2 Med errors in a week

[aspiringparamedic]

Hey guys, I am a newly graduated baby RN working in a paeds clinic. It is an extremely busy clinic with a lot of movement in and out of the consultation rooms/treatment rooms. My clinic is unable to provide a preceptor as one senior staff is currently on leave and they're constantly on a shortage of RNs. I made the first medication error when I administered nebuliser treatment to a particular pt (whose parents responded and said 'yes' it's their child, but it wasn't). We do not have any IT system that we can scan the ID tags for double checking (this hugely increases the risk in errors made).

I made a second medication error later this week, am supposed to perform incentive spirometer before and after nebuliser administration but I overlooked that part of it. This in turn affected the physician's treatment method.

I'm hugely traumatised by the two incidents and feel extremely guilty over it. I am unable to forgive myself for the mistakes made, thus leaving nursing for the safety of the pts.

Any Nurses out there left nursing because of serious errors?

[JKL33]

Now why would you leave nursing instead of:

1) Reviewing these instances to see categorically how you went wrong. In the first instance you did not ensure the 5 Rights which is a basic nursing principle that must be observed in any setting and in every instance of administering a medication or other prescribed treatment. I don't know what you mean when you say the parents said it was their child when it wasn't, but it seems like asking them to state the child's name and BD would've revealed whether you had the correct patient or not. This is an easy fix: Ask for the information itself, not for confirmation of non-specific information. "Are you John?" = Wrong. "I need your (child's) full name, please" = Right. The second situation, by your description, sounds like you also did not take note of available information (I say that only because you said you overlooked it. It would be different if it were some unwritten protocol that you had no way of knowing).

2) Considering whether this is the right setting and employment situation.

You can get past all of this by being proactive. I think you can make a couple of tweaks with the potential for great improvement! You have to slow down, practice the basics, review things carefully, and ask questions. If there is literally no one with whom you can double-check your practices as you get up to speed, then you do need to look for a workplace situation that is more friendly/appropriate for the novice stage of your career. What you can't do is anxiously sequester yourself away and feel so pressured that you can't think things through.

I really do think you can do it.

[Crush]

Now why would you leave nursing instead of:

1) Reviewing these instances to see categorically how you went wrong. In the first instance you did not ensure the 5 Rights which is a basic nursing principle that must be observed in any setting and in every instance of administering a medication or other prescribed treatment. I don't know what you mean when you say the parents said it was their child when it wasn't, but it seems like asking them to state the child's name and BD would've revealed whether you had the correct patient or not. This is an easy fix: Ask for the information itself, not for confirmation of non-specific information. "Are you John?" = Wrong. "I need your (child's) full name, please" = Right. The second situation, by your description, sounds like you also did not take note of available information (I say that only because you said you overlooked it. It would be different if it were some unwritten protocol that you had no way of knowing).

2) Considering whether this is the right setting and employment situation.

You can get past all of this by being proactive. I think you can make a couple of tweaks with the potential for great improvement! You have to slow down, practice the basics, review things carefully, and ask questions. If there is literally no one with whom you can double-check your practices as you get up to speed, then you do need to look for a workplace situation that is more friendly/appropriate for the novice stage of your career. What you can't do is anxiously sequester yourself away and feel so pressured that you can't think things through.

I really do think you can do it.

Adding to the above, maybe consider the environment too for a new grad. You are new, no preceptor, is just not a good mix in my opinion. While nursing school and our passion drive us to what we do, the real learning actually begins once you hit the floor and continues from there. I haven't met many nurses who have not had at least one med error in their career. I don't mean to sound flippant about med errors but they happen and should be taken seriously.

I think you will be fine. Take a day or two off and and regroup. You can do this.