Med error: what would you do here?

[perfectbluebuildings, BSN, RN]

OK so, I just tried to type this and it screwed up. I don't think it's going to work becasue my computer is being unprintably frustrating but I'll try b/c I really need the advice.

Last night was the first night after a month of checking meds with another nurse, that I got to be "on my own" in that manner. And, guess what, of COURSE I made a med error.

It was on a med ordered q24h, then came up on the printed MAR as q12h, and for some reason I signed off the orders without noticing the discrepancy which makes no sense, and gave a 2nd dose of the med. It was still in the safe weight range for the patient, but that doesn't matter because it was not what was ordered and was an error, IMO. So I told the oncoming nurse (I didn't realize it till the middle of report), and filled out a safety thingy, and gave that to and told the day charge nurse what was up, as the night charge nurse had already gone home. OK, fine, so far so good right.

Well as I was clocking out, the charge nurse was in the break room eating her breakfast, it was just the two of us in there at that time and as I was leaving she said she was going to "hold onto" the report for the time being since it had been a safe dose and the doctor might have meant to prescribe it that way anyway. Now at the time, I was like, ok sounds great! But now I'm thinking, after sleeping and thinking about it for a while, doesn't matter if the doctor "meant" to order such and such, that's not up to me- it's up to me to give the med as ordered OR question the doctor and get a different dose ORDERED, and to notice that ALL the parts of the order on the MAR are on there correctly when I sign it off. It was a med error, pure and simple and while I don't want to be in trouble (obviously who does?) I also don't want the error just to be seen as "OK" because it was safe. Do I make any sense here? I don't want to compromise my integrity with my managers either, make it seem like I'm trying to get away with something. But I need some perspective please. Thank you.

[jaimemds]

If I were you, I would report the med error per policy. You don't want it to look like you are trying to covering anything up.

[Dayray, RN]

I wouldn’t worry about weather or not the charge nurse turns in the report. You did what you were supposed to and gave her the report.

Everyone eventually makes a med error and what really matters is that you first do everything you need to make sure your patient isn’t harmed and then just make sure that you don't do it again.

It sounds to me as though you are wanting to accept responsibility and that's why you are bothered by the charge "holding on to" the report. As if that will diminish your responsibility for the mistake. What you have to realize is that a disciplinary action or mark on your record doesn't really matter. What matters is that you internally accept responsibility (which you obviously do) and make corrections so as not to have it happen again.

It almost sounds as though you are hoping for punishment. That shows that you do feel bad for the mistake and that’s the part that really matters. Most likely the hospital wouldn’t do anything but tell you not to do it again.

As nurses we all have to deal with the guilt of mistakes or things we "could have done better". The important thing is that you accept responsibility for them but at the same time don't beat your self up too much.

Tell your self "I'm a good nurse who is still learning and I'll never make (that mistake again". Then go back to work and don't make (that) mistake again and hope that your next mistake isn’t a big one.

[TypicalFish]

If I were you, I would report the med error per policy. You don't want it to look like you are trying to covering anything up.

I agree with this train of thought for a couple of reasons; although the charge may be "looking out for you" by holding on to it, it LEGALLY should be reported. If the nurse who wrote you up finds that it wasn't filed, she may feel that you are getting special treatment or that her opinion is not being respected, so to speak. Also, I wouldn't like to have that hovering over my head-"will she or won't she?" kind of thing. And also, if -heaven forbid-you make another mistake down the road, heads could roll if it is found out that you made another error that was "covered up". Honesty is the best policy; and since it was, as med errors go, not a significant error; it shouldn't be too bad. BUT! be careful how you handle it, because the charge, who is doing you this "favor" may take it the wrong way for you to not "appreciate" it-just go to her and tell her how you feel, and let her know how much you appreciate her kindness....Best of Luck

[TazziRN, RN]

"I wouldn’t worry about weather or not the charge nurse turns in the report. You did what you were supposed to and gave her the report."

I agree with this one. If it would make you feel better, have a chat with your nurse manager. Don't tell her that the day charge told you she was hanging onto the report, just tell her about the mistake and that you wrote it up.

[perfectbluebuildings, BSN, RN]

Ah well, worried over nothing they turned in the report anyway and made me write an e-mail to the NM about it. I figured that would happen. In some way I also feel like the charge nurse was "testing" me to see if I'd jump at the chance to cover up a mistake, and I fell for it. I dunno.

But, I do appreciate your replies/thoughts!

(BTW it was me that wrote up the error not another nurse, just to clarify)

So, guess that's that. Another day, another step closer to firing!

Edited to add: this is my facility's policy for reporting med errors, to write up the report and give to the charge nurse and they are responsible beyond that, I believe. Again thanks for your help. :)

[KatieBell]

Do you think you might do better on a day shift? Lots of people have all sorts of night shift difficulties, and this might be contributing to your med errors.