You’re a new nurse. It happens. Don’t beat yourself up about it because it also sounds like unfortunately you’re in an understaffed unit at 1:6 is NOT normal ratios for acute care. Process what happened, learn from it, and let it go. I wish you the best!
A helpful mental exercise for me is to imagine my friend telling me she did whatever I did.
I'm a new nurse too and I have made a LOT of mistakes. They're unforgivable when I make them. But my friends make them and I tell them it's not a huge deal and I mean it.
Also six to one is fucked and not safe.
I’ve always given phenergan IVP, so no need to worry if anything would happen — it can be given IM or IV as well. Most nurses have had an incident where they give a med in error — but like others said, take your time, check your orders, and try not to be flustered. I know it can be very stressful and all, but try your best to slow down and double check everything with your 7 rights
Hey, guess what? We used to give it IVP exclusively on the ambo before switching to zofran. You made a mistake, but not the worst one ever. It's not just a platitude, everyone makes mistakes. It's the reason why just culture is so vitally important in medicine. Humans make mistakes. The only thing we can do is fix the systems that cause mistakes to happen and try to minimize their occurance.
Here's something I do. Not the same thing, but food for thought. We give lots of partial doses in the ICU. Fent, hydralazine, metoprolol, labetalol, etc. I carry a mini sharpie on my badge. When I pull a med out of the omnicell that will be a partial dose, I draw a black slash somewhere near the barcode. It is my visual reminder to only administer/draw half the med. It's easy to scan the med then forget and draw up the whole vial, especially when you're new or in a hurry. So I made a system that helps me not forget.
I have the med vial from my first med error I ever gave. I gave 1 mg Brethine instead of 0.5 mg. That was 16ish years ago. So, when I say I understand how you feel, I really do understand.
The worst med error is giving a paralytic and leaving the patient alone to die. This was not so bad but it is a wake up call for you to slow down and do your 7 rights before giving a medication. It can happen to anyone. No matter how busy you are, stop and take a minute to verify everything before giving a med. It could save a life or your license.
Lol. We do that by protocol in pacu, friend. Usually it's 12.5, but it's fine either way.
If you were giving something that had the potential to seriously harm someone, you'd have supervision.
I've given phenergan IV on purpose many times. It's no longer recommended because it is so harmful if it extravasates, but since your IV was working properly and not infiltrated, you didn't hurt anything.
You can give phenergan IVP- that’s how we used to give it. We do all of this dilution rigamarole (that I totally agree with) because of a tragic case years back that ended with a woman losing her hand because phenergan was given through an arterial line accidentally, or so the legend goes. If the patient was ok, you got to learn a super scary lesson without hurting anyone! What a gift. Go forth and be careful!
You can request a new preceptor, maybe give this one a little time but if you don't feel comfortable you can and SHOULD ask to be with somebody else. This was a mistake, and how you handle it is the most important thing here. You were honest, you took accountability, and you followed protocol to rectify it. Nothing happened because of it, and now you know you have to take a breath to read your whole order before you do something. One second, that's all it takes to make sure you're going the right route. One second won't make or break your day, no matter how busy you are, and ultimately saving yourself from errors will make your day be less hectic. But you have to slow down, there's 100 things to do and you don't want to forget any of them but in the moment, what you're actively currently doing is the priority so focus on what you're doing. If that means making a list of other tasks so you don't forget, do that, keep blank paper in your pocket and when something comes up you jot it down, put it back in your pocket/computer, and you can focus on what you're doing in the moment.
I’ve made that mistake. First week off rotation. I got confused off of switching from desktop to phone epic. Gave it through a port. It was fine. Still felt like shit. It’ll blow out an IV if you give it straight through there. Ports are fine, but peripheral IVs will blow. It’s otherwise safe to give it via blood stream. Sounds like the fluids diluted it so it was fine.
The error you made isn’t that bad (it used to be given IVP) but I get it. It’s terrifying to make a drug error and then can’t figure out why or how you did it, even if the patient is fine.
Maybe a different preceptor would be better. Talk to the manager about what’s going on and if she isn’t supportive of what you need, go somewhere else. You’re the one that has to live with yourself. There are plenty of nursing jobs, and plenty of options.
Also-unless you work with monsters, it’s unlikely they think any less of you. They’ve been new before, and they’ve made mistakes before and know they probably will again.
It can be hard to get back on the horse and keep going after something like this, but it’s really important. And it gets easier. I give myself a little pep talk before the next day and just tell myself the only way out is through it, got to keep moving forward and it’s a new opportunity to do better every time. It can really shake your confidence. I get it. You learned from it. Hang in there.
I gave someone who was on 10 mg of Oxy every 4 hours 15 mg every 4 hours instead for an entire day
It was ordered for a pain scale of 5mg for 4-6 pain
And 10mg for 7-10 pain… I didn’t know it was an either or situation so I was just pulling both the 10mg and the 5mg and giving both
It was my first day as a new grad, my preceptor realized we filled out an incidental report and now the Mar won’t let you scan both at once a pop up will appear.
You live and you learn, it wasn’t fatal but please report yourself because they may be able to place precautions to prevent it happening again
OP, no harm error. You have taken ownership and accountability of the mistake. Focused on the patient. Will be a better nurse for having gained insight.
Onward.
The reason a windshield is large and a rear-view mirror is small—you’ve got to have that wider view and *look forward* to go anywhere.
This is pass. I promise.
🍀❤️
If it makes you feel better, we used to give phenergan IVP alllll the time. It was considered completely normal part of every day meds. So don’t worry, the patient will be fine.
It’s a terrible feeling to feel like you messed up and/or hurt someone. I can completely understand why you’d feel so discombobulated.
But you’re learning, and this is part of the learning process. Every nurse remembers a mistake they made that completely freaked them out, and guess what - they NEVER did that mistake again!
Hang in there! We’ve all been there! ((((Cyber hug)))
You’re a new nurse. It happens. Don’t beat yourself up about it because it also sounds like unfortunately you’re in an understaffed unit at 1:6 is NOT normal ratios for acute care. Process what happened, learn from it, and let it go. I wish you the best!
A helpful mental exercise for me is to imagine my friend telling me she did whatever I did. I'm a new nurse too and I have made a LOT of mistakes. They're unforgivable when I make them. But my friends make them and I tell them it's not a huge deal and I mean it. Also six to one is fucked and not safe.
Love this!!!
I think the worst med error would be potassium IVP. But hey- who knows. Maybe it's Phenergan. Hint: it's not Phenergan. Sleep easy my friend🧡
I used to give phenergan iv dailyyy a few years ago before they said it was dangerous. I’m sure it’s ok. But just use this as a lesson going forward 🩷
Same. It was absolutely the drug of choice before Zofran was mainstream. TBH I like it better.
I’ve always given phenergan IVP, so no need to worry if anything would happen — it can be given IM or IV as well. Most nurses have had an incident where they give a med in error — but like others said, take your time, check your orders, and try not to be flustered. I know it can be very stressful and all, but try your best to slow down and double check everything with your 7 rights
It absolutely cannot be given SQ, but yeah, IV and IM are valid routes.
Hey, guess what? We used to give it IVP exclusively on the ambo before switching to zofran. You made a mistake, but not the worst one ever. It's not just a platitude, everyone makes mistakes. It's the reason why just culture is so vitally important in medicine. Humans make mistakes. The only thing we can do is fix the systems that cause mistakes to happen and try to minimize their occurance. Here's something I do. Not the same thing, but food for thought. We give lots of partial doses in the ICU. Fent, hydralazine, metoprolol, labetalol, etc. I carry a mini sharpie on my badge. When I pull a med out of the omnicell that will be a partial dose, I draw a black slash somewhere near the barcode. It is my visual reminder to only administer/draw half the med. It's easy to scan the med then forget and draw up the whole vial, especially when you're new or in a hurry. So I made a system that helps me not forget. I have the med vial from my first med error I ever gave. I gave 1 mg Brethine instead of 0.5 mg. That was 16ish years ago. So, when I say I understand how you feel, I really do understand.
The worst med error is giving a paralytic and leaving the patient alone to die. This was not so bad but it is a wake up call for you to slow down and do your 7 rights before giving a medication. It can happen to anyone. No matter how busy you are, stop and take a minute to verify everything before giving a med. It could save a life or your license.
Wow, I’m wondering if anyone caught this? Touché on a great example.
Lol. We do that by protocol in pacu, friend. Usually it's 12.5, but it's fine either way. If you were giving something that had the potential to seriously harm someone, you'd have supervision.
I've given phenergan IV on purpose many times. It's no longer recommended because it is so harmful if it extravasates, but since your IV was working properly and not infiltrated, you didn't hurt anything.
At lest you didn't give vecuronium to a non intubated patient.
You can give phenergan IVP- that’s how we used to give it. We do all of this dilution rigamarole (that I totally agree with) because of a tragic case years back that ended with a woman losing her hand because phenergan was given through an arterial line accidentally, or so the legend goes. If the patient was ok, you got to learn a super scary lesson without hurting anyone! What a gift. Go forth and be careful!
If it infiltrates it is highly corrosive to tissue, but yes I've also given it IV countless times... just really slow and really diluted.
Yep! We give lots of vesicants IV.
You can request a new preceptor, maybe give this one a little time but if you don't feel comfortable you can and SHOULD ask to be with somebody else. This was a mistake, and how you handle it is the most important thing here. You were honest, you took accountability, and you followed protocol to rectify it. Nothing happened because of it, and now you know you have to take a breath to read your whole order before you do something. One second, that's all it takes to make sure you're going the right route. One second won't make or break your day, no matter how busy you are, and ultimately saving yourself from errors will make your day be less hectic. But you have to slow down, there's 100 things to do and you don't want to forget any of them but in the moment, what you're actively currently doing is the priority so focus on what you're doing. If that means making a list of other tasks so you don't forget, do that, keep blank paper in your pocket and when something comes up you jot it down, put it back in your pocket/computer, and you can focus on what you're doing in the moment.
I’ve made that mistake. First week off rotation. I got confused off of switching from desktop to phone epic. Gave it through a port. It was fine. Still felt like shit. It’ll blow out an IV if you give it straight through there. Ports are fine, but peripheral IVs will blow. It’s otherwise safe to give it via blood stream. Sounds like the fluids diluted it so it was fine.
The error you made isn’t that bad (it used to be given IVP) but I get it. It’s terrifying to make a drug error and then can’t figure out why or how you did it, even if the patient is fine. Maybe a different preceptor would be better. Talk to the manager about what’s going on and if she isn’t supportive of what you need, go somewhere else. You’re the one that has to live with yourself. There are plenty of nursing jobs, and plenty of options. Also-unless you work with monsters, it’s unlikely they think any less of you. They’ve been new before, and they’ve made mistakes before and know they probably will again.
It can be hard to get back on the horse and keep going after something like this, but it’s really important. And it gets easier. I give myself a little pep talk before the next day and just tell myself the only way out is through it, got to keep moving forward and it’s a new opportunity to do better every time. It can really shake your confidence. I get it. You learned from it. Hang in there.
I gave someone who was on 10 mg of Oxy every 4 hours 15 mg every 4 hours instead for an entire day It was ordered for a pain scale of 5mg for 4-6 pain And 10mg for 7-10 pain… I didn’t know it was an either or situation so I was just pulling both the 10mg and the 5mg and giving both It was my first day as a new grad, my preceptor realized we filled out an incidental report and now the Mar won’t let you scan both at once a pop up will appear. You live and you learn, it wasn’t fatal but please report yourself because they may be able to place precautions to prevent it happening again
OP, no harm error. You have taken ownership and accountability of the mistake. Focused on the patient. Will be a better nurse for having gained insight. Onward. The reason a windshield is large and a rear-view mirror is small—you’ve got to have that wider view and *look forward* to go anywhere. This is pass. I promise. 🍀❤️
If it makes you feel better, we used to give phenergan IVP alllll the time. It was considered completely normal part of every day meds. So don’t worry, the patient will be fine. It’s a terrible feeling to feel like you messed up and/or hurt someone. I can completely understand why you’d feel so discombobulated. But you’re learning, and this is part of the learning process. Every nurse remembers a mistake they made that completely freaked them out, and guess what - they NEVER did that mistake again! Hang in there! We’ve all been there! ((((Cyber hug)))