I have made a med error in administration and I feel terrible. I have been an RN for 4 years, and with one staffmember out sick, md trying to get me to do three different patient requests at the same time, and a patient that needed an injection and kept saying he was in a hurry, MD trying to leave, all did me in today! I gave a patient decadron 1mg IM, in the deltoid instead of the gluteal. I have not given this drug in over 4 years, I knew it was IM. I couldn't find our current drug book, so I used the Lexicomp online that we have and did not see a reference to IM GLuteal. A second drug book also did not reference it. My own fault, I should have, just told everyone to stop. Even when pt mentioned the last time he got a steroid it was in the but! I didn't hear him. Md went behind my back and told the pt he could, leave. Within the five minutes it took me to realize the error, the patient had left, OK'd by md. I explained the error to the doctor and she did not want me to call, patient because he works for the local hospital. She doesn't want me to report it as a med error either. I have form all written up and am now all stressed out about this. It is making me sick.
SFRN 104 Posts Specializes in Adult Cardiac surgical. Has 5 years experience. Sep 11, 2009 I'm confused. The deltoid is a muscle. So, where is there error?
morte, LPN, LVN 7,015 Posts Sep 11, 2009 I'm confused. The deltoid is a muscle. So, where is there error? http://www.reutershealth.com/atoz/html/Dexamethasone.htmmost of the way down the page....this is something i either forgot or never knew......take care to the OP
Trauma Columnist traumaRUs, MSN, APRN 153 Articles; 21,229 Posts Specializes in Nephrology, Cardiology, ER, ICU. Has 31 years experience. Sep 11, 2009 I guess I don't see this as an error either - its only 1mg!
rpric7990 28 Posts Specializes in telemetry, long-term care, oncology. Sep 11, 2009 Looks to be ok, you should avoid the deltoid, but it was still an IM injection. You should not listen to a physician who tells you not to file an incident, either way, you make a decision to file an incident if something unexpected happens or if you give a wrong med, dose or route certainly. You should be able to file incidents without fear of punishment. We need nurses we can trust to disclose errors. I have made real med errors and straightforwardly admitted it. I file the incident, we discuss why it happened and try to improve our processes.
miss81, BSN, RN 342 Posts Specializes in Surgery, Tele, OB, Peds,ED-True Float RN. Has 8 years experience. Sep 11, 2009 Oh my... I suppose technically this is a med error because it can cause muscle atrophy, but I don't think the nurses I work with would report this as an error. Can one injection of decadron in the deltoid cause muscle atrophy??? Anyone have experience with this???
rpric7990 28 Posts Specializes in telemetry, long-term care, oncology. Sep 11, 2009 So that is when I decide to go ahead with an incident report in case a complication does develope. The worse thing that can happen is you don't report an error and then you get found out. Consider how the manager feels a lack of trust if someone covers over an error. Open honesty is what my managers get from me and they can relax knowing I would never cover something up. I have been fired twice. I joke " I have been fired from the best", once a 911 dispatcher wrote a complaint about me. My bosses decided to solve the process problem by firing the RN - so the next time a nurse is in a similar situation he or she may make the same mistake. They were not honest about the firing and told everyone I quit voluntarily. Interesting. So sometimes you have to move on to where management appreciates integrity.By the way after this minor incident and hearing your response, I would hire you in an instant and know that you care enough to be cautious. You will have learned from this and become more valuable in your experience.
BSN75 56 Posts Specializes in Family Practice. Sep 11, 2009 Honestly, I don't really see this as a med error. Yes it should have gone into the glut instead of delt, but I think the odds of this one time injection causing a problem with the muscle are very slim. But if you would be more comfortable alerting the patient, then you should. It doesn't matter where a patient works, you should treat them the same as you would any other patient.
netglow, ASN, RN 4,412 Posts Sep 12, 2009 Unless I am just too tired no specifics on site are mentioned in my Davis guide off my iTouch.
diane227, LPN, RN 1,941 Posts Specializes in Management, Emergency, Psych, Med Surg. Has 32 years experience. Sep 17, 2009 Well I guess I am just stupid after all these years but I have always given this drug at that dose in the deltoid muscle and there has never been a problem.
