Reposted from http://onlinelpntorn.org/2014/drug-errors-are-bad-mkay/
I don't know about everyone else, but I learned the five rights of medication administration literally on day 1 of nursing school. In case that day hasn't arrived yet for you, these are as follows:
- Right patient
- Right medication
- Right dose
- Right route
- Right time
Now there are five more, for those of us who aren't so freshly minted:
- Right patient education
- Right documentation
- Right to refuse
- Right assessment
- Right evaluation
I am starting to see medication errors happen more frequently and less preventably and to receive more punitive reactions. The only possible result of this cycle will be nurses not reporting errors anymore, which we do voluntarily to assist healthcare as a whole in troubleshooting systems errors. Before non-nurses react, consider this: if 5 departments contribute but you have to take the fall, are you going to walk up to the firing squad if instead you can clock out and go home as usual? I forecast great doom if this punitive environment continues, and not just for nurses: "The public interest will be served if protection is granted to individuals who submit reports to voluntary reporting programs" (American Society of Health-System Pharmacists).
To support my forecast, consider this: I just watched a physician try to call the wolves off a nurse who'd made an error. He'd reported it at once and gotten the appropriate orders and nothing went very wrong. But "they" pick and choose which errors are held up as examples and which are allowed to pass, and this one was chosen as an example. The physician finally just deleted the commendation of the nurse for his integrity and prompt recognition, reporting, and treatment, because "that is all they'll accept." I don't know "they" were in that case, but I know "they" seem to be involved in this game of random selection across the board.
Medication errors fall into the category of ivory tower nursing ideals. I lived in that tower for about a week until I made my first medication error, and I didn't mess around: I overdosed a patient on heparin. To do this, I had to have another nurse cosign on two doses and a third nurse double-check our interpretation of a policy, but technically it was my error. I feel like there should be a division of error, somehow (why NOT initial that heparin without checking if the nurse who gives it will get reported to the board if it's wrong and nobody will bother with you?).
Now that ivory tower is so far away that the light from it will not reach me for a hundred years. Resources are so pinched and...where are all these patients coming from? Sick ones? Who need a lot of meds? At lots and lots of right times? It is easy to hear about the end error and judge the nurse who completed the final step of the series, but this interpretation and treatment is simplistic, ultimately undercuts the entire idea of systems improvement, and drives nurses away from the profession.
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