med error? idk...

What kind of facility is it and what was the med?

Nursing home (all paper charting) and the med was a lovenox injection.

I wouldn't sign something saying I made a medication error unless I agreed that I had. So if you don't agree, don't sign!

So, I went into work to find a paper for me to sign, stating that I made a medication error. This medication was not on the MAR for the dates that they say I made the med error and another nurse admits this to be true (since she made the mistake of not putting it on there). I am wondering if this is a true medication error... If a new medication were on the MAR, I would, of course, check it with the physician's orders to ensure it's accuracy; however, this medication was not on the MAR. It just doesn't make much sense to me. Am I expected to check through every patient's chart to ensure that every medication order is noted on the MAR? I really don't want to sign this paper, because it would be admitting fault. Please help!

Another nurse was taking care of that patient and did not write the medication order on the MAR. So of course you were not responsible for not giving that medication. The only issue is is any nurse, clerk, shift, etc., responsible for going through the patients chart for the last 24 hours to check that all orders were noted?

At my old job the 11pm to 7 am shift was responsible for doing this.

Nursing home (all paper charting) and the med was a lovenox injection.

That's a hard one IMO. During report had there been some type of change with that particular resident... had they been to surgery etc... that's when the red flags go off. "But" with the paper MARs as I know they are in LTC if all orders aren't put on the MAR when processed that can lead to med errors.

Were you alerted to the fact that there had been a change in the resident? If not how could you have known. RNs who are passing meds don't have the luxury of going through every chart to check for new orders. Going through the charts and making sure all the new orders are processed in their entirety is usually night shifts side job (but not everywhere).

In my experience with LTC the primary reason lovenox is ordered is due to a post surgical procedure...did the resident just have surgery? If so then you got a fight on your hands in relation to who should have done what when etc... The experienced RN would have most likely caught it; the novice, probably not. LTC nurses who have the med pass from Hades don't have time to look up orders in the charts continually (not overlooking the fact that they're paper MARs as well).

My advice is to go through the steps in detail and see exactly where the break down occurred so as to avoid it in the future.

Every experienced RN who's honest has med errors on their record; it's unavoidable. No matter how careful we are we are still only human. You don't have to sign the document. In fact I would wonder why they are so casual for you to sign without some type of learning intervention.

It's definitely an error...whether you choose to accept any responsibility towards it is your own personal decision but I know you've learned something from all this. The question you need to ask yourself is should you have known a med could have been ordered for this resident due to what ever change occurred?

Let us know what happens :)

At my old job the 11pm to 7 am shift was responsible for doing this.

Night shift nurse in LTC here. Only on the quietest of super quiet nights would I have time to look at every chart to make sure all new orders had been transcribed. Basically, I can usually only make time to look at physicians' orders for residents on which I know changes had occurred. The computer system makes it easy to see new orders that had been transcribed. But if they aren't transcribed, then we have a problem...

in ltc i found a narc med error from another nurse, i filled out the form as much as i could and gave it to the doc. i had nothing to do with the error, but i still signed it where it said witnesses/those involved - although i did not do it i was involved.

i don’t know what it is that you are signing, we had forms that you had to say step by step what happened, if what is written is false or does not tell the whole truth then i would not sign it and write my own. med errors are not the end of the world. and i don’t think you did anything wrong. mistakes get made, we just try and learn from them.