My First Write Up

[gt4everpn, BSN, RN]

huh!!, hi everyone, i'm a new lpn grad working in the nrsghome for about 3months, i got my first write up yesterday!! you see i work at night, and usually the night nurse audits the md order book to the mar to verify the new med orders, so i audited and made sure that the orders in the md order book and the mar matched, but i missed 1 order and the patient did not get an additional 3mg of coumadin for 4 days!, until another night nurse caught it!! so the supervisior basically gave me a good yelling at plus a sympathetic pat on the back! she told me that i was doing well but this med error is unacceptable and so i was written up!!. the thing is i was building up my confidence and much of my anxiety as a new nurse was going away, now that this happened i feel that anxiety coming back!! i even know where i went wrong, i kinda rushed through the auditing that night because the shift was ending and i was working a double shift and had to get to the next unit!! i realize that i make mistakes when i rush and things get hectic. the supervisior had spoke to me before about other little things i forgot to do!! all in all its a learning lesson and the other nurses tell me its one big learning process, but its so scary, when things go wrong, no one cares about how inexperienced you are!! i just needed to vent!! my i's and t's will definitely be dotted and crossed after this!! thanks for listening!!

[underpaidrn]

huh!!, hi everyone, i'm a new lpn grad working in the nrsghome for about 3months, i got my first write up yesterday!! you see i work at night, and usually the night nurse audits the md order book to the mar to verify the new med orders, so i audited and made sure that the orders in the md order book and the mar matched, but i missed 1 order and the patient did not get an additional 3mg of coumadin for 4 days!, until another night nurse caught it!! so the supervisior basically gave me a good yelling at plus a sympathetic pat on the back! she told me that i was doing well but this med error is unacceptable and so i was written up!!. the thing is i was building up my confidence and much of my anxiety as a new nurse was going away, now that this happened i feel that anxiety coming back!! i even know where i went wrong, i kinda rushed through the auditing that night because the shift was ending and i was working a double shift and had to get to the next unit!! i realize that i make mistakes when i rush and things get hectic. the supervisior had spoke to me before about other little things i forgot to do!! all in all its a learning lesson and the other nurses tell me its one big learning process, but its so scary, when things go wrong, no one cares about how inexperienced you are!! i just needed to vent!! my i's and t's will definitely be dotted and crossed after this!! thanks for listening!!

hang in there. we've all had a chunk taken out of our back sides at one time or another. it's part of the learning process. i can almost guarantee that you will never make this mistake again. you learned from it. you're a good nurse, don't second guess yourself on this one. own up to the fact you goofed, and move on. i've made more boo-boos in my career than you probably ever will and my patients still survive! be kind to yourself. :icon_hug:

[CoffeeRTC, BSN, RN]

:yeahthat:

[RNDreamer]

don't beat yourself up. making this mistake and learning from it will help prevent you from making an even bigger mistake that could've have led to something tragic. i'm sure you are doing a great job....hang in there

huh!!, hi everyone, i'm a new lpn grad working in the nrsghome for about 3months, i got my first write up yesterday!! you see i work at night, and usually the night nurse audits the md order book to the mar to verify the new med orders, so i audited and made sure that the orders in the md order book and the mar matched, but i missed 1 order and the patient did not get an additional 3mg of coumadin for 4 days!, until another night nurse caught it!! so the supervisior basically gave me a good yelling at plus a sympathetic pat on the back! she told me that i was doing well but this med error is unacceptable and so i was written up!!. the thing is i was building up my confidence and much of my anxiety as a new nurse was going away, now that this happened i feel that anxiety coming back!! i even know where i went wrong, i kinda rushed through the auditing that night because the shift was ending and i was working a double shift and had to get to the next unit!! i realize that i make mistakes when i rush and things get hectic. the supervisior had spoke to me before about other little things i forgot to do!! all in all its a learning lesson and the other nurses tell me its one big learning process, but its so scary, when things go wrong, no one cares about how inexperienced you are!! i just needed to vent!! my i's and t's will definitely be dotted and crossed after this!! thanks for listening!!

[rn-jane]

We all make mistakes, please don't beat yourself up over this. You will take this and learn and grow but i know it makes you feel like crap right now. Your manager should be thinking a way as to why did it take 3 days for this mistake to be found and how can she make sure it doesn't happen again. We check charts every shift and do a 24 hour chart check on night shift so maybe you can suggest this when everything blows over. You doing a good job, you realize you've been rushing and know you need to take more time with things.

[leslie :-D]

you must be doing a lot of things right, if your confidence was building.

you're doing great.

i am more concerned with the new nurse who never makes mistakes.

all of these stumbling blocks are tremendous learning opportunities.

keep on moving forward.

it sounds like you work in a supportive environment.

you're going to shine.

leslie

[CHATSDALE]

coumadin usually given in afternoon, should have been caught sooner esp if this was not a new drug

agree with others, learn from your mistakes and you will be a good nurse

[GingerSue]

learn from mistakes

figure out ways to prevent them

No one should be yelling at you.

[4theBetterGetter, RN]

huh!!, hi everyone, i'm a new lpn grad working in the nrsghome for about 3months, i got my first write up yesterday!! you see i work at night, and usually the night nurse audits the md order book to the mar to verify the new med orders, so i audited and made sure that the orders in the md order book and the mar matched, but i missed 1 order and the patient did not get an additional 3mg of coumadin for 4 days!, until another night nurse caught it!! so the supervisior basically gave me a good yelling at plus a sympathetic pat on the back! she told me that i was doing well but this med error is unacceptable and so i was written up!!. the thing is i was building up my confidence and much of my anxiety as a new nurse was going away, now that this happened i feel that anxiety coming back!! i even know where i went wrong, i kinda rushed through the auditing that night because the shift was ending and i was working a double shift and had to get to the next unit!! i realize that i make mistakes when i rush and things get hectic. the supervisior had spoke to me before about other little things i forgot to do!! all in all its a learning lesson and the other nurses tell me its one big learning process, but its so scary, when things go wrong, no one cares about how inexperienced you are!! i just needed to vent!! my i's and t's will definitely be dotted and crossed after this!! thanks for listening!!

my question is ..who was supposed to be verifying the mars the other nights?? 4 days of missed doses......i agree with other posters...you have learned....we have all made mistakes. the only ones not makeing mistakes aren't doing anything. don't beat yourself up...lift yourself up!

[nyapa, RN]

You shouldn't have been yelled at.

I'm not quite sure what your employer is like, but you did mention the words "pat on the back", and that she said you were basically doing ok. And your colleagues have said that it is all one big learning curve. What's done is done. You can't change it. But if you have as much support as you are indicating, then you must be fairly good, hey? .

[TheCommuter, BSN, RN]

I work in LTC, and my facility takes Coumadin orders very seriously. After all, we've had a few elderly patients develop pulmonary embolism or DVT after a few days without their Coumadin. If the patient dies or is placed in jeopardy due to a missed Coumadin order, the facility can be fined thousands of dollars by the state. Also, you do not want a patient injury or death to linger within your conscience.

Take this write-up as a learning experience. Learn from it, continue to build your confidence as a nurse, and ensure that this type of mistake does not occur again. Coumadin is nothing to play with!

[deeDawntee, RN]

OK, I think this is bullcrap!! I would call this a "system" error of which you were a part. There should be a double check on MD orders, with 2 nurses checking and signing off on the orders. (Or a HUC and a nurse). But there should be 2 sets of eyes doing it. This is far too important to leave to 1 nurse on the night shift who is rushed to verify ALL the orders for the day... you've got to be kidding me??!! And then your manager had the BALLS to yell at you?? She had better turn her yelling back at herself and look at WHY the error happened to begin with. This is why a lot of med errors are never reported, it is because nurses are blamed and shamed and the underlying issues aren't addressed. Personally as a new grad nurse of only 3 months, I would have been very nervous to be the sole person responsible... I don't know what to tell you about how to address this but perhaps at some point you could ask her if they ever had 2 people sign off the MARS. How does it work at the end of the month? Does just one person verify the new MARS, or are they double checked? All the LTC facilities I worked at, always double checked all med orders...