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My first big med error

Nurses   (1,816 Views | 11 Replies)

737 Profile Views; 16 Posts

Hi guys, I’ve been a nurse for almost 4 years now and I recently made a med error which had got me feeling so horrible and questioning whether I should give up on nursing...

I recently went through several big life changes and haven’t been on top of my game lately. My dad died 6 months ago, and shortly after that a long term relationship ended, I left the hospital I had been at since a new grad, moved to a new city and started working at a large, busy, level one trauma center ICU. I wanted to take this job to gain more experience before applying to CRNA school. I’ve been at the new job for 3 months (including orientation) and feel overwhelmed probably 1/3 to 1/2 the time. And I’ve been anxious and depressed lately at baseline since my dad died and all these life changes happened. 

What happened was my patient was on TPN and an insulin gtt. The next bag of TPN had insulin added to it and I mistakenly thought the plan was to d/c the insulin gtt because it was now in the TPN. I had the drip off for 4 hours before I realized this was incorrect. I told my charge and the provider and restarted the drip. They were both very forgiving but I am so mad at myself, I want to cry. The patients BG was of course elevated due to this and a few changes were made for meds/doses to try to better control it. 

Im so angry with myself, I feel like a complete failure and am questioning my career aspirations. 

If I can’t handle this ICU, and mess up an insulin gtt, will I be a failure as a CRNA? Is 3 months here too soon to give up? What should I do? Please give me any advice you have!! Thank you so much!!

 

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LibraNurse27 has 5 years experience as a BSN, RN and specializes in Community Health, Med/Surg, ICU Stepdown.

220 Posts; 3,240 Profile Views

I understand insulin drips are serious it luckily it doesn’t sound like the patient suffered any long term consequences. I’m so sorry to hear about your dad and I can’t imagine returning to work after a life event like that. Does your new job have any sort of EAP or the possibility of bereavement leave to regroup? I know it must be harder to ask for leave when you are new but hopefully they will be understanding if you’re planning to stay in the job for a while. I hope your new job is a supportive environment and that you have a good support system outside of work as well. 

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Been there,done that has 33 years experience as a ASN, RN.

4 Followers; 6,256 Posts; 69,939 Profile Views

There is no single med error worth giving up your nursing career for.

"I’ve been anxious and depressed lately at baseline since my dad died and all these life changes happened. " I can feel that pain.  My dad died... I got a divorce ... it was hard to keep on in our care giving role. If you are still anxious and depressed... please seek  professional help. 

"I mistakenly thought the plan was to d/c the insulin gtt because it was now in the TPN." That is an error in judgement that may or may not, have anything to with your emotional state. You did not see an order to DC the insulin drip.

 Please take care of yourself . Grief  presents many challenges.

Best wishes.

 

 

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traumaRUs has 27 years experience as a MSN, APRN, CNS and specializes in Nephrology, Cardiology, ER, ICU.

165 Articles; 21,045 Posts; 194,069 Profile Views

The above posters have provided some very compassionate advice. Please ask for some help to deal with your grief. Take care. 

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CharleeFoxtrot has 7 years experience as a ADN, RN.

630 Posts; 8,297 Profile Views

12 hours ago, Been there,done that said:

There is no single med error worth giving up your nursing career for.

...

 Please take care of yourself . Grief  presents many challenges.

Best wishes.

 

 

Can't second or like this enough.

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ruby_jane has 10 years experience as a BSN, RN and specializes in ICU/community health/school nursing.

5 Followers; 2,790 Posts; 11,614 Profile Views

17 hours ago, jessica45 said:

 

If I can’t handle this ICU, and mess up an insulin gtt, will I be a failure as a CRNA? Is 3 months here too soon to give up? What should I do? Please give me any advice you have!! Thank you so much!!

 

You can handle the ICU. Unfortunately you started a new gig right as two of the most stressful life events occurred, making your total of stressful life events three - which would jack with any of us. 

You need a solid two years in the ICU before you can decide you can or cannot be a CRNA. One of the most important qualities in any nurse but especially in a CRNA is HUMILITY. And, for better or worse, mistakes keep us humble.

You owned up to your mistake, reported it, saw your patient safely through, and I guarantee this will never happen for you again. Do you have access to an EAP? If so, they may get you some solution-focused counseling for the other two stressful events.

Chin up! Onward!!

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StrokeAlert has 8 years experience as a ADN and specializes in Neurology/Med Surg/Telemetry Intermediate Care.

4 Posts; 747 Profile Views

First, I am so sorry that you're going through this.  I am so sorry to hear about your father's passing.  It is so hard to not let what is going on in our personally lives effect 

Second, we are ALL human! We make mistakes.  Its unfortunate and even more so in nursing.  It happens to all of us.  Please be kind to yourself.  Med errors are always so stressful, no matter how small. I'm sure we have all made errors, known or not.  It is going to happen so, I like to think what you do after the error is what really counts.  It sound to me like you responded wonderfully, informing all the appropriate people and first ensuring the patient's wellbeing.  I would use this as an opportunity to learn and grow.  What can you do to prevent it or something like it from happening again?  And please, take time for yourself if you need.  Its so important.  You can't pour from an empty cup.  Good luck!  I'll be thinking of you!

 

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humerusRN has 7 years experience.

100 Posts; 853 Profile Views

Better to not give enough insulin than to give too much insulin!!! ;)

Don't beat yourself up. You CAUGHT your error, you fixed your error, you did everything right. 

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HomeBound has 20 years experience and specializes in ED, ICU, Prehospital.

1 Follower; 255 Posts; 1,426 Profile Views

Yes to all of this advice.  You did something wrong. You caught it. You immediately acted, reported and quite clearly and most importantly, learned from it.

This isn't a mistake worth ending a career over, especially since you are professional, responsible and owned it.

3 months in an ICU? "Including orientation"?  Sweetheart. Please, even without all of the other life stressors you are experiencing, 3 months is barely out of orientation where I work. If you'd said 3 years...I'd be more critical. But you have a crap-ton of new concepts sitting in front of you.

Critical care, if you haven't guessed, is a true team sport. You need to be able to ask everyone and anyone for clarification, help, ideas, corrections and criticism. Calling and waking that resident up in the middle of the night should not even bother you in the least. You have a question or your patient looks wonky and your neck hairs are standing up?  Call for help. Anybody. Charge, the nurse next door. The resident. It's their job. Don't you ever feel stupid or inexperienced---you may just save somebody's life because of your "feeling that something isn't right". And, you may just learn...hey....that thing is normal. Now you know.

As for the personal things. I am so, so sorry. No one can act as armchair quarterback, but to me, because I experienced exactly the same things, all in succession like you have---

I was trying to exert some sort of control over my life by changing things when these "uncontrollable" things happened. My dad died. I got divorced. My personal life fell apart in a different way.

So I changed  everything.  Stopped the travel that I loved doing. Got a job at a place I didn't even research, just grabbed the job because it was (again, the similarities are eerie) Level 1 ER. Bought a house much too far from where I worked (because I convinced myself I couldn't afford anything closer. maybe that was a sign I shouldn't have been in the market to buy anything in the first place). The house was isolated and secluded.

It was what I thought I had to do to control my environment when these other things happened.

Grief is a strange thing. Don't do what I did. Don't keep changing things. It's hard to confront how you're feeling---it's overwhelming. Find a good therapist---someone outside of work. Trust me on that. 

But changing things and running around with too much on your plate is only going to make this less manageable.  Don't isolate yourself, please. Reach out to anyone you can trust and start examining how you are feeling over these  major life events.

Some people can't even handle ONE.  YOU are handling what....3?  4?  Simultaneously, and in a brand new critical care unit that you are pouring all of your care and skill into.

Time for some self care, dear. I don't advocate quitting the ICU job, if your eye is on the CRNA prize. This is a blip. You have learned to speak up and clarify if you have  any questions. RIGHT?  :)  Be that nurse. The one that calls and wakes that resident up when needed. The documenter. The stickler. Until you get a handle on ICU, just be the micromanager for your patient.

The other things---prioritizing what's important to get out of the way--divorce stuff, custody or child support issues---do them one at a time, and ask for as much help as you can get.

I never got over my dad's passing. I never will. And frankly? I don't think anybody ever gets over the death of a parent or a child. It does get easier over time--but finding ways to cope and deal--instead of pushing through by not thinking about it--isn't a winning strategy. Ask me how I know. Some days are easier. Some days, I actually pick up the phone to call him for advice.....and he passed in 2006.

I have a good cry now, remember things he's taught me and be thankful I had such a great dad.  You will come to this, but first you have to work through the emotions of his passing. Divorce is also a death. So you've gone thru two in a short period.

This is long.  I just couldn't read how you're struggling over this human error with all of the burden on your shoulders, and not say something.

Please reach out to as many people as you can. Don't beat yourself up, and don't quit. Don't isolate yourself.  It's hard and you'll cry  a lot, but you can make it through.

Good luck to you.

 

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TriciaJ has 39 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

14 Followers; 3,697 Posts; 38,371 Profile Views

On 3/7/2019 at 7:35 AM, StrokeAlert said:

 Med errors are always so stressful, no matter how small. I'm sure we have all made errors, known or not.  It is going to happen so, I like to think what you do after the error is what really counts. 

 

I agreed with the whole post, but this is the part that really stood out for me.  Amen to that.

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16 Posts; 737 Profile Views

UPDATE:

Thank you to everyone who replied. Your comments meant a lot.

I didn't give up, kept working hard, learned a lot, passed my CCRN test, applied to CRNA school and got in.  I start in the spring.

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CharleeFoxtrot has 7 years experience as a ADN, RN.

630 Posts; 8,297 Profile Views

Thank you, thank you thank you for updating and congratulations!

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