Too many errors :'(

Nurses Medications

Published

Dear all,

Where do I start? I feel like such a failure as a nurse. I have been working in a hospice for 10 mths, and, committed 4 medication errors - 1 during probation and 3 on my own.

We are using paper MARS, and, no matter how careful I am, I keep making mistakes. I was previously from a hospital that uses EMR. I'm not saying that it was fool proof, but, it certainly helped a lot. I've never committed any med error until I came to this hospice.

I am in danger of losing my job. The DON has "counselled" me about every med error, and, said that I am a ticking time-bomb.

I love hospice care, but, can't seem to get my meds right. My former preceptor has stopped talking to me (a senior said the management probably instructed her to distance herself from me). I do not have a mentor. I feel humiliated, isolated, and, I know that everyone doesn't trust me to serve meds. I am feeling so depressed and am on the verge of tendering resignation. They might ask me to tender anyway... But, I am completely self-supportive with no family to fall back on. I want to keep this job, but, don't know how.

Specializes in NICU, ICU, PICU, Academia.

Ask for a written performance improvement plan. Ask for help. Go back to your nursing texts and review the five rights. Put a copy on your brains sheet. Before you give ANY med EVER again, look at that list of rights and tick them off in your head. DO NOT give a med until you have done so. If you can't line up the rights with what you are giving- ASK ANOTHER NURSE TO CHECK YOU.

Med errors are generally process errors. Make certain your PROCESS is error-free and your med pass will be too.

Hello Lisbeth,

Sorry to hear of your troubles. In addition to MMJ's excellent advice, I suggest taking another opportunity to examine the errors you've made to make sure you know the hows and whys of your errors. Are you misreading the MAR? Misinterpreting ambiguous orders? Administering the med correctly and then not documenting such? Making mistakes due to infamiliarity with meds? Random/various errors? Rushing when under stress and omitting essential steps?

Understanding the errors already made may help increase your awareness of your own responses to various circumstances, but the bottom line is that you must do just as MMJ said. Every time.

Second thought: I would imagine your situation is a bit of a blow to the self-esteem, which is an added difficulty moving forward from here. Somehow you have to proceed with some confidence so that you minimize your risk of being so frazzled that you make additional errors. Get your process in place, recommit to it, and then believe you can. I agree with asking for support and help as you go forward - and not in a helpless way. Let your supervisor/director know that you are committed to a prudent medication administration process and to righting this situation.

Best wishes ~

Specializes in 15 years in ICU, 22 years in PACU.

What kind of med errors are you making? Without a careful analysis of the errors, you are doomed to repeat them or keep making new and different ones. Writing them down or just the act of trying to explain them to a trusted person helps.

I don't think any of our suggestions will work if we don't know the problem.

It's hard to offer specific advice without knowing the circumstances the errors occurred. Where they wrong dose? time? med? Route? Cause could be internal or external ranging from misunderstanding of the order to environmental distraction. You don't have to share what they errors where but sit down and break down what happened that lead to each error and come up with a plan to avoid them. As the other's have suggested be sure you internalize the rights of administration and even if it slows you down make sure each and every time you administer a medication you adhere to those rights.

Give us the down and dirty- what errors did you make?

Now that you've had these errors, I'm sure you're fairly anxious about giving meds. Calm down and go through the steps every time until you have them engrained. As suggested, it could be a process problem. Write out the process for yourself: every-single-step to give a med.

But, I am completely self-supportive with no family to fall back on.

Maybe it's time to make some friends?

Also, if you really think you're close to being given the pink slip, maybe it's better to resign now than actually being fired for medication errors. Just throwing that out there.

Specializes in ICU/community health/school nursing.

Has this risen to the level of "I need to be retrained?" Only you can answer. You might consider voluntarily taking a medication management refresher course before someone formally asks you to do so. Your BON should have suggestions and locations. Good luck.

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