Missed order?

RN403, BSN, RN · Sep 18, 2015

I highly doubt you will lose your license over this.

Unfortunately, none of us can give you a certain answer on what is going to happen. Go to the meeting and explain what happened and be sure to let your manager (or whoever you are meeting with) know what you plan to do in the future to prevent this from happening.

I have worked the busy med surg floors and I understand how quickly you can forget to do something when things are so hectic. This is why it is important to take a moment to look at your orders and write down what you must do for your shift. This way, even when you forget, you will have your paper to reference and remind you.

We all make mistakes. Some big and some small. Hear the feedback of your employer, take the consequences, and make a plan to avoid making the same mistake in the future.

Very best wishes.

JustKeepSmiling, ADN, BSN, RN · Sep 18, 2015

Do you use electronic charting to acknowledge orders and document meds?

If so, did you document that you gave it and forgot to give it - or - did you just acknowledge the order and forget to give it and chart it?

That changes things depending on exactly what you charted.

Acknowledging an order does assume you are taking accountability but these things do happen. Or if you acknowledge a stool collect order but it doesn't happen on your shift - then it just doesn't happen.

I've seen this scenario several times in various ways. Mostly coaching is done, sometimes performance improvement plan if its a recurrent issue.

Was the surgery postponed? Did postponing the surgery cause harm to the patient? Was the patient harmed by not receiving the ordered med?

I wouldn't be too concerned with an angry surgeon, I'd more concerned with how this affected the patient and how you plan to prevent forgetting something in the future.

Mamarn1216 · Sep 19, 2015

I definitely did not chart it's as being given. I know she had her surgery today and went to the ICU afterwards, which was expected. This patient is very well known to us because last time she a as with us for 3 months. We anticipated her going to ICU anyways.

I have come up with a plan to avoid this incident happening in the future, but I am concerned with the present. Thank you both immensely for your input.

Mamarn1216 · Sep 19, 2015

SSE. I wish it would've been added into the eMAR because then at least it's more obvious! Ours just shows up as z:Notify and then it's free text under the comments. I really appreciate everyone's help. I am even more upset because I found this out on my way to an interview for a postpartum unit. I got a job offer but they were going to check my references. One is a charge nurse and one is a coworker- both have said they will still put in a good word for me but I'm worried they'll call to speak with my current director and she'll tell them I'm on suspension and they'll rescind the offer. I'm so stressed this weekend!

anh06005, MSN, APRN, NP · Sep 19, 2015

Try not to worry. If the worst you do in your first year of nursing is forget an enema you're golden. The patient wasn't harmed. It was a mistake that humans make and, as far as I know, you are human

BuckyBadgerRN, ASN, RN · Sep 24, 2015

So it's escalated to you being suspended now?

SSE. I wish it would've been added into the eMAR because then at least it's more obvious! Ours just shows up as z:Notify and then it's free text under the comments. I really appreciate everyone's help. I am even more upset because I found this out on my way to an interview for a postpartum unit. I got a job offer but they were going to check my references. One is a charge nurse and one is a coworker- both have said they will still put in a good word for me but I'm worried they'll call to speak with my current director and she'll tell them I'm on suspension and they'll rescind the offer. I'm so stressed this weekend!

Melissavictoria90 · Feb 20, 2016

This scenerio should be taken as a learning experience in your nursing career. I understand that you are concerned about the repercussions of your error, but it doesn't seem like you are at all concerned about how your error negatively affected your patients health. This situation can happen to any one of us, but I hope you fully grasp the magnitude of your mistake. I am in no way shape or form trying to kick you while you are down, but medication errors such as these can be life threatening. Missing or overlooking newly perscribed or changes in medications could possibly land you in a courtroom with a malpractice lawsuit if the patient experiences suffering, injury or death due to your negligence. It can be as simple as a dosage change in an anticonvulsant medication that was overlooked and caused the pt to have a grand mal seizure resulting in death. An overlooked discontinuation of a antipsychotic medication. What if you gave the D/c'd medication and the elderly pt just happens to have a stroke later on in the evening. A missed change in the dose of Coumadin to be administered and critical PT/INR, your pt ends up having GI bleed during the next shift! Whose butt are they coming after, the nurse, charge nurse and MD. In this field, we ALWAYS have to consider the worst case scenerio when it comes to our patients in order to prevent an acute life threatening situation from occurring. No, we cannot prevent many of the unexpected changes in condition our patients experience, but we try like hell. That is our job and the responsibility we accepted when we took our oath. Your concern should be for your patients wellbeing at all times. How can your ensure your patients saftey and provide competent nursing care? Learn from this mistake and make the appropriate changes in the way you practice.