I just got off orientation (10 days LTC). It was my second med pass on this floor. I don't usually work on this unit, and it was only my 2nd med pass alone since off of orientation.
I gave Coumadin to a resident that was on hold untill the next day. I didn't realize the arrow was pointing to that date. I realized when I went through the book later to make sure I signed everything off. I informed the supervisor on at that time. (3-11) She had me fill out an incident report.
During the narc count, the oncoming Nurse realized I gave 2 0.5 ativan instead of 1mg. I did not see the 1mg card. I know she got the right dose, but it was another careless mistake on my part.
I am sick to my stomache, did not sleep all night wondering If I screwed anything else up. I am going into the DON to talk to her today and make sure everything is okay. Am I just new and inexperienced or just plain careless. Everyday I go in wondering If I am fit to be a nurse, I feel like I do not know anything. So afraid I'm not going to know what to do is something major goes wrong. I am so sick over this.
How do you know if you are really cut out to be a nurse? Maybe I'm just not compitent enough. I don't want to put anyone else in danger.
Sometimes you need to just relax. When I get to work.. 7-3 is still buzzing around like angry bees. I come in and I keep my face like this.. -_-. or else I will get worked up and start stinging people.
So you made a med error( a med error! the ativan doesnt count because the right dose was given to the right patient at the right time). I made one with coumadin once. A patient was on alternating doses of coumadin(very dangerous!) and the coumadin sheet ended and the nurse who made the sheet forgot to add on the alternating dose. It ended up that I gave 0.5mg more. I thankfully was not written up for it because I didn't make the coumadin sheet. But it has opened my eyes to double check the coumadin sheets when a new one is written.
Specializes in Gerontology, Med surg, Home Health.
It's good to hear your DON was supportive and not punitive. Many times med errors are SYSTEM errors so it's important to report them all. We've all made med errors and those who give meds every day will likely make one or two more before they retire. We can learn from our mistakes and hope that when we make a mistake, no one gets hurt.
We are TOO BUSY. It's hard trying to do hundreds of meds (in large nursing homes you do give hundreds in 1-2 shifts), and we have to check every single one. Sometimes docs don't write properly. Pharmacy check our med charts for us, but if there's a new med been written up they don't get time. Meds written up can be interpreted different ways. I gave 2 of a medication - not a serious error - when the Dr wanted the dosage split up - but he DID NOT WRITE THAT on the chart! The other staff were all long term & just 'knew' what to do with this doc's meds. Well that isn't good enough I said! I didn't have to fill out any paperwork, but you still have to - it's not against you - it's a legal and ethical requirement facilities must fulfill (in case anything goes to court & the paperwork is reviewed by a committee usually).
Some tips that work for me:
- DO NOT let anyone rush you doing meds, whether it's patients, doctors, families etc. Even if ur behind, take a few breaths, and read all the order first. Interpret it in your mind - what is the doc asking for? Re-read every label, med order twice & patient wrist band 2 or 3 times - follow all your drug checks.
- Even if u know a patient, still double/triple check everything, even their wrist band.
- If unsure never give a med. Follow up with another, senior nurse. Better not to give it than to harm someone.
- If people nag you to 'hurry up' with meds, politely but firmly explain I haven't been on this unit before, am doing this a bit more slowly so I don't make serious errors. One RN nagged me one night & I said to her: instead of criticising me why don't u come & help me? And she did! (I'm so bad sometimes!)
- With IV meds always check your facilities drug book on how to mix them and triple check with other nurses before taking to patient - I even check NS before flushing with another RN just to cover me.
It is hard being a nurse and juggling so many duties. I'm sure your DON won't throw u under the bus! We have all made mistakes or nearly made mistakes - and yet we still get blamed because we IMO are not seen as professionals - just servants and hand maidens. When will management realise that there are only ONE of us for so many patients & we can't split ourselves in two for the demanding patients! If we could clone ourselves, life would be wonderful!
Review everything with ur DON, then learn & move on. Write it all out in a journal. That helps me a lot :) You will be OK!!
Just want to chime in one more time....the ativan wasn't a med error!!!! So you really only made 1 error.
Please let it go! You are doing fine! Relax, we have all made med errors...and the those who say they haven't either are too new to have made them and will eventually...or are lying....it happens...no one died...no one had adverse effects...(except for YOU)...so calm down.
I agree with the poster that said you were astute to pick up on the fact that the ativan was only 0.5mg so you needed 2 tabs...that shows attention to detail!
So you really only made 1 error.
Forever Sunshine, ASN, RN
1,261 Posts
Sometimes you need to just relax. When I get to work.. 7-3 is still buzzing around like angry bees. I come in and I keep my face like this.. -_-. or else I will get worked up and start stinging people.
So you made a med error( a med error! the ativan doesnt count because the right dose was given to the right patient at the right time). I made one with coumadin once. A patient was on alternating doses of coumadin(very dangerous!) and the coumadin sheet ended and the nurse who made the sheet forgot to add on the alternating dose. It ended up that I gave 0.5mg more. I thankfully was not written up for it because I didn't make the coumadin sheet. But it has opened my eyes to double check the coumadin sheets when a new one is written.