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.
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.
Your cavalier attitude actually concerns me more than the fact that OP made a med error.
OP, it happened. It's not the first time someone has made an error in dose calculation, and it won't be the last. Now is the time for you to learn from your mistakes, and work with your supervisor to put in place checks to help everyone down the line (yourself included) avoid making the same mistake.
This is actually why incident reports need to be done; not to point fingers and assign blame, but to utilize critical thinking skills and make the environment as safe for the patient as possible.
Yes, be concerned, but don't beat yourself up. You'll become so afraid of making a mistake you'll be paralyzed and you won't be able to make ANY decisions regarding patient care. (OP, you can disregard the rest of this post; the message isn't directed at you and I don't want you feeling any worse than you already do).
Now, RNdynamic, it's your turn. It's "just lasix"?? Are you aware of the possible ramifications of an overdose of IV Lasix?
How does DVT (from severe hypovolemia) sound? Or hearing loss (Lasix is very ototoxic at high doses, especially when given IV).
Or, some of the more "garden variety" side effects, like electrolyte depletion, severe muscle cramps, seizures, etc?
I haven't worked in a hospital in 10 years; these are just side effects I remembered off the top of my head. I'm sure our acute and critical care colleagues have others.
So, you won't "kill anybody". But you have a better than good chance of making them miserable, and leaving them with irreversible sequellae. If that's what you're willing to settle for, you scare me.
Apologies for using something that sounds so cliche, but I think it is appropriate.
OP, you need to own this mistake instead of it owning you.
You realize that you made an error; now you can continue with your career and be a better nurse for it.
I remember a nurse on a committee about med errors saying she felt safer having a nurse who had made an error, handled it appropriately and learned from it. That nurse knows she is fallible and will likely be more cognizant of her practice.
OP, with this error, you join a multitude of nurses who have also made errors and gone on to lead satisfying and successful careers.
Your cavalier attitude actually concerns me more than the fact that OP made a med error.
OP, it happened. It's not the first time someone has made an error in dose calculation, and it won't be the last. Now is the time for you to learn from your mistakes, and work with your supervisor to put in place checks to help everyone down the line (yourself included) avoid making the same mistake.
This is actually why incident reports need to be done; not to point fingers and assign blame, but to utilize critical thinking skills and make the environment as safe for the patient as possible.
Yes, be concerned, but don't beat yourself up. You'll become so afraid of making a mistake you'll be paralyzed and you won't be able to make ANY decisions regarding patient care. (OP, you can disregard the rest of this post; the message isn't directed at you and I don't want you feeling any worse than you already do).
Now, RNdynamic, it's your turn. It's "just lasix"?? Are you aware of the possible ramifications of an overdose of IV Lasix?
How does DVT (from severe hypovolemia) sound? Or hearing loss (Lasix is very ototoxic at high doses, especially when given IV).
Or, some of the more "garden variety" side effects, like electrolyte depletion, severe muscle cramps, seizures, etc?
I haven't worked in a hospital in 10 years; these are just side effects I remembered off the top of my head. I'm sure our acute and critical care colleagues have others.
So, you won't "kill anybody". But you have a better than good chance of making them miserable, and leaving them with irreversible sequellae. If that's what you're willing to settle for, you scare me.
Simple and plain.
I agree with your post, 100%
I think RNdynamic is trying to get a rise out of people. She/he has other posts about doing "whip its" while being in a monitoring program and charting fake vital signs and assessments on patients....
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.
We've used them before, you can titrate for output & the steady infusion sometimes seems to work better for certain patients who don't respond that well to a push dose... Don't ask me why lol! I don't find it that common, though.
To the OP... We've all done it. It is what can only be described as a horrific feeling when you realize what you've done. Be kind to yourself. Learn. Move on.
ETA: sorry, I don't consider myself "experienced" with 3 of my 5 years of nursing in ICU! I only saw you asked for an experienced opinion after! Apologies.
I haven't had time to read through every post on this thread, but I just want to say, please don't quit due to this. Most, if not all, nurses have made mistakes. Also remember, a "good" facility will not finger point at you. They will perform a root cause analysis, to find out what systems in place could have prevented this from happening, and implement safety protocols to prevent it from happening to another nurse and patient. After all, we nurses are human and humans make mistakes! Your error can very well prevent a more serious one from happening and improve/implement better safety protocols. I know it's hard right now but hang in there!! You worked hard to get where you are now, - don't let this one event take that away from you.
Don't resign. As a nurse for 20 yrs 15 of which where pediatrics. The first thing all new grads realize when they start working on their own is you don't learn the important things in nursing school. You learn it with experience. And only with experience. I worked at a teaching pediatric hospital. I saw mistakes from every level. Attending, residents, nurses, nursing students, pharmacy. And of course we all make mistakes. At my hospital general care new grads got 8 weeks orientation. Many times more if needed. Experienced new hires 6 weeks. All critical care a minimum of 6 months.
During your review meeting be calm and open. Review your mistake and refect on what you should have done different. And what you will do different from now on. Learn and grow from your mistake. Let it make you a better nurse.
I've been a nurse a long time and when I was new I laid an oxygen tank on a bed with a humidifier attached, guess what, I gave my patient an nice nasal rinse as the humidifier water went through the tubing and up his nose. I was mortified. Now 20 years later every time I use portable oxygen and put it on the holder under a gurney I make sure there is no humidifier on. It will stay with you but in a good way.
I too have made med errors, as other's have said it you don't think you have you just didn't realize you made an error. Over the course of my practice we went from only putting IVs with meds on pumps to all IVs on pumps. We scan meds now and take out of a med dispensing machine. Vials of potassium used to be up on the units, now never. Lots of these practices have come to be because of past errors.
Do not even think of quitting. The hospital has invested in you and wants you to be successful. The patient is ok. Any reputable hospital will do a root cause analysis and you may see new protocols put in place because of your error. As others have said not allowing you to chart the med unless another RN does an independent double check and scans her badge may become a new practice.
Specializes in OR, Nursing Professional Development.
RNdynamic said:
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.
Side effects of Lasix overdose: dehydration, blood volume depletion, hypotension, electrolyte imbalance, hypokalemia, hypochloremic alkalosis. Hmm, what can happen with those side effects, especially the hypokalemia? Oh yeah, arrhythmias and death.
If you're this concerned about it, recognized and reported it, and followed appropriate channels - as a manager I would NOT be worried about you. Have some ideas to give your manager as to how to avoid repeating this error, then never do it again. I join the litany of experienced nurses who have made (at least) one med error. Mine was as a grad nurse, and my patient died. There were many system errors that contributed, and they were addressed so hopefully it never happened again. I did not think I would be able to continue as a nurse, but I did - I've been a nurse for 19 years since then. I never, ever forgot that feeling. I never will. The error isn't the problem - just make sure you learn from it.
Specializes in Cardiac,Progressive,Med-Surg,Hospice&Pal.
This is an opportunity also for the system to be look into...Do not fret take this as a learning experience most of the time mistakes happen when we rush and feels like we are running out of time especially for new nurses...focus on every task in front of you and again do not rush take time to think...it's okay multi tasking is a skill you learn over time..Cheer up...Reflect on what factors that contributed to this error and this will improve your nursing practice.
Specializes in Clinical Documentation Specialist, LTC.
((((HUGS)))) OP. Med. errors, especially when you're a brand new nurse, are devastating, no matter how minor. I remember the first med. error I made almost 20 years ago as a brand new nurse when I duplicated a BP med. on the same patient within 30 minutes of each other. I cried and called the doctor who actually laughed and said to just monitor vitals and let him know if there were any complications with the patient. Thank God the patient was fine.
The most recent was about a year ago when I was floating to a very fast paced pediatric clinic and gave an infant the wrong immunization. After I picked my heart up off the floor and dried my tears, I went straight to the ordering Pediatrician who commended me for being honest. The Pediatrician called the mother who was very understanding, and thank God the baby was fine.
All nurses working bedside have or will make a med. error in his/her career. Look at it as a teaching opportunity and move on from it. You will be fine :)
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Jensmom7, BSN, RN
1,907 Posts
Your cavalier attitude actually concerns me more than the fact that OP made a med error.
OP, it happened. It's not the first time someone has made an error in dose calculation, and it won't be the last. Now is the time for you to learn from your mistakes, and work with your supervisor to put in place checks to help everyone down the line (yourself included) avoid making the same mistake.
This is actually why incident reports need to be done; not to point fingers and assign blame, but to utilize critical thinking skills and make the environment as safe for the patient as possible.
Yes, be concerned, but don't beat yourself up. You'll become so afraid of making a mistake you'll be paralyzed and you won't be able to make ANY decisions regarding patient care. (OP, you can disregard the rest of this post; the message isn't directed at you and I don't want you feeling any worse than you already do).
Now, RNdynamic, it's your turn. It's "just lasix"?? Are you aware of the possible ramifications of an overdose of IV Lasix?
How does DVT (from severe hypovolemia) sound? Or hearing loss (Lasix is very ototoxic at high doses, especially when given IV).
Or, some of the more "garden variety" side effects, like electrolyte depletion, severe muscle cramps, seizures, etc?
I haven't worked in a hospital in 10 years; these are just side effects I remembered off the top of my head. I'm sure our acute and critical care colleagues have others.
So, you won't "kill anybody". But you have a better than good chance of making them miserable, and leaving them with irreversible sequellae. If that's what you're willing to settle for, you scare me.
Simple and plain.