Med Error

Published

I am a new grad and have been working at my first nursing job in a smaller hospital on the med-surg floor. I have been there for about 8 weeks and I really like it. Everyone is nice and helpful. However since it is a small hospital the pharmacy is only there from 8 to 3 and never there on weekends. That is a huge responsibility for us nurses who work there. We have to override the Pyxis at night and on weekends to retrieve the meds the doctor has ordered. Being a new nurse I am terrified of getting out the wrong med or reading the doctors order wrong, because they have such great penmanship. Come to find out I have already made a mistake...there was a varience report in my folder that I have to fill out because evidentally I took out glipizide 5mg XL instead of glipizide 5mg. This was a few weeks ago and I didn't even know it until yesterday. This week is my first week by myself and I am a little scared!:no:

Up Vote Up Vote ×

Don't worry. Take it as a learning experience and a way to stay on your toes. Even the best nurses make errors sometimes. Thankfully nothing happend to the patient?

Take care

Up Vote Up Vote ×
Specializes in Medical Surgical.

This system does not sound kosher to me. Granted sometimes we all have to override with a new order, but I thought JCAHO etc. mandates there hss to be a meds system in place where routine orders are double-checked at some point. Can you at least work as a team to decipher the orders and set up a temporary med sheet? Another option would be to require a witess nurse to override (yes, I know how much extra work this would mean.) But this sounds like an accident waiting to happen.

Up Vote Up Vote ×
Specializes in Adult Acute Care Medicine.

Wow. I can't even imagine working in a hospital with such limited pharmacy hours! (My hospital has pharmacy 24/7...and I call pharm all the time to check compatibility etc)

Still, mistakes do happen, everywhere at any hospital. Our docs have to enter orders on computer and I have made at least 3 mistakes (that I know of). I have been a nurse for about 1.5 years.... and felt horrible - yet learned from each one.

Don't get down on yourself...we all make errors...just keep on trying to be error free, follow 5 rights, utilize coworkers, etc.

If need be, call that doc that wrote the order.

Best to you!

-Jess

Up Vote Up Vote ×
Specializes in OB/GYN,L&D,FP office,LTC.

We have all made med errors at one time or another. Just follow the 5 rights and ask

questions if need be. The system you are using does notall that great.Could the charge nurse or supervisor be a witness when the system has be be over ridden?

Up Vote Up Vote ×
Specializes in Management, Emergency, Psych, Med Surg.

In very small hospitals it is not uncommon for there not to be a pharmacist on duty at NOC. It makes it really hard when you are having to do a lot of overrides. It is easy to make an error. What has always bothered me about Pyxis is that when the medications show up on the screen they are really crammed together and you have to really look one by one to make sure you are getting out the right drug. It really slows me down (and I have been doing this for 30 years). The med error you made was really a minor error as errors go. Just learn from the experience and keep going. You will do fine.

Up Vote Up Vote ×
Specializes in ER, Med/Surg.

I did the exact same thing, gave XL instead of "plain" Toprol. She was a new admit and (of course) didn't have a list of her meds...

Don't get down on yourself.

Up Vote Up Vote ×
Specializes in Emergency.

Hi,

Please don't beat yourself up. Even in a well staffed hospital mistakes happen. I have made a few (luckily without harm to the patient), and have felt AWFUL each time. What's important is that you learn from your mistake, and try your best not to let it happen again. Also, if you didn't feel bad about making a med error, you would be in the wrong profession. We are human and will make mistakes, no matter how careful we are.

On another note, I am shocked to hear that there are hospitals without full time round the clock pharm staff, but thats another post.

Amy

Up Vote Up Vote ×

Just wanted to add, don't be afraid to pick up the med book and look at dosages, or side effects. No body knows everything about all the meds, and you shouldn't feel bad about looking things up. Also, if you're reading dosages of meds you're unfamiliar with, it's good to second guess yourself if you've ended up with a handful of pills to reach the "proper dose" or more than one vial of a med. That's always a clue to me that maybe I've read the dosage wrong. Most meds are formulated so that patients only need one or two of any pill, and the same for a vial of medication.

Up Vote Up Vote ×

A girlfriend of mine just landed a job as a medical assistant in a pediatric office. She's been there about a month now and has already made a few mistakes. The major one though was her administering 0.5mL of a vaccine (whatever it was, I didn't ask) to four patients when she was supposed to be administering 0.25mL! Big whoops, right? She's totally freaking out about it, because her office manager told her from now on she's on front desk duty, meaning no more clinical. I've never been a situation like this before, so I'm just curious, are those grounds for termination?

Up Vote Up Vote ×
Specializes in LTC, case mgmt, agency.

Happens to the best of nurses. Use this as a learning experience and don't sweat it too much.

Up Vote Up Vote ×
+ Add a Comment