Today was our last day in clinicals. I made my first med error! Before giving ferrous sulfate, lovenex and effexor I failed to take vitals. I was bordering on giving them late for several other reasons, and didn't feel that I needed to take these measurements before administering these particular drugs. I have been written up for it and given a bad mark in patient assessment, medication administration 5 rights, and prioritizing care. Needless to say, being the last day and first error I feel pretty badly! I was doing really well until today and believe me from now on, I am taking vitals first thing regardless! Oh well, I ALMOST made it through first semester. I have a conference tomorrow, and have been told that this will "probably" not fail me out but will be put in my permanent record regardless.
Here is what happened:
The meds were due at 0800 and I got out of report at 0730. The patient was asleep so I began looking up the 14 drugs I had to give (3 at 0800 and the other 11 at 0900) and rounding up the labs. The breakfast trays were delivered at 0800, so I went in woke patient and introduced myself, cleaned patient up a bit, and delivered breakfast. The deadline for giving the 0800 meds was 0830.
The things going on that needed to be done and that made me run behind were: 1) foley bag had been emptied and not capped properly, urine was all over the floor when I got there 2) patient was not wearing an armband so I could not give meds -- had to confirm identity, then get the armband 3) patient had not signed a consent for effexor, and I needed consent before administration (patient declined medication and did not sign consent btw) 4) patient was comfortable, no distress or pain, A & O x 3
So, I got the meds together (the shot and the iron, plus the effexor and the consent) to present to my instructor for review at 0825 and she dinged me for not doing vitals yet. Because I had not done vitals, the meds were given later than 0830. So, I didn't prioritize correctly, meaning that the meds were late and that was also the 5 rights ding... she also wrote me up for not assessing the patient properly.
Can anyone tell me how they, as a first semester student, would have handled the no -name patient with a leaking foley any differently? Or would you have just wheeled in the machine over the wet floor and taken the vitals immediately, even though you were only giving iron, an anti-D and lovonox? In any case, I could not have given the meds as I couldn't check the armband and had no clue on how to approach the identity confirmation. Advice appreciated!
