Medication Error and Overtime

pagandeva2000, LPN · Jul 31, 2008

I am sorry that you are having a hard time. What I am wondering, though, is maybe the DONs office is not bringing you in to discipline you, but to offer suggestions...maybe they realized that you are overwhelmed and that is why you made the mistake? Not sure, but try and think positive until you actually hear what they have to say.

However, I do believe it is inhuman for both, the patients and the nurses to be responsible for so many. I'd like a bit more feedback on what you mean when you say that you are alone during your 6am medication pass. While I know that the nurses and CNAs are a team, you are still relatively new and need to learn your own job. This could be why a mistake was made...you were overextending yourself. Help when you can, yes, but remember that you have additional responsibilities that the CNAs do not have. I remember when I first became an LPN, I was told that while we "know how it is to be an aide", we have to learn how to be nurses, now. I wish you the best, and keep us posted.

lookingbeyond, BSN, RN · Jul 31, 2008

I am sorry that you are having a hard time. What I am wondering, though, is maybe the DONs office is not bringing you in to discipline you, but to offer suggestions...maybe they realized that you are overwhelmed and that is why you made the mistake? Not sure, but try and think positive until you actually hear what they have to say.
However, I do believe it is inhuman for both, the patients and the nurses to be responsible for so many. I'd like a bit more feedback on what you mean when you say that you are alone during your 6am medication pass. While I know that the nurses and CNAs are a team, you are still relatively new and need to learn your own job. This could be why a mistake was made...you were overextending yourself. Help when you can, yes, but remember that you have additional responsibilities that the CNAs do not have. I remember when I first became an LPN, I was told that while we "know how it is to be an aide", we have to learn how to be nurses, now. I wish you the best, and keep us posted.

Thank you so much. I feel your care. How do you give and give as a nurse and then come here and nurse us new nurses? Thank you...I was alone with 40 residents. I was the only staff member on the hall for about a half hour during the 6 am med pass. It felt like an eternity. I had two CNA's for the night, just not very dependable.

Thank you again for your care.

militarymom06 · Jul 31, 2008

I am so sorry you are having such a difficult time. It's not easy being a LTC nurse, especially when you work nights and you are basically on your own. I have been in your shoes, and I know how you feel. It gets frustrating, and you just want to cry..atleast that's how I felt. You just need to instruct your cna's that they have to stay on the floor. Actually, there should never not be atleast one cna on the floor at all times. As far as the med error goes, don't beat yourself up about it. Every nurse, at one time or other, has made med errors. You didn't harm your patient, just try to be a little more careful. Honestly, I've been doing this for 20 years and I made a med error not long ago. It happens, none us are perfect, we are only human. The important thing is that you learn from your mistakes and go on. Once you get into the "swing" of things, and get your routine down you won't have so many problems with the overtime, I promise. Good luck!!!

makes needs known · Aug 7, 2008

Don't give up.

#1 The pts allright, right? probably slept really good.

#2 Your charting will get easier, chart only what is needed, chart during the shift instead of saving it for the end, chart less. You don't have to write a book.

#Talk to your aides- be nice, but let them know, what you expect from them. They might get mad at you, but that's too bad. You help them, they help you. They probably think because you used to be a cna that they don't have report to you. They're wrong, let them know.:chuckle

makes needs known · Aug 7, 2008

Don't give up.

#1 The pts allright, right? probably slept really good.

#2 Your charting will get easier, chart only what is needed, chart during the shift instead of saving it for the end, chart less. You don't have to write a book.

#Talk to your aides- be nice, but let them know, what you expect from them. They might get mad at you, but that's too bad. You help them, they help you. They probably think because you used to be a cna that they don't have report to you. They're wrong, let them know.

But what am I talking about, After 8 years of being an lpn, I still make errors, I work overtime to complete charting, and my cna's sometimes still do whatever they want. But some nights everything runs smoothly, we all work together and I know I' m a great nurse.

pagandeva2000, LPN · Aug 8, 2008

Thank you so much. I feel your care. How do you give and give as a nurse and then come here and nurse us new nurses? Thank you...I was alone with 40 residents. I was the only staff member on the hall for about a half hour during the 6 am med pass. It felt like an eternity. I had two CNA's for the night, just not very dependable.
Thank you again for your care.

The reason why I can speak to newer nurses is because I know how it is, and we need to support each other rather than tear each other down. This is the reason why I am sure that Brian started the allnurses forums to begin with and I am glad to be part of this team.:heartbeat

t.l., ASN, RN · Aug 11, 2008

as the Licensed person, you are responsible to see that your CNA's do the tasks assigned to them. Perhaps you should speak to them, or if that doesn't help, speak to the DON. I worked as a CNA before I was an LPN, and it is not that difficult of a transistion . You cannot allow the CNA's to do as they please.Offer suggestions, advice, and strong hints to make sure that your patients are not neglected. That's a HUGE work load for 1 person.

Good Luck.

Thornbird · Aug 13, 2008

There should never be only one person on the unit. The CNA's must relieve each other for breaks so that you are not in that situation. You are in charge and it's up to you to see that they are taking their breaks appropriately. That also seems a bit late in the shift for breaks. During your med pass, they should be doing rounds. Bring these issues up. Sometimes new nurses are taken advantage of by CNA's.

I've been a nurse a long time and still have those shifts with disappearring aides. Can't let the patients be falling because nobody is there to help and I get overwhelmed too. Work on this issue with your supervisors. Doing other people's work when you should be doing your own is what makes you late.

Don't worry too much about the med error. Errors are certainly not a good thing, but it happens to everyone sometime. The main thing here is that this particular error didn't cause harm to the patient. Those are the ones you will get in trouble over.

Good Luck.

iwanna · Aug 20, 2008

lookingbeyond,

I agree with pagnadeva. The DON was there to help you, not against you. Working OT and in those circumstances could cause anyone to make a med error. And, I believe that just about every nurse has made a med error at least once in their career. I can remember being called into the DON's to review a med error. It was a very chaotic day. Also, I was working three 16 hrs. shifts a week. Talk about being sleep deprived! Anyways, back to the topic, you were extremely busy. Fortunately, it was not a serious error. It sounds as if the CNAs are taking advantage of you being a new nurse. To just take off and leave only one on the unit is very dangerous. Shame on them!

God bless all of you who work in LTC. :bow: Although, I do like geriatrics, the patient load is insane.

And, this site is a great support to nurses. Although, I have lurked on the boards for a few years, I just recently started posting more often. I have found great support on this board. I am looking forward to getting back into nursing.

skwlpn · Aug 20, 2008

Oops...new fingers...

the same kind of responsibilities I have in my personal life. When I first got out of nursing school, I was a charge nurse in LTC with 50 resident's in my care overnight. I made a med error involving insulin because I was rushed and overwhelmed in my 0600 med pass. Sure, I was responsible but time was certainly the biggest contributing factor. Obviously much more serious than the error you made. 0.5 MG is still well within the safe doseage for geriatrics.

I also worked for a DON who called me into her office and said that "if you can't get your work done within the shift we will have to find you a less busy shift." What???? Less busy shift? How about a little help??? How about some more realistic expectations? How about I am not cutting corners as a new nurse. ALL of my treatments were done (check my initials on dressings), all lotions and potions applied, ALL meds passed, and all tucked in safely, etc. There were fewer falls during my shift than any other and I am the one who is questioned regarding my time management skills. And I had great, supportive, hard working CNA's helping me.

Yes, your DON is there to help you, but she is also driven by the corporate machine that pushes LTC which is usually a for profit corporation. Perhaps I am completely off base and the others are right.

I worked in LTC for the same company in the same facility for 2 years with the same responsibilities. I felt like I was the only advocate for my patients and I finally had to leave because I refused to take short cuts.

I make less money at a wonderful hospital, but I feel like I can take better care of these acutely ill patients who are far fewer in nubers than LTC. I now love my job even though I miss my residents.

All this is to say, you are in good company. LTC is tough to impossible but hang in there if this is your passion. That is what makes you a good nurse. Mistakes happen. Be grateful that this was relatively minor and resolve to check, check and recheck your work. Ask your CNA's to let you know or to ask you before they leave the floor but be good to them because they can make or break you. I am not suggesting that you blurr the supervisor/subordinate lines, but that you make sure that they know you respect and appreciate them for the role they play in your "team" and that they will know where you are and you need them around too.

Of course it is not too late for you. I am sure that your are a wonderful nurse. You obviously have a passion for your work. A quiet confidence will serve you well and check, check and recheck your work. It takes a minute but I would rather be challenged on time management than take a chance on making a mistake.

Do good work!

Stacey