LVN instead of RN

Mommy TeleRN, RN · May 1, 2007

ouch... I can't even imagine what you are going through! What types of med errors were they?

If there are no other current options for RN then I'd likely do the LVN route..not in CA so I haven no idea about that.

Maybe later on a school would let you do LVN to RN route?

KellNY, RN · May 1, 2007

If you're being told that you can't continue the RN route because of a med error....maybe it's not the best thing to just test into becoming an LVN?

I gave more meds on a daily basis as an LPN in one day than I do in a week as an RN.

What kind of errors were they that you can't repeat this course?

Sorry, but this worries me.

TazziRN, RN · May 1, 2007

I agree with Kell. You may qualify to sit the LVN boards but LVNs pass just as many, if not more meds than RNs. Were the two errors similar, or different? If they were similar then you didn't learn from your mistake.

cancalbloop · May 1, 2007

The first med error, I gave it too early. He was on a routine med. It was an analgesic. The patient did not die and had no adverse effects.

The second med error, I did not check the blood pressure before I gave the blood pressure med.The parameters were systolic

I've learned from this mistake and was willing to do whatever remediation there was

What I'm trying to figure out is that nurses are making med errors while they are licensed and how are they being reprimanded? Is it worse to make mistakes as a student or a licensed nurse? Or is it equal?

KellNY, RN · May 1, 2007

I'm not trying to scare you or make you feel bad, but either mistake could have seriously hurt your patient.

Both of these med errors were careless-just looking at the MAR would have prevented both of them it sounds like. (Have we all made careless mistakes? Yes. Does that make them any less dangerous? No)

So in that sense-they're the same kind of med error and I question if you learned from your mistake. It shows poor attention to detail and poor pharmaceutical knowlege as well-especially in the case of the antihypertensive. And that worries me.

When an RN or LPN makes a med error-they are "reprimanded" based on many factors-did it hurt the patient? Has this happened before? What were the circumstances. ie-Giving an Azithromycin IVPB an hour and a half late because you had a code on the floor would likely result in no more than a "Try not to do it again". Where as, giving your Pt an antihypertensive not only without checking parameters, but after the previous vitals were outside parameters would be more serious. Had that Pt bottomed out, fallen, etc, that nurse could have been sued and/or lost their license.

It really doesn't matter how they are reprimanded-Pt safety is the priority, not wondering what kind of trouble you'd get into if/when you make a med error.

TheCommuter, BSN, RN · May 1, 2007

for the HONEST person that I am, told my preceptor right away and physician was called.

Unfortunately, honesty was the worst policy (in your situation). If you would have kept your mouth shut regarding this med error, you would have been graduating in a few weeks.

However, everything happens for a reason.

Mommy TeleRN, RN · May 1, 2007

as far as the antihypertensive..had you not done vitals at least earlier in the morning? in our clinicals we always assessed first thing and took vitals. How can you pass meds if you haven't assessed?

Also, our teachers checked off the meds..we had a window of time to give them (ie 9am meds between 8-10) For each that needed a lab/VS we had to have it in hand to tell her, or write it on the MAR.

Why wasn't the teacher double checking everything? even as a new grad nurse I will be working with a preceptor for several months and I will not be passing meds until RN is behind my name (although I will be watching preceptor and helping her prepare them to strengthen my understanding)

This is the 2nd type of case I've read here this past week and I'm just not understanding why the teachers are letting the students go off and give these meds with no supervision...heck it's their license on the line!

when you are in clinicals you are still in learning mode and this to me is why the teacher is there .. to help us avoid mistakes and see what we are doing wrong. Meds are very overwhelming and there is a lot to learn..esp when you rotate floors and are dealing with an entirely diff pt population with diff meds (ie this semester I had to deal with pulmonary on one floor and cardiac on another) I think when you settle into one floor as a new grad you can hone in on the common classes given and vastly improve your med knowledge..until then... you need supervision (this isn't spec. to the OP..just general thoughts)

fultzymom · May 1, 2007

Unfortunately, honesty was the worst policy (in your situation). If you would have kept your mouth shut regarding this med error, you would have been graduating in a few weeks.
However, everything happens for a reason.

But what happens if she did not say something et the patient coded? It doesn't matter what trouble you might get into about something. When a patients health/safety is on the line, HONESTY is ALWAYS the best policy.

MelodyRNurse · May 1, 2007

So if I understand correctly you are not licensed to pass medications yet. Your precepter or teacher was not there to double check when you pulled the med nor was he/she there when you gave it?? Yet your being held soley responsible for these errors but your not licensed? I don't understand that. We would never be allowed to do that without someone double checking, and most of us are LPNs. The instructor would also be responsible. I feel for you. You are still learning and have to make good judgement but should have had someone assisting you.

I have been in a similar situation, where I reported my own med. error, even though there was no harm done. I'm glad I did because I don't think my conscience would have let it go had I not.

TazziRN, RN · May 1, 2007

Unfortunately, honesty was the worst policy (in your situation). If you would have kept your mouth shut regarding this med error, you would have been graduating in a few weeks.
However, everything happens for a reason.

Whoa, there.......and if the pt had had an adverse outcome because of this? It would have gone worse for her if she hadn't said anything.

OP, always be honest about your mistakes, no matter what the potential outcome to you.

jjjoy, LPN · May 1, 2007

For those who say 2 med errors = fail, does this mean that nursing students, to pass, should make absolutely NO errors during their training? I might agree if there were several "practice" med passes wherein students have to pass meds to simulated patients and the instructor reviews their practice to catch any problems. However, in many programs, there are no such "practice" med passes.

Thus, as another noted, the instructor should be carefully guiding the students through their med passes, emphasizing, reiterating and checking that the students cover all bases. We all know that upon graduation, students don't have anyone double checking them all the time. But to me double-checking is to help the student improve. When a mistake is caught (which should be BEFORE it's given), the student now learns something. IF a student continues to make the same mistakes or seems careless and makes different mistakes regularly, then yes, the student shouldn't be allowed to pass the course.

Ideally, no one makes errors but we all know that's impossible. The chances are that more mistakes are made than we're aware of and we just never notice them. Thus, failing a student SOLELY on two caught med errors doesn't seem justifiable. If the set up is such that all student med passes aren't being monitored closely by the instructor, it's likely that other students DID make med errors and either didn't report them or never even noticed it.

Unfortunately, many nursing programs don't have enough time and instructors to devote more time specifically to med passes.

In this specific case, we don't know the whole picture so I don't want to comment on it directly.