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.
I can't thank everyone who took the time to read about my situation and post such thoughtful responses enough. I was shocked at the amount of and quality of the responses. Saturday was one of the worst days for me, and reading through all the responses from both new and experienced nurses made me see that this experience (as horrible as it was/is) will not define my entire career as a nurse, and that I can become better for it.
I did have a meeting with my charge nurse and nurse manager. I explained that I made the error, which there is no excuse for. I told her that I was, essentially, devastated that my error could have lead to serious implications for the patient and that when I found out she was okay, really thought about what factors lead me to make such a mistake. I'm not going to lie, I got emotional and shed some tears during part of the meeting, but I was being honest and really made it clear that I never want to feel that I've put a patient at risk ever again and would do whatever it takes to grow from this.
My manager reiterated the seriousness of the error and as per our hospital policy, the meeting served as a "verbal discussion and response" to the incident. I'm on a mandatory 2 month probationary period and have to check all IV drips with the charge nurse (I'm happy with that, but I"ll expand on that later). At the end she told me about a med error she made as a new nurse, and said what many of you posted; that good nurses learn from their mistakes, are extremely careful after, and move forward. She told me she believed I have the foundation to become a great nurse and not to let this make me jittery and scared around patients, but to focus on the task at hand, and to always ask questions and get a set of second (or third and fourth if needed) eyes.
I walked out being happy it was over (it sucked feeling like that meeting was hanging over my head) and feeling like I can move forward and be not only allowed to take the time I need to learn, but expected to question everything that is new to me (which is a lot). Does it kind of burn to be on a "probationary period"? Yes. But, I now I feel like there are so many people I can go to then I am not 100% sure about something. I did not feel this way before, which I realize now was when I should have said something. Giving medication correctly and safely aside, before this event I felt like I needed to be able to get things done in the time schedule that the other nurses did. I was so overwhelmed and felt so alone, and like I was such an idiot and that I was suppose to have learned how to do a lot of this stuff in school. (Of course I knew that you should always ask when you were not 100% sure, but in the midst of a million things going on and a hundred things being asked of you at once, I didn't feel like I could press the breaks, stop everything, and get the charge nurse to answer questions I had (ex. is there a policy on the amount of time a patient needs to be off BiPap after breathing or is this left up to the doctor or respiratory therapists discretion? OR do you need to clamp the foley before a patient goes down for certain renal tests? --- these are random and not 100% accurate examples I can think of now, but I hope you catch my drift). Now, I'm expected to ask a million questions and will meet with my manager weekly to go over progress.
Of course I wish this hadn't happened, putting a patient at risk is the opposite of what it means to be a good nurse. But I do think good will come out of this. I know I will always be extremely vigilant when it comes to medications and patient care, and I feel like I'm getting the support I really need as a new grad.
Thank you again to everyone who shared their stories and gave advice. It made me realize I was not alone and that I can work hard, be diligent, and become the nurse I want to be.
Specializes in Certified Med/Surg tele, and other stuff.
I'm sorry you feel bad. It has become easier at the years pass to make med errors due to the pace of the floor, the complexity of the patient and staffing. Toss in mg/hr and mcg/hr, screaming phones, call lights and it's a recipe for disaster.
Get over it and move on. Everyone makes med errors and if they say they never have, then they are lying.
You will be a better nurse because of this. (((hugs)))
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?
In my area, lasix drips aren't unheard of. I work in a pediatric heart center. Our patients often require a LOT of diuresis, but sometimes their tiny bodies cant handle the scheduled IVP dosing without significant swings in blood pressure. Not ideal when sometimes your diastolics are barely staying above 30 to begin with. So they might end up on a gtt instead so that we can agressively pull fluid off without the swings in blood pressure.
I am told that studies dont show a significant difference in total output with equivalent gtt vs. IVP dosing, although I suppose there are some patients that one can work better than the other for.
OP Thanks for the update! So glad that your meeting went ok. And yes a probationary period can feel like it is a burn, but it is an investment in your future, and what it can do is get some amazing mentors in place for you.
For anybody who says that NETY is the norm - this thread is proof that it is not. 1 unrefined coworker vs dozens of positive responses from allnurses members + backup of management. Win!
keep your head up! Making a med error is hands down the worst feeling in the world. My stomach hurt just reading this because it took me back to how I felt when I made my big med error. I felt the exact same as you are feeling now. Yor charge nurse sounds like a real B.. My charge, CNS, Managers and fellow nurses al came to me and told me about their med errors to be supportive because they knew how upset I was. If it wasn't for that I probably would have quit too. The way you are feeling shows you are a good nurse, the ones who make excuses and brush it off like it's not a big deal are the ones to worry about. If you do leave that unit, let it be because you want to work with a supportive team, not because you don't think you are cut out for it.
You are not the error and the error doesn't define you.
In my opinion, the best provider to have is the one who *has* made a serious error for it is that person who truly knows how easily errors can happen and who has generally developed personal strategies to ensure that they don't happen again.
I work @ a teaching hospital, we all are run crazy, we all make mistakes, we all learn from our own & your mistake too. I am so sorry this has happened to you & your pt. Be a professional, meet with everyone, if they do not give you a 2nd chance it will be their loss. You will now be that super diligent nurse that will double & triple check all of your med orders! Where I work, we now have a computer program where we scan the med & the pt, if it is the wrong drug, dosage or pt it will tell you. Best thing ever invented in nursing. I thank the IT department every day that I have to given meds.Hang in there, its a hard job but very rewarding.
MasonDixieChic
6 Posts
UPDATE:
I can't thank everyone who took the time to read about my situation and post such thoughtful responses enough. I was shocked at the amount of and quality of the responses. Saturday was one of the worst days for me, and reading through all the responses from both new and experienced nurses made me see that this experience (as horrible as it was/is) will not define my entire career as a nurse, and that I can become better for it.
I did have a meeting with my charge nurse and nurse manager. I explained that I made the error, which there is no excuse for. I told her that I was, essentially, devastated that my error could have lead to serious implications for the patient and that when I found out she was okay, really thought about what factors lead me to make such a mistake. I'm not going to lie, I got emotional and shed some tears during part of the meeting, but I was being honest and really made it clear that I never want to feel that I've put a patient at risk ever again and would do whatever it takes to grow from this.
My manager reiterated the seriousness of the error and as per our hospital policy, the meeting served as a "verbal discussion and response" to the incident. I'm on a mandatory 2 month probationary period and have to check all IV drips with the charge nurse (I'm happy with that, but I"ll expand on that later). At the end she told me about a med error she made as a new nurse, and said what many of you posted; that good nurses learn from their mistakes, are extremely careful after, and move forward. She told me she believed I have the foundation to become a great nurse and not to let this make me jittery and scared around patients, but to focus on the task at hand, and to always ask questions and get a set of second (or third and fourth if needed) eyes.
I walked out being happy it was over (it sucked feeling like that meeting was hanging over my head) and feeling like I can move forward and be not only allowed to take the time I need to learn, but expected to question everything that is new to me (which is a lot). Does it kind of burn to be on a "probationary period"? Yes. But, I now I feel like there are so many people I can go to then I am not 100% sure about something. I did not feel this way before, which I realize now was when I should have said something. Giving medication correctly and safely aside, before this event I felt like I needed to be able to get things done in the time schedule that the other nurses did. I was so overwhelmed and felt so alone, and like I was such an idiot and that I was suppose to have learned how to do a lot of this stuff in school. (Of course I knew that you should always ask when you were not 100% sure, but in the midst of a million things going on and a hundred things being asked of you at once, I didn't feel like I could press the breaks, stop everything, and get the charge nurse to answer questions I had (ex. is there a policy on the amount of time a patient needs to be off BiPap after breathing or is this left up to the doctor or respiratory therapists discretion? OR do you need to clamp the foley before a patient goes down for certain renal tests? --- these are random and not 100% accurate examples I can think of now, but I hope you catch my drift). Now, I'm expected to ask a million questions and will meet with my manager weekly to go over progress.
Of course I wish this hadn't happened, putting a patient at risk is the opposite of what it means to be a good nurse. But I do think good will come out of this. I know I will always be extremely vigilant when it comes to medications and patient care, and I feel like I'm getting the support I really need as a new grad.
Thank you again to everyone who shared their stories and gave advice. It made me realize I was not alone and that I can work hard, be diligent, and become the nurse I want to be.