Wracked by Guilt -- Need Help -- Long

allnurses Guide · Nov 13, 2007

I am a brand new nurse just off orientation. Recently things got so hectic I kind of lost it and screwed up a few things.
1) I forgot to open the stop wheel on a Q6H antibiotic I hung and noticed two or three hours later that it hadn't run it.
2) On another patient I started an oral antibiotic X4D and forgot to give the second dose.
This all happened at the end of a very trying day. In the first instance I just ran the antiobiotic in when I noticed it hadn't gone in and then just started the next dose on schedule. In the second, I just signed off on the second dose, which I didn't give and then gave the next on time. I know both of these things were way wrong to do. I know a lot of it was about being a weasel and not wanting to take responsibility but some of it was just being rushed and not even knowing how to fill out an incident report, which I know my supervisor doesn't want to deal with either.
I need help on this because I am feeling really, really bad about it and I don't know what to do about it. Should I just move on and never ignore or falsify a med error again, or do I come clean with my manager now.
If I make another med error, what do I do. HELP!!!!! I feel horrible.

I've done the same thing with an IV antibiotic . . . wish the IV pump would alarm when the piggyback doesn't infuse. And I've missed a med. And been tempted to not tell.

I think what happened to you happens to all nurses, sooner or later.

But what you did after needs to be addressed. So you don't take the same route. Stop this before you start to take the easy way out as a matter of course.

I'd go talk to your supervisor. Fess up. Honestly, that horrible feeling will go away.

Next time it happens, just call pharmacy and ask them when you should actually hang the next IV or give the next pill. Write an incident report.

You are your patient's advocate . . . even against yourself and errors you might make. Stand up and be the best patient advocate you can be.

If I could, I'd give you a big hug right now. :icon_hug:

steph

hikernurse · Nov 13, 2007

I doubt there are many nurses out there who haven't forgotten to open a stopcock or give a dose of meds. You will feel better if you own up to it and next time call the pharmacist--you don't want to give some meds too close together. I doubt anybody will yell at you for a mistake. But, I surely understand the temptation to just want to walk away.

And please change your name--you're not a lousy nurse, just a human one :).

{{{{{{{{{{nurse}}}}}}}}}}

jlcole45 · Nov 13, 2007

I agree with the other postings. Learn from you mistakes and move on but never sign off a med again that you haven't given - it can develop into very dangerous habit.

If you find you are struggling to keep up then it is your responsibility as a professional to tell your charge nurse that you need a help. You are new and still learning, don't be afraid to speak up. Besides even the most experienced of nurses will have crazy days were all heck breaks lose and they need a hand to stay on top of the load.

Don't beat yourself up too much - this is an important lesson so use it to become a better nurse.

GingerSue · Nov 14, 2007

be aware of the habit that is developing, break the habit of signing off meds that haven't been given, then learn from this in order to make changes for improvement

newohiorn, BSN, RN, EMT-P · Nov 14, 2007

I agree with the others. I think we've all hung a piggyback that didn't run in because the roller clamp wasn't open. I'm sure I've done it more than once but when another nurse brought it to my attention I learned to always double check that because I didn't want someone to have to tell me that again. As for giving a med late--that happens all the time for me. Sometimes things are simply out of control and you have to do what you can in the timeliest manner you can. I agree that you shouldn't sign off that you gave it but rather call pharmacy and figure out what to do. I've had nights where I felt like none of my patients were assessed at the right times and all the meds were late, etc. and the more experienced nurses have told me that sometimes you just have to take care of the one that needs you the most (the sickest) and do the best you can with the others. It's not a perfect science. I've been waiting to have "the perfect shift" where everything goes right and I do everything exactly on time but I'm pretty sure that's NEVER gonna happen.

gonzo1, ASN, RN · Nov 14, 2007

I have done both the things you mention, forget to open the clamp, and miss giving meds. But I always fess up. The most important thing a nurse can have is their integrity, you don't want to lose that.

I once gave a patient triple doses of the med they were supposed to get, and I did it 3x per day for a day and a half. I don't remember what it was, something like maalox for dialysis pt. When I finally realized what I was doing I told the charge nurse, the pharmacy and called the doctor.

Everyone supported me and just told me to learn from my mistake. The doctor laughed and asked if I was gonna be on the next day when the patient was gonna get the "runs" from my mistake. And I was.

If you fess up to your mistakes people will trust you more, not less. And you are less inclined to roll down that slippery slope and covering up mistakes that can eventually cause someone a big problem.

As for the guy that got too much "med" pharmacy decided the packaging was confusing and they package it differently now.

I wasn't the first who made that same mistake.

Good luck and keep caring about doing a good job. Nursing is very hard, but very rewarding and we all need to support each other.

sleepyndopey · Nov 14, 2007

First of all, relax. We are all human and we all make mistakes. The fact that you are so upset about shows how much you care. You are not a lousy nurse, you should change your name.

Now, as far as reporting it as another poster suggested- I have reported myself after making an error, this was when I was brand spankin' new and I gave the wrong pts pills. I almost died right then and there. Anyhoo, I reported it right away, there were all kinds of meds involved:o. Pt was ok though. In your case, I don't see the benefit of reporting it now. I know I might get some heated responses from others on this, but this is how I feel. My reasons are

1.You didn't report it when it happened and you might get in more trouble for that.

2. There is really nothing that can be done about it now.

3. Is getting a write-up (or two because you reported it late)going to make you feel better?

4. Will you do this again or have you learned a lesson?

I know it's important to report errors to PREVENT the error from happening again but in this case I don't think it will do anyone any good.

Good luck

Dolce, RN · Nov 14, 2007

On the days where I have a crazy-busy shift I often drive home feeling guilty. There is always something to feel guilty about. When your shift is so busy that you are unable to think straight you will do things or forget to do things that you will regret later. I quit my first nursing job after 7 months because I was so guilty about the poor care that I provided that I would often come home in tears. I wasn't trying to provide poor care but the facility was so short staffed that it was beyond my control. Remember, you are human. All you can do is to give it your best, learn from your mistakes and move on.

On the days where you feel really guilty about yourself and are kicking yourself for not being perfect just say to yourself "I did the best I could."

suanna · Nov 14, 2007

You are new at this-give yourself a break! I hesitate to say but I would do nothing. You are obviously concerned about your problems that night- that alone tells me you are not a habitual screw-up. I'm sure you will be more careful for quite some time...problem solved! You will get more proficient with time. No patient was harmed and no action needed to be taken to treat or correct the issues you mentioned. EVERYONE makes those kind of errors. I work on a unit that has more seniority than anywhere else in the hospital on day shift and at least once a mos I find a clamped antibiotic hanging when I come on. The fact that you are concerned enough to write your post indicates you are an O.K. nurse. If yo find you are having chronic problems passing your meds or making frequent errors you may need help with you organizational skills but from your post I think you are making a mountain out of a molehill. From what I hear there has only ever been one perfect person and even he got condemed for other peoples mistakes. The rest of us just do our best and try to be a little better tomorow than we were today.

kanzi monkey · Nov 14, 2007

I just thanked everyone who has posted in this thread. These are things I am scared of doing, of missing, of thinking of later, etc...

Nursing, especially in the first year (or, at least from my experience :) can be extremely stressful and chaotic. I stay on my toes, but just barely sometimes. Med errors from confusing dosing schedules, meds not being available, pt's being off floor, or something as simple as not unclamping the piggyback seem inevitable sometimes.

Every single one of you understands this, and I don't know why but I feel a small weight has been lifted from my shoulders from reading your responses. Not that I don't still carry the same responsibility, but just knowing I'm not alone.

-Kan