Making Mistakes?

While the computerized med pass is a pain, it definitely prevents med errors as long as the scanning is done. Don't skip the computerized scanning of both pt and med and you and your patient will be safe. There was a case in the news a few years ago where a nurse working an extra shift skipped that process and gave an overdose to a pregnant women who then died! So sad and didn't have to be. No matter how rushed you feel the computerized med pass will keep you from making a major mistake that could harm your patient.

If you forget to change tubing, I'm sure the next shift would get to it. The most important thing is the patient is safe! As far as flow sheets it best to chart as you go then you will not forget to chart something.

Breathe :) and remind yourself that you are human and people do make mistakes. The most important thing is that you learn from your mistakes and try not to make the same mistake again.

Little mistakes like you described are okay as long as you make them only occasionally. It becomes a problem when you start justifying it as okay since they are "minor" things and it turns into a habit. Little mistakes may not be obviously bad, but they aren't acceptable either. It's hard when you have a very busy day and are unable to get your low priority things done, but it happens.

I'm guilty of this at times with unlabeled IV tubing. When I'm rushed and notice the tubing wasn't already labeled (which means I should change it, since our protocol says tubing is good for only 96 hours), I hang whatever medication/fluid I need to then forget about the unlabeled tubing. It's so low priority that it may not get changed my shift. Or the next. Then it's a problem because god knows how old this tubing is and everyone's too busy to change it.

So with IV tubing in particular If I see it's old/unlabeled and not infusing I instantly take it down. That forces me to get new tubing when I need to hang the next IV medication. I carry a mini per enact marker with me so if I forget to being a tubing label into the room then I can at least write the date on the tubing when I hang it. That helps me.

At the end of shift I go over my hourly roundings, I&O's, and orders one last time just to check that everything is done.

I still go home and literally play my day out in my head before I go to sleep. I do it obsessively. Sometimes I remember a minor thing that I forgot to do or mention in report. It usually causes me so much anxiety that I have difficulty sleeping. I am still fairly new (RN since 5/2012) but I have talked with seasoned coworkers who say they do the same thing.

Anxiety over mistakes is normal. At least you care, and know your little mistakes. There are those who don't care or don't realize and those coworkers are the ones you end up habitually cleaning up after.

I don't know if the anxiety ever goes away. Hopefully it becomes manageable. Eventually as you become better with time management you will find that you make these little mistakes less and less.

While the computerized med pass is a pain, it definitely prevents med errors as long as the scanning is done. Don't skip the computerized scanning of both pt and med and you and your patient will be safe. There was a case in the news a few years ago where a nurse working an extra shift skipped that process and gave an overdose to a pregnant women who then died! So sad and didn't have to be. No matter how rushed you feel the computerized med pass will keep you from making a major mistake that could harm your patient.

If you forget to change tubing, I'm sure the next shift would get to it. The most important thing is the patient is safe! As far as flow sheets it best to chart as you go then you will not forget to chart something.

Computerized charting, the EMAR, and med scanning alone will not prevent you from making a major mistake that could harm your patient. Medication orders can be entered incorrectly, medications can be mislabeled, and the order can be totally inappropriate. For example, there was a patient on our oncology unit with ordered chemo. Chemo scanned correctly, but the RN noticed the color was a little different than usual. Barley. She notified pharmacy and it turns out it was the wrong chemo and had been mislabeled. Major event adverted. You still need to go through your 6 rights of medication administration because you are not safe with the computer alone.

It's also not acceptable to expect that the next shift will notice and change the tubing. If your shift was busy, then the next shift probably will be as well. If everyone is too busy to change it, then will will it get changed? It's a little thing but not something to be totally dismissive about either.

re: computerized med scanning, the same thing that the pp described happened to me with a dose of Lasix. It was fairly large and pharmacy had to send it up. Well it was a po dose in an amber syringe when it should have been iv. I had the pt the night before and knew it was iv. The label scanned and even said iv. I hope that all nurses know that amber means oral and wouldn't have tried iv... but who knows. The more likely issue would have been giving it po and not even knowing it was iv. My point is, even with the best computerized system there is plenty of room for user error and always double check at the time of scanning and administration. Everyone makes mistakes but the important part is you learn from it and don't make the same mistake a second time. I've had oncoming nurses tell me it's a 24 hr job and I don't need to get everything changed on my shift. Then I've had a nurse tear me apart because I didnt change the diprivan tubing. Everyone has their little things. I like to say "thank you for catching that, I will be sure to look out for that in the future" or something similar.