No nurse is going to answer this honestly but here it goes........

[c_beshore_rn]

I'm the sort of nurse that has flown by the seat of my pants for many years. My first priority is making sure my patient is cared for...I hate paper work!!! What do the rest of you consider "med errors"??? I know there are times in a shift when I've given an ABT 30 minutes late, I forgot to lower the fluids from 100 to 75, I haven't been able to get the 9pm meds out until 1030pm. These are all true "med errors" that I should be filling out incident reports for everytime......am I horrible for just giving the meds and going on with my night????

I understand that if I gave someone 10mg of Ativan instead of 10mg of Valium that'd be a biggy to call the Dr about. I also understand if Im 2 hours late hanging the pts Vanc- thats a biggy, it'll mess up the entire trough/ peak thing. I also understand if I give kayexelate through a urinary cath- I'm just retarded and should surrender my license ASAP!! (lol did anyone else read that??)

Since I moved to med/surg it seems time management is a huge issue. (I had 20 patients on psych and could break up brawls, talk folks off of ledges, teach groups, etc and not blink an eye) We do total care at our hosital most of the time and I usually have 4 or 5 patients (which isn't that much, I know). But when you have 2 crawling out of bed, 3 incont of bm and 1 of those are on a colonoscopy prep, 2 fresh surg., 1 screaming in pain etc etc.....4 patients can seem like a MILLION!! ANY SUGGESTIONS WOULD BE APPRECIATED!! My ADHD is kickin my rear and my conscience itches.:bowingpur

[cardiacRN2006, ADN, RN]

I just completed a 'how to prevent medication error' class online, it was useful..you can find various classes online..my class discussed different approaches on how to deal with med errors and some tips for nurses on how to avoid them

Not to be rude, but this isn't what the conversation is about. We know how to avoid med-errors. We don't need an online class to teach us why our med errors are happening.

We are talking about short staffing, poor ratios, and overworked nurses with too many sick pts. We are talking about the impossibility of doing the job perfectly and on time due to the position that our workplace puts us in.

No online class needed for that. Better management, fewer ratios, more nurses, and appropriate assignments would be a start...

[JomoNurse]

i was trained by NPs for my RN. they always told me to use my best judgement. for example, realizing you're running an IV at 80 ml/hr when it should be 100 ml/hr and then correcting, truly isn't that big of a deal. simply adjust the rate and go about your business. there are much, and i mean much, bigger fish to fry.

also, if mr. smith gets his multivitamin at 2300 instead of 2100, it's not the end of the world. i think the longer you've been a nurse, the more relaxed you become. use your best nursing judgement.

[VivaLasViejas, ASN, RN]

Not to be rude, but this isn't what the conversation is about. We know how to avoid med-errors. We don't need an online class to teach us why our med errors are happening.

We are talking about short staffing, poor ratios, and overworked nurses with too many sick pts. We are talking about the impossibility of doing the job perfectly and on time due to the position that our workplace puts us in.

No online class needed for that. Better management, fewer ratios, more nurses, and appropriate assignments would be a start...

:yelclap::yeahthat::tku::clphnds:

[JomoNurse]

I also wanted to add another thing. I've been in management before, and while "incidident reports" are used to improve quality of care, they are absolutely used against you. If, for some reason, down the road you do something, they have it on file and use it as leverage to get rid of you. Management does a lot of brainwashing... "oh, don't worry, we just use it to improve our care!" That mostly bull caca.

On several occasions I have found the wrong IV fluid running during my chart checks. I don't report them. The patient is fine. The world is fine. I simply change the bag out and go about my business.

[truern]

:yelclap::yeahthat::tku::clphnds:

O/T, but I love your pic! It looks just like I imagined you to look

[truern]

We use the new med system where we have to scan the med, scan the pt id, scan our badge...and on every danged new admission when I go to give their meds the little pop-up comes up that "this med is two hours late"....well, yeah...because I've been taking care of the patient and pharmacy timed it at some ridiculous time. Do I write up those "med errors"?? No.

Our system has some way to enter that a med wasn't given (maybe the pt was off the floor or whatever) and when you give it later there's a huge torturous mess you have to go thru to give it. I never go thru all that. I just give it when I can and let the pop-up tell me what I already know: it's late. If TPTB would only make the system less difficult we'd all be happier!

[LEN-RN]

No I dont write anything up when its late. Things happen that cant be controlled.

I worked with a nurse who was a buttkisser. She was always reporting herself. She wrote up when she forgot to give a VITAMIN C. I am not kidding. And she faxed it to the doctor.

[c_beshore_rn]

WOW guys thanks....I feel so much better. I was beginning to think med/surg wasn't for me because its so chaotic. Nurses that have done it for years just seem to float through without a crease in their brow. I go home in tears about one morning a month because I just can't seem to get it all done. I feel better now. I think I'm just going to do the best I can and if that d-a-m-n-e-d vit c tablet is 3 hours late----who gives a ****!! Maybe that why the seasoned nurses look so relaxed: They quit sweating the small stuff years ago!!

Mucho thanks

[LEN-RN]

I assumed no other nurse would admit to making med errors they didn't report. And I probably give too much personal info on my profile to be admitting to such things.

LOL. please protect yourself;)