Made a med check error -- feel terrible

[SoundofMusic]

The whole thing was so screwed up from the get go. I had a pt in pain, but he's a chronic pain pt, and I'd been medicating him ALL day long -- so many different pain meds for this man, It was ridiculous and nothing was bringing him relief. At 1600 or so he asked for some more after being sat up in a chair. I went back to the nurses station and just plain got distracted for 40 minutes with paperwork and charting because at 4 p.m. you've got to get certain things done. After that time, on goes the call light and I go back in and there he is in pain with my manager standing there wondering when I was going to bring some pain relief.

So, I was so nervous, I ran to get it, and ran back in and gave it WITHOUT checking his ID band WITH MY MANAGER standing right there.

So, she walks out and turns around and says in a very snotty tone that I forgot to check the pt's ID band. Nothing else -- just walks off. No counseling -- she just went to tell my supervisor.

So, in she went to my supervisor's office, and the door closed shut as it always does when they want to talk to each other about someone and I knew it was about me.

Later the supervisor came and mentioned it to me..reminding me again. I asked if it would affect me since I am still on orientation and she said NO, I am on orientation and it's all a learning experience. She is good about it, but I am mortified.

The whole thing just blasts me. I am SO careful with meds all day long. But this one time I forget to check it w/ my boss standing right there?? I have to wonder what is wrong with my brain?

I also have to wonder if I can take the responsibility that goes with being a nurse -- constant vigilance, no error, one mistake and you could kill someone, etc, etc. It just really shook me that I was caught, and that perhaps one day I could do it and it WOULD have a dangerous result.

I am also confused and hurt that my manager couldn't take the time to discuss it with me directly. Maybe her taking the time to reprimand me would have shown that she cared. Instead all i got was a snide remark and look.

I't's just sent me into another round of looking at want ads again. I'm just not sure I'm cut out to do a job where there is so little room for error.

[nightmare, RN]

The one thing that stands out for me in all this is that you had been medicating this patient all day.Now,it's never good to forget your checks but you knew this patient.If it had been a brand new patient who you had never met that would have been quite a different thing altogether.

[cherilee]

You are being WAY too hard on yourself. Yous ound very concscientous

and you are more than likely doing fine.

In a perfect world, we check bands every single time we walk in a room. Like the previous person said, You had been medicating the patient all day long. Give me a break. You knew the patient.

As a new nurse, try to shake the smaller things off. You come across as more confident that way. Fake it until you actually can really do it on the inside. Unless a manager brings up something as a major concern , just keep your head up and keep learning. You will be amazed

Lisa

[SoundofMusic]

Well, our hospital has these rules that you check the bands EVERY single time, even if you've been in there all day, even if you think you know the patient, etc.

But if I can't pull the med up under anyone else's name, and I have looked at the med sheet twice, I think I am reasonably sure it's HIS DRUG -- and I was. But still, they require the check. I suppose they are right that it could still be confused, but it seems so unlikely.

I will learn to shake it off -- will just have to if I want to stay. they're not talking anything about it except I'm still in orientation and learning -- but it hurts to have that manager be so stern about it and say nothing else. that is what gets me. I mean, there are many different ways she could have handled that.

[racing-mom4, BSN, RN]

Iam ready to take the lectures and the warnings but truth be told. Unless it is a brand new to me pt, I never check the ID.

Granted the most I ever have is 3 pts. I go to the pyxisis and have to enter in their name and bed number to even get the med. I dont carry other pts meds with me, or other pts mars with me. I do one patients med pass at a time.

Thank God the "check the ID band" is not a hard and fast write you up policy at my hospital.

I think the nurse that went and ratted on you sounds like a bully. I despise when people dont come to you 1st. I have 4 kids at home, I get enough of the tattle tales, I dont need it at work!!

Sorry you had to go through that--like our jobs are not hard enough to have to deal with the personality issues of our peers.

[helper T cell]

Totally in agreement with racingmom above :nuke:. I wanted to write the same thing about the ID bands but was chicken!!

I always ck when pt new to me and it it is a heavy duty med and of course blood has all the cks.

I agree that your manager was trying to eat you. She could have discussed it with you first. Jeez I'm sorry you had to go through that. You sound like a safe caring nurse that is ready to take all feedback and help . I'm sure you are kicking yourself for not checking the ID band. Don't feel to bad. Once a few weeks ago I made the same med error twice in a row. Talk about feeling like a complete failure. Luckily it was o.k. for patient as it was not even close to max dose (ibuprofen). it did explain why pt didn't have fever though when clearly pt had other s/s of infection. The important thing is to be accountable for errors and report them. I worked out a plan with my preceptor and redid med competency. Am ever so vigilent now about all cks etc etc. Please don't quit you sound like a great nurse.

[SoundofMusic]

Granted the most I ever have is 3 pts. I go to the pyxisis and have to enter in their name and bed number to even get the med. I dont carry other pts meds with me, or other pts mars with me. I do one patients med pass at a time.

This is exactly how it is at our hospital. Dang, I mean we CAN'T pull any other patient's meds up under the one pt's name -- and you do your check at the counter. If I've been giving them all day long to THAT patient, know it's HIS drug when I pull it out of the pyxsis, don't do anything else between that time and the time I get to the bedside ...I mean, geez.

I know you can't be too careful. I guess that's all I'll say about it. I was totally in error. But it was jerky of HER to stand there and not even give me a small reminder while standing there. Then to walk off with her back turned and "tell" on me. She's not another nurse, she the manager of the unit!

I plan to go in and discuss it w/ my supervisor -- who so far is a great lady to work with and tell her how I feel. The whole thing felt like an initation into the "terror zone." Our hospital has a very strict policy on it, and I know that -- but I am human and new at this, and well, it happens.

I wish our hospital would go to the scanner system at the bedside. Patients just get plain annoyed at being asked their name and birthdate also 10 times a day, especially when they're not feeling well.

[doublecheck]

i've been a nurse for just under a year, and you mentioned some things in your initial post that echoed inside of me:

"i also have to wonder if i can take the responsibility that goes with being a nurse -- constant vigilance, no error, one mistake and you could kill someone, etc, etc. it just really shook me that i was caught, and that perhaps one day i could do it and it would have a dangerous result.

it's just sent me into another round of looking at want ads again. i'm just not sure i'm cut out to do a job where there is so little room for error."

i feel like i have been unhappy with my job as a nurse since i started. as with most nurses, i've been disappointed by the inadequate, and often unsafe staffing; i've been frustrated by the amount of responsibility i am "assigned" as a result of the rn shortage (i.e. i work on a medical oncology unit and because we often don't have adequate staffing, and even though i am not chemo certified, i have had pts who are receiving continuous chemotherapy), but this responsibility comes with the job; and, i don't like hospital politics.

but in the end, these things aren't the source of my unhappiness and they pale in comparison to the patients and my love for patient care. i love being able to offer compassion, kindness, care, and knowledge when people need it the most. it's humbling to work with someone when they are really sick, and inspiring to watch them get well, recover, and hopefully be healthy again. i can't begin to describe the feelings and emotions i experience when caring for someone who is preparing, and actually ready, to pass on to whatever god has in store for us after this life. these aren't situations or emotions one experiences is a typical career, and i do feel very lucky to be a nurse and have these opportunities to truly help others and simply be present for them when some have no one else to support or care for them.

unfortunately, there are aspects of this job that overpower the aforementioned positives and negatives. i am constantly struggling with the intense stress of being a nurse and the amazing responsibility that comes with dealing with a person's life - or death. nursing is a serious job, this isn't news to anyone. but what i never fully realized or appreciated as a nursing student is how just one slight oversight, or one slight omission can affect a patient in a major way.

i've been told that with experience comes knowledge, and subsequently confidence in one's nursing care. i hope this is true, and i hope i reach that point soon. for now, i leave each morning worrying about my patients and hoping that i didn't forget some pivotal piece of care. wondering if i did everything right, and everything within my scope of practice to provide quality care. for those times when i know i could have done something better, or when i've had a "learning experience", i lie awake worrying that i caused undue harm to my patient or possibly did something that will get me written up.

how do we, as nurses, new and experienced alike, come to deal with this? how does one get over the fear of this immense responsibility and accountability?

[RNmaria]

I too feel your anxiety. I am a new grad (May 07) and began my carreer in a large teaching hospital in October. I trained on the ICU for a step-down unit that just recently opened. We are now OFF orientation and I have to say that it is scary. My collegues and nurse educator say I am doing fine, but I still re-hash the whole day in my head and often wonder if I forgot something or did not recognize something. Do these feeling ever go away or soften? I find this forum so refreshing because not every nurse will tell you they feel this way.

pasha :nuke:

[Scrubby]

I don't know what the law/policy is in your country but when you give pain meds where i live you have to do it with another nurse and the patient is checked no matter how long he or she has been in hospital.

I think that your manager probably didn't handle it the best, but at least your supervisor is being supportive. I probably wouldn't dwell on this one, make sure you do everything BY THE BOOK when you know your manager is around.

[NurseLyla]

I'm sorry about your bad experience but this is one thing I too have really noticed since I have been a nurse...you can do wonderful things for your patients and bust your behind all day long but if you do even one minor thing wrong (I'm not talking about a major life threatening error or even a serious error which does merit consequences from superiors) or forget to do something minor, you are treated as if you are a hopeless idiot. It is very frustrating.