I keep identifying new ways to prevent them, but someting always slips through.
Most commonly, an order will say something like: Tylenol 325mg I-II tabs PO Q6h prn. I will only see the 325 and not the "1 to 2" part.
That's just an example. I have also missed a couple things outright. A few weeks ago I nearly gave the wrong heparin due to miscounting the zeroes... the patient would have got only a fraction of the dose.
A nurse at work has been on me about it, a bit overly so. Okay, a lot overly so. I feel like she's obsessed with everything I do. She has taken her concerns to our boss, and wasn't happy with her response so is taking it to the next higher boss now. Our direct supervisor is trying to help me but has advised me not to make even the tiniest mistake while I'm under such scrutiny, and yesterday, I made a mistake. She's fed up with me even though she agrees that my coworkers is overstepping her bounds.
In the past month I've made probably 4 real mistakes:
-one near underdose of heparin, caught by the other nurse
-one missed order which the MD did not flag (I was off the floor though on an ACLS run and left my patient in the care of another nurse for a while)
-one wrong route of an antibiotic.
-one antibiotic that didn't infuse, which I caught later and corrected, on an abnormally busy day... but it took me a long time to catch it
I have been trying SO hard not to mess anything up. I've become nearly obsessive compulsive, checking everything over and over throughout the day. Even after I've already seen it. And at the end of the day I check over every bit of paperwork and the patients themselves, with a second set of eyes to help me. But this overzealous nurse has written up, along with these errors which were true errors that needed to be adressed, about three times as many things that never happened. For example I had a detox patient with a high BP and she thought I never gave him his blood pressure medication. She asked him and he said nobody had given him any pills all day.
He also thought that something that had happened 4 hours ago, had happened "yesterday" (and this was day shift), that there were women in the bed near his, and that his walls and window were moving! Yet she is writing this up as an incident report, using sketchy circumstantial evidence to paint me in the most negative light possible. Even if most of them are false, enough write-ups and you look bad.
I can't afford to make a single mistake. Even non-mistakes are getting me in deep hot water. I am utterly desperate and trying my hardest to do everything perfectly, but I am in a job where neither of us are likely to be fired or transferred, and I can't quit.
Maybe I'm a terrible nurse for making these mistakes. All I can say is that I am doing my best. I am not stupid, careless, or lazy. For some reason I just keep messing up. And with this obsessive woman relentlessly breathing down my neck, it's so bad that I am losing confidence, losing sleep and losing weight from all the anxiety.
Can anyone help?
How do you prevent med errors?
Why do I keep making them? I've been a nurse for almost 3 years now.
How many med errors do you think each nurse makes on average anyway?
Am I just in the wrong career field? Should I not be a nurse?
