Student Nurse Med Error

[heallis]

(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?

[dream'n, BSN, RN]

Refine you 'brain sheet' Put an area on it for important information that you must check off before you leave. Sometimes running around busy and learning of or thinking of something important can lead you to forget. You might be involved in a complex, busy issue and forget the information you received. So what i do is write a quick synopsis on my brain sheet at that moment and make a square next to the task to be checked off. For example, if a patient is going to need Q 2 hour Neuro checks (which is out of the norm where I work), I'll place it on my brain sheet with check off boxes next to 2 hour intervals and if I don't have the time to chart real time, I'll make a note next to the checkbox to chart the results with the VS, time, and pertinent information for my note later.

Use your brain sheet to keep track of what needs done. I write all my diabetics down at the beginning of the shift with boxes for the blood sugar level and another for insulin information. I also put any labs I need to pull from PICCs or CL. Before I leave for the day, I check my brain sheet for any thing undone. It quickly lets me know that I've completed everything I needed to.

You don't need an excellent memory all the time with a through brain sheet. Box check offs are my life