I can't describe how horrible I've been feeling for the past 24 hours.
Yesterday, I got a call from the day RN I had given a pt to regarding a missed insulin dose. The glucose in the AM was over 400 and he was scheduled to receive 11u of lispro per the sliding scale. I called on-call since it was only 6 am and primary sx wasn't there yet to double check if additional insulin should be administered and/or if the pt's tube-feedings should be turned off for a hour or two until his glucose improved. The on-call told me not to administer any additional insulin and not to turn off the tube-feeding. I did as he said. About 630 I saw an order from the primary sx increasing the patients sliding scale to 21u. I checked with a more senior RN whether I should give the additional 10u or leave it to the day RN to give after re-checking the glucose after 2 hours. She advised me to hold the additional 10u and it could be given later if needed.
I gave report to the day RN and told her about the changes to the order and she could give the additional units if needed later and despite what the MD said, I turned off the tube-feeding before I left (to be turned back on after an hour).
The mistake is, I saw the order for the change in lispro but missed seeing a NOW dose of Lantus. All day the pt's glucose remained high and the MD's were ****** I hadn't given the dose. I know this missed med is a med error and I'm very scared of the consequences (possibly losing my job?)
A year ago, right off of orientation I made a med error as well. I had 2 pt's in the same room. One in a-fib on a Cardizem gtt and during the night my patient in the second bed went into uncontrolled a-fib. Long story short, I thought I had been told bed 1 was in uncontrolled a-fib, alerted the MD, took vitals and pushed IV cardizem before realizing it was bed 2 who needed to be tx.
I care about my patients. I care about not just being a good nurse, but the best nurse I can possibly be. I was a strong student and always received the praises from my instructors. But in 18 months I've made 2 errors. I acknowledge my mistakes, but I can't shake the feeling that I'm a bad RN.
I want to scream, cry and quit. I feel like this job has no room for error so maybe if I can't be 100% I shouldn't be there at all....
I can't describe how horrible I've been feeling for the past 24 hours.
Yesterday, I got a call from the day RN I had given a pt to regarding a missed insulin dose. The glucose in the AM was over 400 and he was scheduled to receive 11u of lispro per the sliding scale. I called on-call since it was only 6 am and primary sx wasn't there yet to double check if additional insulin should be administered and/or if the pt's tube-feedings should be turned off for a hour or two until his glucose improved. The on-call told me not to administer any additional insulin and not to turn off the tube-feeding. I did as he said. About 630 I saw an order from the primary sx increasing the patients sliding scale to 21u. I checked with a more senior RN whether I should give the additional 10u or leave it to the day RN to give after re-checking the glucose after 2 hours. She advised me to hold the additional 10u and it could be given later if needed.
I gave report to the day RN and told her about the changes to the order and she could give the additional units if needed later and despite what the MD said, I turned off the tube-feeding before I left (to be turned back on after an hour).
The mistake is, I saw the order for the change in lispro but missed seeing a NOW dose of Lantus. All day the pt's glucose remained high and the MD's were ****** I hadn't given the dose. I know this missed med is a med error and I'm very scared of the consequences (possibly losing my job?)
A year ago, right off of orientation I made a med error as well. I had 2 pt's in the same room. One in a-fib on a Cardizem gtt and during the night my patient in the second bed went into uncontrolled a-fib. Long story short, I thought I had been told bed 1 was in uncontrolled a-fib, alerted the MD, took vitals and pushed IV cardizem before realizing it was bed 2 who needed to be tx.
I care about my patients. I care about not just being a good nurse, but the best nurse I can possibly be. I was a strong student and always received the praises from my instructors. But in 18 months I've made 2 errors. I acknowledge my mistakes, but I can't shake the feeling that I'm a bad RN.
I want to scream, cry and quit. I feel like this job has no room for error so maybe if I can't be 100% I shouldn't be there at all....
Hey, med errors happen. I made one during orientation, and I made one after 3 years of experience. You should not be fired. You should just receive some education on how to avoid making the same error in the future and realizing why the error was made in the first place.
Besides, 1.) At least the sugar was high and not low because you gave too much insulin. 2.) The day shift nurse should have caught it and given it anyway, and she should have been monitoring the pt's BS during the day, as well thinking, "Hhmm... an order to hold the insulin when the BS is 400 is a little odd....." .... Where I work we give report and do the chart check together (2 signatures) in order to go over any new orders that shift.
Mistakes are actually learning opportunities. They happen to us for a reason, and you are obviously a really good nurse to admit and evaluate your performance. Kudos to you, and thanks for sharing :)
Skwidward
107 Posts
Hey, med errors happen. I made one during orientation, and I made one after 3 years of experience. You should not be fired. You should just receive some education on how to avoid making the same error in the future and realizing why the error was made in the first place.
Besides, 1.) At least the sugar was high and not low because you gave too much insulin. 2.) The day shift nurse should have caught it and given it anyway, and she should have been monitoring the pt's BS during the day, as well thinking, "Hhmm... an order to hold the insulin when the BS is 400 is a little odd....." .... Where I work we give report and do the chart check together (2 signatures) in order to go over any new orders that shift.
Maybe suggest this as a new policy?