i am at my third year of nursing.on my second last day of my clinical, i made a medication error. i gave patient t's nitroglycerin patch to patient s, (they are in the same room). s' systolic bp went down to 60. during the day s also received 2 bags of iv morphine for pain management, the np thought the bp drop maybe due to morphine. i did not realize the error until the next clinical day, i was told by my tutor. the floor nurse educator told my tutor one of the nurse found the nitro patch on s at night, they figured out s' low bp is due to nitro patch.
my tutor was really angry at me. she failed me. (my 3 months of hard work!)
now i need to repeat the clinical course next term, or maybe i have to repeat the whole year, depend on the progression committee's decision. i don't know how i am able to survive the next two year without the support net work i had with my other nursing friends. i am also scared to make another mistake again. i am scared of nursing now. i am dealing wit pt's life. i am not sure if i am safe. i don't know if i will ever be competent to be a nurse.
help!!! how to write a letter to progression committee?
Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.
hi, i want to explain the situation a bit more.
i was at a neurosurgical floor. most patients i had were not alert, no responsive to command. do you still explain to them "the medication you are giving, and why?"
you never assume anything no matter the diagnosis. you always talk/educate your patients. if educating the patient does nothing for them there is no harm done. in fact, it will definitely do something for you because it forces you to know what you are doing at all times!
as well, both of my patients have oral medications through gastrointestinal tubes, so all oral meds have to be crushed and put in cups, plus other meds, heparin, and supository i have to administer. these meds did not have pt's names on them when they are out of patient's med drawer. it became difficult to remember what are the meds, and who these meds are for.
thanks
the medications do not have to have the patient's names on them to be safe. in fact, to be safe you should never pass meds (pull them or draw them up) for more then one patient at one time. plus, you should always have a document with you that has the correct medication orders for that patient as well as the patients id information (a mar) as you walk in the room to compare with the correct patient's arm band. if the patient cannot speak or is confused, another person should help you identify the correct patient. if anyone interrupts you (i work in an er so interruptions happen to me all the time), stop yourself and start over (5 rights and three checks) before giving the meds (yes, i do this all the time).
out of curiosity, when did you figure out the bps were low on the wrong patient? also, when you found out, what did you or the nurse do to re-assess the patient?? did you two even look at the patient?? the reason i am asking these questions is because i cannot figure out from reading your original post why the night nurse was the one to discover the mistake. it is as if no one bothered to re-asses the patient during day shift. in fact, from reading your original post, i think part of your problem is the rn who was in charge of this patient.
i would not have just shrugged off low bps even if the problem was morphine because low bps are dangerous! there is no way that patient would have had low bps the rest of my shift! if i were your nurse, i would have implemented interventions that would have caused me to find the patch on the wrong patient. with that said, be prepared for this nurse to throw you under the bus because she/he was in the wrong and practiced unsafe.
can you use that as an excuse for your school? nope... if this nurse's manager wants to go after her/him then the nurse will be reprimanded accordingly. however, this will have nothing to do with you as a student. as a student you are to follow the protocols as taught to you in your school and will be disciplined for not doing so. as the other posters have mentioned, you need to own up to your mistakes because you made quite a few and it was no one's fault but your own.
Specializes in Chiropractic assistant, CNA in LTC, RN.
My grandmother had a saying "the lessons that you learn in pain you seldom have to learn again." I had awful time management skills in nursing school and was sent home from a clinical for being 2 minutes late. It wasn't my first time and I deserved it. I was in a crappy relationship and had a lot of personal issues going on but it was no excuse. I had to come back on a Sunday with a group I didn't know and it was embarrassing to be sent home in front of my fellow students. Let me tell you, I was never late again. This punctuality has also carried over into other aspects of my life.
My advice is to learn what you did wrong. You've been given excellent advice. You ALWAYS check the patient's arm band RIGHT before you give the meds no matter how many times you have already checked. Not all facilities have MAR either and not all patients are responsive enough to tell you their names.
I would stop beating yourself up,accept that it happened, figure out how to NOT let it happen again, and start over. If you learn from this experience then it was worth it. Thankfully the patient was ok. Maybe this happened now so you would learn. Next time might not turn out so well.
Specializes in Critical Care, Clinical Documentation Specialist.
I'm sorry this happened to you, but I wanted to say thank you for posting your mistake here. It allows people like me, who aren't in NS yet, to learn from your mistakes and have it driven home how important this is, and how easy it can be to make a mistake, whatever the reason.
I think you are lucky if you are able to retake the session, it will be costly in time and money, but you can learn from it and still continue on to get your license.
Good luck with your meeting, I hope it works out for you!
sorry to hear that but i am sure you are happy nothing happened to your pt. just learn from your mistakes and make sure it doesn't happen again and don't be scared of nursing if it's what you want to do don't let anything stop you. also don't be mad at yourself what happened you can't change so there is no point in being anger or mad about the situation sometimes bad things happen to good people and it's not what happens that matters it's how you handle the situation that determines what kind of person you are. good luck and be positive!
Specializes in CT Surgery; Transplants; VAD Specialist.
Anyway I personally think it's a very harsh punishment failing you like this. When people fear this sort of harsh reprisal it's no great surprise when people won't admit their drug errors. It should be an opportunity for you to reeducate yourself with the principles of administering medication, not to dole out extreme forms of punishment.
Specializes in Chiropractic assistant, CNA in LTC, RN.
I also think failing clinical, if this is a first offense, is a bit harsh. If people know they are gonna be failed, they aren't as likely to admit their error. Like I said though, chalk it up to a lesson learned. Sometimes that is all you can do and move on.
Where was your instructor? I know when I gave meds the instructor was right there with me. I'm really sorry this happened to you. I was thrown out of my nursing program for much less than a med error. You're a student, you're learning, what do they expect, perfection? Hopefully you'll only have to repeat the semester. That's what I'm fighting for, to repeat the semester not the whole year. Good luck!
If you don't have the barcode system, that is why is it so important to take the paper mar in the room with you and perform the 6 rights of med administration.
I'm sorry to hear that...the positive thing about this whole ordeal is that it's a reminder that life gives us opportunities to grow..you made a mistake, but the pt is okay, and you made it as a student with no chance of license revoking or job termination. My advice is be accountable, reflect on the mistake to learn from it, and forget about it! Best of luck!!
No you didn't. You have to check the armband at the patient bedside immediately before applying the nitro patch. Learn from your mistake and do your best to move on. I'm sorry it happened to you. I know you're heartbroken over it. Don't let it scare you away from nursing.
And even then, you still need to use two identifiers to ID a patient, so after you scan the barcode, you'd ask him/her his DOB or SSN or match him to the picture in the MAR (can't you tell I work in psych ).
I'm sorry it happened to you: I've made a med error during clincial as well and they do really suck--I've felt a lot of the same feelings you did too. And med errors happen even to the most seasoned nurses--there's a thread in the General section about a nurse who made her first error in 20+ years of practice. But look at three important things:
1. The patient made it though OK--it could have been worse.
2. Even though you failed clinical, you are not out of the program so you have a second chance. I think it's harsh that they failed you...but you've still got that chance.
and most importantly:
3. This is a wake-up call that perhaps you're not practicing the rights of medication administration as diligently as you think you are....because if you were, the wrong patient wouldn't have gotten the medication.
I recommend making a list of what the rights of medication administation are (there are at least 6, I follow a set of 7, and it ranges up to 10 and more in some textbooks--but a lot them can be consolidated) and review those rights often.
I'd also remember to check the medication three times: when pulling the med, before giving it to the patient, and immediately after giving it. And if you're interrupted or if there's any doubt, stop yourself and recheck. The more often you do these things, the more they will become second nature.
After my med error, I received a booklet titled "101 Medication Errors and How to Avoid Them." I make it a habit to read it once every few weeks, just to remind myself how easy it can be to make an error even for the best of nurses.
We are human! A mistake by a student needs to be eaten by the the Nurse!
Actually--and we are told this many times over in NS, textbooks, etc.--the student is still liable for their actions in clinical. The fact that she's not licensed doesn't mean she is immune from responsibility or the consequences.
We are human! A mistake by a student needs to be eaten by the the Nurse!
Uhhhhh......no. STUDENT needs to own up to the mistake and figure out how to make DANG sure it doesn't happen again. Failing is harsh, but we are playing with patient lives. I don't think OP should be kicked out of the program, but I don't think it is unreasonable to make OP do the clinical again.
).
SummerGarden, BSN, MSN, RN
3,376 Posts
you never assume anything no matter the diagnosis. you always talk/educate your patients. if educating the patient does nothing for them there is no harm done. in fact, it will definitely do something for you because it forces you to know what you are doing at all times!
the medications do not have to have the patient's names on them to be safe. in fact, to be safe you should never pass meds (pull them or draw them up) for more then one patient at one time. plus, you should always have a document with you that has the correct medication orders for that patient as well as the patients id information (a mar) as you walk in the room to compare with the correct patient's arm band. if the patient cannot speak or is confused, another person should help you identify the correct patient. if anyone interrupts you (i work in an er so interruptions happen to me all the time), stop yourself and start over (5 rights and three checks) before giving the meds (yes, i do this all the time).
out of curiosity, when did you figure out the bps were low on the wrong patient? also, when you found out, what did you or the nurse do to re-assess the patient?? did you two even look at the patient?? the reason i am asking these questions is because i cannot figure out from reading your original post why the night nurse was the one to discover the mistake. it is as if no one bothered to re-asses the patient during day shift. in fact, from reading your original post, i think part of your problem is the rn who was in charge of this patient.
i would not have just shrugged off low bps even if the problem was morphine because low bps are dangerous! there is no way that patient would have had low bps the rest of my shift! if i were your nurse, i would have implemented interventions that would have caused me to find the patch on the wrong patient. with that said, be prepared for this nurse to throw you under the bus because she/he was in the wrong and practiced unsafe.
can you use that as an excuse for your school? nope... if this nurse's manager wants to go after her/him then the nurse will be reprimanded accordingly. however, this will have nothing to do with you as a student. as a student you are to follow the protocols as taught to you in your school and will be disciplined for not doing so. as the other posters have mentioned, you need to own up to your mistakes because you made quite a few and it was no one's fault but your own.