med error already-just a mess

  1. I am just beside myself tonight. I can't believe I made a medication error-I feel like such a failure! I am not even licensed yet and already I have tainted myself. I know many many nurses who have NEVER made an error-oh GOD!

    It wasn't a HUGE error in the way it could have been, THANK GOD and I am not a dum dum- I was giving a prn morphine, 15mg. I gave my patient her dose. We have to get it out of our pyxis. I didn't even SEE the "other" morphine 15mg. We have FOUR- Morphine 15 mg (MS CONTIN) and Morphine 15 mg (MSIR). Same for the two 30 mg doses. I didn't even realize there was a difference. I know now that the difference is in how long the med takes to work-time released. I made the incident report and informed the patient who said "I don't care-it's a pain med". I didn't feel any better. I wanted so much to say for most of my career that I never made an error. I haven't even gotten my RN plan yet and already this. Please tell me I am not a horrible nurse. I really need some support.
  2. Visit mel1977 profile page

    About mel1977

    Joined: Jan '06; Posts: 157; Likes: 14
    I am a full time medication nurse. I will occasionally charge and do admissions. I am the chair head of the Medication Admistration Committee
    Specialty: Brain Injury Rehabilitation

    15 Comments

  3. by   LoriAlabamaRN
    You are not a horrible RN at all! You are simply HUMAN. We have all made med errors, and if we haven't we will. I made one myself not long after being licensed- misread a MD order that was sloppily written and gave the wrong med entirely. I felt horrible, like I had been stabbed through the heart with an icicle. I could have killed him if he had been allergic to what I gave or if it reacted badly with his other meds or if the dosage hadn't been in the safe range. But you know what? You did the right thing by reporting it. Too many nurses would just try to cover it up so noone knew they had made an error. I can guarantee that you have learned a valuable lesson, and I'd put money down that you will never make the same mistake. You learned a valuable lesson about PYXIS. Who knows, had it not been for this harmless mistake, you might have made another one that could have hurt someone. We all make mistakes. It's what makes us human. Please don't let it make you feel as if you are a bad nurse. We need more conscientious nurses like you in this profession. You have probably already given hundreds of meds and you made ONE error. That's like a 99.99% correct rate. Just be more careful from now on, and you will do fine.
  4. by   Hellllllo Nurse
    Every nurse has made a med error. Those who say they haven't are either lying, in denial, or are unaware of their errors.
  5. by   mel1977
    (PN)
    I feel better already-thank you to you both. I think I can sleep now. When I told my supervisor she sure didn't make a big deal about it and that should have been a clue to me, but the perfectionist I am would let me let it go. To err is human, right???
    Thank you again.
  6. by   wjf00
    If you dwell on a med error, your chances of making another error only increase. Identify what you can do better next time, incorporate that into your practice and move on. I don't mean to sound cold, I am not, in fact I have been there. I can tell you from experience that moving forward is best for you and your patients.
  7. by   UM Review RN
    You also might inform the Pharmacy and suggest that the meds be moved further apart to avoid other nurses making this same mistake.

    In our Pyxis, the Morphines are stored in completely different places. So no chance of grabbing the wrong thing.
  8. by   mel1977
    So over it. Helped to talk and hear from you all and I shared this with my mom, who I work with (she's an RN) and she told me the same thing. Those who say they never had are either Lying or don't know they did. Funny she said the same thing as was said here. She told me that she gave heparin to a patient who was allergic to it-I didn't even know she ever made a mistake. So, I feel much better now and it is done and over with. A great learing experience.(?)
    The meds are seperate in the pyxis, but on the screen they aren't So you really have to be sure you are selecting the right one. But now I know to keep my eyes a little more alert for things like that.
    Thank you all.
  9. by   traumaRUs
    The morphine PO dosages ARE confusing. However, I will bet you won't do that again. The person who wrote that all nurses make mistakes is so truly right.
  10. by   Furoffire
    I made a med error as a new grad long ago. I gave Emperin w/ ASA instead of Tylenol, easy mix up and we did not have pyxis in those days. I was horrified, had to call the doctor etc. No harm to the patient BUT you learn a valuable lesson that sticks with you. Since than I really pay close attention. You are not alone, human and learned a wonderful lesson.
  11. by   Tweety
    Every single student says during school and when they graduate "I'm going to be different, I'm not going to make a med error ever". Then one day the reality hits. I'm surprised you know "many many" nurses who have never made a med error, because I know very few.

    Making a med error, as devastating as it is, can be a learning experience. You learned something you didn't know and you will never do that again.

    Don't beat yourself up.
  12. by   gonzo1
    When I was in nursing school one of my teachers said that I was so meticulous about meds that she thought I would never make a mistake. I knew of course that wasn't possible but was flattered to hear it just the same. Well guess what. I have made med errors, remember and beat myself up over them for a long time. You can never be too careful. Always be honest and let the md and supervisor know when this happens so the best outcome can be achieved. There are very few med errors that will truly cause harm to the patient and honesty is the best policy.
  13. by   DutchgirlRN
    300,000 hospital deaths per year attributed to med errors. Yikes, enough to scare the hell out of you and wonder why you ever became a nurse? I've made several med errors, minor, but upset me very much. Good nurses make mistakes, that's a fact, you handled it correctly, you learned from your mistake. Forgive yourself.

    I'm so thankful that where I work we scan meds. Mistakes can still be made but 96% less of a chance. Awesome feeling of security! Ask when the hospital will start scanning or see if another in your area is scanning.
  14. by   L.O.E.N.
    Yup... i learned the hard way that you never accept a cup full of meds on someone elses word and then give them to an unlabled nursing home patient. I gave a whole cup of blood pressure meds, ativan, and MS Contin to a little old lady who looked just like her roommate during a clinical in school.... they literally could have been sisters. Same clothes colors and everything. This was a bad one, I got put on a medication suspension in my last semester for my RN. It was infuriating, and dreadful at the same time. That little lady was nearly down to the point they might've had to inject her with a bit of ephedrine to bring her BP back up. She woke up the next day and told the staff that was the best she'd slept since she'd got there.

    Never give a drug you didn't pull from the pack/bottle/syringe and always check your MAR's thrice... :uhoh21:

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