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.
Specializes in Psych., Rehabilitation, Developmental Di.
Well Ms. Mason Dixie, I want to welcome you to the world of nursing. Just so you know, all nurses have made med errors mm inclyding yours truly. Goung in front of the Board of Nursing isn't fun, its nit suooised to be. In my case my lucense was sanctioned, probation. Here's the deal, errors happen thousands of times a day. You are already on the right track. You have accepted responsibility for the error. Get iff if the "I feel just horrible" bus. It dies nit serve yiyr purpose. Feel bad, every nurse despises med errors. Don't carry the burden, let it go, and move on. You have a long fulfilling career ahead. I don't think aspiring nurses realize that we've chosen a dangerous field of study. We "practice". They say practice makes perfect but, not in nursing. There are no perfect nurses, we are all human. To err is human. Move forward. Do what needs to be done to insure you don't make the error again, period. You attract what you think, remember that. If you think error, guess what, you error.
I wush you all the best. You'll regret mistakes, you won't regret being a nurse. Sincerely, Joe A.
It is great to see the support that nurses offer other nurses, especially those nurses with years and levels of experience who acknowledge the realities. With that said, in my limited experience, the health care system is a set up for failure and needless stress. Stress is going to be there if only because of the nature of caring for people, but needless stress is not only a waste but it takes competent and caring people to places that get in the way of their practice. The comments by nurses about the hectic pace of their settings alone is proof of the set up for failure. The determinants that go into creating that hectic place are talked about and criminal, as well. I've heard experienced nurses include in a conversation the issue of keeping their licenses or the threat of losing their jobs due to competing safety interests and other aspects of care, where they feel that they are in a catch-22, more times than I or my classmates wanted to stomach, in clinicals or on the job. All these factors get in the way of good and competent nurses, and people in general, reflecting on and developing their practices. 2 x 4 (as in go to punitive reactions) therapy approaches to improving care are stupid and don't work. They may save a few jobs for periods of time, but they aren't going to make patients any safer or improve their quality of life.
As the other nurses have said we have all made a med error and it is very important that we own it and learn from it. You feel overwhelmed and there is fear in your plea. There are many less stressful nursing environments that will allow you to learn the practice of our profession. Nursing is a gratifying and fulfilling profession and there are many ways to practice both within your current hospital and in your community. Use this experience as part of the tempering process of your nursing career. And don't give up or give in to your fear.
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.
My heart goes out to you. I am so sorry this happened. One thing your post says to me is that you are a caring and conscientious person, who is going to be an outstanding nurse. You made a mistake, yes; but, you owned up to it regardless of the mental anguish, and you were/are concerned about the patient. Everyone has made med errors. Just learn from this, and rock on!
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.
Asking myself the same question. Why complicate what can be accomplished quickly IVP? Been pushing it since 1975 and have NEVER heard of patient harm from Anyone administering it IVP.
You made a mistake, that's rough..: but you self reported and took responsibility....in the facilities I have worked in, you would not be fired... Maybe have some increased education but that's about it... Talk to your manager before your next shift... They may alleviate some of your fears. Keep working hard, be careful, and use this experience as a learning moment... If this unit is to fast paced, look for something that may be a better fit... Don't give up!
Specializes in Oncology, Rehab, Public Health, Med Surg.
jadelpn said:
As noted above, there is not one nurse who can honestly say they are 100% perfect 100% of the time.
Now onto your meeting:
"I made an error, I have a full understanding and have reflected on my error. My goal is safe and effective patient care. To prevent errors in the future, I will make use of my resources to ensure safe medication administration. Beyond the rights of medication administration, I will be sure to read the pharmacy label on the IV bag, against the order, double check the correct dosage in the IV medication book, and have a senior nurse check my pump settings."
They may (and should) have a timelined improvement plan for you. Something along the lines of getting your IV meds checked over a period of time for accuracy. If that is the case, be sure to have ready the order, don't spike the bag until the nurse is present, look at the label, recite the mg/kg or hourly rate or whatever it is that you need to do. Set the pump, have the nurse observe, THEN press "go".
There will be in your career IV meds that you will get to know off the top of your head, and others not so much. And IV Lasix given as drip is not typical, therefore, there's many of us who would have to look it up. Just be sure when you look it up, if it needs clarification, get it. If the order was written mg/kg and that is not how it is to be administered (and your pharmacist is a great resource) clarify!!
Do not get caught up in the emotional aspect of this meeting. Then you could revert to making excuses and elaborating due to feeling defensive. Just don't do that. We all know you feel horrible. But now is time to think about moving forward.
Best wishes and let us know how it goes.
What a great post! Seriously, this should be a stickie for new nurses--
First of all, I'm glad the patient is OK. Second, I'm so sorry this happened. Med errors - or any kind of mistake - make us feel foolish and doubt our skills. But - IT HAPPENS. We are human. We make mistakes. Try to remember that. I think that you did the best thing that any nurse can do in this situation: you thought of your patient first. Also, you owned up to it and did not try to pass blame. That shows integrity and maturity. Good for you! Now, this is what I've done whenever I've made a mistake or almost made a mistake. I looked at why it happened. I look at my frame of mind when it happened. I also evaluate the atmosphere of the unit when it happened. No, it's not to pass blame - you're right, it's YOUR mistake - but it's to see what could have helped contribute to the error. You sound like you're a very concientious nurse who takes her job and well-being of her patients very seriously. I doubt you did this because you were careless. And, no, I don't think that it means you're unsafe around patients. You made a mistake. Learn from it. I can almost guarantee you will not make the same mistake again, because from now on anytime you start a drip you will be quadruple checking it. Give yourself a break and go back into work for your next shift with your head held high!
#2. Find out 'why' you made the med error. Busy? Wanting to finish the task? Too many patients?
#3. Identify what you could do to prevent that med error. i.e. slow down, when it is important matters, slow down and double check.
#4. Thank God the patient is safe. That is the important thing, over anything, your job, feeling embarrassed, etc.
#5. Use the experience to decide if you want to further in that unit or specialty. Maybe you can decide on a 'slower' pace unit, which has nothing to do with you being a good nurse. Even the best nurses/professionals know what their limits are without being ashamed. You will still have your license and you won't be used and abused by your employer.
As a manager, I have had to go through similar situations with nurses and it is so hard to watch them beat themselves up when this clearly a process problem and not all the blame belongs to you. Because of short staffing and sick calls etc, new nurses are allowing themselves to work in float pools when clearly, they are not ready. The lure of money and flexible hours is too great. ICU step down is the worst floor in the hospital (PCU here) because of the patient turn over rates, higher acuity and higher nurse to patient ratios. Float pool should not include units like this but have to because no one wants to work here for long. The fact that you feel a deep sense of responsibility and you are asking for help tells me that you are a good nurse who is growing into greatness. I'd love to have you on my team. Keep your head up, learn from this and use it to do something positive, like mentor other new nurses or get smart pumps at your facility. Good luck to you!
I am so sorry this happened. One thing your post says to me is that you are a caring and conscientious person, who is going to be an outstanding nurse. You made a mistake, yes; but, you owned up to it regardless of the mental anguish, and you were/are concerned about the patient. Everyone has made med errors. Just learn from this, and rock on!
joe a.
110 Posts
Well Ms. Mason Dixie, I want to welcome you to the world of nursing. Just so you know, all nurses have made med errors mm inclyding yours truly. Goung in front of the Board of Nursing isn't fun, its nit suooised to be. In my case my lucense was sanctioned, probation. Here's the deal, errors happen thousands of times a day. You are already on the right track. You have accepted responsibility for the error. Get iff if the "I feel just horrible" bus. It dies nit serve yiyr purpose. Feel bad, every nurse despises med errors. Don't carry the burden, let it go, and move on. You have a long fulfilling career ahead. I don't think aspiring nurses realize that we've chosen a dangerous field of study. We "practice". They say practice makes perfect but, not in nursing. There are no perfect nurses, we are all human. To err is human. Move forward. Do what needs to be done to insure you don't make the error again, period. You attract what you think, remember that. If you think error, guess what, you error.
I wush you all the best. You'll regret mistakes, you won't regret being a nurse. Sincerely, Joe A.