I gave an IV medication that the patient is allergic to

[19rma]

I have been at my job for more than 1 year and this is the second medication error I have made. And it is the same mistake: I gave a patient a medication she is allergic to. I am on my 3rd night shift and while receiving a patient during hand over, my ward manager told me to start this IV antibiotic because she was too busy to start it. I started the medication, i checked the allergies but as the patient had a lot of medications in the allergy box and I was in a hurry because the medication has already been delayed by more than two hours, I failed to see that this patient was allergic.

I am so frustrated with myself. Why am I stupid? How could I be so careless?

I didn't realise my error until it was too late. My co-worker called me from work asking me about this and i was scared so i told her to monitor the patient for the first signs of alleric reaction. I feel really bad because the patient suffered a stroke a frw months ago and has dysphasia.

Sometimes I wonder if this is a sign I should stop being a nurse. I know I am succumbing to self pity but this has happened to me and I was so careless and i failed to check.

I will be making an incident report about this, i am worried about the patient and hoping she will be alright.

[Kitiger, RN]

You acknowledged that you made the error. You see how & why it happened. You feel awful. You're worried about the patient. You've reported it, and taken steps to mitigate the damage.

I predict that you will not do this again, and that you will be a better nurse because of what you have learned.

[19rma]

Thank you for your kind comment. Just an update; the doctors are aware that patient is allergic to it but because the allergic reaction is just vomiting and more of a sensitivity to the medication, they wanted her to keep having the IV metronidazole as it benefits the patient more. So far she hasn't exhibited signs of vomiting but I am still having her monitored. Instead of relief after finding out this information, i felt frustrated because it is still an error in medication giving and also a breakdown in communication! But thankfully the patient is okay as she is the priority here

[MunoRN, RN]

I'm not sure where you feel a medication error occurred. Vomitting with Flagyl is not unusual and does not represent an allergic reaction to Flagyl. Keep in mind that typically the majority of what's listed in a patient's allergy list are not actually allergies, which is why we don't define allergies by what's in the list but instead by the reaction. You mentioned that the MD was aware of the reported 'allergy' and determined the benefits outweighed the risks and still wanted it given. Unless there was a reason to refuse to give it, which there wasn't, then not giving the Flagyl is what would have potentially been a medication error.

[19rma]

I guess it was because i've already made an error before that I was in a panic and did not realise that i need to check what type of reaction she had with Metronidazole. We explained it to the family that it was just a side effect of the medication and that after her dose of the metronidazole that I gave her, she had no signs of nausea or vomiting.

[LPNpaired]

I'm not sure where you feel a medication error occurred. Vomitting with Flagyl is not unusual and does not represent an allergic reaction to Flagyl.

Because a med error DID occur. If a patient lists something as an allergy, it's your responsibility to not give that med, even if (and I say this to OP as well, so she can rest easy) 90% OF THE TIME IT ISN'T A TRUE ALLERGY BUT MORESO A SYMPTOM OR ADVERSE EFFECT THAT MADE THE PATIENT SIMPLY UNCOMFORTABLE.It doesn't matter if they have "oxycodone" listed as an allergy only because it made them itch for a while or nauseated. You still screwed up if it's listed there and you gave it. Hell, it doesn't matter if they listed hydrocodone as an allergy when really their allergy is to hydromorphone. You give the hydrocodone, you made an error. Always check those things, girl.

Nurses make mistakes, we are human. You'll learn from it and likely not do it again. Full disclosure, I've given the wrong meds to the wrong patients before more than once. (Not a ton of times, but more than once.) Never reported (Its natural to be scared in that situation. Nobody wants to lose their livelihood). But I did catch it immediately and monitor my patient/s for reactions. Had they had any, I would have reported and gotten them care. But not a one of them had any symptoms at all. Most meds are pretty safe for a dose or two. Even the ones the patient is "allergic" to.

[MunoRN, RN]

Because a med error DID occur. If a patient lists something as an allergy, it's your responsibility to not give that med, even if (and I say this to OP as well, so she can rest easy) 90% OF THE TIME IT ISN'T A TRUE ALLERGY BUT MORESO A SYMPTOM OR ADVERSE EFFECT THAT MADE THE PATIENT SIMPLY UNCOMFORTABLE.It doesn't matter if they have "oxycodone" listed as an allergy only because it made them itch for a while or nauseated. You still screwed up if it's listed there and you gave it. Hell, it doesn't matter if they listed hydrocodone as an allergy when really their allergy is to hydromorphone. You give the hydrocodone, you made an error. Always check those things, girl.

Nurses make mistakes, we are human. You'll learn from it and likely not do it again. Full disclosure, I've given the wrong meds to the wrong patients before more than once. (Not a ton of times, but more than once.) Never reported (Its natural to be scared in that situation. Nobody wants to lose their livelihood). But I did catch it immediately and monitor my patient/s for reactions. Had they had any, I would have reported and gotten them care. But not a one of them had any symptoms at all. Most meds are pretty safe for a dose or two. Even the ones the patient is "allergic" to.

No medication error occurred, when an allergy is reported by patient then the ordering physician reviews the reported allergy, evaluates whether or not it is an allergy, and then weighs the reported symptoms vs the benefits. We don't do open heart surgery on someone we know didn't have a heart attack just because the patient thinks they had a heart attack, and we don't expose the patient to harm because they falsely think they may have had an allergic reaction to something when it clearly wasn't.

A medication is when avoidable harm or potential harm occurs, if a physician has reviewed a patient's reported allergy to something and determined it is not an allergy, but the nurse still refuses to give it due to a knowledge deficit and the antibiotic is not given or delayed as a result, then that is a medication error.

[JKL33]

If a patient lists something as an allergy, it's your responsibility to not give that med, even if (and I say this to OP as well, so she can rest easy) 90% OF THE TIME IT ISN'T A TRUE ALLERGY BUT MORESO A SYMPTOM OR ADVERSE EFFECT THAT MADE THE PATIENT SIMPLY UNCOMFORTABLE.

That is simply incorrect.

[mtmkjr, BSN]

Nurses make mistakes, we are human. You'll learn from it and likely not do it again. Full disclosure, I've given the wrong meds to the wrong patients before more than once. (Not a ton of times, but more than once.) Never reported (Its natural to be scared in that situation. Nobody wants to lose their livelihood). But I did catch it immediately and monitor my patient/s for reactions. Had they had any, I would have reported and gotten them care. But not a one of them had any symptoms at all. Most meds are pretty safe for a dose or two. Even the ones the patient is "allergic" to.

This comment is kind of unsettling.

You do a disservice to your patient and to other nurses when you aren't forthcoming in your med errors. We learn from other's mistakes that are known. Unknown mistakes will more likely be repeated. What harms come to people when any of the 5 rights are wronged? What can we learn from the mistake? How to prevent in the future?

Besides the fact that you are putting your patient at greater risk by simply deciding to monitor them on your own.