Multiple vaccine errors.

[lrkelso95]

I feel like the most inept, useless nurse to ever exist.

Today I made my 3rd med error ever. I've been an LPN for one year. My past two errors were incorrect dosages of flu vaccines, which is bad, but not particularly harmful. Today, I was supposed to give a child a meningitis shot and instead gave him MMR.

I don't like making excuses. All I can say is that I'm mentally at the end of my rope with this job. I'm the only support staff for a doctor who sees 25 patients daily. That doesn't include calling patients for test results, scheduling appointments, and everything else that comes up in between. He's a very demanding doctor, and the patient load is simply too much for one person. I get overwhelmed and mixed up, and inevitably do something wrong.

I haven't been written up yet, but an incident report has been filed. Everyone in my life says I shouldn't beat myself up over it, because errors are bound to happen when someone is as stressed as I am. But these are people's lives we're talking about, not a typo in an email. I just feel awful, like I shouldn't even be a nurse if I can't get my head screwed on straight. What should I do?

[NurseSpeedy, ADN, LPN, RN]

I agree that the 5 rights of Med administration will help to eliminate these types of errors. I will also say that 25 patients a day and one nurse to handle back office is insanity-hard to keep the 5 rights straight when you are being pulled in several different directions and probably reprimanded for going into OT if it occurs. When asked WHY the error occurred, it is probably simply because you are understaffed, unable to think clearly, and made a stupid but thankful not harmful mistake assuming the MMR vaccine is not an issue for this patient and they eventually get the right vaccine.

5 rights need to be followed but safe staffing is also needed to allow them to be practiced accurately and consistently.

[Jory, MSN, APRN, CNM]

If you have made three errors in one year, you are not practicing the five rights of medication. Not trying to be cruel, but if the first incident and the second didn't change your practices, don't blame it on the staffing. When it comes to medications, I wouldn't care if there were 100 people in the waiting room for two hours...that is your license on the line and that patient is counting on you. You need to block out what is going on and make sure it is correct.

[ruby_jane, BSN, RN]

SO -

In the flu vaccine errors, how were those vaccines stored? All together or were the pedi and adolescent vaccines separated?

The MMR vs Meningoccoccal - a child who is old enough to need a MCV4 usually doesn't need the MMR (BUT I have seen some wonky vaccine records).

If this is a storage issue: are the tubs that the vaccines are kept in labeled in big letters? I did that for my clinic so I could see.

Is someone routinely tasked with making sure only what's supposed to be in the MMR vaccine section is there? We did this in my clinic with inventory.

You know you need to do the five rights. But it sounds like you are being time pressured. Please help yourself by slowing down.