help, new grad with first NARCOTIC med error :(

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made my first med error today at work; gave a patient a discontinued 7.5 mg lortab fo.r pain

i knew she had always had this med pr for pain in the past, but for some reason, i didnt check the mar before i gave it.

what makes me feel more worse is the fact that the package no longer even had"prn" written on it (though she has had it prn in the past), and for some reason i just went on that "assumption", instead of checking on the actual mar and rechecking the label on the med pack (stupid i know)

im even more upset about the fact that this med had been d/c for 2 weeks now (the pt was d/c to a hospital for surgery during that time), and no one even bothered to take the d/c med out of the cart to help prevent any error (though i take full responsibility).

felt like a idiot trying to explain what happened to the DON. this is the second time im being written up this month(first time was for missing a dressing change). the administrator warned me from here on out i cant let anything like this happen again (which is understandable), but this means im basically hanging onto a thin piece of thread as far as my position goes for a really long time.

i know safety of the pt comes first, and i assessed and reassesed her throughout the shift, and she had no complaints. totally fine. but the administrator told me they have to notify the fam as well, and im terrified cause they have given us a hard time lately (dropping hints that theyre ready to sue :S if anything goes wrong)

im thinking its probably time to throw in the towel...god it's like everytime i make a mistake and learn it, another comes out of nowhere...all i wanted was to be the best nurse i can be...

im seeing the don tommorow, and im thinking of resigning before she fires me....my self esteemis at an all time low now

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but the administrator told me they have to notify the fam as well, and im terrified cause they have given us a hard time lately (dropping hints that theyre ready to sue :s if anything goes wrong)

im thinking its probably time to throw in the towel...god it's like everytime i make a mistake and learn it, another comes out of nowhere...all i wanted was to be the best nurse i can be...

im seeing the don tommorow, and im thinking of resigning before she fires me....my self esteemis at an all time low now

first of all, with any incident report the family has to be notified (ltc, right?). if the person ate a crayon (hey, it happened on a locked dementia unit :D) the family has to be notified, even though "non-toxic" is all over the box.

second- if you're going to hang it up over your first med error (narc or not) get a grip :D :d :D :d :D

you will make more; you learn more each time - and this was a med that had been prescribed; no error is good, but you didn't give her something that was prescribed to someone else, that caused an anaphylactic reaction :eek:

you should be ok :up:

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Specializes in Certified Med/Surg tele, and other stuff.

Aww hugs :hug: In a hospital it would not get you fired. This place sounds a bit anal, but it sounds like a lot of LTC facilities are like this.

Yeah, you made a mistake, but like xtrn said, this won't be your last and it could have been worse.

You admitted the mistake and that speaks volumes on how much you care.

When you go in and talk to the DNS, admit your mistake and offer ways to fix the broken system. Maybe spearhead some sort of audit to show how often dc'd meds get left in the cart and offer ways to fix it. Try to show you do care and want to fix what is wrong with the process.

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Specializes in A myriad of specialties.

i agree with tokmom. i would add that most definitely an audit/check system needs to be in place(it should have been already) where the nurse who takes the order to dc a med physically removes that med from the med drawer and conveys this new order onto the coming shift. it really all comes down to communication; something which i know our hospital most definitely lacks.:devil: i hope things turn out well for you, cherielpn23!!

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Specializes in ICU, ER, EP,.

no one may agree with me, but I would call the primary doc. tell them of my mistake and ask for a one time order to cover me and insure that communication of the discontinuation was prevalent. Many times, doc's understand, no harm comes and then you are covered.

Those that haven't practiced for 16 years are now going to blow my response out of the water. Just consider my reply, call the doc immediately, get an order. Those that are hot to disagree will remember this advice when you make the same mistake. We all make them, call the doc and just get an order for what you did. If they won't give you one, then you write yourself up, QCC it and take the blame.

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Specializes in NICU, Peds.
no one may agree with me, but I would call the primary doc. tell them of my mistake and ask for a one time order to cover me and insure that communication of the discontinuation was prevalent. Many times, doc's understand, no harm comes and then you are covered.

Those that haven't practiced for 16 years are now going to blow my response out of the water. Just consider my reply, call the doc immediately, get an order. Those that are hot to disagree will remember this advice when you make the same mistake. We all make them, call the doc and just get an order for what you did. If they won't give you one, then you write yourself up, QCC it and take the blame.

Even those who have practised for a long time know that this advice is rubbish.

Check your drugs before you give them ... that's advice worth following. Not "meh, don't worry if you make a mistake, cos the dr will cover your butt".

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Specializes in LTC, medsurg.

I can't believe this place is so anal about mistakes. No one got hurt. I've made plenty mistakes, learn from them and move on. Luckily, I work in a teaching hospital so it's not too big a deal if we made a mistake like this. Life is about learning from our mistakes....GEEZ! Sounds like this place you work for don't deserve to have some one as caring as you. Don't be hard on yourself and don't throw in the towel. Just do Your job and be as careful as possible. I bet you won't make this mistake again. That's is the great thing about mistakes.....it gives us experience and teaches us. Your DON is an ----!!

Take care Hun!!

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Specializes in LTC, medsurg.
Even those who have practised for a long time know that this advice is rubbish.

Check your drugs before you give them ... that's advice worth following. Not "meh, don't worry if you make a mistake, cos the dr will cover your butt".

I don't think that's what she meant in her post. I didn't take it that way. Drs aren't there to save our butt however she could have gotten an order to cover her. Doesn't mean she's going to keep making the mistakes!!!

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Specializes in Gerontology, Med surg, Home Health.

Why is it anal to care that med errors are made? Do you know that 75% of the hospitalizations for people over the age of 65 are related to taking medications incorrectly? It's serious business. Always always check the MAR before giving any med, especially a PRN. There might have been a systems error involved if the med wasn't dc'd on the MAR or narc book, but that doesn't seem to be the problem here. We all make mistakes. Learn from your mistakes and check the MAR before you give any med.

I don't think this is something to be fired for.

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Specializes in LTC, medsurg.

I don't think it's something to be fired for either, that's why I said it was anal. I'm not saying med errors aren't serious but that we lern from them!!

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Specializes in Psych ICU, addictions.
no one may agree with me, but I would call the primary doc. tell them of my mistake and ask for a one time order to cover me and insure that communication of the discontinuation was prevalent. Many times, doc's understand, no harm comes and then you are covered.

I actually do agree...though I'd be on the phone with the doc telling them about the error anyway even if I wasn't planning to ask for a one-time order.

Even those who have practised for a long time know that this advice is rubbish.

Check your drugs before you give them ... that's advice worth following. Not "meh, don't worry if you make a mistake, cos the dr will cover your butt".

I don't see anywhere where she stated that calling the doctor for a one-time order excused making the error in the first place. It goes without saying that it doesn't. Unfortunately, this society has become so litigation-happy, you can't blame one for wanting to CYA as much as possible. And mistakes happen even with checking and rechecking.

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Specializes in Acute Care Psych, DNP Student.

I look for two things when a preceptee makes a medication error:

* He or she understands and acknowledges personal responsibility for the error

* He or she appears to genuinely feel badly and express concern for the patient

If the nurse does the above, I'm not too concerned as long as the patient was not harmed. Medication errors happen - that's just reality.

I am precepting a new grad who made her first medication error this week. The nurse I'm precepting right now acted like it was no big deal and did not express concern or act like it was important. That sets off my alarm bells. Her medication error turned into a big deal because she did not act appropriately when she learned of her error. That's the under-reaction response. The opposite is the over-reaction response - the OP might be at risk for this type of response.

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