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.
Stupid question, but I'm an ER nurse and have never hung a lasix gtt- is this routinely done? What is the advantage of a lasix gtt vs IVP every few hours? Is it titratable? What situations do you use a gtt for and why instead of IVP scheduled? Maybe one of the experienced ICU nurses can answer for me?
Sorry, didn't mean to hijack your post, but maybe my questions can help you realize what you should be asking yourself and have answers to before giving a medication. We all make mistakes. Learn from it, take responsibility for the mistake when meeting with supervisors and how you will prevent further med orders. Learn the protocols for all drugs administered in your facility- can't ever go wrong following protocol.
There was a recent post about med errors on this site and there were many people who shared their med error stories. Point being, the majority of us will make a mistake at one point in their career.
The noble nurse will own up to their mistake, as embarrassing and difficult and frightening as it my be. I made a big medication error during my first year as a nurse and I felt all the feelings that you described. I thought that I would forever be known as the stupid girl who made the medication mistake. But life goes on and the incident is a distant memory for others. But it will be a lifelong lesson for you. You will learn and grow from this.
I am proud that I owned up to my mistake. I could have easily hidden it but I could not live with myself if I did.
I'm very glad you posted, and I hope that you have alleviated your anxiety and embarrassment so that you can begin the process of learning from your mistake. I've made a few errors in my relatively short career--never the same one twice!--but just remember the patient is all right. That's the most important thing.
I've been a nurse for almost five years, and yesterday morning, I had a good cry over something that happened with a patient on Friday. It wasn't technically a med error, but rather it was an appropriate medication order that became inappropriate when the surgeon diagnosed a complication. I knew what the med's major side effect was, and I understood the complication, but I just didn't put 2+2 together, and I gave another dose of the med. Found out the med was d/c'd 2 hours after my shift was over, but the pt went to emergency surgery anyway in the wee hours of the night. If only I had said, "Hey doc, you might want to d/c this med..."
I didn't mean mean to hijack your thread, but I do want you to know that I know how awful you feel and how it can tear us up sometimes. (((Hugs)))
My dear nurse friend...of course you still have your job. The manager who "freaked-out" was inappropriate. Do 3 checks very quickly before pushing a med and make yourself do your 3 checks when you set up a pump. When I am tired or things are crazy I do 5 quick checks. The pt. will be all right. My eyes are always moving quickly from vial to pump settings to bag to label to pt. (at noc all little old grannies look the same in dim light). I walk out of the room pretty comfortable that my "rights" are ...well...right. Now, my concern.is for YOU dear one. Don't let this trauma burn you. A few months from now you will see how you have grown in your practice and as a person. Take Care, Empathetic Nurse
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. Help.
No, you shouldn't be worried about losing your license. DId you make a mistake, Yes. But each and every one of us who has practiced nursing for more than a minute has made a mistake. Thankfully, your patient is fine and years from now, you will be able to share this story with another nurse who is equally upset about an error he or she just made.
Specializes in EMT since 92, Paramedic since 97, RN and PHRN 2021.
Will you make this mistake again, I'd bet a million bucks no: and that's life. Fortunately for the patient and you it wasn't heparin(like happened to me once, and caught before anything bad).
Live and learn. You will grow from this experience.
We've all made errors before because - news flash - we're human! Every time a mistake is made, use it as a learning experience instead of something to beat yourself up over. When I was finishing a clinical in the OR back in nursing school, I accidentally pulled out a patient's peripheral IV while helping to transfer from table to cot by not noticing the line was wrapped around some equipment. Fast forward years later, and IV lines are some of the first things I check before moving a patient.
You learn from mistakes every day - it's one of the many ways you develop as a nurse.
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!
Gotta give love to Gahart - that book has saved my butt more times than I care to think about (and not that expensive either).
I am sorry you are going through this!! As others have said, all nurses have made mistakes. I made a mistake with a heparin drip once, thankfully the patient was fine. Hugs!
I agree with so many others that you are not alone in making mistakes. The only nurse who has never made a mistake is a nurse who has never worked bedside! Think of all the things you did right. First off, you took error seriously. Second, you cared enough about the well being of the patient that you reported it to the proper people and didn't try to cover it up. You have integrity and honesty, and I'm sure your managers find that valuable. As others said, know where you went wrong and have an action plan ready to fix it. In general, facilities are trying to get away from taking punitive measures with med errors because they want people to report them. And when in doubt - ask someone. I have been a nurse a few years and still ask when I'm not 100% sure. If anyone thinks it is dumb you ask questions, then they are clearly the dumb one.
Don't resign! Every nurse makes mistakes, especially when in a hurry. Go to the meeting with the manager and talk it out. Discuss how you could prevent this in the future. Clarify which drips need a double check (and when in doubt for any drip, double check if you're unsure of the setup).
Do you scan your meds? If so, why did the computer did not prompt you to have another nurse double sign off if that is required? I would ask if a safety measure such as this could be put in place.
What do you do to cope with stress and relax? Maybe read a book, take a bubble bath? Take a deep breath and try to relax.
Uhm, it's just lasix. You aren't going to kill anybody with lasix. Relax. It isn't as if you overdosed them with IV digoxin. Don't make a mountain out of a molehill.
ED Nurse, RN
369 Posts
Stupid question, but I'm an ER nurse and have never hung a lasix gtt- is this routinely done? What is the advantage of a lasix gtt vs IVP every few hours? Is it titratable? What situations do you use a gtt for and why instead of IVP scheduled? Maybe one of the experienced ICU nurses can answer for me?
Sorry, didn't mean to hijack your post, but maybe my questions can help you realize what you should be asking yourself and have answers to before giving a medication. We all make mistakes. Learn from it, take responsibility for the mistake when meeting with supervisors and how you will prevent further med orders. Learn the protocols for all drugs administered in your facility- can't ever go wrong following protocol.