med error i think

[bessiepig1]

I am a new grad and started working for an agency about a month ago. i was working at this facility without orientation and everything was going fine. i worked a double on monday and in the morning i was on a unit with psych/developmentally delayed residents. i gave my am meds no problem then pre poured my noon meds and when i called the staff to bring one of the residents over they informed me that she went off the grounds to a workshop but she would be back before my shift ended. i got distracted and left the narcotics on the cart in the office ( i was the only one who had access to the office). when the evening shift nurse came on i explained to her that i didnt give the meds and she said i'll give it at 4:30. evidentally she didnt and when they came to her to ask what happened, she threw me under the bus. i felt like it would be better to get her meds to her even if they were late then to waste them. i said ok and ran off to my second shift in another building. i look back and realize what i should have done but they are not even going to let me come back to the facility. i am heart broken because i loved the facility. please give me some advice.

[nyapa, RN]

It sounds to me that it is a lesson to be learned. It is sad to say it, but sometimes you can't trust your colleagues if they feel they are at risk of damaging their reputation.

You are saying that you are with an agency and can get work elsewhere? I would continue to look forward to the future, and build your reputation from there...

[racing-mom4, BSN, RN]

Lesson learned. Here is what I do when I cant give a med for a certain reason or another. I document it on the MAR. I will circle the med and put what ever reason I have for not giving it ex:NPO/Low BP and I document the B/P right next to the med. Low heart rate and again document the heart rate etc etc etc. Had you have done that, you would have been covered. You could have circled it and wrote, "off unit"

As far as you not being able to go back to that unit. Sounds like they dont have good teamwork so no major loss. What is with the double shifts though?? Eegads, I feel drained after 1 shift!

[elkpark]

Learn the lesson and move on -- not much else you can do.

[Scrubby]

A similar thing happened to me. I wasn't an RN then i worked as a pre registration nurse assistant. My patient required methadone and it was not given. I wasn't allowed to give this drug so to this day i don't understand why i was blamed the way i was. I told the RN several times that this drug was due and I assumed she would give it. I didn't check the chart before i left and document that i had told the RN she had to give it and the next day i was told off about it. The nurse in charge of course denied that i said anything. They were really angry with me and made me feel terrible because the man was in pain etc. In the end i had to contact the union and the unit was told off for putting the blame on an unregistered health care worker.I was not very popular after this and this was hard for me because it used to be such a nice place to work.

My advice here is you should never depend any nurse to do the right thing by you. I"m not saying that all nurses are incompetent and should not be trusted but the sad reality is that nursing is a dog eat dog world. Never rely on ANY nurse to do your job for you because chances are they will just forget because they are probably overloaded with enough work and too many patients. Everyone is just trying to cover their own butts so you need to cover yours too.

And with any drug that you don't give for whatever reason (especially narcotics) then always document why it wasn't given and that it was verbally handed over to the next nurse in charge.

[bessiepig1]

if i knew then what i know now haha i miss that facility but have had plenty of other oppurtunities to NOT make that mistake again. it did make me a better nurse because i know i have to rely on myself for EVERYTHING and i am much more careful(that may have come with more experience also). Thanks for the wisdom and support. i am going for my rn now so i will need the support once again. :1luvu:

[RN BSN 2009]

The first part of your post that irked me was the fact that you said you did not have an orientation.

There are just things in the beginning that are needed to be clarified before you hit the floor.

Hope this is a lesson learned, for you and others reading this topic.

[bessiepig1]

I haven't had orientation or a proper one at that at any job i have had. I work per diem for agencies and have worked full time and had 2 days of improper training. I jumped in head first when i graduated because i wanted to get the experience under my belt. I would have been more cautious if i knew then what i know now. I wasn't being negligent or sloppy, I just got overwhelmed and wasnt aware of the residents and their habits, just to clarify. Like I said, I'm better for it and no one got hurt.

[Meriwhen, ASN, BSN, MSN, RN]

I'm sorry this happened to you

You have learned three important lessons here that you'll probably never forget after this:

1. NEVER EVER leave a narcotic out. If it's not in your hand ready to give to a patient, it should be replaced and locked in the narcotics cabinet/PYXIS/wherever you store them, or immediately wasted. IMO, better to waste a narc than risk it going missing. You'd be surprised how many people have access to offices that "only you" have access to, and what if the narc went missing? Guess who's the one to blame--YOU for the missing narc if you signed it out.

2. If you didn't give a med for any reason, you need to immediately document it. The patient not being there is a valid reason not to give a med, so you should have written something to the effect of "medication not given; pt off of floor, medication replaced/wasted". Then let your charge nurse know immediately as well as the next shift's nurse when they come on.

3. Even in the best working environments where everyone pulls together as one happy team, you always remain responsible and accountable for your duties. I'm not saying you're never going to be able to trust your coworker when you ask them to do something for you or they offer to do it...but keep in mind that that is delegating, and therefore you are still held accountable for the task being done. So if you do hand off a task to someone else, be sure to follow-up on it.

Learn from this experience and use it to improve yourself. We all make mistakes, even the best of us :) And I'd be wary of any place that gives you minimal or no orientation!

[bessiepig1]

thanks to all for the comments! i learned a lot and wont ever make the same mistakes again:D