help, new grad with first NARCOTIC med error :(

[cherielpn23]

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

[PinkRocksLikeMe]

1st of all (((((((((((((((((((HUGS))))))))))))))))))))))) I am NOT a nurse but a EMT-I and want to tell you that you WILL make mistake along the way. The important thing is that you admitted your mistake. I hope you called the doc as well ( I did not see that in post, but maybe I missed it), you monitored your patient, and you told your DON. What I would suggest is that you write something for the DON and the doctor, outlining what you did, what actions you took when you saw the mistake and what you are going to do in the future to prevent that from happening again. Do NOT say someone should have taken it out of the MAR (even though I agree) it is still your responsibility to check. They will appreciate you took the time to make a action plan to try and prevent further errors. Listen, a person with a license that is able to administer ANY kind of med WILL make a mistake somewhere along the way, it is the ones that say "oh, I have NEVER had a med error) THOSE are the people to watch out for.

As for the notification of the family, I as well would speak to them stating that you apologize for your error, what actions you took after mistake was made, and that you checked on their loved ones many times, doing vitals, etc...They will also appreciate your honesty and the patient may even be thankful for the extra dose of pain meds, even though I am not saying it was right,

Hang in there, don't give up!! You will be a great nurse, but remember you are HUMAN and not a robot OK, now stop beating yourself up and go work on that action plan.

Good luck!!

Pink

[DixieRedHead, ASN, RN]

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.

I totally agree. AND if this is your first med error, narc or not, you can be sure that if you stay in nursing long, it won't be your last. Learn from it and move on.

[Forever Sunshine, ASN, RN]

This is why when I take an order to D/C a narcotic. I write it in big black letters and highlight the mar entry, narcotic sign out page, and on the narcotic itself. I wouldn't want to be the one called in to blame because someone didn't see that it was dc'd.

Don't give up so soon. You will get more confident and comfortable as time passes. Every new grad feels at one point that they should throw in the towel. Hang in there.

[MomRN0913]

As for the notification of the family, I as well would speak to them stating that you apologize for your error, what actions you took after mistake was made, and that you checked on their loved ones many times, doing vitals, etc...They will also appreciate your honesty and the patient may even be thankful for the extra dose of pain meds, even though I am not saying it was right,

Good luck!!

Pink

I do not agree with this. You let your management talk to the family. I was advised never to confront the family about the error by facility management yourself. This is for litigation reasons. Before you do this, you better check with your DON.

[VICEDRN, BSN, RN]

I hate to say it but as the voice of experience, I would have advised you to ask the doc for a one time order, accept the awful humility of the whole thing, learn from it and move on with your day.

[nurseygurlie]

I'm sorry if I appear insensitive but you are a new grad AND you aren't checking your MAR while you give meds?? To me, that's already a "med error"...at the very least its negligent.

Maybe you should take your job a little more seriously.

[Wave Watcher]

I just wanted to check in on you and see how you were doing and how your meeting with your DON went?

Don't give up. I have been in your position before and I felt like I had failed. Failed as a nurse, a caregiver, failed my patient and so much more. I wanted to run off the floor crying (yes I cried because I scared myself by making an error) and never go back to nursing. EVER! I worked so hard to make sure I didn't make a mistake, that my patients were taken care of from the time I stepped onto the floor and to the time I walked off the floor. BUT accidents do happen. EVERY single nurse (whether they admit or not) has made some kind of mistake while nursing. We are HUMAN. Do not let this keep you from nursing again. If need be...take a break...relax....give yourself credit for getting this far. You know what your doing....at this point you have stressed yourself out so much that you can't think nor function on the floor. You are so scared of making a mistake that you make mistakes. Easily done. Your patient is fine. Take a deep breath. Now.....think about what kind of nursing you want to do. Is it floor nursing? Is it clinical nursing? Home Health? School nursing? ER? Whatever your answer is....do it. Come off the floor your on.....start new and fresh.

I did keep nursing after my situation.....BUT I refused to take a job I knew I was not going to like. I refuse to work floor nursing. I have found other Nursing Jobs that are so much better (for me), less stressful, and actually FUN. Yes, I said FUN! So, there is hope. Don't throw all your hard work away. Build up your confidence in yourself! You can do this!!

[milksteak]

OP,

any updates on what happened?

I hope everything turned ok!

[Peetz, BSN]

Administration could learn a valuable lesson from this mistake also. They should be asking themselves "What allowed this mistake to be made?, and how can we learn from it?" Do NOT throw in the towel, you caused no harm to the pt. You owned up to the mistake and learned from it. If we all gave up on our second or even 20th mistake there would be no nurses. There are two kinds of nurses: Those who make mistakes and own up to them, those who make mistakes and hide them.

Good for you for being the own up nurse.

[Peetz, BSN]

This is why when I take an order to D/C a narcotic. I write it in big black letters and highlight the mar entry, narcotic sign out page, and on the narcotic itself. I wouldn't want to be the one called in to blame because someone didn't see that it was dc'd.

Don't give up so soon. You will get more confident and comfortable as time passes. Every new grad feels at one point that they should throw in the towel. Hang in there.

This was a team mistake, the narcs should have been removed from the cart and destroyed long before two weeks. Not saying that a mistake is okay, I have made a few myself, but as a learning tool, all actions need to be looked at not just yours.

[cherielpn23]

I just wanted to check in on you and see how you were doing and how your meeting with your DON went?

Don't give up. I have been in your position before and I felt like I had failed. Failed as a nurse, a caregiver, failed my patient and so much more. I wanted to run off the floor crying (yes I cried because I scared myself by making an error) and never go back to nursing. EVER! I worked so hard to make sure I didn't make a mistake, that my patients were taken care of from the time I stepped onto the floor and to the time I walked off the floor. BUT accidents do happen. EVERY single nurse (whether they admit or not) has made some kind of mistake while nursing. We are HUMAN. Do not let this keep you from nursing again. If need be...take a break...relax....give yourself credit for getting this far. You know what your doing....at this point you have stressed yourself out so much that you can't think nor function on the floor. You are so scared of making a mistake that you make mistakes. Easily done. Your patient is fine. Take a deep breath. Now.....think about what kind of nursing you want to do. Is it floor nursing? Is it clinical nursing? Home Health? School nursing? ER? Whatever your answer is....do it. Come off the floor your on.....start new and fresh.

I did keep nursing after my situation.....BUT I refused to take a job I knew I was not going to like. I refuse to work floor nursing. I have found other nursing jobs that are so much better (for me), less stressful, and actually FUN. Yes, I said FUN! So, there is hope. Don't throw all your hard work away. Build up your confidence in yourself! You can do this!!

hi i appreciate your comment, but the DON's reaction has a lot to do with why im so discouraged. she even asked me what nursing school i went to, possibly implying that she regrets that she even gave me a chance. yesterday i spoke to her and she told me that she'll be writing me up (understandable); but then she told me that the administrator and her "will be in touch with me." could she mean that they're firing me? should i ask her?

[Wave Watcher]

May I ask how long you have been at this hospital/facility?

I believe it can't hurt to ask if they are meeting to discuss your dismissal.

It seems like you are in a tough situation. I think they will be eyeballing you and looking for any excuse to fire you at this point. I think that even if you wanted to succeed at this facility they are going to make it to where you fail.

I personally, because I would not want to be fired would just resign if I could financially. I think you have worked yourself up and stressed yourself out at this place.

Before you leave find 3 RN's on your floor who would be willing to be a reference for you, and who would recomend you for another job if needed. Get their names, numbers, addresses and emails. You will need at least 3 references for your next job more than likely. You can also use instructors from your school/clinicals.

Hang in there. I just think it's time to leave. I bet when you give your written notice and finally walk out of that place you will feel a burden lifted. You will sleep better.

Let me know how it goes!