Nothing compares to the sinking feeling you get when you realize you’ve administered the wrong medication to the wrong patient. As nurses, we strive to give the best possible care to each and every one of our patients, and that does not include giving them a medication that may possibly cause harm.
Your first step is to swallow your pride and convert that sinking feeling into action. If the drug is still infusing—if it was an IV dose, for instance—stop it at once. Assess the patient for any adverse reactions and treat as necessary.
Next step: Contact the physician and let her know about the error. If the administered dose was considerably higher than the ordered dose, you may have to consider an antidote to reverse the potentially harmful effects of the overdose. You’ll probably also have to monitor your patient’s vital signs and I&O more carefully over the next few hours. Depending on your facility’s policies, you may need to notify your supervisor as well.
As soon as the patient care situation is settled, fill out an incident report. Don’t look at the incident report as a paper laying blame; look at the incident report as a way to examine the problem and implement better practices. Most med errors are not the result of carelessness, but rather are the result of system failure. Perhaps the physician ordered one drug, but another was entered on the medication record. Perhaps the pharmacy sent the wrong pill. Maybe you hung an antibiotic without realizing it was related to one your patient is allergic to. An incident report detailing the circumstances of the error will help ensure that similar mistakes are not made in the future.
As to whether or not to tell your patient, check facility policy. Some facilities have full disclosure policies, and have generally discovered that openly admitting mistakes does not lead to increased legal action. Rather, patients who are told about mistakes are more likely to forgive.
Finally, check yourself. After all is said and done, ask yourself what you could have done differently and recommit to providing the best nursing care possible.