Published Jan 28, 2014
newgrad1988
23 Posts
I am a brand new RN and just started my first job. Unfortunately in my first week I made a med error. Thankfully the patient was ok and I got everything taken care of that I needed to. The next day I worked I gave a patient metoprolol succinate that had parameters to hold if the pulse was less than 50. His pulse was in the 70's but his sbp was 114. I decided to give the med due to his pulse being well within the parameters and not having any bps parameters. I don't know if it's because I'm new or just my personality or because I already have a had a med error, but I've been stewing over the fact that his bp really wasn't high and now I'm questioning whether or not I should have actually given him the med. has anyone else been in this situation before? I'd love some advice on what you would do.
LadyFree28, BSN, LPN, RN
8,429 Posts
There are plenty of nurses who have been in your situation, including myself; best thing to do is being aware-if you need to triple check, do so ; ask questions when in doubt-get the charge nurse or a seasoned nurse and bounce the question off of, or call the physician; and learn to let the mistake go enough to have the lesson learned, and NOT make you want to throw in the towel.
You are doing fine.
cassie77775
175 Posts
The best you can do is check your parameters and if unsure, clarify with your charge nurse. We have had patients with standing orders of a very high dose of insulin, no matter her blood sugar. I gave her I believe it was 90 units and her blood sugar was just 130. I clarified with my charge nurse, even called the Dr to make sure he wanted us to give her that much. And he did. And her blood sugar didn't bottom out. Some Dr's know their patient's reactions to certain meds really well and can help guide you if you are unsure.
nursejami
37 Posts
Re: the metoprolol, why was his blood pressure in such a good range? Was it because his BP meds were keeping him there? :) How does he trend? Also, you always want to look at the history. WHY is he taking the metoprolol? For BP management, HR management, CHF management? That BP doesn't really worry me at all. But these are definitely the questions that kept me up at night after work when I was a new grad. Keep your head up! It gets better! :)
hospiRN
13 Posts
Oh girl you sound just like me when I started. As a new grad, you will question everything you do...I know everyone says it gets better, and you may think pffft, not for me...but it will I promise. If the area you are in still gives you anxiety after a while, maybe its not your niche, and you should open up your options. I switched from hospital to hospice after dealing with an incredible amount of anxiety related to night shift, floating, and just everything related to hospital and it has been the best decision I have ever made. Hospice is my niche. I hope I don't ever have to do anything else.
naptimeRN
188 Posts
You will become way more comfortable as time and your experience progresses (but not too comfortable where you don't critically think still, of course). You will still face anxiety in nursing, even 10 years down the road, because it's just one of those jobs where no day, moment, patient, diagnosis, medication effects, etc are ever exactly the same! I still have nights that I come home and wake up in a panic about something. But it has greatly decreased over time. Don't worry, it gets better once you gain experience. Never hesitate to ask more experienced coworkers questions. That is how you learn!
Ruby Vee, BSN
17 Articles; 14,036 Posts
Welcome to nursing. Everyone makes a med error at one time. So welcome to the club! I've made some doozies!
Was your patient's blood pressure so well controlled BECAUSE of his metoprolol? What was he taking for BP control? Why was he taking the metop? On my unit, everyone gets metop unless their blood pressure is
iPink, BSN, RN
1,414 Posts
You were good in giving the Metoprolol with that BP and HR.
Sometimes it takes a med error the first time to make us more aware and diligent so we don't make the same mistake. Also sometimes MDs won't enter a parameter but if sbp is
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