Med error, 1st "write-up"

[ivyleaf]

So I just had 2 med errors in the past 6 months and was written up for the 1st time in my career.

I have been a nurse for 10 years and have been at my current job for 2 years; I have been w/ the same hospital/group for 3 years an the same overall organization for 5 years. I had one error about 3 years ago at the hospital my group is affiliated with, and Im not sure if my current group could see that incident report (I was not written up)

The first error, about 4 mo ago, I self reported.

I followed a drs order exactly but the patient/family/doctor all thought it was the pt's first time getting the med (Pt and family confirmed with me she had never received it before I administered).

When I was reviewing the chart later, I noticed that the pt had received the med 3 mo ago. It is supposed to be given q 6 mo. I s/w the MD, who hadn't noticed either. No harm likely to come to pt; she informed pt and I filed a "safety event"/incident report. When discussing it w the risk management nurse, it came out that I had administered the med in a room without a computer, which was against policy (which I wasn't aware of).

I explained (we have 20-something different offices) that the only room we have in the office suite to give meds does not have a computer, and hasn't for 10+ years, and (and I if everyone else jumped off abridge, no, I would not), EVERYONE in the office was using that room for med admin without a computer.

The 2nd error was a big one- I gave the pt 5x the dose of IM steroid she should have received. We do not have scanning, but I was using the computer (this was in a different office). I feel horrible about it and depressed and anxious every time I think about it. I looked at the bottle multiple times, even printed out the order, etc, and I still made the mistake. Luckily the pt was fine.

However, I wasnt following policy because I didn't predocument/load the lot #/NDC/info into the computer ahead of time/prior to administering, which we are supposed to do-- if I had, I probably would have caught it. I was at an office giving meds w/o a computer for almost a year (I float btw offices), and got out of the habit of doing it, which is completely my fault.

Also (and I STILL should have done it), the vast majority of people dont follow that policy, it is a new one within the past 1-1.5 yrs since so many errors were occurring.

So I had to meet w the clinical/nursing manager and risk management nurse on Friday and I was given a written "first warning." They told me HR wanted to give me a "final warning," although I don't really understand because I'd never even been given a verbal warning, let alone first written warning by my supervisor for the first incident..

I take complete responsibility for my errors, particularly the 2nd one as I feel it was much more egregious; but am anxious about:

1) this affecting me if I try to change jobs/need a reference; especially if I try to transfer to the affilated hospital, which may have access to the write up.

2) I am extremely nervous that what if I miss something and make a 3d error and get fired. I assume that would be a final warning, and it would have to be a 4th error to get fired, but what if I am there for 10 more years? There is a chance I may make 2 more errors...

I am really anxious about giving meds (which I know I should be-- I got too comfortable)

Any thoughts/feedback or tips would be much appreciated.

I have to pass off on following the correct procedure on Monday and watch a video. I have re-read the policy several times and hilighted/notated it. I even read a CEU course on patient safety. I am going to be much slower, more careful, and more present while I am giving meds in the future. always going to use a computer and pre load the info

I am just terrified I am going to make another mistake at some point..