3 medication errors in 7 months!

Nurses New Nurse

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I know, I know...most of you must be looking at this and thinking :eek: I'm living it and I feel the same way. I'm posting this because I really need some advice; I'm depressed, confused, feeling incredibly stupid and very guilty. Let me give you the scenarios and you can tell me what you all think. By the way, in case you can't tell...I'm a new grad, June 2005:

1) First medication error occured when I gave the wrong patient the wrong medication (I did a stupid thing by carrying two patients meds at the same time). This patient happened to be a chronic pain patient, knew the medication wasn't for him but accepted the medication anyway. The medication was Percocet 5/325. I alerted my charge nurse right away, told the doctor (who started laughing and told me not to worry about it because this patient was on so many meds the percocet wouldn't do anything to him.), and wrote out the incident report. Went home that day feeling terrible and wondering if I'm really going to be good at this. :o

2) Second error: received report from Step-down unit, was told this patient had not received his evening dose of Coumadin. When this patient came up to the floor I looked in his file to see if the Coumadin had been given, couldn't find the documentation in the usual place, called the nurse back in an attempt to find out whether it had been given or not, later found out I was connected to another nurse who had also given me report that same night and who told me she had not given the Coumadin. Gave the patient 5mg Coumadin and then found out the original nurse had already given the 5mg!!! Once again filled the incident report and once again went home feeling terrible and wondering if I made the right decision to be a nurse. :o

3) Latest one: Received report from one of the nurse on my floor that the patients Unasym had been discontinued and the patient now had an order for Penicillin Q24hr, when I looked in the MAR I saw the registrar had picked up the order as Q24hr also, I signed off in the patients chart right under the registrars signature. To make a long story short, next day received a call from the charge nurse on days alerting me to the fact that the patient had missed 3 doses of her penicillin because it was ordered for Q4h!! Filled out another incident report, was written up for this latest occurence, went home and cried myself to sleep and have been feeling horrible ever since. :o :o

For the past 20 years all I've wanted and dreamed about was becoming a registered nurse, I graduated at the very top of my class, received the Gold medal at graduation, and am was hired at one of the top orthopedic facilities (which has Magnet status) in the nation right out of school. I can't help but wonder...what has gone wrong? :uhoh3: I can honestly say, I've learned from each and every incident, but I'm beginning to wonder if I should quit before I'm fired. :crying2:

Any and all advice will be very much appreciated. Thanks.

Specializes in Medical/surgical.

Well on Friday I hung Ancef for a patient that is allergic to penicillin. If I had completed the five rights/three checks I would have noticed that the patient's name on the bag was not mine. Like others on this topic, I was rushing (because I feel that I am too slow and am too late charting). I reported it to the charge nurse, called the MD, and, with my charge nurse, advised the patient, and will file an a incident report tomorrow. Thankfully, the patient did not react, but I am devastated. I am starting on day shift tomorrow and one of the day charge nurses who wasn't even present at the time sent out a "reminder" about medication errors, which for all the world feels like a personal attack. I am a mess to begin with because of my guilt and self-doubt, but this makes me want to crawl in a hole and certainly doesn't make me want to start my new shift with this nurse tomorrow. I am trying to dig my way out of this pit I have dug for myself, but I could sure use some encouragement from other nurses. Thanks!

I just dont know where to begin!!!! I recently had a med error and it is the only thing on my mind since. I cant stop crying about the situation. Im so upset with myself and I want to move forward and learn from my mistake, although I just dont know the necessary steps to start this process. My patient wasnt hurt by the mishap, but I feel incompetent at this point. I just don't know what to do....I've wanted to be a NURSE for as long as I can remember. HELP!!!!

I'm a graduate lvn. I can't say I understand or know what your feeling but can say that there is RAMPANT med errors that are not being reported.

We saw them left and right while on clinical rotations...heck when I was doing my first piggyback med I had to stop my nurse midsentence because she was about to tell the wrong patient I was going to be hanging her med. Had I not been there she would have hung that med on completely the wrong patient.

I've seen meds listed as discontinued and yet when I checked the order just out of curiousity found there was no d/c ordered. The one was a near miss, she was super busy, had a handful of critical pts and was rushing. The second...had gotten by two chart checks and 4 different nurses. I found it purely because I was a student and wondered why her med had been d/c'd without giving an alternate..which would have been the norm in her situation. We told the nurse. She did not tell the Dr. or the Charge nurse of the errors made. I actually had a nurse mgr helping me locate the order in the computerized system (it WAS a transcription error)...and although she 'fixed' the error it was not reported nor was any kind incident report written...and I see why.

WE ARE HUMAN.

We are going to make mistakes. That's just the way it is. I agree with the CYA approach but also understand that the CYA approach very much promotes the nurses eat nurses mentality.

If I don't acknowledge an error on my shift from a previous shift, whether I correct the problem or not...the next nurse will throw ME under the bus for it even though it wasn't my error. I feel like we are policeing each other rather than working as a team to provide the best care possible. ...

I don't like the constant threat to my license. that's nuts but I do believe that a true error...will happen sometimes. It's just reality and it reminds us to slow down.

I know my day is coming....we ALL will have that day.

The GREAT positive of Nursing is there are sooo many different areas that you can work in. And over 25 years I have come to realize that it is OK to search until you find the area that best utilizes your strengths. Some people are better at Urgent Care where as that nurse who can hold the hand of the dying patient and console the family are a special breed. Find your talent, and remember that we are all Human and make mistakes. Nurses don't talk about mistakes in person, almost a taboo. Its OK to admit a fear, or mistake and you would be surprised at how many nurses would agree and feel releived that someone else felt like them.

I know exactly how you feel. I have just started working in ED i have only been working for 8 months an 2 days in on my own an the doctor says to give a patient lasix and lactulose as stat order he takes med chart off me gives it back to me and says here you are just give these. so i did i had a quick look at the chart i thought all was good till i went to sign off after giving the meds and realised the doctor had orded lasix an hour ago and neither of us had noticed that it had already been signed off and given. i felt so bad i almost cried then and there i told the in charge she was so nice and said dont worry doctor wasnt inpressed but said it diddnt matter either. the patient was fine. i still feel so stupid. i all ways check my charts 3 times i dont know why this time was any different. im having so much trouble getting over it i feel so ashamed an im afraid the in charge will never trust me again. :crying2: i hope in time we can put our mistakes behind us and learn from them. i just hope its sooner rather than latter.

I think that we are hard on ourselves because we care. I am also learning that when I am feeling overwhelmed/stressed that is most likely when I'll make a mistake. I think taking a second or two to calm down even when things seem to be getting out of hand can help....no just to get myself to do it! Anyway forgive yourself...nobody is perfect

i know how you all feel.

i made an error today and it was so stupid. been a nurse for 30 years and thought i knew my drug names but i confused a generic singulair for mylicon the names are not even similar. i think because the bottles were similar. what an idiot . i have to feel out an incident report and don't even know what to put. it was in a home and a cops child ewwwwww and i told on myself lol which i always tend to do.

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