Please Help - Need Advice re: Med Error

[July17]

I hope this isn't too long: I am in Ontario, a RN who took five years off, and worked only for 6 months after getting my degree.

When I was ready to go back, I decided to do a RN Refresher course to get my basic skills back.

I explained to the manager and preceptor at my placement that I needed to work on my basic skills - and they assured me I would do fine.

While giving Insulin to a patient I made 2 errors: I forgot to check her nameband (it was a patient I knew-not a safe action) and under the supervision of my preceptor, I failed to inject the whole sc injection - which luckily she caught. I received an email on Friday asking me to have a meeting with Manager, clinical leader, etc. They told me to still come to practice but I won't be giving any meds. There is also concern overall about my speed and skill. I haven't been there long and I know I can improve and I am trying my best - but I guess they expected me to pick up faster.

And the insulin error is understandably something we want to discuss because I could have made a serious error and put the patient at risk.

I am asking help for two things: how do I prepare for this meeting, if they bring up that I am not progressing fast enough? And I will explain that I understand fully that I made a serious medication error but that I hope I can continue to administer medications under supervision?

Thanks so much for your help - I am really scared over all of this.

[NurseCard, ADN]

When you have the meeting, just be prepared to listen and

to ACCEPT their criticism... use it to your advantage, to become

a better nurse.

One question... how do you not give the "whole" SQ injection?

You drew the insulin up but didn't give all of it? Why?

[July17]

Thank you for your advice. The reason all the insulin wasn't given was because although I thought I pushed the plunger all the way, I hadn't. I think this is because I was injecting too slowly. For now they don't want me to give medications - I don't know if this will change after the meeting. I feel very bad about making the mistake and all along I have found the placement difficult because I am scared of making mistakes.

[Ruby Vee, BSN]

hiring and training a new nurse is expensive, and no manager wants to lose a potentially valuable employee. your job may depend upon your behavior at this meeting, however. go to the meeting and be humble -- do not be defensive. you know you screwed up, and by now you've thought of some ways you can avoid screwing up like this in the future. if you think you need a refresher course on medications, look into how you can get that. if you need more orientation time, ask for it. whatever you think you need, and whatever they think you need, even if you don't think you need it.

my husband used to be a union representative, and has gone to numerous meetings like this with nurses who requested union representation. the worst thing you can do is be defensive or argumentative. you want to show them that you understand the enormity of your mistakes and the potential consequences to the patient and that you're willing to work as hard as it takes to get up to speed. good luck.

[canned_bread]

A colleague had a similar situation. What helped her was an offer for her to to have a smaller patient load for 2 weeks so she could orientate herself a bit more (4 lighter patients instead of the 5-6 average), and also had every medication she was giving double checked for 1 week, and if one medication was given incorrectly then another meeting would be scheduled. She did fine. It's similar to a new graduate out of nursing school, just a shorter amount of time whilst she got back on her feet.

With any job it takes a while to get the hang of it after a significant break. Plus you are probably nervous.

Think of things you know might help, such as the above, and propose it. Make them see that you are willing to work with them to be the best employee you can possibly be.

[Dafabb, LPN]

Hello I am an LVN(35 yrs) and I feel for you on renewing your skills under the watchful eye. I have shadowed new RN grads at their request(I don't get tacky)...LOL and I see that same nervousness. Many times they go too slow, when you do not need to, an get more nervous. I always suggest to pull the orange out. They also have other doodads for the same thing. Practice makes perfect and doing it without the watchful eye is always easier for confidence. Barring certain medications, moderate speed is a good rule of thumb. I wish you well......