about, forget about the other person. Don't ever follow that kind of non-sense again.

[melissamabd, DNP, RN]

It's time to use these two episodes as learning experiences. You need to go back to nursing fundamentals and the rules of proper medication administration, and there are many. To give medications safely, you need to have an assessment on your patient. Why would you just go give meds to some other nurse's patient? Also, you need to read orders for yourself. We never take orders from each other and frankly, I think both of you are at fault there. Do you not have to scan medications into the system prior to administration?

Lastly, there are required components to every order. You do not have an order if any of these are missing. Period. No one should give you grief for insisting on safe medication practices; if they do, time to work elsewhere.

Last thing... are you working agency? Why did you not have much orientation in this environment? I don't think it's safe, whether it's them or you. If you are inexperienced, agency is deadly unsafe. I have 37 years' experience and I STILL would feel unsafe just waltzing into a new environment without much orientation. I tell this to all my students; please heed.

Good luck to you.

[Here.I.Stand, BSN, RN]

melissamabd, I beg to differ that they were both at fault. Recently I was caring for a pt who had been ARDS-ey although was recovering; his lungs still looked bad and he was not ready for extubation, although he wasn't on a paralytic anymore. This was a huge young man who made the Hulk look like a frail granny, had self-extubated earlier in the day while firmly restrained. He could go from zero to throwing his legs over the bed and reaching for his tube in seconds.

So anyway, I was busy with my other pt, and a colleague came in and said pt #1 was trying to sit up and can she give him anything? I said "You can bolus him with 50 of propofol." I've done the same, or given prns/titrated drips on other pts whose assigned RNs are tied up. It's teamwork.

However a prudent nurse would 1) follow the 5 Rights, and 2) if the RN didn't know what to do for whatever reason -- such as she didn't get oriented and was unfamiliar with the meds -- she'd better not give that med.

The rest of your post was spot on though, hence the "like." :)

And I completely agree that not orienting a nurse to an ICU -- especially an inexperienced ICU RN -- is a dangerous practice that puts pts at risk. Regardless though, each of us is responsible for our own nursing practice, and med administration is Nursing School 101. The mistakes outlined in the post are both on the OP.