New nurse, first job, med error

[Tiramisu567]

I am a brand new LPN, got licensed in Feb, applied for first job in April, was hired and started in May. The job is in a LTC/rehab facility. I have been there less than 2 months and only work 3 days per week. Up until this week I've been on the same few halls on the rehab side with a max of 14 patients. On Sunday they threw me on a new hall on the LTC side with 32 patients I'd never had before (after I'd been told I wouldnt be floated for my first 90 days there). They nurses working the halls by me were helpful but they also said that was the hardest hall in the building. I ended up with 2 med errors that were found the next day, I missed a med pass for vicodin and I gave the wrong dose of norco to a different patient. (10/325 mg instead of 7.5/325 because she had both scheduled and PRN doses available). My question is how common is this? I have no idea what the 'punishment' will be or if it will affect my job. I feel terrible, but I was so ridiculously overwhelmed on that hall and have no idea why they'd think they could put me there! Another nurse who did orientation with me is STILL orienting to that unit while I've been on my own on the rehab side since 5 days prior to my start day. I feel like a crappy nurse already.

[Isitpossible, LPN, LVN]

oh please don't feel like a crappy nurse... we have all been there done that...!! learn and move on... its not a reflection of your nursing, its a reflection of being HUMAN and lack of experience on that unit...

[Morainey, BSN, RN]

Ugh, I had something similar happen to me. In addition to not knowing who ANY of those residents were, and trying to keep up with the narcotics and insulins for the med tech on THEIR side, I also didn't know that some of those sweet little grannies will scream in your face if she doesn't get her pills "on time". Hugs - you're not a bad nurse.

[HeyHeyitsMaay]

This happened to me when I was an agency nurse. When management is using wisdom, for QA purposes they won't put you in a position like this without either having the on call nurse by your side, a unit manager on site to monitor your progress and be available for questions, or another nurse working right a long side you to assist. It was poor judgment on the part of whoever did the scheduling, but as a nurse I want you to remember something that WE ALL forget because we're all Wonder Woman and we can do it all. :)

You can refuse an assignment in a polite, professional, non-confrontational way based on your concern that it might not be in your residents' best interests. You CAN ask for help, inform your direct supervisor that you're going to ask other nurses who have more experience where you've been assigned to change shifts with you, or otherwise make every effort on your part to let them know that your assignment is not a good idea. When (not if) it happens again, do exactly this and you'll thank yourself for it. Otherwise, you aren't a crappy nurse.

I learned to grab a sheet of plain white paper, go through my MAR to write out every single resident I was assigned who had blood sugars, every single resident with changes of condition, every single resident with odd med pass times or tube feeds. And keep that piece of paper to ensure that I didn't miss the stuff that could potentially turn into a problem. Maybe come up with a similar system to use in the future? And when (again..not IF) you make a mistake again, pull out your brain sheet or whatever you're using, take it to your supervisor and explain that this is what you do to avoid mistakes along with your 6 rights, and ask what you could've done differently so that your mistake didn't happen. Whether or not you received disciplinary action.

The problem isn't your mistakes at all. They are INEVITABLE!!! The potential problem is how you respond to and address them. You're doing better than you realize. Don't give up!!!

[TerpGal02, ASN]

Oh man I remember my first med error. It was probably a monthish or so ago. My first job was in the community, I packaged them for delivery and I could take all day if I wanted. Fast forward to now, passing meds to 20 pts on a full adult unit, 8 AM med pass. I had 2 pts with the sale first name. Well dontcha know it, I gave one of the pts the other's meds. I realized it as she was swallowing. It was like slow motion, "Noooooooo". So I radioed the charge that day, told her what happened. She called the doc, I did incident report. No harm to pt, no one ravingly mad at me. I felt like there was a black hole under my feet ready to swallow me up. I beat myself up, bad. All the nurses on that day told me what every nurse is told on making their first med error, "you're only human, we all make med errors and anyone that tells you otherwise is a liar"