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(plsppardon the double post asi also posted this under patient medications before realizing that was probably not the right place). l am a nursing student doing a preceptorship on a med/surgery floor... I worked a night shift last night and I was not myself at all, quite spacey all night. I am realizing after coming home this morning that I don't remember giving one of the patients her insulin!! Her insulin was high (16.9) so I remember thinking "gotta get her that!" Yet I seem to recall she did not have an insulin order sheet or something. I was so spacey that I can't remember clearly.. I know I did give her a needle... but that may have been lovenox.... I called the floor and told her RN for today that they should be on the lookout for that. When I called they asked if I had given that same patient patient PRN benadryl or gravol for her nausea. Even though I did my checks 3x before GIVING the med, I was not so thorough when SIGNING the med after and apparently signed for benadryl instead (I did describe the pill I gave to the RN and it was indeed gravol).
I am absolutely freaking out! This means that if I did indeed forget to give her insulin I made two med errors on the same patient in one night!! Though only one that actually reached the patient, but still... My preceptor is very nice but my course instructor is known for being a hardass. I feel so stupid and scared I am going to flunk out! My only relief is that I did call the floor so I know they will be watching her and she will likely not be harmed. Still, I am really anxious this could be the end of my nursing career. Is it common for students to get kicked it for things like this? Do you think I am doomed?
As you can see, THAT expectation is dangerous. In the U.S, students cannot legally pass meds without a check from a licensed nurse. You needed to realize that you were spaced out, and should not have been passing meds. I am not trying to beat you up after the fact, but in the future... know that if you are impaired like that... you should not be administering medication.
Shouldn't be at clinical, period. I initially skipped right past that "Spacey comment." Yikes. Why were you Spacey?
Yes, if I give insulin it does need to be double checked. However there would be nothing to check if I didn't draw up any insulin and only gave the rest of her medications. We are expected to give medications alone during preceptorship as we should be independent by the end of this placement.
Even seasoned nurses double check insulin, independent or not!
I intensely dislike the idea of a student giving out drugs independently. Glad you did give it, I've done night shifts gone home and been like did I do X or Y so don't take it too badly, but if you feel you're struggling on a night shift and feeling spaced make sure you tell you preceptor.
,(plsppardon the double post asi also posted this under patient medications before realizing that was probably not the right place). l am a nursing student doing a preceptorship on a med/surgery floor... I worked a night shift last night and I was not myself at all, quite spacey all night. I am realizing after coming home this morning that I don't remember giving one of the patients her insulin!! Her insulin was high (16.9) so I remember thinking "gotta get her that!" Yet I seem to recall she did not have an insulin order sheet or something. I was so spacey that I can't remember clearly.. I know I did give her a needle... but that may have been lovenox.... I called the floor and told her RN for today that they should be on the lookout for that. When I called they asked if I had given that same patient patient PRN benadryl or gravol for her nausea. Even though I did my checks 3x before GIVING the med, I was not so thorough when SIGNING the med after and apparently signed for benadryl instead (I did describe the pill I gave to the RN and it was indeed gravol).I am absolutely freaking out! This means that if I did indeed forget to give her insulin I made two med errors on the same patient in one night!! Though only one that actually reached the patient, but still... My preceptor is very nice but my course instructor is known for being a hardass. I feel so stupid and scared I am going to flunk out! My only relief is that I did call the floor so I know they will be watching her and she will likely not be harmed. Still, I am really anxious this could be the end of my nursing career. Is it common for students to get kicked it for things like this? Do you think I am doomed?
The fact that you were 'quite spacy all night' and don't remember give a patient her insulin, this alone would be grounds for dismissal. Why? You could be 'spacey' at home or forgetful at home, but not when you are at work. Good you gave it, but if you're a student I would believe you have to be extra careful.
Which of these statements made by the nursing student indicates a necessity for further education?
A. "I am realizing after coming home this morning that I don't remember giving one of the patients her insulin!! Her insulin was high so I remember thinking gotta get her that!"
B. "Even though I did my checks 3x before GIVING the med, I was not so thorough when SIGNING the med after and apparently signed for benadryl instead"
C. "This means that if I did indeed forget to give her insulin I made two med errors on the same patient in one night!!
D. "I was so spacey that I can't remember clearly.. I know I did give her a needle... but that may have been lovenox.... I called the floor and told her RN for today that they should be on the lookout for that."
E. All of the above
Correct answer: E.
I don't know how common it is for students to get kicked out of a program for two med errors or forgetting to administer insulin, but I do recall during my student nurse days, another student nurse either failed to administer insulin to her patient or gave it late. Not only was the student expelled from the program, our school was no longer welcome to do clinicals at that hospital.
I know your post was about how common it is to get kicked out for med errors, but there was another important question here, and that was could you get kicked out for being spacey, which resulted in med errors.
Triddin
380 Posts
I think for final preceptor ships, the instructor aren't on site but the student is closely mentored with a preceptor nurse. The instructor instead does weakly check ins with the nurse and student to talk about how he student is progressing through the course outcomes the instructor can have up to 8 students in different locations and wards. This was atleast my experience when I was a student