Worried I made a mistake

[em3120]

This happened months ago but it still bothers me......I was passing meds and the Pyxis called for 8 tablets of x med, I had never heard of the med (I'm in psych and this was a non-psych med) so I googled it and it was a high but normal dose, I scanned them with the MAR opened, and everything was fine.  Later I started to get worried that 8 seemed like a lot and I regretted not calling the pharmacy.  The patient has long since been discharged and I can't even remember what the med was but I have guilt that maybe I made a mistake.  I'm not working at the same place anymore.  And obviously there is no way I can track down the patient and ensure they're OK.  I have lots of anxiety about passing meds and I worry I accidentally did something wrong (even though I followed the orders and nothing ever came back to me).  How do I deal with the second-guessing everything and fear that I made a horrible mistake and hurt the patient?

[Hannahbanana, BSN, MSN]

I can pretty much promise you that if something untoward had happened you'd have heard by now. Pharmacy is also a checkpoint; they are supposed to flag any weird or dangerous orders for recheck, and if they are doing their job they would have called you.

Your actual question is how do you deal c the second  guessing and fear of injuring a patient. That is likely beyond the scope of all the reassurances we can give here, and that you are sure to get. Seriously suggest that you seek out a brief series of counseling for anxiety (which may be affecting other parts of your life too) to learn how to deal with these feelings as they arise. This will benefit not only your work as a nurse but many other things too. 

[em3120]

On 5/17/2021 at 4:17 PM, Hannahbanana said:

I can pretty much promise you that if something untoward had happened you'd have heard by now. Pharmacy is also a checkpoint; they are supposed to flag any weird or dangerous orders for recheck, and if they are doing their job they would have called you.

Your actual question is how do you deal c the second  guessing and fear of injuring a patient. That is likely beyond the scope of all the reassurances we can give here, and that you are sure to get. Seriously suggest that you seek out a brief series of counseling for anxiety (which may be affecting other parts of your life too) to learn how to deal with these feelings as they arise. This will benefit not only your work as a nurse but many other things too. 

Thank you.  I guess I worry because I would be responsible regardless of what the pharmacy does.  I do struggle with a lot of anxiety and it's been spilling over into work

[amoLucia]

Go easy on yourself!  Yeah, I know! Often easier said than done. Every now & then you'll get a realllly weird order. Like for loading doses of Coumadin, comes to mind.

I just needed to take fifteen (15), yes, fifteen) pills of prednisone 10mg for an allergy CT scan prep. Total dose was for 150mg prednisone. It was an OK order; just that my new pharm didn't have the larger mg dose pills on hand in stock. So it was filled with the smaller dosage pills.

Rule of thumb is that usually only 1 or 2 pills are administered at one time for a single dose. When you have something greater then the usual, you have to check it out.

Pyxis did allow the distribution and like PP Hannahbanana commented, you would have heard about any adversities timely.

Not sure what type of spec counseling could help, but it does sound like you need some confidence boost, and also some anxiety prevention. Maybe some kind of CEU could self-help.

Good luck to you.

[em3120]

16 hours ago, amoLucia said:

Go easy on yourself!  Yeah, I know! Often easier said than done. Every now & then you'll get a realllly weird order. Like for loading doses of Coumadin, comes to mind.

I just needed to take fifteen (15), yes, fifteen) pills of prednisone 10mg for an allergy CT scan prep. Total dose was for 150mg prednisone. It was an OK order; just that my new pharm didn't have the larger mg dose pills on hand in stock. So it was filled with the smaller dosage pills.

Rule of thumb is that usually only 1 or 2 pills are administered at one time for a single dose. When you have something greater then the usual, you have to check it out.

Pyxis did allow the distribution and like PP Hannahbanana commented, you would have heard about any adversities timely.

Not sure what type of spec counseling could help, but it does sound like you need some confidence boost, and also some anxiety prevention. Maybe some kind of CEU could self-help.

Good luck to you.

Thank you.  I'm a worrier for sure and have a hard time letting go of that anxiety

[Hannahbanana, BSN, MSN]

A therapist will help you with the, “Don’t say can’t, say won’t” part of that. Good luck. 

[amoLucia]

Anxiety will predispose you to high BP and gastric issues. Not worth it!

I particularly like 'don't strain for perfection, strive for excellence'. Big difference and more easily achievable.

[Lynker, LPN]

We have all made a fair share of mistakes. But as said before, if there was you would have known about it. We learn from our mistakes, big or small. Whether they're still happening or not. We all have to learn to let go and move forward. We're human!!

[nursel56]

On 5/20/2021 at 6:18 AM, em3120 said:

Thank you.  I'm a worrier for sure and have a hard time letting go of that anxiety

I agree with hannahbanana, the root of the problem is anxiety. I had lots of unreasonable fears related to medication administration over the years, and several jobs required quite a lot of injectable medication administration. Even though, like you-- I was very certain to do all the required checking, and my conscious mind knew that, the "what ifs" in my mind ran away like a freight train.

I wish I had aired some of that with a trusted person outside of work,  although in hindsight I can almost laugh at some of my fears.  That little old lady was so skinny! Did I hit her sciatic nerve? Is she paralyzed?  

Wishing you the best in dealing with this issue, em3120