I made a boo boo!!!

Tweety, BSN, RN · Jan 31, 2007

I'll doubt you'll be in "hot water". If your asked anything at all it will be "you know we don't give conscious sedation on the floor don't you?".....you will say yes you do, and that will be the end of it.

Lesson learned.

Mags4711, RN · Jan 31, 2007

I agree, I cannot see how you could be in trouble for this at all. You were witnessing a waste, which you did properly. It's not your responsibility to double check that your fellow nurse gave the right med. As you said, you did not administer it.

allnurses Guide · Jan 31, 2007

Just before finishing up after a hectic 12-hr night shift the other morning, the charge nurse asked me to witness a waste. She told me what she was giving, how much she was wasting, drew it up in the syringe & showed me her wasting it in the sink and showed me where to sign on the sheet. I signed it and went on about my business.
A little while later, I was walking to the parking lot with another nurse and she said something about the charge nurse giving Versed to a patient and we aren't allowed to give that on the floor because it's conscious sedation. She told her that and the charge nurse gave it anyway, saying it was ok because the doctor ordered it and it wasn't enough to cause sedation. That's when it hit me! I know we don't give Versed on the floor! But I was the one who'd witnessed that waste! I hadn't even give any thought at the time as to what it was that she was giving. This charge nurse has been nursing for many years and is the one all of us go to whenever we have any questions and I trusted her.
Do you think I'll be in hot water over this for witnessing the waste even though I wasn't the one to administer it to the patient?
I had just assumed (I know assuming can get you in trouble :chair: ) it was a med she got from the pyxis. Come to find out from the other nurse, the nurse who gave it had gone down to pharmacy and picked it up. I didn't really question having to sign a sheet instead of witnessing in the pyxis because at the hospital I previously worked last year, we often had to sign a sheet like that when we gave a nonfloor stocked med.

You just witnessed the waste of Versed...You didn't give it or does it sound like you were involved in the patients care. I don't see that you were at fault for what your charge nurse did..right or wrong.

I would also look up your units policy for yourself on giving Versed. I am sure you probably give Ativan on your floor and don't consider that conscious sedation. There is a difference between preoperative uses, anxieolytic uses, and conscious/moderate sedation. Just because someone is using Versed doesn't make it conscious sedation. Versed is usually only used for preoperative uses and sedation because of its short half-life. I could see the physician/provider ordering it if the patient was getting a very short procedure and they just wanted them to relax for a short time/anxieolytic giving them a longer acting benzodiazepine.

Hope this helps...

rita359 · Jan 31, 2007

Knowing no more than is in the post, do you actually know the nurse gave the med or was a physician in the room and the nurse was getting the med for the physician? That would make it a normal procedure, no problem.

SCRN1 · Jan 31, 2007

Knowing no more than is in the post, do you actually know the nurse gave the med or was a physician in the room and the nurse was getting the med for the physician? That would make it a normal procedure, no problem.

I didn't see her give the med, but I did see her head off with the syringe in her hand to go give it. No, the physician wasn't in the room. She'd mentioned it was a pre-op med. We often give some pre-op meds, but not Versed. Even if the physician was in the room, it is policy that it's not given on the floor (tele) where I work.

oramar · Jan 31, 2007

Don't feel bad, it was end of 12 hour shift. Brains don't work so well a that point. It was not your error. I never verify the five rights on a waste. If something hits me as wrong I would speak up but it might not.

NicoleRN07, RN · Jan 31, 2007

I think that it was an honest mistake and I do not think that it will cause you any trouble at all. At the very most, your supervisor may just ask you if you're aware that you can not administer Versed within your dept. It is a learning experience, and next time you'll know!!

clemmm78, RN · Jan 31, 2007

I agree with the others - your role was signing off for the waste.

I'm surprised that you can't give Versed on your floor. I give so much versed in one shift on our floor that it's a stock med.

ICU_floater · Jan 31, 2007

agree, your legal liability was that to witness the count for the waste, not how the drug was utilized. You are Solely signing off on seeing the waste for the narc and documenting it's disposal... what you choose to do from here with the knowledge you've gained is on your conscience. That is another thread in itself!

c

ICU_floater · Jan 31, 2007

last minute ? with JCAHO, we are not allowed access to certain meds. If you're not allowed this on the floor, how did you gain access to it? We have a pyxis system that has a set drug list for each unit on which it's policies allow it to give, you CAN'T over-ride it. the special order drug must be scanned, approved by pharmacy, tubed up or picked up depending. This is the safe-guard to prevent this. you might file an occurrence to prevent this from happening again.

SCRN1 · Jan 31, 2007

last minute ? with JCAHO, we are not allowed access to certain meds. If you're not allowed this on the floor, how did you gain access to it? We have a pyxis system that has a set drug list for each unit on which it's policies allow it to give, you CAN'T over-ride it. the special order drug must be scanned, approved by pharmacy, tubed up or picked up depending. This is the safe-guard to prevent this. you might file an occurrence to prevent this from happening again.

As I said earlier, I did not get the med...never had my hands on it at all. I later learned that she had gone down to pharmacy to pick it up. The doctor had it ordered for that patient, so apparently, they didn't question it since she was wearing an ID that says RN on it.