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 ?
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
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.
You mean they even have medication aides in the ICU? That blows my mind. Remind never to get sick.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
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.
Actually JCAHO now requires agency nurses to have recent experience (within the past year) in any area they work for the agency. I found that out when I tried to get agency work in my previous areas of expertise. I was ineligible because my experience was not within the previous year.
OK... But think of the possible consequences. Were anything to go wrong, the first question from an adversarial attorney would be what was assessed and known prior to acting. I hear your real-time world perspective. So many things go into whether or not it's safe to act. For this nurse, I recommend revisiting those old rules.
I agree with others, there is a common theme between these mistakes: you act without a complete order. This is either gross negligence or you are filling in blanks with your own assumptions, both of which result in you practicing dangerously out of scope.
You absolutely have no complaint. Giving meds without a complete order and without verifying the order. That's nursing school 101!.
Now, that being said.....if you feel that you need to say something about not being properly trained or oriented to the unit, then I would maybe send an email with concerns (not complaints) about how you feel that you were not provided the proper training for the unit. But you have no complaint to stand on. Your lucky that they have not reported your license. Those are some serious med errors.
You mean they even have medication aides in the ICU? That blows my mind. Remind never to get sick.
I've never seen med aides in an acute setting personally, let alone a critical care setting. Actually from the sounds of it my hospital is in a minority in that we even have CNAs in the ICUs. They certainly do NOT function as med techs though! It's rare that they even touch a pt without the RN present. I mean once in a while we have someone they can bathe independently, or put on the bedpan, but otherwise they do pt care *with* the RN or do non-nursing stuff like stocking the supply carts or running blood products for mass transfusions.
I've never seen med aides in an acute setting personally, let alone a critical care setting. Actually from the sounds of it my hospital is in a minority in that we even have CNAs in the ICUs. They certainly do NOT function as med techs though! It's rare that they even touch a pt without the RN present. I mean once in a while we have someone they can bathe independently, or put on the bedpan, but otherwise they do pt care *with* the RN or do non-nursing stuff like stocking the supply carts or running blood products for mass transfusions.
Same for our hospital and the two ICUs in which I work. We do have one aide for nights on both units - they help with non-vented patients' ADLs (rare - they're usually gone once they extubate), help with supplies, do some HUC duties, assist families, and run stat labs/gasses for us. Very very helpful. I have never seen a medication aide in a hospital. In my state, aides can't even do blood glucose checks unless they have an additional phleb certificate or something. The law just recently changed.
As as to the OP, I think others have summed it up well. The bottom line is that the critical care setting may not be for you. These are core safety measures that should be rote for a nurse of any level. With experience, I would expect that you would have certain medication dosages memorized - we certainly tend to give a lot of the same meds and should be able to recognize at a glance when an order sounds unusual or is incomplete. I can't imagine not double checking orders. If possible, please take a break from nursing and spend some time in self-reflection.
However, I will answer as if this event actually occurred.
You did not practice nursing safely. I think it was the correct action that you were let go. Would you want a loved one being taken care of by a less than thorough nurse that willingly gives medications without caring the orders are complete? I sure wouldn't. I know you wouldn't either.
Good luck with your next adventure, and I hope you learned a few lessons here!
I've gotta say..... I'm usually incredibly soft on people when a mistake is made especially if the person feels awful about it but come on. Your post tells me you really have no remorse but are more worried about lodging a complaint. Take some responsibility here! TWO medication errors in TWO days? You gave mLs when it should have been mcgs? Given that information, I can't say I blame them for firing you. You need to quit being upset about being fired and thank GOD that you didn't kill one of those patients. Instead of worrying about making a complaint, go over the rights of medication administration. Giving meds is a huge responsibility and it sounds like you need to take it more seriously. Clarify orders that don't make sense, look at the MAR before doing anything, and never ever give a med you didn't draw up yourself. Every day, I pray to God that I will never get lackadaisical and make a mistake that harms my patients because they are relying on me to keep them safe.
Do some soul searching, take a refresher course if necessary, and count this as a learning experience. Grow from it. Above all, remember that your patients are counting on you. Ask yourself: "What is this were my mother, father, child, husband, sister, wife?"
You mean they even have medication aides in the ICU? That blows my mind. Remind never to get sick.
I never said there were medication aides in the ICU.
Someone asked the OP if they were a nurse or medication aide. So my comment reflected that even if the OP's unit allowed medication aides, I would not be comfortable with that, especially in an ICU.
I think the person asked the OP that question because it seemed impossible to believe that a nurse could possibly make that kind of error- we are educated extensively about the implications of units of measurements when giving medications. This just seems almost unbelievable the more I think about it.
I think the person asked the OP that question because it seemed impossible to believe that a nurse could possibly make that kind of error- we are educated extensively about the implications of units of measurements when giving medications. This just seems almost unbelievable the more I think about it.
I agree. The OP has not returned. I was wondering as I was typing my reply if this was a genuine post or not. The more I think about it, the stranger it seems. Like with the fentanyl example above, if someone asked me to give 25 of fentanyl, I would know they meant mcg, since I am familiar with how the med is dosed.
I noticed that in the original post, the OP referred to his/her place of employment as a "private hospital". This had me wondering if maybe they were not in the US? I know some people use that term here, but not very often; I work for a public hospital district, a county hospital, and what could be referred to as a "private" hospital. I've heard it more often in the UK when people are distinguishing between an NHS facility and a "private" facility. Not sure if they use med aides inpatient in the UK? I don't know enough about non US medical care I guess ....
TriciaJ, RN
4,328 Posts
You mean they even have medication aides in the ICU? That blows my mind. Remind never to get sick.