Today I made a big mistake.

Nolli · Apr 1, 2014

To those who are unsure how OP even pulled meds:

We're allowed to pull meds ourselves if the clinical site allows it, but our instructor has to be there when we administer them and they have to check them prior to us administering them. Initially we were unable to pull meds ourselves and our instructor had to be present for all of it. I think it depends on clinical site, program, and stage in program.

Ultimately:

I think/hope OP will learn from this judging by the remorse. That said OP you will most likely need to convince your program that you have truly learned. The policies are there for a reason, be it syringe pump vs IVP etc. They are there for safety. If you don't like a policy as a nurse you can't disregard it without going to your boss and explaining why you think policy should be broken on that occasion or outright changed. Acceptable reasons include patient harm or something that runs counter to ANA code of ethics etc... But not giving meds without an instructor present is there to protect both the patient and you. As a student the whole purpose of the system is to have someone oversee you so you can make mistakes, but not irreversible ones. It is expected that students may make errors initially or every once in awhile and so they have an instructor there to catch the mistakes and correct them so next time there is not one. Please understand I am not judging you or trying to lecture you. I hope you do learn from this and that you are successful with your endeavors whatever happens.

Okie36 · Apr 1, 2014

Thanks all who clarified for me.. I understand it now...every program is different...OP I wish you the best. I'm thinking you learned the hard way and will not make the same mistake twice.. Good luck in future endeavors :)

sadiemae1123 · Apr 1, 2014

If I'm understanding OP correctly, she made 2 mistakes. First, she violated school policy by administering medications without her instructor present. Second, she ignored the 5 Rights of medicine by administering 2 medications by the wrong route. There is also the question of how she obtained these medications - are students allowed to access the med carts and/or Pyxis to pull medicines at this facility and by the school's policy. These are all serious issues.

If you sincerely want to continue then you need to show the school that you fully understand what you did wrong, why it was wrong, and most importantly how to avoid it in the future. You could start by showing them you know why using shortcuts and workarounds when doing a task is a danger to patient safety. You could also develop an action plan as to how this will not happen in the future and what you would do if it were to happen again.

Good luck to you.

dt70 · Apr 1, 2014

If you accidentally administer that injection to the side due to the convenience of the patients position it can squirt blood like a geyser, at least for a few moments, not helpful to the patients HR.

nette1022 · Apr 2, 2014

The thing that most students don't realize is that in clinicals you're working under your instructors license. The are responsible for the care you provide to a certain extent. You took the initiative yourself. Luckily there were no adverse reactions. Your instructor is responsible for maintaining a safe learning environment for all parties involved. I had an issue with one program and I dropped out. I then went back after some time and finished. I have known students that have been kicked out for various reasons and they have re-applied or been accepted to another program. You have to be honest when applying to another program and exhibit what you have learned from your experience. The sad thing is nursing clinicals and classes don't transfer if you have to start over, every program is different. I was eight weeks from graduating with all prereqs done and I had to repeat all of my nursing classes and clinicals.(I found out my program had not received their accreditation because it was a new program, so I chose not to finish until they were accreditated). Some programs will make you sign a contract and one of your instructors will be your probation officer. I hope they just council you. Make sure you tell them you realize your error and have learned from it.

allnurses Guide · Apr 2, 2014

Look at what GrnTea said. This is the advice of a seasoned nurse. Take heed.

First and foremost is patient safety.

After that comes the nurses responsibility to themselves.

Both of these are called into question in the OPs situation. No matter what level provider you are, from ULP to CNA to LPN to RN to APN, it is vital to both patient safety and the protection of your license to fully understand your scope of practice and adhere to it. This scope protects both you and the patient. Never be bullied or seduced into practicing outside of this scope.

It is not a simple "mistake" if you know you are practicing outside of your scope and do it anyway, regardless of your current role from ULP to APN.

allnurses Guide · Apr 2, 2014

And don't be fooled, you are not "practicing under the RNs license": your are ultimately responsible.

nette1022 · Apr 2, 2014

Let me clarify what I am saying, not practicing as a nurse but your instructor is there to make sure that you as a student are safe. and that the patient is safe. You are still learning, your instructor is there to make sure you apply what you are learning in a safe manner. You have learned a lesson early on that will teach you that rules are there for a reason and you will pay attention to rules in the future. This is not a good experience to go through. Have a good cry and sit down and write out what you have learned and why you will never do this again. I would not keep mentioning that your patient talked you into it. Nurses have to be able to think independently and analyze the situation while doing their job in a safe manner (for the patient and to protect themselves). This lapse in judgment is a signal to the instructors that a bigger problem in judgment may exist and it needs to be addressed as well as a safety/procedural issue. They have a liability and accountability as a school that has to be protected. I wish you luck we all work so hard to obtain a license and only other nurses can understand how we truly feel when something happens. I wish you luck and I hope they work out something with you.

matthewandrew, NP · Apr 2, 2014

True dat.

Matthew Andrew, BSN RN

nette1022 · Apr 2, 2014

Also you are not working under your instructors license she is responsible for giving assignments according to your level of learning. If she gives you an assignment beyond your scope of learning then she is held accountable. That is why students have Liability Insurance in school. You are responsible for your own actions. Good luck!!!!

la_chica_suerte85, BSN, RN · Apr 2, 2014

There are some very critical things people can do that can result in their dismissal from programs and administering meds without your instructor is a big no no. Though they were "simple" meds to administer, the whole point of participating in a med pass is demonstrate to your instructor that you understand what it is you're doing and that your assessments are on point. They also need to ensure that you are safe with your technique and are doing proper MAR checks, etc. etc. Other things like simply leaving your notebook out and it getting taken can result in a HIPAA violation for the facility your clinical is at. That happened to someone in a cohort ahead of me and they were considering dismissing her as well even though the notebook was found by another employee and kept in a safe place so ultimately no patient privacy was violated but still -- it's serious. You have to be on your best behavior times 100 in nursing school.

springchick1, ADN, RN · Apr 2, 2014

Stop eating your young. We all make mistakes. The student clearly understands what they did wrong.

How is asking questions of the OP "eating your young"? Good grief people are quick to throw that statement out!!