How many mistakes can one nurse make? (A vent)

[canoehead, BSN, RN]

Well, did she call a code?

[Salty1]

Well, did she call a code?

If you are referring to my post about stashing the DOA in an equipment alcove behind a curtain -- no, she did not call a code upon discovering the body. I had already removed the clothing, wrapped the body and affixed a mortuary tag to the toe. Paper work had been done. If I had simply shoved the person behind the curtain without tagging, etc. I suspect the Night Nurse would have called a code if only on a CYA basis and I would have heard much more than a rant from the Night Nurse.

Salty

[wooh, BSN, RN]

Even better than 7 am Protonix (which EVERYONE seems to have to have these days) is the 7am insulins for breakfast. Breakfast rarely hits the floor before 9am, never before 8:30 am. We managed to get Humalog changed, but we still have to give regular insulin before we leave. Always fun when 3,4,5 patients all need it....

[Betty_SPN_KS, LPN]

I'm worried about a mistake myself right now. Not mine, but how I charted on a mistake someone else made.

Last night we had an agency med aide working with us. She confused two residents in our LTCU. They are roommates and their names sound similar, and when she asked one res "are you so-and-so?" he answered "yes." Later, she realized her mistake and told me about it. I had to call his doctor and all that.

I am concerned about how I worded the note in the chart, because I said it was an error and was given by agency CMA. The oncoming nurse told me you have to be very careful how you write it.

An interesting side to this story is that the man who got the wrong pills was supposed to have an accu-chek done. His roommate got it (the med aide thought he was the other guy) and his BS was found to be 254 at 8:30 pm! So I let his doc know about that too. I felt the med aide's mistake may have discovered something that needed to be discovered.

[Mermaid4]

If we were all perfect, we couldn't be good nurses. At least in my opinion. Sometimes nurses who seem to convey disgust or dismay when we have an imperfect moment or moments, are the ones who might not let others know when they make mistakes..

It is not unreasonable to feel badly for a short time, but then you have to find a way to move on...Usually I will just be upfront and mention that I am tired and if there are any questions please feel free to call me at home. I know the nurse you mention is imperfect as well and perhaps just doesn't feel as confident as you do about being honest with her (or his) own insecurity.

Now that you know some of the things that you have to work on it, just make an effort to look through the med book and write down with boxes on your cheat sheet that you have meds at a certain time. I have to do that because I know in the morning is when I am the most tired and likely to forget.And often, people just don't know how difficult it is to work nights. Not that other shifts aren't difficult or as conducive to exhaustion, but it is a different sort..It is an interference with circadian rhythms and just different..Hang in there....When you identify something you think you need to work on, devise an intervention that works for you..For me sometimes I really have to go through the med book as soon as I am done with report, or even before that if I manage to get in early , and write those meds down next to my patients name on my cheat sheet or kardex with a block that I can check off. When I am in charge I make a big sheet with Mother/ Baby with blocks for vs, ivs, meds and whatever we need to do, such as hearing screens, labs, etc..as well as the nurse assigned to the patient, so we can check off the blocks as we go along. That particularly helps all of us on really busy nights because we can all double check and see that the tasks are done or at least well on the way to being done before the next shift comes on. If we think we can't get to everything, we do the most important stuff first and let them know what they need to do since the oncoming shift needs to sometimes do things they would prefer that we did...You will be ok and the majority of us will have times more than once such as you describe. It doesn't mean that you aren't a good nurse. It means that you are someone who is human, is conscientious, and wants to do the best job you can. Good for you and kudos.....

[eak16]

wow- change of shift meds! that had never occurred to me! Meds at my hosptial are NEVER schduled for change of shift for the exact reasons discussed above. And furthermore, if the nurse has a good reason why the med should be rescheduled (like the fosamax at 6 am when the pt is sleeping well) we can pretty much reschedule things within reason with no problems from pharmacy or management.

Furthermore, I made a benign mistake that made me feel like an idiot last week- I discharge a pt without an order! Had talked to the doc and the pt about the discharge, thought I was doing quite well thank you, and then about two hours after the pt. left, realized I had never acutally seen an order! The chart was already in medical records, i had to fish it out, cal the doc, (who, thank God, was equally embarassed that he had forgotten to write it). He HAD meant to discharge the pt. that morning, but I still felt dumb. Med-surg is rough.We have to be a lot tougher than we look!

[RNforLongTime]

Yes, med/surg is rough. It's one of the reasons why I decided to become a critical care nurse. At least I only have two (3 at the most) pt's to worry about.

But don't beat yourself up over those minor details. I'm sure the meds in question weren't life or death matters as to whether they got them at 0700 or 0800. And WHY must protonix be given at 0700 anyway? At my hospital, we give the protonix at 1000. IF a nurse tells you that she/he has never made a med error, that person is lying. Keep your chin up!

[JacelRN, BSN, RN]

Thank you everyone,

It does help to know others out there have gone through this. It's what makes this BB so great!

Since then, I have forgiven myself of the mistakes and promised I would do my best when dealing with this particular nurse. Afterall, she is only human too (like you all pointed out.)

I also realized that my mistakes were most probably due to my recent change in jobs and this happened due to that transition. My primary job dosen't deal with scheduled meds all that much (hospice), and I work Med-Surg optional only once a week so my focus is altered. So I have since given myself some slack and noticed that I must pay closer attention to my scheduled meds and tasks at Med-Surg since that is what seemed to suffer most from learning a new job. The good thing however, is that my patient care truly became better attuned, it was worth the mistakes in my original post.

Thanks again for the virtual ears! You guys and gals are great!

JacelRN

[cabbage patch rn]

Dearest Jacel,

Don't fret it, I've been a nurse for nearly 14 years and I still do stuff like that from time to time. Just know it will be less frequent when you become more experienced, but we're only human. If you didn't endanger anyone's life you did well. You sound like a very good nurse. As for the nurse that makes you feel insecure, it must be lonely at the top for her.

[country nurse]

I'm actually talking about myself!

I just came home from an exhausting Med-Surg day. I forgot to tape report on one of my patients (that's how tired I am) and I forgot to give 2, 7am meds. And to top it off, I had to call and tell about the meds to the same nurse who stopped me from leaving about the report. She had all three of my patients I messed up on! Argghh :imbar

For some reason, this nurse knows exactly how to look at me or talk to me to make me feel like a toddler at her feet. She's never outright rude or mean, but she just acts superior. I can never do any good by her.

I guess I just needed to get this off my chest and vent to others before I fell into my pillow. Some of you must have experienced this type of shift and coworker, unfortunately. It just makes you feel like the worse nurse in the world. :angryfire

What I keep telling myself however is all the good I did this shift. I sat with a scared and lonely patient and prayed, gave her reassurance and just listened. I explained a surgery to another patient and gave her details on the time for surgery so she could call her concerned family asap. I cleaned my other patient's incontinence despite being bit and swung at. I attempted an IV stick for an MRI at shift change when they called out of the blue and said "Oh yeah can you get an IV in him?" And I fnished my night by giving a complete bed bath to my little lady going to HDU and fed her breakfast.

Thanks for the virtual ear,

JacelRN

WELCOME to the wonderful world of nursing. Seems like if all of your patients are still breathing at the end of the shift, and none of them have an attorney on speed dial, then it's been a good shift. Maybe the nurse who relieved you, acts that way because she has never, ever made a mistake or had a bad shift!:rotfl: To quote a well worn phrase,THAT WHICH DOES NOT KILL US MAKES US STRONG! Everytime a patient thanks you, even if it is for something like changing the channel on the tv, wear it like a badge of honor.:)

[tommycher]

I love you all!!!!!!!!! This thread is so great, really did not know others beat themselves up so bad for being human also! It really is the thanks, and knowing you helped someone with pain and stress to have a better day that makes it all worth it, and do not let a know it all nurse negate the good things you have done. The greatest thing about mistakes is that we learn from them. Good days, bad days, you just never know what each day will hold, at least it isn't boring!

[nowplayingEDRN]

JacelRN,

Been there and done that! I think what is equally as horrifying as the DOA shoved behind a curtain and unintentionally forgotten is the pt you just rounded on 30 minutes previously and your aid comes and tells you that despite beening contracted up and all 4 side rails up, your pt is now on her knees, on the floor, between the rails and dead! :imbar or the pt that took 6a meds from you and at 7:30a the doctor comes in and starts his rounds with that particu;ar pt and comes out to the desk and asks if anyone was aware that the pt in bed such and such is dead!!!! Makes you feel like you could just melt into the floor and like you will never do anything right! But, like many others have said.....that is all in the day of the life of a nurse at work on a VERY busy floor or ER or whereever else he/she may be working. As cabbagepatch said, the longer you are a nurse the less it happens.....you get a system that works for you and keeps you from making the mother of all messes out of everything for the most part and when you still make a mistake, you brush of the dust and go on......but I have found that the respect earned for being big enough to say, I goofed far outways any trouble that would ensue if one tried to cover the mistakes up. (((((HUGS))))) It will get better and there is always next shift....but always take comfort in the good you did do during the shift!!! Somehow I have a feeling that you make a bigger difference than you may think right now.