Help!! I made a medication error!!

Editorial Team / Admin · Mar 1, 2020

First, I would be questioning if you should even be giving meds if you have no access to the EMR. How can you verify orders and the MAR if you have no access?

Second, pretty much all nurses will make a med error in their career. Some may not even realize they've done so. What is important is owning up to it and knowing how to prevent it from happening again.

However, you are still a nursing student and schools do take these things very seriously. I would go into your meeting prepared to accept responsibility for the med error and a plan for how you will prevent yourself from making this mistake in the future. Be prepared to hear things you do not want to hear- most likely you'll receive an unsatisfactory for that clinical day at best, but you may indeed be facing repeating the course. I would think dismissal from the program if you don't have a history of issues in clinical unlikely, but that isn't a guarantee.

JKL33 · Mar 1, 2020

15 hours ago, svicente0520 said:
(Note: I don't have any access to the emr in the ER at the facility I'm doing my practicum).

?

That is really unfortunate.

**NICU Guy, BSN, RN** · Mar 2, 2020

9 hours ago, Rose_Queen said:
First, I would be questioning if you should even be giving meds if you have no access to the EMR. How can you verify orders and the MAR if you have no access?

The preceptor has access and should have been at her side when giving meds. There is no way that I would hand a nursing student (even a Capstone/Practicum student) meds and let them run off and give the meds. The preceptor has to bear some of the responsibility for the med error. How was the student suppose to verify the meds with the MAR without the preceptor's presence at the bedside?

JKL33 · Mar 2, 2020

45 minutes ago, NICU Guy said:
There is no way that I would hand a nursing student (even a Capstone/Practicum student) meds and let them run off and give the meds.

That's right.

Ditto.

svicente0520 · Mar 3, 2020

Update. So I have failed my practicum. I will not be graduating in May as planned. I will be able to retake the semester this Summer. I hope I never make this kind of mistake again. I thank everyone for helping me. I understand I made a mistake but my preceptor only blames me, which is what it is. I'll continue to count my blessings and keep persevering.

Spooky, RN · Mar 3, 2020

1 hour ago, svicente0520 said:
Update. So I have failed my practicum. I will not be graduating in May as planned. I will be able to retake the semester this Summer. I hope I never make this kind of mistake again. I thank everyone for helping me. I understand I made a mistake but my preceptor only blames me, which is what it is. I'll continue to count my blessings and keep persevering.

I'm sorry to hear that! That's really awful! It was a hard lesson learned that wasn't even all your fault! I agree with the other replies. That is not right. Maybe see what you can do about continuing some other time or an appeal? I wish you all the best on continuing your education. Keep that optimism! ?

JKL33 · Mar 3, 2020

@svicente0520,

I am very sorry this has happened.

I know it is extremely difficult as a novice to know when it's okay for things to be different than what you were taught in school, and when it isn't okay; when it's right to follow the lead of more experienced people around you and when to know that you need to do something different. Altogether these are factors that affected this situation. Making sure to have the right patient (and all of the "rights") is one of those things that is always non-negotiable.

I don't think it's right to place a student in a situation where the usual process of properly administering medication that is used in the facility is not made available to the student nurse and then to react harshly when it doesn't go as it should.

But...the way to move forward here is to just learn the lesson, and also have your eyes opened to the overall situation: There will be plenty of opportunities to cut corners or to do be expected to do things in a way that is not overall safe or best, so the bottom line is that when pressures and expectations, sometimes even rules, are such that the patient is placed at risk -- be able to recognize how to operate so that safety is not compromised. If you can learn that from this experience you will be ahead of a lot of people.

Best of luck ~ ?

BSN-to-MSN, ADN, BSN, RN · Mar 3, 2020

I'm sorry, you must be feeling awful.

It's common that the nursing STUDENT does not have access to EMR. So they don't mess up the documentation. A student may have access sometimes, but the primary RN will then co-sign their documentation before it becomes a part of a permanent legal record.

A student is supposed to be giving meds ONLY when primary RN or instructor is present. Did you know that?

svicente0520 · Mar 3, 2020

Yes. My Preceptor was within shouting distance and didn't come with me. She stayed behind to "talk" with the other nurses. I take full responsibility for my actions, as I know I did the wrong thing. I have failed my practicum for my mistake. And will not be graduating on time.

Editorial Team / Admin · Mar 3, 2020

1 hour ago, RN-to- BSN said:
It's common that the nursing STUDENT does not have access to EMR.

Not in my area. The student is giving meds with their instructor (or preceptor if in capstone) and do the documentation themselves. It is not left up to the nurse to document that another person gave the meds.

turtlesRcool · Mar 3, 2020

12 hours ago, svicente0520 said:
Update. So I have failed my practicum. I will not be graduating in May as planned. I will be able to retake the semester this Summer. I hope I never make this kind of mistake again. I thank everyone for helping me. I understand I made a mistake but my preceptor only blames me, which is what it is. I'll continue to count my blessings and keep persevering.

You have a fantastic attitude, and that will stand you in good stead as a nurse. Having made this mistake once, you will probably be one of the most careful new nurses the hospital has ever seen. I'm glad you will be able to retake the course this Summer. Honestly, there's not that much difference between graduating in May and graduating in August.

I do disagree that the blame is ONLY on you. If you don't have access to the EMR, how are you able to do the 5 rights verification process? The verification means being able to make sure what you have in front of you (patient and meds) match up to what is ordered.

FWIW, I would never allow a student to administer a med without me right there to verify it. Never. If it's being charted under my name, I'm making damn sure I see it given. If someone doesn't have the authority to chart a med independently, he or she does not have the authority to give a med independently.

Although your preceptor may blame only you, I highly doubt the hospital sees it in the same light. My guess is the RN who walked away from you is in some hot water of her own (because being within "shouting distance" is not the same as supervising a student who is giving meds without an EMR at his/her disposal). If this kind of "supervision" is the accepted norm, hopefully this incident will prompt a hospital policy change due to the high likelihood for error.