Need some advice.  I've had 2 bad experiences with insulin.  First, the MAR was incorrectly written with a U for units and I took it for a 4 resulting in too much insulin admin.  Didn't feel right drawing it up.  And just yesterday, I correctly administered an insulin dosage for a new resident of 60 units of Humalog resulting in resident becomining unresponsive, dyaphoretic, 7 was sent to hospital. 

Both times I lost it, thinking I killed the resident.  Especially the second time, since it was correctly read & written.  With this second incident after speaking to the son, he informed that he had an issue with the insulin dose being too high, a few days prior (resident usually only received 30-35 units in AM).  Anyway, just how does a nurse prevent herself from totally loosing it???  I love what I do, and do have some screamish issues with trach care and such. But, I realize that becoming that way does not effectively help anyone let alone allow me to look competent to individuals around me.  Please help.  I also am starting school to continue on to RN.  I don't want to think I picked the wrong profession.  Please respond ASAP.

 

elana

I have had several close calls-- oxycodone or oxycodone hcl or oxycodone sr----I always and I mean always--I do not care how aggrevated someone gets--I go to the original order--another nurse--and if I have to my supervisor.---I will even call the md who wrote the order.I am not about to lose everything I have worked for over something I don't think is correct---I check things 3 times and if I am still not sure I start my little protocol.......this has not only saved not only me but alsomy patients.

I agree with Cindy. If I think an order doesn't seem right, or is unusual I will always refer to the original MD order. If I still don't feel comfortable about it I will check with another nurse or superviser and then call the MD for clarification. You always need to not only protect your patient from a med error, but yourself as well. It may seem like an inconvienience, but it will save a lot of problems in the end.

One thing I always attempt to do prior to my shift actually starting is glance over the MAR's for my patients for any new orders. Especially on any new patients that come on my load. To many transcription errors occur because there are either to many hands in the pot, or the patient was just admitted 15 minutes prior to the end of someone elses shift. Anyway, it's always a good idea to "try" and look over the patients chart prior to the medication pass not only to make sure the orders are correctly transcribed, and if not, address it then, but also to get better background information. God only knows how many times I have received half- a** reports "patient admitted with bi lat hip surgery" then you read the chart...HIVpositive, TB positive, IV drug user...and the list goes on. If you don't understand something, ALWAYS QUESTION IT. No one will think you are stupid, we have all been there done that at some point in our careers. After 22 years at nursing I still question alot of things.

 

Good luck!

Thanks Marine.  Thanks for your advice, will take it into great consideration.  Listen, I think I bit off more than I can chew right now.  Enrolled in an RN program at a local community college and feel like I'm swimming.  I'm in an OPB rotation and feel like the instructor is hounding me cause of my inexperience, plus the fact that I'm comming in the program midway.  I'm gonna stick it out and give it my best.  Been practicing my assessment skills and have to do another with the instructor.  It's like some of the stuff I've already learned in technical school for my LPN. 

Any advice would be greatly appreciated.

elana

I am a new LVN in Yuba City, CA. I work part time in Med Surg in a small Hospital of the area.

I am studying to be an RN. They are 14 prerequisites before the one year step up program and it is a full investment.

I would suggest Elena Rita that you relax and continue on the RN program because you will give care on the higher level, you will improve your income and have more opportunities to find the right job for you.

Every Nurse made mistakes when they start and even after. Our job needs a very precise understanding of what is going on with a Pt, his Lab, diagnostic, prescribed Meds etc.. The approach must be systemic.

 Now, regarding the "U" for unit abbreviation, it should not be. It has been removed from the abbreviations due to many mistakes of interpretation. When you doubt about something, ASK, it does not matter if we sound inexperienced. The main think is to be SAFE.

 RN are very needed in this society. Courage! Continue to the end. Experience plays in our favor. We are useful to the world and it is a good feeling of accomplishment.

Catherine

 

I want to tell you, not to give up hope.

I just started as an lvn after 8 months of having my license. I never thought I would end up in a sniff, because my  heart belongs to the er.

But here I am.

I am working on my RN, just like you. Only because i am afraid that when I tell someone  they are wrong. I might lose my job because theyhave a step up on me.

I will be in the air one day as a flight nurse, not sitting behind a desk telling people what to do.  But the fact is that even though I am straight out of nursing school, I have seen so many errors at work n the past three days, that I don't even know if I should stay. Even though I am told by my fellow classmates that it's normal... I trust them.

I have been charting weekly reports on patients I  havent even known for two days!  How in the hell do you do that? But I have. Three times!

We are Supposed to know what to expect when we give a medication as a new nurse, But how?

Trial and error?! Lets just hope that they are a dnr and we don't end up beating ourselfs up for the rest of our lives.

All I can say is...... ask..... if they are shitty nurses.... ask the RN. You are still new, nursing is not like nursing school..... and if you have a passion you will be a great nurse.... if you didn't care you wouldn't be asking for help on this web site.... We are supposed to know what is the right medication dose and what is not, but maybe that comes with time? everyone is different, so maybe that comes with mind reading.? Who knows.....

If you gave the right dose, you are not responsible for the Pt's reaction, you are responsible for charting and doing everything possible to keep your pt. alive.    PERIOD.  Do what you can. Be the best possible nurse you can be.

You are only human.. If you expect more from yourself, give more of yourself... Read more, look into what you are doing; I found you because I don't know how to chart properly... I know how to love someone, anyone. as a matter of fact... But, am I fully doing my job by knowing how to care? Absolutly Not. I need to go the extra mile and do the research...

I don't know a lot of things, but I do know this... You are a WONDERFUL NURSE and so am I.