My first med error... Yikes!

[RiverNurse]

Hi all,

So, I've been a nurse for 3.5 yrs now. I guess it was bound to happen??? How could I have been so stupid?

Synopsis: Working midnight til 8 am... No nursing assistants on the floor so we are doing total care, charting the initial assessments for LPNs and so, are obviously short staffed.

I hang an IVPB of Fortaz right before shift change. It's infusing, but it doesn't look right... it just doesn't register with me... However, it is the right patient, right time, right med and right dose. So, I check on it again, it's infusing - so I give report, let the day shift nurse know it's infusing and I go home.

Two days later my manager wants to talk to me. She says there has been a med error. The primary fluids were hanging above the IVPB. So, I get written up.

GEESH! How could I have been so stupid? :banghead::banghead:

Once I collect my thoughts and stop internally freaking out about making this type of mistake after having been on the floor for so long, I asked her what the final outcome/resolution was. She said, "I don't know, yet. I have to finish my investigation." I paused, then said, "Well, I was talking about the patient. Is he okay? What type of negative impact did this have on him? How adversely did this affect him?" She said, "I don't know. He's been discharged for two days."

Tomorrow is another day... ;-)

Rivernurse

[tokmom, BSN, RN]

Even your nurse manager has made a med error. I used to work with this one LPN that had been a nurse for a million years. She swore she never had made a med error...Oh bull!!! She did, but just never was ratted out or never realized it.

It was on a pump, and it got infused, right?

[DavidKarl]

For what reason, or motivation, I'm unsure. But nurses, unlike most other professions that 'draw their wagons into a circle' to protect their own...DO NOT. They attack, connive and scheme against each other. Constantly. It's a well-known fact, yet never have I heard a theory to explain it. And more likely than not, if we speak honestly- it's the least competent, and laziest, and least compassionate nurses that seem to want to raise the most hell, am I right?