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.
The saddest thing about this story other the fact that there was a medication error, is the way that you were addressed by your "colleague". She missed the opportunity to turn a mistake into a teachable moment.
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!
Lasix might not be dose in mcg/kg where you work, but where she works it certainly might be. As a transport nurse, I pick up patients in multiple different hospitals. Every day, I see a new medication being delivered/dosed/prepared a different way. There's no reason why lasix cant be dosed mcg/kg. It's hospital preference.
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.
I see it often in patient's who are in failure, but not fulminant pulmonary edema and have borderline blood pressures or potassium levels. 1mg/hr or what not, just to get the fluid out, but not cause profound hypotension/hypokalemia.
You sound just like me. You are being way too hard on yourself for not being perfect. You are a human and make mistakes. You admitted to your mistake and told the appropriate people. Kiddos for that. You did not try to cover up your mistakes. It's OK. This does not make you a bad nurse. Just take this experience and learn from it. You are a new nurse. You are learning. The patient is OK and you will be too. As far as the individual telling you that you are unsafe I feel is a little harsh. Maybe this person is just trying to make herself feel important I don't know. Don't give up on nursing. Hang in there. You should be proud of yourself for owning up to your mistakes.
Specializes in Cardiac (adult), CC, Peds, MH/Substance.
I think your obvious concern for the patient and self-reflection means precisely that you ARE cut out to be a nurse. You made a mistake. It was recognized. You didn't hide from it or try to explain all the reasons it's not your fault. Someone else stated that anyone who says they have not made a med error is lying, didn't realize it, or very new. I think that's pretty accurate. Chin up, keep accepting responsibility as you have been, learn from it, and don't make the same mistake twice.
I laugh at myself when I read this. I can honestly relate to. I also made errors before and was talked to by the nurse supervisor and chief nurse. It's not a major error but an error all the same. After that incident, I have promised myself to be even more careful specially when carrying out orders and giving medications. I was not fired or what not but that incident gave me a lesson and same as yours, that was when I had only recently graduated and passed my license exam.
Every nurse has made a medication error. If they haven't they probably are just too embarrassed to admit it. I have found that through various mistakes med related and otherwise, I have become more careful and viligent. Believe me, you will never make that same mistake again! Don't beat yourself up over it. You did the right thing by not covering it up and filling out a report and telling the doctor. Mistakes make us human and we grow from them.
I must say I was equally surprised at how relaxed and laid back this response seemed to be.....but then after reflecting on 16 years of long term care with one year of med surge hospital work under my belt....I can relate to this. I can remember my first med error, feeling like I'd killed someone, when in actuality, there was no effect. But as a new nurse, one doesn't realize that until years of experience and knowledge. After working in the field, and making more then one error.....because most of us do, and working in management and being responsible for staff discipline and seeing how many others make errors, it really is more common then one would think. Unless a patient ends up getting something they end up having anaphylaxis to.....it usually is not a major issue. Just learn from your mistake and always be willing to ask for help....No questions are stupid......And your manager should not be a manger if she can not be supportive, firm but supportive too!!!! Good Luck!
Do not beat yourself up because of this. Yes it was unsafe and could of caused harm to the patient. However the patient was fine, you did the correct procedure you informed everyone that should know and monitored your patient. You was honest and actually cared which shows you are a caring person and a good nurse who is new and will make mistakes because you are human. It is hard and it is scary because you have peoples lives in your hand and I have made errors before and I felt awful and wanted to quit, felt like I shouldn't be a nurse because look at the mistake I made. But I had to eventually realise and accept that I am human, I didn't do it on purpose but yes there are ways I could improve my practice and prevent this mistake from happening again. So its a learning curve which is terrifying but it really reinforces how careful you need to be and you now know and will always remember to double check not because your not capable but to ensure you keep your patient safe. You are still a new nurse and you need to get your confidence back up and you will get there! if they thought you was good before, then they still will and if they judge you from this mistake then they are wrong because although you did make an error, I ensure you every nurse has either made an error and realised or not realised because they are not checking properly. You realised and ensured you made that patient safe, you had the courage to be honest and that's what we need. It should not be a blaming system, you was honest, you learnt from it and this will shape you into the nurse you want to be. Just take each day as it comes, make sure you ask questions and get support. You are new and they were new once too so use them for their knowledge and skills. Just remember you made it through your course and gained the registration so you are a nurse and must be good enough to be a nurse to be given the opportunity! So don't crawl in a hole! take it as a big learning curve, write a reflection and then accept you made a mistake, the patient was ok! and let it go and move on or this will pull you down! Good Luck.
You are fortunate that your charge is well and that you have the courage to face up to this mistake and whatever may come of it. Quiting should never be an option. Buck up and continue on, we need more 'sisters and brothers in nursing' with the caring nature and character that you obviously have.
CamillusRN, BSN
434 Posts
^^ This.