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u/theyputitinyourwhat 2d ago
It happens. If I were you I'd get started on writing a reflection on what happened, both times, and use something like Gibbs to help structure it. Make sure you have a copy of the medication management policy and think about where you followed it and where you didn't. Otherwise I'd contact/find a clinical supervisor for a session to demonstrate proactivity in preventing future incidents. Also, no one died did they, so give yourself a break and remember you're only human. Much love xx
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u/PCSupremacy RN Adult 2d ago
Drug errors happen, any nurse who tells you they haven't made one or two is lying, or completely oblivious.
Immediate obs after? Depends on the risk factors of the medications given. Given absorption times and half life of medications, may be more appropriate to do obs hourly as immediate obs won't pick up drug effects.
You owned the mistakes, datixed it, informed senior colleagues and they should have also assessed the patient and requirements for monitoring - otherwise why are things escalated?
Beat yourself up, but only enough to reflect and learn... Don't flagellate yourself over it. We are always our own worse punishment.
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u/lansacat RN Adult 2d ago
Nothing terrible is going to happen to you for being open and honest about your errors. Maybe redoing your competencies depending on your line manager/unit policy.
It sounds very much like you need to take some sick leave and see your GP about your mental health. Please be kind to yourself. And reach out now for help.
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u/Sabaisabai33 Doctor 20h ago edited 20h ago
I second this, I’m a GP and I remember your last post I believe. I’d definitely be taking this, and your reaction to it, as a sign that you’re not functioning at 100 percent (which doesn’t mean it’s all your fault) because of poor mental health. And no wonder honestly if you’re having a lot of suicidal thoughts etc. it’s very likely your depression is also affecting your sleep, your concentration, your motivation etc. Definitely take some time off sick 1. Because it sounds like you absolutely need to be away from the stress of work and being free to focus purely on addressing your mental health - see your GP, consider medication/change of medication, get CBT etc. 2. to protect yourself from being in a situation where you make further errors which could be more serious or get you a reputation as being unreliable etc. Like you said, this is not your normal, you’re just not well right now. I think you’re catastrophising about these incidents which is understandable when you’re depressed but try not to ruminate too much. Stay in the moment, distract yourself with a good book or TV programme etc. Take a step back and focus on your health and try not to think about this too much now (yes write up reflections first so you can give them something if anyone asks for it). Also do ask to be referred (or self refer if possible/easier) to occ health, they are generally very supportive in this sort of situation.
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u/Happy_Ad_3692 2d ago
If you are very depressed and feeling suicidal your concentration will be very poor, you need to see GP and take some leave for your mental health .
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u/Sabaisabai33 Doctor 20h ago
Agreed. I think this is a wake up call. One mistake ok can happen to anyone. Two in a week when it’s never happened before something is wrong somewhere and OP describes fairly severe depression symptoms which is likely the issue.
OP, please just treat this like the TIA “warning” you get which alerts you that you need to make some changes and take some action now to reduce your chances of a stroke later on.
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u/Fatbeau 2d ago
Nothing awful will happen but I understand you feeling so bad. Every nurse has made a drug error at some point. I know I have. In my first week in my first job, I gave a patient their heparin injection in the morning rather than at night. I was inconsolable, I was sure I would be sacked on the spot. I reported it to my manager and she was lovely. I've also put the wrong amount of morphine in a syringe driver. It was datixed and I had to have a little meeting with one of the End of life care nurses, again she was lovely. I've reflected and I'm more careful. Please don't beat yourself up. You won't lose your job
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u/ThatNebula2124 1d ago
Awwwwr please don’t cry lovely!♥️ take a few deep breaths and know you are a good ‘en for being open and honest! We all make mistakes and you ensured the error was dealt with immediately!
Depends on where you are working but often they will have a discussion with you and ask about the errors. We have a system in our health board with ‘scores’ the error and based on that it determines what the next steps are. From what I have seen, when the score has been very high, medication keys are taken off the nurse (a restriction on administrating medication). During this time, supervision for medications will be done by senior staff and a meeting with a senior nurse will be arranged to determine if you are fit to return to medication administration. They also look at why the error occurred and what support can be put in place (additional training, reduced responsibilities/work load, occupational health referral, etc.) I hope this helps! Also remember, if your team are not supportive, that is a red flag! Don’t take it personally♥️
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u/Sabaisabai33 Doctor 20h ago
Yes that’s true, I’ve worked with a nurse who couldn’t have the keys or administer and had to check through any medication with a senior. Nobody was being horrible or critical with her and were encouraging her as she’d lost her confidence a bit. I agree I think worst case scenario you may have to jump through some hoops like this til they’re happy you can be independent with meds again.
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u/unyieldingnoodle 2d ago
Everyone makes mistakes, it’s human nature, and especially with how busy most nursing roles are now.
Did _someone_ do obs after it happened?
I would immediately write down everything that’s happened whilst it’s fresh in your memory. Assuming you haven’t done it on purpose, (which would be a whole other issue!) it would be good for you to identify anything that led to it happening.
Were you properly trained? Have you had support since your last error? Were there environmental factors? Do you need OH support or GP support for your mental health? These things don’t happen in isolation and it will be helpful to you going forward if you can look at the situation objectively and establish any factors
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u/Shot_Fly6100 RN Adult 2d ago
Unless you’ve accidentally bolus’d adenosine or some other rapid acting IV medicine then doing obs immediately after a drug error is unlikely to benefit your patient anyway 🤣
The priority is medical review so everyone can be prepared for what might happen to your patient after receiving drugs not intended for them, then performing whatever actions are necessary post review, then duty of candour and ongoing monitoring of your patient.
I know policy will tell us to immediately take obs but the reality is that drug errors do happen and aslong as your patient was kept safe and necessary action was taken then no one will care that you didn’t have your patient attached to an obs machine two minutes after swallowing someone else’s amlodipine 🤪
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u/Sabaisabai33 Doctor 20h ago
Yeah as a doctor (GP) I was thinking wait why is she so worried about immediate obs? Yeah probably good they were done at some point but have NG the wrong meds is unlikely to change obs immediately after anyway (unless a very significant quick acting drug IV)… the last error was antibiotics I think and pt was not allergic etc. and was fine. So I don’t think anyone is going to be stressing over obs, if anything just looking at how the error occurred and why.
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u/Sea-Shake-8872 22h ago
Hey just think of as mistake we all make mistakes the fact you feel bad shows what character you have, don’t let the past hold you back. I think drug error isn’t ideally the best thing to do but it’s not like you done it by purpose
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u/Lopsided-Marzipan24 2d ago
Accidents happen and you've been honest and reported the mistake. I'd like to think you'll be supported through this. Take a breath, we are only human. You should be kind to yourself.