Please Help, I'm new & made a huge med error, I'm devastated.

[MasonDixieChic]

I need some advice. I made a big med error today and I don't know what to do. I can't put into words the way I feel right now. So afraid, ashamed, embarrassed, discouraged. Here is what happened. I'm giving other information NOT because it is an excuse for me making such a blatant mistake, but just to give some insight into how I feel. Even before this, I've been feeling like I'm just not cut out to be on such a hectic unit. I know all nurses have hectic jobs but our floor is one that all float nurses and nurse assistants say they hate and tell me "good luck" once I tell them I'm a new RN on the floor. The other nurses are really great, its just so fast paced, its an ICU step down and in one day you can get several admissions and discharges. Even before today I felt like I was struggling just to keep my head above water. I had two months of orientation but looking back it was kind of like having a team mate to do the work with, so I didn't learn things from the perspective of a nurse working solo.

But Today I did the worst thing. I messed up, it was no ones fault but my own. Basically a patient was ordered to switch to a Lasix drip. When I started the drip, I entered the intended ml/hr into the mcg/kg/hr. I looked at the orders in the computer and remember thinking "double check" - and I **thought** that I had. The patient showed no signs of distress, and only when the bag was empty 3 hours later and I called for another and pharmacy said I had enough for the next shift did I realize that the drip was going at THREE TIMES the intended dose. My heart stopped and immediately I felt this feeling of doom. I immediately checked the patients' vitals, which were fine thank god then told the charge nurse. She (rightfully) freaked out and asked why I didn't have someone double check the rate. I thought we only needed certain drips checked and honestly did not realize. I called the doctor to let him know and filled out an incident report with the charge nurse. She said I was unsafe with patients and after this, I agree with her! I was under the impression I would be fired and was worried about my license. I have not been able to sleep or eat since this happened. I just found out that the patient has been fine in the last 12 hours since this happened and that he is okay. I am SO SO SO thankful that the patient is okay but just feel like such an idiot. I feel like I've worked so hard to become a nurse and apparently I'm not cut out for it. I'll be meeting with the supervisor, manager, and charge nurse in a couple of days (which I'm already so scared for and dredding) but am scheduled to work before then. I'm new and I honestly doubted that I even had a job after this, so when one of the other nurse managers emailed me telling me everything with the patient was fine and that she would see me for my regular shift on Monday I was surprised.

I'm scared to go back. I'm not only devastated to have made such a blatant and terrible mistake that could have been life altering for that patient, but I'm doubting my future and career as a nurse. Before this, my patients and colleges have had good things to say about me but now I feel like I'll always be known for this. I feel like i'll be walking around with a big X on my head. I could my patient serious harm! I honestly feel like resigning, but feel a weird mixture of having just disappointed everyone and yet like I would disappoint them more if I express interest in moving to a different unit with a slower pace. I just want to crawl into a hole. Help.

[AlaBro2010]

I've made a med error before. My colleagues told me that a good nurse reflects on their mistakes, learns, and never makes the same mistake again (versus someone who just says oh well). I've made a med error before and you bet I quadruple check now.

[Rose_Queen, BSN, MSN, RN]

Each and every nurse working at the bedside will most likely make a medication error at some point in their career. Those that say they haven't are either lying, never realized it, or are very new. Some of those medication errors will be benign (like giving a local without epinephrine when the surgeon's preference is with epinephrine) and others will be devastating, like the teenager who now needs a heart transplant because something intended for topical use was given subcutaneous.

What's important is what you learn from this: the however many medication rights we're up to now, getting a second set of eyes to verify drips, and what you will personally do to make sure this doesn't happen in the future. Should you be pulled into the office, make sure you have a plan for what you will do in the future. Going in and making excuses vs going in and having an action plan ready can mean the difference between losing your job, being disciplined, or other options (like being reassigned to another unit).

[kakamegamama]

Take a deep breath. Learn from this. You will be more careful in the future. Cut yourself some slack. I remember my first.....and only....medication error like it was yesterday. Why was it the only one? Because I double/triple check/confirm dosage with another nurse on "important" meds before giving. I learned, and I think you have too. I'm glad the patient is fine. Hang in there.

[iluvivt, BSN, RN]

Did you look the drug up in a good IV book such as Betty Gahart.If you had you woud have learned that Lasix is not dosed as mcg/kg.I suspect you did not do this or you did not use a smart pump.Do you have smart pumps and a good IV medication book? If you do not have access to a good IV medication book. ..run to get one with Gahart being the absolute best.You are too new not to look up every single IV drip you set up and then have an experienced RN check it for you.That is what you need to take from this.What I would have been worried about is the pts electrolytes, fluid balance,and BP.It will be OK but you must learn from this and begin to practice more safely.....use your resources!

[klone, MSN, RN]

I'm sorry your charge nurse responded the way she did. Her response was inappropriate, please realize that. Best of luck with the meeting.

[Karou]

I am glad the patient was okay.

Maybe this can lead to new safeguards for insulin drip administration. At my facility anything that requires two nurses will have a pop up and won't let you proceed with signing the EMAR until another nurse logs in and co signs. That's how we do insulin, TPN, heparin, blood, chemo agents, ect...

Perhaps your facility should implement something similar for insulin drips?

Most nurses I know admit to having made a med error. I have! One led to a change in policy hospital wide that will improve patient care.

I am glad you acknowledge your mistake and the severity of what happened. Be kind to yourself too. We are human. I hope this error leads to a policy change and that it's not purely punitive towards you.

[NurseMaybeBaby]

I disagree with you. This does NOT mean you aren't cut out to be a nurse. You made a mistake--and you will learn from it. You will never do anything like this again.

We ALL make mistakes. Everyone. Learn from it an move on. [emoji6]

[RiskManager]

I cannot endorse enough the comments above how everyone, sooner or later, makes a med error. It is what you learn from it and your ability to move forward that distinguishes the professional. I have done a lot of these meetings with the personnel involved in the error and I follow a just culture approach. From the leadership point of view, what I am looking for is if the staff member or the system committed or contributed to the error; does the staff member have the necessary insight as to his/her contribution to the error and accepts responsibility thereto; has the staff member thought about what happened and how this could have been prevented; and does the staff member have any ideas or suggestions as to how future errors of this type can be prevented or mitigated. A necessary part of these meeting is giving support to the staff member. As professionals, we have probably already been staring at the ceiling at 0230 beating ourselves up about it. Appropriate corrective action may need to be applied, but we can still respect everyone's dignity in doing so.

[SmilingBluEyes]

In my first year, I made what could have been a devastating med error. Had 2 patients with the same last name in rooms across the hall from each other. BOTH were on antibiotics for the same reason, one a sulfa drug and one not. The one patient was allergic to sulfa. Well you guessed it; I mixed the two up. Yep got in a big ole hurry and screwed up.

My heart fell to my feet and I felt faint. My legs felt like lead and I could barely stand. I stopped the infusion on the allergic patient and as calmly as I could asked her what her allergic reaction to sulfa was.

Thank GOD it was "nausea" which is not really an allergy, but a reaction. I felt so relieved I thought I might pass out.

Lesson learned; years later I am so much more careful to read and get those med rights correct.

The truth is, we will all make some kind of med error if we are at it long enough. Some early in our careers, which I consider "lucky" because it's something we will never forget. Thankfully, most are minor and bring no harm to the patient.

I feel for you; take what you can to learn from this. Go the meeting telling them you realize your error and have learned from it. Then hopefully, all will be ok.

But those who have been at this as long as I have (19 years) who say they never have made a mistake, either never work or are lying----or scariest still, have no clue they did so.

[Cola89]

Don't resign. Not yet. You made an error and it's good that you take that very seriously. Also good that your managers do also. Thank GOD the patient is alright and learn.

[AngryAngel]

Trust me I have been doing this for 43 years. Experience cannot be bought. You must live through it. I am an ENFP according to the MBTI. The perfect nurse is supposed to be an ENSP. where she does things by rote, and never is upset with anything that is repetitive.I hate repetitive tasks. So I drifted into the ED. It was hectic but within four hours they were discharged, admitted, or dead. After 4 hours the ICU was where they needed to go. I left the ED when we were unable to move patients that fast any more. So realize the wonder of Nursing is that there are hundreds of places you can serve. This position may not be the one for you. But never never get discouraged because you made an error. Years ago we buried our errors and they were not as investigated as they are now. That is a good thing as it does help enforce a more cognizant understanding of how errors are made. Yet they are made. One article about a generation ago admitted that every day in American hospitals over 250 people died due to med errors. That was equivalent to a 747 filled with people crashing every two days, killing all on board. That did prompt some changes, but again it is not something you need to be fried over. If you do not begin to see that we are people and not robots, that we can and will make mistakes. You will rest better at night. Errors are errors and should never be made, yet there are more then enough lawyers out there to keep things in check. Once I mixed up a IV bag with a liter of fluid and 40 meq of KCL in it. We did not have Iv pumps back then and I set the flow and when I came back to check on the patient his bag was empty. I too nearly fainted. According to everything I knew his heart would stop and he would be dead any minute. It didn't happen, and we all knew we needed IV pumps, but they did not become the norm for another 20 years. So check around their are many other things you can do in nursing, but you will never make this mistake again. Move on, the river has a current and you cannot fight it. Go with the flow. If this area is not to your liking and your skill set look elsewhere. But if it is just what you want then understand this is only one of many things you will do wrong in the future. You must accept you are human and not perfect. Do the best you can always, but your experience will one day be vast because of all the mistakes you will make. I hear the Chinese definition of a Master is one who started before you did. It makes a lot of sense. P.S. look into that MBTI on google and see where your personality brings you (16personalities.com). It was a revelation for me...