Learning from my mistakes

[dorselm]

Recently I made some very stupid mistakes. I had a patient who was admitted for hypoglycemia. When he came to our floor his blood glucose level was 94. Later he was ordered 30units of lantus. I was supposed to scan the patient, scan the meds and then give the meds. Instead, I scanned the patient, and skipped a step and gave the meds. I inadvertently gave 30of humalog instead of lantus. When I went to scan the med immediately it came up humalog and my heart dropped!!!!! I instantly got terrified because a patient on my watch a few weeks ago got out of bed and broke her hip.

I checked the patient three times but neither me or the nurse checked the bed alarm. The next day I told the nurse practitioner expecting him to call the family but neither he or the daylight nurse called the family and the family was livid that no one was notified. I didn't get reprimanded for this at all. But then this blood sugar incident happened. After I panicked I tried to correct the blood sugar by giving him lots of sweetened juice but of course it didn't bring his blood sugar up fast enough. His blood sugar went to 30 and he felt a little dizzy but never loss consciousness. I kept thinking "just scan the lantus and say he went hypo because of it" but I couldn't bring myself to lie. An hour later, I told the residents who were on the floor and they told me to get d50 which I did and his glucose level came up. But it kept going up and down because the humalog was still working. The daylight crew came on and I stayed until the patient was stable. When I left his glucose was 108 and he felt better but the doctors were livid.

Not only did this happen but the night before the blood sugar incident I had a female patient come in for elevated blood pressures. She was in the 190's and very symptomatic. She had severe headaches, vomiting and rigors. She was ordered to have a stress test. The doctors who ordered her stress test also ordered for her to have a beta blocker. There are standard orders not to give beta blocker with thin 24hrs of a patient going for a stress test. I completely forgot the order or that she was going for the test. My priority was to bring down her blood pressure to alleviate her symptoms. She had betablocker and lisinopril ordered that the doctors ordered. When they found out I gave the betablocker, they were upset with me. The next day the stress test was cancelled and the patient ended up being cathedral and stunted. But this betablocker issue and the blood pressure issue led to me being suspended. My co workers don't feel that I should have been suspended but take full responsibility for it however the blood pressure incident is where I don't think they should count that against me. I deserved what I got and after being a nurse for 5 yrs I should have known better. I could have lied and easily covered it up but I told the truth. I'm scared that I'm going to be fired. Being the main provider for my family and so close to Christmas I am soooo scared but I definitely learned a good lesson. I just needed to get this off of my chest I feel humiliated and ashamed. I will respect any comments that come my way.

[OCNRN63, RN]

I posted another comment which for some reason isn't displaying. I'm going to make this one shorter and simply say that you are having some serious lapses, both in practice and professionalism. You should never put your license/job ahead of the well-being of your patients. There should be no question who comes first. The fact that you even contemplated falsifying documentation on your patients shows you have major issues to rectify. Whatever your co-workers are/are not doing is of no consequence. You should be paying attention to yourself, not them. If you continue practicing this way, the day will come when you will significantly harm, perhaps even kill a patient. You can't take that back.

[cardiacfreak, ADN]

I'm not so concerned about the BP issue, especially since the MD ordered it. However, the insulin and the patient falling resulting in a fractured hip are big concerns. Like a PP stated, my facility also must have a witness for insulin. If you end up going before a panel of your peers in a RCA meeting (that is what would happen where I work), I would mention having 2 nurses witness insulin prior to administering.

I am also in charge every night that I work, yes it can be stressful, but if you are not up to the stress you need to have a talk with your unit manager. It seems to me that you ARE under a lot of stress, take these few days and reflect on what it is that has your mind somewhere else.

I am not passing judgment for I too have made mistakes, yours just seem to be all clumped up together.

[VivaLasViejas, ASN, RN]

I'm thinking that the charge position may be a bit much for the OP to handle in addition to her regular duties. These are some pretty serious mistakes and they seem to have this common denominator. Perhaps she should go back to being a floor nurse and see how it goes from there.

[Rnis, BSN, DNP, APRN, NP]

an order to give a beta blocker now for a patient with those vitals would have overruled a protocol at our hospital. Ideally we would clarify and document that clarification. but I totally understand where your coming from with that issue.

These are some major things that have happened you can't change what happened but you can certainly learn from them and do better in the future. What i see is someone who is super busy and maybe a little overwhelmed. Take a deep breath slow down, use the right protocols and safety checks every time.....Hang in there. Sometimes when you make a mistake you can beat yourself up which leads to more mistakes....as hard as it is you can't dwell on these but just reinforce using proper procedures and safety checks EVERY time, no matter how busy. if you have to leave something for the next shift...so be it. safety first.