Ok, today on clinical my partner drew up some ativan. It was 2mg/1mL. Dose is 0.5mg .She drew up all 1mL into a 1mL syringe. She thought it was 0.5mL , temporary lapse in judgement. Shows the syringe to the instructor and Primary Nurse ( whos in the med room with her watching her draw it up ) alerts her of the correct dose. She fixes it and wastes the ativan up to 0.25mL which is the correct dosage.
we cant do IV pushes alone, so the primary was with her when administering the ativan.
We go to lunch, she gets back and our instructor pulls her to the side and explains that she incorrectly calculated the dosage, and she is getting an unsatisfactory for the clinical day (even though she rocked it out passing a crazy amount of meds to 5 patients today), and explained that shes gonna do med passes with her for the next 4 weeks.
heres how i see it. shes a student. shes learning, she mixed up her dosage/ concentration the instructor let her know, and it was a LEARNING experience. She did not admin the incorrect dose to the patient and the patient was not harmed in any way.
I dont see why she needs to do this to her. at this level of the game its a bit degrading. and i feel like shes being picked on rather than coached.
Am i being naive in the way im viewing this ...maybe someone else or another nurse can provide some insight for me?
She was feeling really upset and frustrated and sad about it and i just told her to suck it up bc we're almost done ...ya know =/
She failed to do the five rights. That's pretty basic, and she must consistently do meds correctly, or she'll fail clinicals. So, not really nitpicking.
Maybe I need to check my math...but, wasn't she about to give 4 times the ordered dose and not double as everyone is saying? She drew up 1 ml...and was only to give 0.25. Confused.
Specializes in Critical Care, Emergency Medicine, Flight.
Maybe I need to check my math...but, wasn't she about to give 4 times the ordered dose and not double as everyone is saying? She drew up 1 ml...and was only to give 0.25. Confused.
she drew up the full 1ml from the bottle so that she could waste and push out the rest. (thats how they have us waste meds....)
Specializes in Critical Care, Emergency Medicine, Flight.
This was not nitpicking. It's a simple calculation she should have done correctly, and a narcotic drug, plus she would have given 2x the dosage needed if she had been alone. This is a grave mistake and she needed to be counted down for it. and meds to 5 patients, LOL. Try 44 dear. It doesn't matter how many you get right if you get the important one wrong.
You pass meds to 44 patients per shift? (confused) that doesnt even seem safe!
You pass meds to 44 patients per shift? (confused) that doesnt even seem safe!
I believe that would be the reality of LTC.
As far as the OP goes, the student in question was about to make a serious mistake. Not really sure how you could think that the instructor speaking to her about it/addressing it was her doing anything more than her job. Nurses and nursing students alike need to be able to do calculations like this and there's no room for error- especially not with a drug like ativan.
In your OP, you said she drew up the full 1 mL which is 2 mg of Ativan. The ordered dose was 0.5 mg. What was drawn up was 4x the ordered dose which, if given, could have very severe consequences for the patient. I am not clear from your OP if she had gone ahead and wasted 0.5 mL as you stated that she thought the dose was 0.5 mL but that, in and of itself, is concerning as this is a very simple calculation.
And I agree with others who said that perhaps the student's reaction to the instructor was more than any of us know. If she was defensive at all "but I just thought it was 0.5 mL, it's only an extra 0.5 mg" that would be a big deal to the instructor. If you make a mistake, the proper reaction is to apologize and try to remedy the situation as best as possible.
Specializes in Critical Care, Emergency Medicine, Flight.
i believe that would be the reality of ltc.
as far as the op goes, the student in question was about to make a serious mistake. not really sure how you could think that the instructor speaking to her about it/addressing it was her doing anything more than her job. nurses and nursing students alike need to be able to do calculations like this and there's no room for error- especially not with a drug like ativan.
in your op, you said she drew up the full 1 ml which is 2 mg of ativan. the ordered dose was 0.5 mg. what was drawn up was 4x the ordered dose which, if given, could have very severe consequences for the patient. i am not clear from your op if she had gone ahead and wasted 0.5 ml as you stated that she thought the dose was 0.5 ml but that, in and of itself, is concerning as this is a very simple calculation.
she drew up 1ml (2mg), and wasted it to 0.5ml(mistakenly) then corrected it to 0.25ml (0.5mg) when she was told.
and i agree with others who said that perhaps the student's reaction to the instructor was more than any of us know. if she was defensive at all "but i just thought it was 0.5 ml, it's only an extra 0.5 mg" that would be a big deal to the instructor. if you make a mistake, the proper reaction is to apologize and try to remedy the situation as best as possible.
there was another incident that happend, last week (non med related) that it just seems like shes pickin on her? but perhaps as you all have said maybe she (the instructor ) is seeing something that i am not, since ..im u know her friend and all.... id naturally take her side.
Oh yeah that is the reality of LTC.One of my friends does med pass for 46 twice a day.
If there was another incident with your friend then obviously the instructor sees a trend. If there is a pattern of problems then she has to do her job and provide the needed supervision and extra instruction to safeguard against any errors and to facilitate learning.Ensuring safe practice in the clinical setting is not "picking on " someone.
Even if she is legitimately getting picked on, she should remember...like getting picked on in grade school, that too shall pass. It seems like a big deal at the time but before she knows it, she'll be employed at a big bad hospital calculating three pressors at the same time.
wooh, BSN, RN
1 Article; 4,383 Posts
I haven't been able to figure out if she tried to give the whole 1ml or 0.5ml from the OP's posts. Too confused....