Med error??

Esme12, ASN, BSN, RN · Nov 2, 2013

Since a vaccine is a med...it's a med error. You had your training...in school. Remember the 5 rights of medication administration?

Some of the basics we all learned in nursing school remain very important for patient safety. When administering medications, it is vital to remember the “Five Rights” of medication safety. Checking to make sure all “Five Rights” are in place before you give your patient a medication will help keep your patient safe and free from harm.

The “Five Rights” are:

1. Right Medication

- Is this the medication the provider ordered?

2. Right Dose

- How may milliliters, tablets, or does are to given?

3. Right Time

- What time of day should the medication be taken?

4. Right Route

- Should the medication be given by mouth, via feeding tube, or is it an injectable medication?

5. Right Patient

- Is the medication for this patient or is it for someone else?

Medication errors are frequently the result of failing to check these “Five Rights”. Giving medications is an act that needs to be done carefully and taken seriously. It has nothing to do with whether or not the patient suffered harm...they were errors just the same.

Did you report your first error to your supervisor before contacting the patient at home? Did you make up an incident report? If not than you were wrong.

I called patient at home explained and asked if he can return to get the other half, pt agreed to come in next day. Next day came pt did not answer, the following day, pt reported he was admitted to hospital (not related to the vaccine) and he blamed the vaccine he received from me, he was very upset, he reported he will contact a lawyer. I then proceeded to informed my supervisor about what patient told me, next day I was given a final written warning for the med error and not reporting

You were wrong not to report your mistake when you discovered it and you should have NEVER tried to call the patient at home without notifying your supervisor and the MD. You were given a FINAL WARNING which is what it says...a final warning.

Then 60 days later you made another grave error...you gave an IM injection of the wrong medicine. What if the patient was allergic to the HepB vaccinations and they suffered an allergic/anaphylactic reaction? What if you didn't catch this error and they patient thinks they are UTD on their immunizations....suffers a laceration, cut, or puncture wound form a rusty nail, gets Tetnas and dies....who is responsible? You are.

Med errors are very serious..you had a final warning. The onus (responsibility) is completely on you.....you went to school, you are licensed as a LPN it is your responsibility for your actions. There is a certain responsibility that comes with that license and that is safe practice.

Your former employer is not under any obligation to ensure you act as a responsible licensed practitioner should. It doesn't matter whether or not the patient is harmed....the responsibility to practice is on you. Your former employer can actually report you to the BON and have your license remediated or disciplined until you finish a medication safety course.

What to tell your next employer is the truth and that you have owned the mistakes and that you learned from them.....be prepared for them to ask how you plan to not make this mistake any more.

cardiacfreak, ADN · Nov 4, 2013

I agree with Esme12 you bypassed your 5 rights of medication administration. We use a MAK system at the facility where I work and if you bypass that safety policy, it is automatic termination. No questions asked, do not pass go, do not collect $200.

Hopefully you have learned from this ultimate error and will never bypass the 5 rights of med administration again.

IMO admitting to your error and giving them examples of how you will not make the same mistake will probably be the best thing. But that is just my opinion.

nurseprnRN, BSN, RN · Nov 4, 2013

I think that anyone with a nursing license ought to have a quite adequate background in the five -or six, or whatever- rights of medication administration. I don't believe it's the employer's duty to spend a lot of time doing remedial work for something so basic.

By bypassing channels calling the first patient, admitting you made an error to him, and not reporting it properly you have now set up your facility for a lawsuit. It may not proceed if there is no proof of damages, and if that happens you can thank every lucky star you have in the sky.

As for you yourself, have you been evaluated for some medical reason you are having such stunning lapses of memory, judgment, and attention? I'd look into that before you seek any other job.

OCNRN63, RN · Nov 11, 2013

Hi, I recently got fired from my job that I really loved, I'm so depress right now and can't let go of the fact that my stupidity cause me this great loss. A pediatric nurse was helping us in Internal medicine, she went to pick up a new box of Engerix (hep B) vaccines, she happen to pick up a pediatric box. I went to give the Hep B shot, I grab the syringe and examined the name, exp. date, name of patient. I failed to check the dose (for adults is 1ml, pedi is 0.5ml) there is no printed order to compare my checks with, but I should have know this I have given it hundreds of time. I gave the injection, later that day one of the nurses realized the box said Pediatric only. I called our pharmacist to verify harm to patient, she told me is the same vaccine just half a dose, I called patient at home explained and asked if he can return to get the other half, pt agreed to come in next day. Next day came pt did not answer, the following day, pt reported he was admitted to hospital (not related to the vaccine) and he blamed the vaccine he received from me, he was very upset, he reported he will contact a lawyer. I then proceeded to informed my supervisor about what patient told me, next day I was given a final written warning for the med error and not reporting on time/trying to cover up (not my intention at all). Two months after this incident I did another med error I gave Engerix (hep B) instead of Boostrix (Tdap) don't know what happen to me, I give vaccines all day long, I had Engerix on my head and that is what I gave, I hate myself for this distraction. I was fired a month after last incident. In none of this incidents the patient was harm. Does anyone know the process that administration should have taken after the first incident, such as in-services, trainings, QI, or other improvements to reduce med errors. Also any advise on what to say on my next interview regarding my termination or just say I left the job. Thank you so much. Also should this incidents be classified as med errors or vaccines error?

The onus is on you to be a safe, competent practitioner. Why were you given a "final notice" after the first incident in your post? Did you make other mistakes as well?

Medication error/vaccine error--they're one in the same.

This post is so much like another one I just read. Medications are serious business, and your mind must be on the game when you're giving them, no matter how benign they may seem to you.

While you're looking for a new job, try to take some online classes for CE on med administration. When you go for an interview, make sure the interviewer knows that you are owning the errors. Don't blame the facility. Explain to them what you've learned, and have something concrete to prove it, e.g. CE certificates.