I need advice on how I might have handled my situation today in a better way. Here's the deal...
Last Wednesday I was staffed on the medical unit where I work as a floor float (which means you help out with RN and nursing assistant duties, but do not have your own patient load). So in the afternoon, one of the nurses with a patient load (11 pt's) got really busy and rhymed off a list of stuff I could do to help her out. I was going to give 4 mg of Decadron to a palliative lady through a butterfly needle in her abdomen. I drew up the med and entered a different palliative lady's room and announced to the family that I was going to be giving Decadron to that pt. They jumped right on me (and rightfully so) before I had the chance to do my number check on the lady's ID band, and before I had the chance to notice that this particular lady did not have a butterfly in her abdomen. They said they thought I was mistaken so I apologized and said I would go double check the med sheet to make sure I had the right patient. I knew immediately after I left the room that it was the wrong lady, but I followed through with what I said I was going to do by checking the medication record. Sure enough, I had the wrong lady in mind and felt really bad.
I returned to the room to apologize to the family for my mistake, and everything seemed okay, they seemed only mildly annoyed at my potential error.
So today I was working a day shift and I had a patient load which included the lady I had had the mix-up with last week. I had just given her a medication and one of the people in the room (I thought she was a family member) asked if she could talk to me outside the room. She said she wanted to let me know how upset the family had been over what happened last week. Stupid me, I asked what happened! She said- When you almost gave "Rosy" the wrong medication, the family was extremely upset. She told me that she wanted me to know that they did not reported me, but that if they had, some people would love to see a young, new nurse like myself in such a situation. She told me that she was not a family member and that's why she felt she could take me aside. She went on to say that in a small town like the town we live in, if she had reported me and it had gotten around, that it would have stayed with me. She told me how she had watched me for the rest of the day (last Wednesday) and could tell I felt bad but that I should be more careful because no one is perfect. She then repeated how she didn't report me and how we lived in a small town again and again until I started to cry. I apologized again and let her know that I had let the nurse in charge that day know of my potential error (Which seemed to surprise her). I also told her I apprecited her sharing this information with me.
I am wondering, did I overreact by crying? I am having my period and feeling emotional. She just made me feel like a piece of crap.
I am wondering if she would have done the same thing if I was a more experienced nurse and did not look like I am fifteen years old (I am 28).
As has been said 9 zillion times..nobody is perfect..your potential error was caught..that's the important thing...as a previous poster said: Nobody is harder on us than we are on ourselves.I made a med error
I agree with the others, Snoopy. You DIDN'T make a mistake. You listened to the patien'ts family, you double checked, and prevented an error. Nothing for you to be ashamed of.
It sounds like this woman who was harping on you is one of those small-town biddies who likes to have her nose in everyone's business, and tries to get the "dirt" on everyone else so she has more fuel to gossip about.
You know, in communicating last night the anger I felt in hearing your story, I COMPLETELY neglected to answer the second question you posed.."I am wondering if she would have done the same thing if I was a more experienced nurse and did not look like I am fifteen years old (I am 28)."
I think what you experienced is nurse abuse. The topic is a comprehensive one, and so this post will be loooong.
Verbal abuse can be more easily minimized when it is brought forward, and we are all subject when reporting it, to feeling that we are reporting ourselves for some implied complaint, and some unrecognized lack in our persons might be discovered. Thankfully, recently more attention is focused on nurse abuse by other players in the hospital, ie, the doctors and management, but that received by nurses from the public they care for remains less discussed.
I am a nurse 15 years older than you. Let me assure you that I am still occasionally shocked by the manner in which some family members speak to me, and also to other nurses older than I [one sad instance I witnessed involved a 60 year old wonderful, wonderful nurse].
This type of nurse abuse has to do with all the things we are taught in nursing school and witness in our priviledged position of intimacy with the ill and dying, the horrible things that are happening to them and their families that brought them to the hospital, their sense of lack of control, and, finally [ VERY important point here] THEIR UNDERSTANDING-LEARNED AS THEIR EXPOSURE TO HOSPITAL CULTURE BROADENS- that nurses can be easy targets for the many frustrations they experience without so much as a comment by anyone calling their attention to their unacceptable behaviour and its recognition. As a group we are inclined towards, and as a profession ingrained from the beginning to be, nurturing, advocating, understanding, accepting-we are classified as one of the "giving" or "service" professions;we must learn on our own to know when a line must be drawn. We do NOT sign up for any type of abuse at all. Our employers are required to assure that we are not subjected to it, or to make amends when it does occur.
But management can't do their job in this regards if we do not report verbal abuse, and , even when reported, managment often does not take the steps required to amend the situation. We can say "This is what's happening in room such and such and I'm very unhappy-it's affecting my ability to safely do my job for it's ruining my attention and composure" to our managers, but we will often hear "Poor people, though..think of what they are going through...they just need to lash out I guess. I'd be a mess too, in their position. Try to reach out to them today- I know that other nurses feel similarly, yours isn't the first complaint, -I think you are best suited for this job because you understand what is happening and can do your job and let it go." This response is not sufficient, for it shifts the onus of responsibility onto the nurse, and entirely sidesteps the issue of management responsibility to assure that a safe environment for practice is fostered in all regards, not least of which, is the safekeeping of the confidence, composure, and trust in workplace psychological safety to which all nurses are entitled, the absence of any component of which undermines the safe accomplishment of nursing tasks and decisions. Big mistakes more likely to occur when we feel we are working in a glass doll house where others can aim at us without anyone so much as raising an eyebrow.
I've learned to NOT apologize when I sense a problematic family but to call a spade a spade-I go to management and say "I think another nurse is better suited for this family, and fear that they will not be satisfied with their experience without this change." I use this option with great discretion.
We nurses need our full attention to accomplish our work. What I do know through years of nursing is that accepting verbal abuse does not make me a good nurse, or a happy person, and CERTAINLY does not make me a good nurse advocate changing, one nurse and one unit at a time, the hospital culture which is stacked against us. I have seen situations where a family is told in social work or nurse management meeting: "We do not have any nurses available who are able to work with your family member willingly, and we need to address why that is, so that we can assure that safe and consistent care, our mission, is met." THIS is an appropriate response for management, and in fact a most important aspect to the manager's job description...but unless nurses step up and demand it, managment will avoid this responsibility and continue to shift the onus onto the nurse, the very machine running the hospital, and generating its profits by being present to allow the hospital to meet its mission.
And by the way, the last time I cried at work was a month ago, and like you, it involved a float to another unit and a VERY abusive family member. When she made me cry as I left the room, I informed the charge nurse, but was told only that she had the reputation for this behaviour and her daughter was soon to be discharged and no change in 24 hour visiting by parents could be managed [in other words put up with it for 6 more hours]. I surrendored to the situation-by calling the social worker to the floor and refusing to enter the room of my patient unmonitored...explaining I did not feel safe to render care in the psychological environment of that patient's sphere and that unless behaviour was curbed my other patient's could be affected for my composure and attention was at stake. , I was told she's routinely abusive and "That's why you got that patient". So, the staff operated with avoidance behaviour [typical for abusive patients and their families] and threw me in unaware to a terrible situation. By having the social worker present I erradicated the abuse each time I entered the room, and had witness to the possible slander affecting my job by complaint I was certain was to occur. The Social Worker was able to do this because she had some ends to tie up anyway. But, If this had been instituted from the beginning, more than the nurses would have been complaining, for the social workers can not be expected to operate as monitors for abusive patients or their family members each time a nurse enters a room, and management would have had to hold themselves accountable to do their job in assuring a safe workplace for nursing and nurses in some reasonable and effective way.
Yes, the patient was adorable, Yes, her mother, the offending party, herself was a victim of domestic violence. Sorry, though I hope she finds her way clear, I am not her punching girl because she's a man's punching girl.And my employer is obligated to assure I am not used in that regard.
Snoopy dearest I send you BIG HUGS. You are just great.
I was a charge on a mother and baby unit some years ago where some babies would, by virtue of their missing organs or deformities at birth, wold inevitably die. It takes a hell of a lot out of you. The Deputy Matron who I confided in - whilst in a bout of sobbing in her office - said in reply to my question "When do you get used to this? "The day you get used to 'this', as you put it, you leave - as you have no compassion left, give me a hug finish your crying, and when you feel OK we will both get back to our compassionate work"!
Nurses are honest, compassionate, caring creatures and full of emotion - thats what makes us special - even male nurses!
The fact that she seemed suprised that you reported the situation to your charge nurse should tell you something.
She made several remarks that disturb me and repeated them.
1. "There are people who would love to see a young nurse like you in such a situation."
2. "I did not report you."
3. "This is a small town."
These are (poorly) veiled threats. The fact she repeated at least two of them several times is a big cause for concern.
Document exactly what you told us and any thing else you can think of. (Not necessairly in the patient record) keep a copy and give a copy to your nurse manager. Find out from her or your hospital's legal department if it should be made part of the patient record or not.
You cannot be sucessfully sued for a potiential mistake nor for
a mistake where no harm resulted. However, that does not stop a costly frivilious suit.
Since this is a personal threat you may want to talk to leagal counsel.
Consider reporting this to law enforcement (they may or may not be able to do anything with a threat) but tell them you want it on record that a threat was made.
Don't worry about crying. It happens sometimes. You couldn't control it in that situation. So let it go. It is the least of your problems.
It Could be nothing comes of this. That will be wonderful. Hope for the very best, and prepare for the worst.(((hug)))
At the very least document it.
It would be wise to give a copy of it to your nurse manager. If you do nothing else.
Then let it go. There is always a jerk lurking some where. Hopefully she intends never to harm you or the hospital. Perhaps she sees herself as a dutch uncle who is really looking out for you.
However you have no way of knowing her intent. In either case she is a jerk, even if she doesn't realize it.
I agree with Agnus. This woman was not trying to do you any favors, she was all out threatening you, especially by reiterating her points over and over again. If you are in a small town I would be cautious of her slandering you.
I think it's good that you reported it to your NM even if no harm was done because if any of the family did happen to go to her about the incident I'm sure she would have appreciated the "heads up".
I also think it is smart to document this. Not that they would necessarily go after you since no harm was done but what if they have issues with their doctor or another nurse and come back some time from now and say that they received poor care and use your incident as just one of many examples of poor care.
I also wanted to say that while the family may have been a bit upset over this incident the information you are receiving about their feelings is really just the opinion of this small, kiniving, busy body of a woman. She may be "blowing" this whole thing out of proportion and the family may not really be as "upset" as she is leading on.
Also, you need to forgive yourself. No harm/no foul was done. You know you would have discovered the mix up. So you walked into a wrong room, it was a hectic day and darn those rooms look alike! At the least you would have discovered you had the wrong patient when you noticed she had no butterfly in her abd!
I have a feeling that you felt about this right after it happened, but this woman's comments have made you feel 10x's worse and have shaken your belief that you are a good nurse. Don't let her comments make you feel bad. There is a reason there are procedures to giving meds and you know you were going to follow them. She does not.
Hey, I just want to offer you my sympathies. I live in a small town too. Sometimes it's rough knowing too many of our patients and their relatives a little too much. I think you did what you were supposed to and you are only human. You've got to know that not many people would've been as honest as you were in this whole situation. You are a person of great integrity and young or old you're someone to be proud of. I am sure you felt bad enough about the almost error in the 1st place, you did not need the intervention of that old witch. You'll move on from this and things will be better. Unfortunately, there will always be people like this in life.
I once took care of a nurse in one hospital who was having gyn surgery. She had a paradoxical reaction to Benedryl IV. She became tachycardic and extremely agitated. She screamed at me...YOU GAVE ME THE WRONG MEDICINE over and over. I did not, thankfully, but I felt HORRIBLE.
Guess what I took care of her again in a different hospital several years later when she came to deliver. We recognized each other immediately. I offerred to get her another nurse. (I hoped she'd say yes, but she did not.) I was under her microscopic eyes the entire shift. She even told her visitor I was the the nurse who gave her the BENEDRYL at the other hospital. What fun! I wanted so badly to ask her if she'd ever had a pt. have a bad/unexpected reaction to a med, but I didn't want to harass her as she was my pt. and no longer worked as a nurse. I told my manager about our "history" in case she complained and she was very nice. Thankfully, I did not have any further problems from her.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Originally posted by pieWACKet
YOU DID NOT MAKE A MISTAKE. You entered a wrong room, told the people why you were there, since they hadn't seen you before, they alerted you, before your self checks would have, that you were speaking to the wrong patient, and you did all you had to do to correct the situation.
What is really smart is that you told the head nurse.
I agree with pieWACKet. You didn't make a mistake. You were following procedures and would have noticed the lack of abdominal butterfly even if you HADN'T checked the name band, which you were about to do anyway. The system of double checks worked. You didn't make a mistake. You maybe ALMOST made a mistake, but because you followed procedures, you didn't.
That said, it really was smart to tell the head nurse. And not just because this toxic family may have "told on you" anyway. Because now the head nurse can see how seriously you take your job and the administration of medications, because he/she can see that you realize the potential consequences of such an error, and because your head nurse can trust you to "tell on yourself" if in the future you DO make a mistake. (Or should I say WHEN you make a mistake -- we all make them.)
One thing I've learned over the quarter century I've been a nurse: patients can survive almost any med error -- as long as you admit what you did as soon as you realize it, and start appropriate treatment. Congratulations: you're obviously a nurse who can admit her errors and deal with the consequences. You can take care of me or my family any time!
This happened to me once---I am older than you and maybe handled it differently because of that, but I asked the "kindly intentioned visitor" what does she do when she makes a mistake? She got flustered and shut up. You made a mistake and will probably make another some where down the road. You handled it appropriately. As for the crying, I am sorry you felt bad enough to do that, but let it go. The good news is, you care enough to be concerned.
MandyInMS
652 Posts
As has been said 9 zillion times..nobody is perfect..your potential error was caught..that's the important thing...as a previous poster said: Nobody is harder on us than we are on ourselves.I made a med error