Peer Review at work...advice please!!

Nurses General Nursing

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I have been a nurse since January and working since February. Since then I have had 5 med errors since beginning my hospital job. Two errors that were administered to two patients but, fortunately, did not result in patient harm. The other three were errors that were caught by other nurses before administered. I don't want to go into alot of detail, obviously for privacy. I have been informed that for the time being, because of the 'trend' of mistakes, I am not allowed to give any meds and that I will go before a peer review in the near future. I was told the purpose for this was to determine if I can continue nursing, as in giving meds, or start fresh in another department, ect. But in my research, most of the time peer reviews are performed to decide if I will be reported to the BON for unsafe practice. Has anyone else experienced a similar situation? What can I expect? Will this be as brutal as I am expecting it to be?

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Specializes in ED, med-surg, peri op.

Where I work if you make 2 errors then you have to get all you medication double checked by another rn before administering them. Plus you have to complete a big work book too. It's a long process before you can actually give medications again as you normally would.

Med errors unfortunately happen all the time. I've made them, and 99% of nurses have. Especially if you counting med errors that were caught before giving them.

But to make five in such a short time, obviously there's something going on. Take this as a oppurtunity to learn from you mistake and improve your practice. Not as a time of being in trouble.You probably need a bit more help/education/practice. But I wouldn't worry about BON, you made two actual med errors that caused no harm. You'll be fine, as long as you learn from this.

Have a little faith in your employer too, they told what they were doing And have given you a chance to come back from this.

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The first thing you should do is go to your BON website and look at the things they deal with, and the things they discipline for. This should ease your mind regarding BON action, and allow you to focus on what really matters: The way you are practicing now is not safe. How can you learn the skills to safely practice as a nurse?

I catch a fair amount of errors others make. I catch myself about to make errors, and take corrective action. What I don't catch are (most of) the errors I actually make. This scares me, as like all nurses, and all humans, I am not immune from human error. While we know that medication errors are significant problem, there are no good studies that take into account all the un-caught errors. I suspect that the majority of errors are never caught.

Having 5 errors actually caught in this short time span means that something is very wrong.

I think you need to assume that the hospital is starting this process in good faith. If they wanted to fire you, they have ample cause. They don't need to go through some kind of charade to fire somebody who makes a lot of medication errors. You need to enter this process with the intention coming out the other side as a safe nurse.

It can be very hard to participate in this sort of thing without feeling defensive, but that is what you need to do. Don't minimize or justify your errors. Instead, stay focused on a process that will allow you to safely administer medications, and assume that your peer review has the same goal.

Good luck in this process. It could be the best thing that happens in your nursing carreer.

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Specializes in ICU/community health/school nursing.

Is there a pharmacology brush-up course you could take proactively? It is possible that the peer review will result in a recommendation that you do this; if you are proactive it will demonstrate that you see there is an issue and you are actively working to correct it. In TX the BON runs some of these courses, and you can check your BON website for details.

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hherrn, this is great advice. My supervisor went over the fact that I graduated with honors, 3.5GPA, excelled in clinicals (several of rotations were in this department) and she wondered where the disconnect is. I honestly don't have an answer to give her. I have been very forthcoming with the errors I have made, self reported, etc. I want to further my career to be an RN but this pattern of unsafe practice has me shook. I want to be a good nurse, a safe nurse. I want my patients and my co-workers to be able to trust me. I am thankful for my supervisor 'going to bat' for me...the hospital could have fired me but instead she knows I am trying to better my life for me and my kids and said she doesn't want these incidents to affect my career. This will be a difficult time but if it gets me to where I want to be then so be it. I am so thankful for the opportunity but I know it won't be easy.

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Is there a pharmacology brush-up course you could take proactively? It is possible that the peer review will result in a recommendation that you do this; if you are proactive it will demonstrate that you see there is an issue and you are actively working to correct it. In TX the BON runs some of these courses, and you can check your BON website for details.

I will look into this for sure and see what is available. Thank you for the advice.

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I found an online pharmacology certification course through NAPNES.ORG. I am looking into this.

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Specializes in School Nurse, past Med Surge.

Everyone makes med errors, but that's a lot in a short time frame. I would be prepared to - not justify your mistakes - but acknowledge them, be able to identify how the mistake occurred (which of the 5 rights did you miss?), and be able to identify what you would do/are doing differently now to prevent errors from happening again.

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Have you been able to find a common denominator with these errors (trying to work too fast, knowledg3 deficit, not paying attention etc?) If you can figure out the root of these errors, it gives you a direction to work in improving, which you can present to your peer panel to convince them you are in fact a safe nurse

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Hello brockclan3,

You don't have to answer/discuss unless you wish to, but I'm curious whether you received assistance as you were told you would after the Vanco fiasco. Although the Vanco itself had nothing to do with you, there was the separate aspect of having hooked up an IV without doing a proper medication administration process. I was pleased that you weren't crucified for that, but I thought they had a plan to help you. Has any of that happened?

I'm sorry you're going through this and second hherrn's comments.

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Specializes in Case Manager/Administrator.

I would go get my eyes checked out. Additionally I would read the order, then read it again. Think does this make sense?

I would also maybe get some feedback from the Pharmacy department as to how they send the orders up, how they write the orders out for the nurses, is it different form what you are use to, have a pharmacist take 5 mins and explain how the order is written to you of one of the medication errors that was made.

Look back at those med errors is there a common theme?? Common time of med error? Try real hard to find the etiology for this cannot continue. You sound like a bright nurse who really is trying hard. Sometimes when we get into difficulty, hope is almost not there, being positive for a solution and fix may open your mind up more.

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.... and she wondered where the disconnect is. I honestly don't have an answer to give her.

This is the concerning part. How can you learn from your mistakes if you don't know what lead to them?

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