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Recently I had my first med error that went through my hospital's Just Culture.

The error was that I missed a leukemic patients dose of prednisone. This was apart of the patient's oncology treatment.

Today my clinical manager informed me that outcome of Just Culture was that I be written up. I She further reviewed the unit policy of missing a medication.

I feel terrible about this whole situation. I worry for my patients and I want to do well as an RN. I've reached a year of RN experience and was just starting to feel confident.

Just seeing if anyone has insight on this situation and how big impact a right up will have on my career. How will this effect getting hired later on?

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Specializes in Psych (25 years), Medical (15 years).

Welcome to AN.com, Mluer001!

It is understandable that you feel badly about your mistake, but we're human and we're going to make mistakes.

I remember the first time I was written up for a med error, 33 years ago.

I learned from that mistake, but went on to make many more throughout my career. I've never had a problem getting hired.

Live and learn and go on, Mluer001, to hopefully, make fewer mistakes than I have!

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Specializes in Emergency Department.
Recently I had my first med error that went through my hospital's Just Culture.

The error was that I missed a leukemic patients dose of prednisone. This was apart of the patient's oncology treatment.

Today my clinical manager informed me that outcome of Just Culture was that I be written up. I She further reviewed the unit policy of missing a medication.

I feel terrible about this whole situation. I worry for my patients and I want to do well as an RN. I've reached a year of RN experience and was just starting to feel confident.

Just seeing if anyone has insight on this situation and how big impact a right up will have on my career. How will this effect getting hired later on?

If I read this correctly, you missed giving a dose of prednisone to your leukemic patient? If so, that's a med error, potentially in as much as giving an incorrect dose to a patient. At about 1 year, you start feeling more confident but you still have stuff to learn. That can be a dangerous place to be. This is a good time for you to review policies and review what you know and have learned. Think about how and why the error happened and see what you can do to prevent this from happening in the future.

Yes, med errors happen and everyone commits them at some point. We're human. We just do our best to have adequate safeguards in place that prevent the errors from actually causing a problem. Because of my own workload, sometimes I may end up giving a med a few minutes late (technically an error) but sometimes that's unavoidable as a med may not be actually available. Sometimes this "extra" time allows me to catch an error by the provider... I've been thanked more than once for catching an error.

Just don't let this mess with your head or your confidence. Learn from this and move on.

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I'm in a similar situation as you and awaiting to speak to my manager. I been working at this unit for 6 months. I haven't been written up yet...but I sure I will be

I try my best in everything to not make mistakes but it just happened.

I'm worried about not getting hired for other jobs too..

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Specializes in school nurse.

What is "Just Culture"?

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Specializes in Nurse Leader specializing in Labor & Delivery.

I assume "Just Culture" is their incident reporting process?

I find it ironic that it's called that. If this is your first error, I think a write-up is a bit harsh.

No, one internal write up is not going to affect your nursing career. Learn from it; if you can do that, it will make you a better nurse.

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I am so disgusted that the whole made a med error, scared I'll lose my job or license mentality still exists.

Over 20 years ago leaders in the medical field proposed that medical errors be handled the same way the NTSB and airlines handle crashes. No one person is blamed, no ones job is threatened. What went wrong is investigated and whatever helps prevent it happening again is instituted.

You all may be to young to remember but airplane crashes used to be more frequent.

The nursing culture instills such blame and shame nurses are afraid to admit they made an error.

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Over 20 years ago leaders in the medical field proposed that medical errors be handled the same way the NTSB and airlines handle crashes. No one person is blamed, no ones job is threatened. What went wrong is investigated and whatever helps prevent it happening again is instituted.

There are many inside hospitals and working in healthcare who would prefer to treat errors this way. But in general, hospitals are more interested in limiting their liability than they are in improving practice and outcomes, so blame is shifted away from imperfect systems and towards individual practitioners.

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I hope you weren't understaffed. We were taught that every patient over 4 (day shift, med surg) DOUBLES your chance of making a med error. That said, everybody makes mistakes. Make sure you take every opportunity to learn from this error. That's how you get to be an experienced nurse.

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Specializes in Critical Care.

"Just Culture" is a philosophy for addressing med errors that is based on viewing med errors as always have at least some amount of systemic fault, unless there is clear reckless behavior then there should be no write up, so it's odd that the "outcome of Just Culture was that I be written up".

https://www.partners.org/Assets/Documents/Graduate-Medical-Education/10_09_27_Just%20Culture.pdf

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Get your union involved right away.

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How come you made the error? As someone else stated, maybe the med was not available? Maybe Pharmacy didn't provide it? Maybe you had to go to Pharmacy and pick it up and were late giving it because of their not timely providing it?

Maybe you somehow missed a new order?

What factors were involved in this error?

It does seem like you should have gotten a verbal warning first?

What exactly does a write-up (not right up) consist of?

There is no reason that a new employer should even know of this error unless you tell them. It's not like it gets reported to your

Board of Nursing or sent around to every other employer.

anyway, as so many have said already, errors are part of the miserable things that can happen in our field. You have to be relentlessly careful.

Own up to any wrongdoing on your part and also realistically assess the contribution of all the parts of your system that could have failed.

Take heart, life goes on. It's good that you feel terrible but don't feel like your life and

work as a nurse are over. I assume the patient got the dose as soon as possible once it was realized that the dose was missed and is OK.

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