New nurse, Second Medication error, Scared

[Kaysonrose]

Hi I'm a new RN and I was recently hired at an acute setting in October 2010. In the past three months, I have made two medication errors and my DON told me the third one will be up for termination? After hearing this, I've been absolutely scared. I mean this is my first RN job and already I'm making medication errors.

First Drug Error: I didn't see the order for potassium and so the night nurse ended up giving it to the patient (4 hours late) but of course I was written up for that.

Second Drug Error: I forgot to give coumadin 2mg for maintenance (written by the pharmacy per protocol) and again I was written up for it.

I admit that I made the mistakes. I was just crushed because just when I thought I had been thorough with my work that day, I get a call from my DON telling me about the error. I'm feeling so frustrated with myself.

I don't want to lose my job. I'm new and I'm learning. I don't even know if they'll put me on probation or not or if there is such thing with medication errors. Will they terminate me if I somehow make another error after a year?

I don't know if I should start looking for another job. But lesson learned, I am NOT leaving that hospital without looking at the MAR and the Chart thoroughly from now on. I'm just feeling so traumatized because I now know I can't afford to make another mistake and so I have this pressure on my shoulders. Now I'm thinking, are they going to automatically terminate me if I make another error? Any advice to ease my stress?

[April, RN, BSN, RN]

if you give less than the prescribed does, is that also considered a medication error?

Yes. If you did not follow the 5 rights of medication administration, then it is a med error. Right patient, right med, right dose, right route, right time. Giving less than the prescribed dose means you did not give the right dose.

[lvnnars1]

Yes. If you did not follow the 5 rights of medication administration, then it is a med error. Right patient, right med, right dose, right route, right time. Giving less than the prescribed dose means you did not give the right dose.

ahh ok, but what if the doctor came in during your med pass and you didnt notice him walk in and he didnt flag out the new lowered dosage in the chart? isn't that an honest mistake?

[scibruin]

the doctor isn't giving the meds, and he isn't there to check up on you essentially he is there to see the patient.

they are ALL honest mistakes!! we never want to or purposely give meds wrong. honest or not med errors suck but they do happen for we are all human.

[CCL RN, RN]

Whoa! Now I'm more confused and curious!

The Unit Secretary can take your med chart and write down an order? What does THAT mean? And why is she doing that?

This does not sound like a good system. If people are adding stuff onto charts all the time, they should at least be TELLING YOU, ie: putting it down on the handover tape, or telling you face to face. No wonder you are missing things! You need to have a meeting with your NM I think - this does not sound like a safe system to me.

Also I meant to say, get a cheat sheet (or make one up) with the patient's names & room number down one side and times (each hour of work) up the top and list all your meds at those times, procedures to be done, etc. I highlight meds in red then cross them off after I'm done - that can help you as well.

This is why I check my MARs many, many times throughout the shift. Our unit clerk can toss a new med on my MAR without me knowing it. Sometimes she walks up to my desk and does it.

So you must Check those MARs all the time!

[sashalang]

...this happened to me when I first qualified. We work long hours and yes we get tired and distracted. On top of being a new nurse in a learning situation being observed and conscious of the fact people are watching you and looking for mistakes. Under these circumstances errors are even more likely to occur. Whilst all the above advice is good, I would also recommend taking steps to protect yourself. Feeling how you do with all this added pressure, go to occupational health and talk things through with them. It is a confidential service and they hear these type of problems every day. Write a reflective account about both errors, and any other problems you encounter. The best way is to e mail it to yourself as it will automatically be dated. This is recognised as evidence should you need it. Next join a union and talk to a union rep. about your present situation. You may wish to stick the job out or prefer to transfer somewhere else. With hindsight, I wish I had transferred somewhere else, and started fresh. I stuck it out and things got worse I nearly had a breakdown and left nursing for good. Eventually, I got a new position with wonderful support and a fantastic mentor and happy to say I am now an experienced nurse.

[SmilingBluEyes]

Erm the thread is 5 years old

[sashalang]

...lets hope these comments including mine will be of help to anyone else reading this...