I have been a nurse for 7 years and have made some minor errors along the way. I thought my acceptance that mistakes happen would get better over the years, but I don't think I've improved. A few examples would be a needle stick (has happened to me twice, once with a combative pt and no help to give an IM due to staffing issues but the other one just stupid), once giving an "underdose" of PO morphine, once giving 200mg IV thiamine instead of 100mg, and most recently giving 75mcg fentanyl instead of 25mcg at a time.
When I did community health I was thrown into giving vaccines with no training and gave an MMR IM and an adult Hep B vax to a (luckily large) Peds pt. Also some minor non med related mistakes that have faded away and caused no harm but at the time felt monumental. All of these mistakes have stuck in my mind for years, and I'm not sure if my reactions are over the top. For the IM MMR I called the CDC to see what to do and they said... do nothing, still counts as valid dose just might irritate muscle a bit. I reported all errors and did reports if advised to. The thiamine the MD said pt will just excrete it in the urine, the morphine pt ended up w/ pain controlled and didn't want rest of dose, the fentanyl pt was fine and said pain well controlled, neither of my needle sticks gave me any diseases. Do you think I've made an excessive amount of mistakes? Or that I blow things out of proportion by obsessing over them for years? Or both?! Sorry, just spiraling after the fentanyl thing.
People have been consoling me with stories of horrible/fatal errors and med errors but it makes me feel better a little but mostly more scared of worse potential errors.
You certainly aren't alone -- and you're not a bad nurse. You are ethical.
As a new grad, I was really upset about my first med error. The house supervisor (SNF/LTC facility) told me: "If a nurse tells you they've never made a med error, they're either lying or they never realized when it happened."
He was a bit jaded, but it was exactly what I needed to hear.
You sound ethical. You report the mistakes. You monitor the patient for adverse outcomes. After thinking about all the things that led up to the mistake (distraction, lack of knowledge, understaffing, etc.) and what you can do to avoid them in the future... you also deserve to let them go.
Specializes in Community Health, Med/Surg, ICU Stepdown.
2 hours ago, RN&run said:
You certainly aren't alone -- and you're not a bad nurse. You are ethical.
As a new grad, I was really upset about my first med error. The house supervisor (SNF/LTC facility) told me: "If a nurse tells you they've never made a med error, they're either lying or they never realized when it happened."
He was a bit jaded, but it was exactly what I needed to hear.
You sound ethical. You report the mistakes. You monitor the patient for adverse outcomes. After thinking about all the things that led up to the mistake (distraction, lack of knowledge, understaffing, etc.) and what you can do to avoid them in the future... you also deserve to let them go.
@LibraNurse27 you sound like such a great nurse. You care, you report, and you reflect. I haven’t been an RN for all that long but have been in patient care for a while, and I’ve noticed the best people are the ones that take your caring attitude but also look forward with optimism. I’m trying to learn that lesson myself every day!
Speaking to two different angles of the main question, I would say one "big deal" is an error that results in harm and another big deal is a pattern of errors made by the same nurse.
I think this holds a lot of truth to it. I remember an experienced nurse one time telling me as a new grad in the ER something about what it’s like to make a first med error. I remember at the time feeling shocked and thinking that I would never make a med error....that only happens to nurses that aren’t cautious, right? Well....I guess that only shows how naive I was ? I do think there is such a thing as “big” errors.
However, I now know what it’s like to work in an environment that is fast paced, high acuity with not enough staff to cover a patient load. I know what it’s like to have too many ICU patients to a nurse or to be so exhausted from working 16 hours that my judgment isn’t the greatest. I have found that all of us are human and thus susceptible to human error. However, I have found ways to try to at least prevent med errors. I no longer stay over a shift unless I feel like I actually have the judgment to do so. I will advocate for myself when I have too many high acuity patients (which may or may not help). I will also admit when I need a change (like moving from night shift to day shift, etc).
You seem like a good nurse LibraNurse. I think you are likely harder on yourself then anyone could ever be. The one thing about making a med error is that once it’s made, that same error will likely never happen again to a cautious, experienced nurse.
Specializes in Community Health, Med/Surg, ICU Stepdown.
On 1/27/2021 at 11:55 PM, 0.9%NormalSarah said:
@LibraNurse27 you sound like such a great nurse. You care, you report, and you reflect. I haven’t been an RN for all that long but have been in patient care for a while, and I’ve noticed the best people are the ones that take your caring attitude but also look forward with optimism. I’m trying to learn that lesson myself every day!
Thank you so much! I like your reminder to look forward with optimism and I can tell you are a great nurse as well ?
23 hours ago, speedynurse said:
I think this holds a lot of truth to it. I remember an experienced nurse one time telling me as a new grad in the ER something about what it’s like to make a first med error. I remember at the time feeling shocked and thinking that I would never make a med error....that only happens to nurses that aren’t cautious, right? Well....I guess that only shows how naive I was ? I do think there is such a thing as “big” errors.
However, I now know what it’s like to work in an environment that is fast paced, high acuity with not enough staff to cover a patient load. I know what it’s like to have too many ICU patients to a nurse or to be so exhausted from working 16 hours that my judgment isn’t the greatest. I have found that all of us are human and thus susceptible to human error. However, I have found ways to try to at least prevent med errors. I no longer stay over a shift unless I feel like I actually have the judgment to do so. I will advocate for myself when I have too many high acuity patients (which may or may not help). I will also admit when I need a change (like moving from night shift to day shift, etc).
You seem like a good nurse LibraNurse. I think you are likely harder on yourself then anyone could ever be. The one thing about making a med error is that once it’s made, that same error will likely never happen again to a cautious, experienced nurse.
Ahh 16 hours is crazy! I'm glad you have learned to advocate for yourself and set limits, and speak up about unsafe staffing (hopefully someone listens!). Thanks for your reply = )
rn&run
46 Posts
You certainly aren't alone -- and you're not a bad nurse. You are ethical.
As a new grad, I was really upset about my first med error. The house supervisor (SNF/LTC facility) told me: "If a nurse tells you they've never made a med error, they're either lying or they never realized when it happened."
He was a bit jaded, but it was exactly what I needed to hear.
You sound ethical. You report the mistakes. You monitor the patient for adverse outcomes. After thinking about all the things that led up to the mistake (distraction, lack of knowledge, understaffing, etc.) and what you can do to avoid them in the future... you also deserve to let them go.
It's OK.