Mistake on orientation..please help

  1. I am in my 7th week of orientation at my new job in ICU. I have a few years of experience but not in ICU. The other day as I was leaving, I gave a med that had been ordered that day, Tylenol Q8. Since it was a new order, the times for which it had been scheduled after the first dose were not moved for 8 hours from the first dose. So I tried to re-time them. However, I didn't notice that the rest of the times for administration had not been adjusted as well. When I gave report to the night nurse, I let her know about the new med but not the timing. The next morning, she tells me that I caused her to make a med error. Due to the fact that I moved only the first dose and not the others, she gave 2 doses Q6 instead of Q8. She said she filed a report about the incident. I felt horribly and have been kicking myself since..my preceptor brushed it off like it wasn't a big deal and said "it's only Tylenol and the patient wasn't harmed" but I am not the kind of person to make these kinds of mistakes and accept them. I can't imagine causing a patient harm as that is the opposite of my reason for becoming a nurse. I strive for excellence especially when it comes to my job.. I hate that that happened while I was orientation too. I have obviously learned from this but I can't seem to move past it. I don't want to lose my new job either..any advice is greatly appreciated..
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    About MommyRN89

    Joined: Sep '17; Posts: 15; Likes: 5

    36 Comments

  3. by   brillohead
    How did she give TWO doses Q6????
  4. by   babeinboots
    I'm sorry, maybe I'm not understanding clearly but I don't see how YOU made HER make a med error. Would it have been nice if you to fix all the times? Yes. Should you have let her know about the time situation in report? Sure. But in my opinion, if the MAR lists the correct time that the last dose was given and the order states Q8, then that's on her for not doing some simple math to ensure the correct time of the next dose.

    I feel like some nurses are relying too much on the computer and not using their own judgement. Maybe I'm just jaded but I always take report with a grain of salt and verify everything myself as needed throughout the shift.

    Don't take it personally and continue to focus on your orientation. That nurse needs to take responsibility for her actions. Congrats on the new job!
  5. by   MommyRN89
    I mean she gave the next two doses 6 hours apart instead of 8 since she said I moved the first but not the next dose so it came due on the MAR sooner rather than Q8
  6. by   MommyRN89
    Thank you for the words of encouragement..I guess her reasoning was that I shouldn't have changed the timing without letting her know so she knew what to look for. According to her, I set her up for failure by retiming a dose that made the rest of the doses' timing incorrect on the MAR..
  7. by   babeinboots
    Quote from MommyRN89
    Thank you for the words of encouragement..I guess her reasoning was that I shouldn't have changed the timing without letting her know so she knew what to look for. According to her, I set her up for failure by retiming a dose that made the rest of the doses' timing incorrect on the MAR..
    If we follow her reasoning then all nurses, everywhere are set for failure at all times, lol. I don't think I ever go through a shift without catching something that somehow got past several nurses and I'm sure those behind me catch things as well. It happens but her to blame you is not cool. If she would have simply did her 5 rights of med admin, it wouldn't have happened and that's on her and not you.
  8. by   cleback
    Quote from MommyRN89
    I mean she gave the next two doses 6 hours apart instead of 8 since she said I moved the first but not the next dose so it came due on the MAR sooner rather than Q8
    But wouldn't that mean just the first dose she gave a little early? Why would she then give the second dose after 6 hrs and not 8.

    Sometimes it seems we nurses get so caught up in trees that we miss the forest. This seems like one of those instances of picking at trees.
  9. by   CharleeFoxtrot
    *rolls eyes so hard she sees cerebellum* the oncoming RN needed to accept she effed up and stop throwing to throw the OP under the bus.
  10. by   NurseCard
    Quote from CharleeFoxtrot
    *rolls eyes so hard she sees cerebellum* the oncoming RN needed to accept she effed up and stop throwing to throw the OP under the bus.
    This. OP you can quit kicking yourself, you did very little if anything wrong.
  11. by   MommyRN89
    Thank you guys for being so encouraging. I found out more details about the report she filed. She stated that I moved the next dose to 9pm. I initially gave it at 12pm so next dose should have been around 8pm. I unfortunately can't remember if that is when I moved it to and since she gave it at 9 I can't see when it was moved too. And then the computer had the next dose timed for 3am so that's when she gave it. Yes the order still said Q8 so technically it should have been given at 5am. But this is how she's saying I caused the error..I just feel so bad. I'm new to this job and I already feel like I've made an enemy
  12. by   mtmkjr
    1200...2000...0400 (should have been)
    1200...2100...0300 (actual)
    Your facility might be different, but In ours, we have an hour before and after scheduled administration to be "on time". In this case, it's Tylenol and should be fine.
    I don't know where she gets the six-hour administration twice from?
    9 hours from 1st to 2nd
    6 hours from 2nd to 3rd
    Next dose would be day shift
  13. by   missmollie
    The order said Q8, the nurse gave the first dose an hour or so later than she should've, but continued with the 3 am dose despite the order of Q8. That's on her, not you.
  14. by   lrobinson5
    Quote from MommyRN89
    I guess her reasoning was that I shouldn't have changed the timing without letting her know so she knew what to look for. According to her, I set her up for failure by retiming a dose that made the rest of the doses' timing incorrect on the MAR..
    No, she is shifting blame on to you to try and cover up HER medication error. She has working eyes and a brain, she was just in a rush and/or not paying attention, which is not your fault. You would be surprised how many people blindly follow what the MAR time says, which is a VERY bad habit. Enoxaparin often will double dose someone because they receive a loading dose in the ED and a different daily recurring dose to follow up the day after. Sometimes it doesn't show up the day after, but instead shows up for that day. Antibiotics are sometimes given late, or they change the dose but the start time is way too early on the MAR and is a med error waiting to happen. Like it would be nice in the future to re-time it as a courtesy, but by no means was this your fault!

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