Nursing Medication Errors: ER Nurses Analyze Critical Mistakes

[00:00:00]So insulin obviously is used to decrease your blood sugar if you're a diabetic.

[00:00:05]If you give somebody the whole bag, your blood sugar is essentially going to be zero, which is not compatible with life.

[00:00:12]Grab a coffee, take a breath. You've just clocked in to the ER edit. I'm Caitlyn. I'm Carly. You are now clocked in.

[00:00:22]>> We are back. Welcome back.

[00:00:24]>> Welcome to episode two.

[00:00:25]>> I know. How was your week?

[00:00:28]>> Just great. and just busy and just life, you know?

[00:00:32]>> I feel like >> Do you feel like everyone's sick right now?

[00:00:35]>> Yes.

[00:00:36]>> Like everyone is sick.

[00:00:37]>> Everybody has pneumonia. And let me just tell you, never did I think as a 30-some yearear-old that I would have pneumonia, but now every single person around me has it. Like my family members do, but every person coming in the hospital does too.

[00:00:50]>> Even people commenting online are like, "I have pneumonia." And I'm like, "Since when has everyone had pneumonia?" When has pneumonia been a thing? My grandma had pneumonia which is like you see that in elderly. I know but like young people are getting >> and it like took me out. I mean you know I was like literally bedridden. It was terrible but >> it does make me feel a little bit better. You know >> you know as nurses that we can have a little bit of health anxiety when it comes to the things we see. Absolutely.

[00:01:17]>> So it always makes me feel better honestly when I see a ton of people checking in with the same symptoms I have because I don't feel like such an anomaly. Well, I'm pretty sure you texted me when I was in Hawaii and was like, "At what point do I need to go in?

[00:01:30]Like, my resting heart rate is like 120." And I'm like, >> I did.

[00:01:33]>> You're dehydrated for sure.

[00:01:35]>> Well, and also I was a full-blown sepsis alert at our own hospital, which is literally the most embarrassing thing.

[00:01:42]But that is also what we do because you text me with your appendix.

[00:01:47]>> Sure did. See, >> I think it's a like you almost need another nurse's validation to be like, >> am I, >> okay, now it's time you have a valid reason to go in.

[00:01:57]>> Yes. You need that person to like give you the little extra bump >> and it can't be your husband >> and never cuz he doesn't know. I need like a person that's boots on the ground. You know what I mean? To be like, "Girl, >> it's time.

[00:02:06]>> It was time two days ago, but here we are."

[00:02:09]>> But then you always have that fear that you're going to get there, you're going to get checked in, and they're going to be like, "Yeah, you've got a common cold." Or for me, they're like, "You've got a tummy ache." Ken is like, "Can't be me." So, you almost feel like, "Well, thank God something was wrong."

[00:02:23]>> Oh, no.

[00:02:23]>> Do you feel that way ever or is that just me?

[00:02:24]>> The second No. The second honestly that they were like, "We need to call a sepsis alert in bed 4," I was aortified because I knew um Can we tell everybody what a sepsis alert is >> in the emergency room? So sepsis alert is when you like check in and I think like by definition there has to be a suspected source of infection with at least two abnormal vital signs correct >> which could be which could be like fast respiratory rate and heart rate like that's it but they at our hospital they overhead page like sepsis alert to bed whatever and then all these like people come in and so to have that happen where you work >> it was horrible >> but also I looked at Nick and felt very validated. And I was like, "Watch, >> see this?"

[00:03:10]>> Well, I said, I was like, "Watch, there's about to be a lot of people that come in this room." And he was like, "Really?" And I'm like, "Mhm." And so then he looked at me and he was like, "Should we have come sooner? Like, you're actually sick." I was like, "I know, but no, we shouldn't have come sooner. It was fine."

[00:03:25]>> Well, I'm so glad you're on the up and up. It's It's been months, right? It's been like over a month.

[00:03:29]>> I know. And I still don't feel 100%.

[00:03:32]That's why you guys are going to see me and hear me coughing in these episodes because I still have that dry annoying cough.

[00:03:39]>> Yeah, >> but like I said, >> I actually have an incentive sperometer for you. Have you been using one?

[00:03:44]>> No, of course I haven't.

[00:03:46]>> I have an inhaler and I haven't used it once cuz I'm afraid it's going to give me anxiety. Guess what we have for you guys today?

[00:03:52]>> Meters.

[00:03:54]We're super excited. We like these are kind of our bread and butter.

[00:03:58]>> This might be my favorite thing segment.

[00:04:00]If you watch our Tik Toks, you know that we read medication errors that people submit. And as a nurse, I just blows my mind that these are real.

[00:04:11]>> I know. Do you think they all are real?

[00:04:14]Okay. We have the same questions that you guys do, though, too, because we are reading comments. These are not from our real life.

[00:04:20]>> These are not our real life experiences.

[00:04:21]>> These are comments that we're reading or you guys have flooded our DMs. We have gotten a lot of messages of people saying like, "Here's my story." Which we love. Don't stop that.

[00:04:33]>> No, don't keep sending them because those ones also are the ones that go into way more detail and are like very mortifying. But >> we are reading these just along with you.

[00:04:44]>> We specifically do not read these ahead of time so that we can actually react with you guys as you are hearing them.

[00:04:50]So, >> let's get into it.

[00:04:52]>> Okay. And we are going to explain why these are so bad now because I know a lot of you have asked like, "Hey, I'm non-medical. Can you know?" Absolutely.

[00:05:01]We would love to talk about it.

[00:05:03]>> Mhm. These ones always kill me too. This one said, "I saw a B-52 given with a blunt needle." Like those ones kill me.

[00:05:13]Okay, so >> for reference, a B-52 is a concoction that we typically give psych patients. I mean that is typically who that is going to be used for.

[00:05:24]>> It's considered a chemical restraint because you're medicating somebody to calm them down.

[00:05:29]>> We are giving them benadryil, Adavan and how doll >> and it's called B-52. Why? Because it's like benadryil and then 5 milligs and 2 milligs.

[00:05:37]>> Five and two. So it's benadryil 5 milligs of halal 2 milligs of Adavan >> which Adavan is extremely viscous. So if you're drawing it up thick so you do need a blunt big needle to draw that up typically. Well, a lot of times you're drawing up your medications with these blunt needles because it's a lot easier than like Yeah. So, these blunt needles are specifically used for drawing up meds only >> only.

[00:06:04]>> They >> like literally only >> are literally empty on the inside and take out a chunk of skin.

[00:06:09]>> It's hollow. It's like how big is the gauge? 18 or bigger?

[00:06:14]>> I would think it was a like a I would think it was >> like a 12, right?

[00:06:18]>> I was gonna say 16. Huge. And it's hollow like and it's not sharp. So like if you're if somebody came up to me and was like, "Hey, I'm going to give you a blunt." It'd be like boom like hole punch your skin.

[00:06:28]>> That is a very good point that I never even thought about is that it is not sharp. There's not a sharp >> There's not like a beveled tip to it.

[00:06:34]>> No, that's even worse.

[00:06:37]>> That's sick.

[00:06:37]>> Okay, so this patient, if you think about it, is already psychotic.

[00:06:41]>> Well, now they're pissed.

[00:06:42]>> Needing to get a B-52 enough to get a B-52 cuz it does take a little bit in order to get that medication. And now they've just been hit with a blunt ne needle.

[00:06:50]>> No. Absolutely. That's my gosh.

[00:06:54]>> Things are about to get bad.

[00:06:56]>> Uh-oh. Uh-oh.

[00:06:58]>> An ER nurse overrode lev.

[00:07:01]>> Okay.

[00:07:02]>> Thinking it was Levoquin.

[00:07:04]>> No.

[00:07:05]>> Hung it by gravity.

[00:07:06]>> No.

[00:07:06]>> Of course, the patient died. Blew their aorta open. Same nurse gave a unit of PRBC's without blood tubing.

[00:07:14]>> Wait, I'm sorry. Was this nurse allowed to come back after the Levoquinn incident?

[00:07:17]>> Well, I don't know which was first, but the blood tubing.

[00:07:22]>> The blood tubing I'm like, is that cuz blood tubing has like a inline filter, right?

[00:07:26]>> It has an inline filter. It also has the two ports so you can hook it up to the NS but like it's more the filter like the chamber that >> but also I'm like it's fine, right?

[00:07:36]>> I mean like I feel like we can get past that.

[00:07:38]>> The Levo though.

[00:07:40]>> Oh my gosh. So Levo is Norepy.

[00:07:43]>> Yes.

[00:07:44]And that's it's a presser. It's a pressor. We are using it for patients who are like that are dying.

[00:07:52]>> Their blood pressure is like in the tank. Meaning it's like so so low that you need a presser to like squeeze to get your your blood pressure to come up.

[00:08:00]That's like a very very basic.

[00:08:03]>> We're going to go very basic on these terms.

[00:08:04]>> But levquin is an antibiotic.

[00:08:07]>> So levo runs at a very very slow pace.

[00:08:10]like what I want.

[00:08:12]>> We start Leivoped at 0.05.

[00:08:17]That is the starting dose of that medication.

[00:08:20]>> Yeah. Not open to gravity.

[00:08:21]>> Wedding that wide open to gravity. Like that's obviously going to be terrible.

[00:08:26]>> And it sounds like >> Can you imagine what I mean? Obviously, if it blew their aorta open, their blood pressure was 300 over 200.

[00:08:34]>> Yeah.

[00:08:36]>> That's not good.

[00:08:37]>> They cannot have a license anymore. And also like how often are you checking on your patient?

[00:08:43]>> Also >> also why >> levoquin levoquin. Okay. So >> every medication has to go on a pump.

[00:08:52]>> Supposed to >> speaking in like >> policy >> policy terms.

[00:08:56]>> Yes.

[00:08:57]>> Every single medication has to go on a pump.

[00:08:59]>> Mhm. There are antibiotics that technically by policy not by policy standards but that run for shorter amount of times. So if you push >> there's some antibiotics you can push.

[00:09:13]>> Exactly. So rosphen you can actually do as a push drug. Our hospital we run it in like as a tube. Not as a tube but like as an um >> like as a drip >> as a drip >> but it can't be pushed. Other hospitals do. Levoquinn is not one of those.

[00:09:30]>> No, >> I think Levoquin's Doesn't it run over two hours?

[00:09:33]>> I think it's 30 minutes.

[00:09:34]>> Is it short like that?

[00:09:36]>> I think so.

[00:09:36]>> I mean, I don't remember the last time I >> Either way, you shouldn't be running it wide open.

[00:09:40]>> I cannot. These ER nurses are [ __ ] up here today. I had an ER nurse hang potassium to gravity because she couldn't find an IV pump. Entire bag infused within 5 minutes. Oh, like a K rider or like >> It must have been a K rider. It must have been, right? Like you're not going to >> Those go over an hour.

[00:10:02]>> I'm curious what would happen though if it ran over that fast.

[00:10:05]>> Well, I mean, you're giving potassium as one of the ingredients for lethal injection.

[00:10:10]>> Well, I'm sure they're symptomatic, but I don't think that was lethal if it was like a 10 mil equivalent bag.

[00:10:16]>> That's probably true. So, just so you guys know, you never push potassium ever.

[00:10:20]>> Ever. That is literally >> even if the doctor tells you >> never because it sounds like sometimes in the comments people be saying the doctor said to push it and you do not push IV potassium.

[00:10:30]>> No. And I am like consistently checking on my patients that I'm even giving K riders to because it makes me so nervous. It also hurts. It is very painful. A lot of the time your K riders have lidocaine in it because it's painful going in. Yeah, but potassium causes horrific and lethal cardiac arhythmias. So like >> different heartbeats for you and that you don't ever. So if you're in nursing school right now and you are going to the hospital and anybody ever tells you to push potassium, don't you dare. And make sure your patients on the monitor when they're getting potassium every time. And sometimes because in the ER you're not like you're doing very focused care. So unlike the floor, you're not going to have an order for telemetry and an order for this. Like you're going to have to use clinical judgment. Like you may have a patient who's there >> and for whatever reason they're not on the cardiac monitor. They don't need to be. But then their labs come back and the doctor's like, "Oh, we're going to give them a couple doses of like IV potassium just to bump it up.

[00:11:31]>> You need to know to put them on the monitor because that is a huge deal.

[00:11:35]>> Potassium is a big one. We had a patient come to the ICU after they had gotten a whole bag of insulin thinking it was venkcomyosin, another antibiotic. The patient had to have about 35 amps of D50.

[00:11:50]>> Wait, a whole bag? Yeah, a whole bag.

[00:11:53]>> Oh my gosh. So, insulin obviously is used to decrease your blood sugar if you're a diabetic. If you give somebody the whole bag, your blood sugar is essentially going to be zero, >> which is not compatible with life at all.

[00:12:09]>> So you would give sugar.

[00:12:11]>> Yeah. And that's what they do, >> which is dextrose. So we give these like amps. We call them amps of D50. So it's like an amp syringe and everything.

[00:12:19]>> The hardest [ __ ] to push in, but thick.

[00:12:23]So you're like shoving this in, but it makes the blood sugar jump. So 50 amps.

[00:12:28]That's a lot.

[00:12:29]That's the most I've ever heard given.

[00:12:30]>> Why didn't they just run an extra strip?

[00:12:32]>> I mean, I'm sure they probably did that, too.

[00:12:35]>> They were probably not thriving, that patient.

[00:12:38]>> Mhm. I I know that this isn't like possible, but what I would really like is to have like a followup with these scenarios. Like, what happened?

[00:12:46]>> I know.

[00:12:47]>> Like, did people like were these like system >> or did was this just literally like a negligent oversight and they lost their license or they got into trouble? Like I have a lot of questions.

[00:12:58]>> I agree completely and I want to know.

[00:13:02]>> Oh no.

[00:13:04]>> Oh no. A new grad got a baby's IV penicellin and mom's in or I am bicellin. Is that an antibiotic too?

[00:13:15]It's got to be >> um mixed up. She gave the bicellin IV to the baby. It blew the IV. So, all of the medi like all of the medication essentially went into the baby's tissues.

[00:13:30]>> No.

[00:13:30]>> And the baby lost two limbs and has cognitive defects.

[00:13:35]>> Oh, no. This is tragic.

[00:13:38]>> I hate that.

[00:13:40]>> I hate that one.

[00:13:41]>> There are certain Well, obviously the dosing on that one was going to be completely wrong because it was mom's I am shot.

[00:13:47]>> Yeah.

[00:13:48]>> And like a neonates shot. But it is very important to know too that there are certain medications that if extravagation no >> infiltrates >> if it infiltrates and goes into the tissues you're [ __ ] >> on some of them. Yeah. Yeah.

[00:14:05]>> They can be like necro it can make it necrotic.

[00:14:08]>> Some meds are really really bad. This is why you always have to check your IVs before you push meds.

[00:14:12]>> Somebody just commented in all caps.

[00:14:14]Stop telling me I take too long to explain things to new grads.

[00:14:21]Valid. Valid.

[00:14:23]>> Oh.

[00:14:25]Oh, no.

[00:14:27]>> I'm an ER nurse. I had an anaphylactic reaction at work. Co-orker drew up the vial of EPI thinking it was benadryil and pushed it through my IV. No.

[00:14:36]>> I went into VTAC and had a heart attack at 27 years old. PTSD so bad from the alarms made it so I can no longer work in the ER.

[00:14:45]>> I believe every second of that. Also, that is terrifying. Okay, that's your safe space that you go to for people that you trust when you get sick and a and a coworker. Oh my gosh, that's insane. Also, how do you how how are you mixing up EP and Benadryil? The bottles look completely different. Unless they had them all out, like the benadryil, the Pepsid, the Epi, all of that stuff, and they just picked up the wrong one.

[00:15:20]>> Sounds like it. It sounds like that's my guess.

[00:15:24]>> Oh my gosh. No.

[00:15:27]>> That honestly made the hair on my arm stand up a little bit.

[00:15:29]>> Can you imagine though? No. Can you imagine being the nurse though who accidentally did that? No. Like, >> how do you go back?

[00:15:36]>> No. And then also you're standing there with your someone you know you're taking care of. You administer something and all of the sudden you see them go to VTA. That would scare the [ __ ] out of me. It would scare the [ __ ] out of me to see any of my co-workers going into V like VTEC. That's our family. Let alone knowing that I caused it.

[00:15:51]>> Yeah.

[00:15:54]>> No. Someone said, "My health anxiety will not let me watch this video unfortunately." I agree with you.

[00:16:02]But here we are. I also feel like some of these that I'm reading are like pharmacy errors and that's kind of scary too because there is a lot of meds that get sent to us by pharmacy.

[00:16:14]>> Like they they made an error mixing up.

[00:16:16]>> Yeah. And that's scary >> which I mean they're human like they are.

[00:16:21]>> I'm sure mistakes are made >> 100%. Someone literally just said some of these are insane but at the same time as a nurse we are human.

[00:16:27]>> Exactly.

[00:16:28]>> Yeah.

[00:16:28]>> And I know that some mistakes are like bigger than others. like lethal medications. I get that. But like in any line of work, like you are going to make mistakes. And anyone who says that they've never made a mistake is lying.

[00:16:41]>> They are 100%.

[00:16:42]>> We've all made mistakes.

[00:16:43]>> 100%.

[00:16:44]>> And I think that it's just having like the safety checks in place or like >> I also think that once you make that very first mistake, your entire literally the entire way that you go about and do things changes like in that very second.

[00:17:00]>> Yeah. because I think you realize like >> well you essentially are [ __ ] your chin like this could have been really bad like what if this was a different medication >> all of the what if start running this one said my 2-year-old grandson was at a top hospital in the state that we live in getting a lumbar puncture so essentially checking potentially for menitis or some sort of infection in the spinal fluid that that's a lumbar puncture the doc ordered 10 ms of propyl for sedation. The grandson started to code. Doctor asked how much propal the nurse gave him. She drew up 100 mls and ended up giving him 80 something.

[00:17:42]>> Oh my gosh.

[00:17:43]>> Not only did the nurse screw it up, but the second nurse checked the medication with her.

[00:17:48]>> Oh no, that's not good.

[00:17:50]>> So propal is a sedative that we use. Um >> that's a lot for a little kid.

[00:17:54]>> Even 10 for a 2-year-old. Yeah, propal is used in many different capacities too. We can use it for conscious sedation. So like if you go have a dental procedure done and you are getting wisdom teeth. That's a perfect example. They'll use propal there.

[00:18:08]>> Will they?

[00:18:09]>> Mhm. They used propal on me for my >> I've never had meds at the office, the dental office.

[00:18:15]>> Why I went to like a specific surgery center.

[00:18:18]>> Oh.

[00:18:19]>> Um >> because the different doses make you sedated at different levels.

[00:18:24]>> Yeah. It's technically weight based is the dosage dosage that you're giving is based on the weight of the patient that you're giving it, >> right?

[00:18:32]>> But propall can be used not only for just like a conscious sedation where you're about to wake them up right after.

[00:18:39]>> It can be used during surgery as you see. Yeah.

[00:18:42]>> But also if we have a patient that we just intubated in the ER and we need to keep them very sedated, we will use propall as long as their blood pressure can like >> tolerate it. Yeah. Um, going back to med errors, I feel like this is a great opportunity and I have no problem sharing the very first med error I made.

[00:18:59]>> Oh, I'll share mine.

[00:19:00]>> And maybe this is a good learning point.

[00:19:04]>> Um, because I think that some people honestly are like afraid to admit that they've made mistakes.

[00:19:10]>> Every single person >> or like even when we post these matters online and people are like I've been asked like have you ever made a mistake?

[00:19:19]Yes, I have. And I will tell you exactly what I did about it.

[00:19:23]>> I know what scrubs I was wearing.

[00:19:25]>> So, I was my I was my brand new nurse like within the first year. Yeah.

[00:19:32]>> And I was on MedTell >> and we had paper charting my first job.

[00:19:36]So, everybody's chart was like outside of their room like in the door like in a slit.

[00:19:40]>> It was typical Grey's Anatomy.

[00:19:43]>> That's what it felt like.

[00:19:44]>> Yeah. So their binders or whatever their folders the it had their room number on it and it said allergies in red and that was like on the outside of the chart. So the patient had an allergy listed I think penicellin and morphine I think.

[00:19:57]>> Okay.

[00:19:58]>> I had been the nurse from 7:00 a.m. to 7:30 p.m.

[00:20:01]>> We were doing bedside report at 7:30 or whatever at night shift. Night shift was coming on and I was giving a report and I was telling them about this patient and that the patient had had pain during the day and I medicated with this and this and this and I said I medicated with like two or three doses of like.5 of morphine or whatever the dose was >> and I'm holding their chart >> with the allergies >> with the allergies and that is the moment I realized I had given them >> multiple doses of morphine and they had morphine listed as an allergy. Now, I think we can all deduce from my story that they did not have a true allergy to morphine.

[00:20:42]>> And by true allergy, I mean like an aniflactic allergy, but also these are the ones that get me because yes, you gave it and it was your med error at the end of the day. However, that allergy is listed in their chart. The doctor had to have ordered it.

[00:20:56]>> Well, and it's paper charting. So, the pharmacy I had the doctor had written it. I had to physically take the paper, fax it to the pharmacy. Pharmacy had to verify it. They stamp something that approves it. They fax it back to us, then it's allowed to be pulled from our Pix machine. So then I went and pulled it. So there's a lot of So I >> It goes through like four or five people.

[00:21:21]>> I'm not like blameshifting, but that's like a system problem where it it obviously went they call it like the Swiss cheese where it fall goes through all these holes. Well, but I think that's important to talk about because I think that people kind of misunderstand that and always think like the nurse and yes, we are that last line. We're the last line to catch all of it.

[00:21:41]>> But it does sometimes have to go through four, five different people all not realizing the same exact >> other licensed people, pharmacy physicians. It's like, so now I'm in this moment and I'm having internal panic. Like internally is puckering.

[00:21:58]>> Oh, I'm like, "Oh my gosh. Oh my gosh.

[00:22:00]Oh my gosh. Oh my gosh."

[00:22:02]>> So I finished giving report. My eyes like you know when you're like trying not to cry and you just have like the wells of water. So I am fully welled up.

[00:22:11]>> My manager was still there. Her office was like down the hall. I went running in her office and I just started sobbing.

[00:22:19]>> I think everybody does on the >> shout out. She was the best manager I've ever had. Her um >> I'm in her office. I'm sobbing and I'm like I can barely talk. I'm like I gave a patient morphine and they have an allergy to morphine and she's like are they okay? And I'm like yeah they're fine. They've gotten multiple doses.

[00:22:36]>> Nothing happened. Like they're great but like you're missing the point. Like I was a new error and I was like I am supposed to be so on my [ __ ] right now because I'm new. Like I'm not like a lazy 10ear nurse who like skips corners.

[00:22:48]Not that you should do that, but like in my head I'm like, if I'm making a mistake now when I'm like this fresh, >> which doesn't make sense, but in my head that's how I felt. Then I'm like, I'm not safe. Like I shouldn't be a nurse.

[00:23:01]>> And she like sat me down. She talked me through it. She's like, the biggest thing is, is the patient okay? Like you're doing the right thing. We had a system where you could like report um >> Yeah. Like a self-reporting system.

[00:23:11]>> Self-reporting system. So I did that. I filled it out because if you think about this, this is not punitive. It shouldn't be. It's like where was there a breakdown in the system? How do we prevent this from happening again? Yep.

[00:23:23]>> So, I filled it all out. Luckily, the patient was good. It's um and you took all the right steps, >> right? And but it could have been so much worse. And that's those moments you're like >> I'm like, "Holy shit."

[00:23:34]>> Well, imagine morphine. They did have a true allergy.

[00:23:38]>> You at the time were on a medley floor with probably what, six other people?

[00:23:43]Six other patients? Four. Six. Uh >> I think four or five. Yeah.

[00:23:48]You leave that patient for some time.

[00:23:51]>> Yeah. I mean, they're on the monitor.

[00:23:52]>> They are, but I mean it.

[00:23:54]>> But yes, you know what I mean? Like sometimes you don't have the time to go back in and check on that patient for at least an hour or maybe more. Yeah.

[00:24:01]>> And then they're just sitting in there with like a full-blown reaction.

[00:24:04]>> Yeah. That freaks me out. So my my guess is it was more of like an intolerance or like in the past had maybe caused like some like not so nice side effects, >> right? Luckily, this time that wasn't a problem.

[00:24:17]>> There are a lot of morphine allergies that come with like nausea, vomiting, like just not feeling good.

[00:24:23]>> Yeah, totally.

[00:24:23]>> And they are listed as an allergy on that patient's chart.

[00:24:26]>> So, that was my very first metair and I'll never forget it.

[00:24:30]>> Like, and it wasn't even a massive medair, but it was my first one. And the feelings that are tied to that, I'll never forget.

[00:24:36]>> It's the worst feeling that I have felt.

[00:24:39]>> I mean, I think my my whole body turned red. All of it. because I I and and like flushed instantly the second that I found out what I had done.

[00:24:48]>> What did you do?

[00:24:48]>> Okay.

[00:24:50]>> I was I was 2 months off of my orientation at the very first hospital that I ever worked at. I started in the ER and so I had gone through all of my orientation and our orientation at that time was like 6 months. It was pretty long compared to what they have now is like 6 weeks.

[00:25:05]>> Yeah. They're like boots on the ground running. Let's go.

[00:25:08]>> So I had a ton of time. So, they had me at the hospital that I was at, which is not the current hospital that I'm at, is um what would be our green area, which was our resuscitation bay. Okay. So, they had me training in there with somebody else. Even though I was technically on my own, you move up a level and you can ch train there. We had a patient came in, >> they needed a blood transfusion. No big deal. They actually weren't that sick.

[00:25:33]It was the perfect patient for me to like kind of get my feet wet.

[00:25:36]>> Yeah. Um, so we hung the blood and at the time in order to get all of the blood down the tubing without putting it into the Allaris pump, I just programmed it like, you know, you could let it drain.

[00:25:52]>> Yeah.

[00:25:52]>> Without putting it in the pump. Or you put it in the pump and you hit 999 to make it run as fast as you can >> just to get the blood to the end of the tubing. just to prime the tubing and then you reset it for whatever it is 60 whatever it may be for your starting dose.

[00:26:07]>> I hit 999 >> and left it.

[00:26:10]>> Uhhuh.

[00:26:11]>> Just threw that blood in.

[00:26:12]>> I bololis that blood into fine into that patient. Correct. But this was like not an immediate release. We were not doing Yes. This was a standard patient with a simple hemoglobin that was slightly low.

[00:26:28]>> Yeah. And I I walked out. So I hit 999, push start on the patient, walked out of the room, and I [ __ ] you not, not like 10 seconds later, the pump is beeping.

[00:26:40]And so I was like, "Oh [ __ ] they have an occlusion." Like something happened.

[00:26:42]Oh, no, no, no. I walk in there, >> the bag, the blood is done.

[00:26:47]>> I have never.

[00:26:48]>> And your butthole about fell to the ground.

[00:26:50]>> I thought I was getting fired. In that immediate moment, I thought that I had just worked so hard to get to this career. Just got done with nursing school. Just got done with orientation and I'm getting fired today on the spot.

[00:27:02]And what am I supposed to tell people?

[00:27:04]>> So I ran out sobbing, sobbing, stopped in on the patient, obviously checked to see if they were okay. Thrilled about life. They kept they had not one sing.

[00:27:14]>> I didn't even have enough time to do my second like temperature check. You know what I mean? And so I was being trained just like you know me. This was Baldev. He was training me and I walked out there tears. I mean just tears. And he's like this old crotchety like vet nurse love. And so I was like bald and he was like what's the matter? Like not a care. And I was like I just gave him that whole bag of blood.

[00:27:41]And he looked at me and he was like what do you mean?

[00:27:45]And so I'm like trying to explain this to him. He looked at me like I was literally the dumbest person in the room. But then he simply put his hand on my shoulder and was like, "It'll all be fine."

[00:27:55]>> And I was like, "Okay, so what do I do?"

[00:27:56]So, same thing. You fill out your own incident report. You do your self-reporting. My managers were all so cool about it. So cool. Just like, "Hey, what can we learn from this experience?"

[00:28:07]You know, how can we do it differently next time, which is, I think, how it should all be treated. And I think that that is >> nowadays one of the things that is lacking. Well, I think I was just going to say depending where you work, like which hospital, which part of the country, like which health care system, like all of those things impact I think what we're talking about. And I think that where I've worked in the past, albeit they have not been the best hospitals, like I've had management where that was the outlook. It was like um >> this is not punitive. Like obviously we don't want people being careless and negligent, but how can we learn from this? And if that mistake was made, then that means somebody else can make it.

[00:28:48]And where in the system did we fail? And what do we need to do to make sure that like other people don't run into that?

[00:28:53]And that's exactly how it should be hel dealt with to an extent. Obviously, there's people where it's like, oh my gosh, you're scary and you shouldn't be administering medications. But for the most part, that's how it should be. Like people should learn from that.

[00:29:10]Unfortunately, I've worked also at places where it's not dealt with that way and it's like, "Oh, a mistake's been made and now we need to look like we've done something, so we're going to fire that person." Yes. And that to me is like not the best way to handle a situation that >> needs to be dealt with like on a system level.

[00:29:26]>> Oh, it's terrible. And I think you have really good solid nurses sometimes that you see get fired and you're like, "Totally, what?" Like, "What the hell?"

[00:29:36]And honestly, it creates so much anxiety within that entire department. Like if you see solid nurses that are getting fired for things that anybody >> Why do you think it's just like they want to make a um like a lesson out of them like >> Yes. But then you go then you're scared to go to work. I think that's something in the nursing field that people don't truly understand is there is a lot of anxiety that comes with doing this profession because no hate to any other career but like I'll use my husband's like he's he's not dealing with a patient's life at the end of the day. So yes, there's huge things that can happen in his field of work that he does that truly do impact a ton of [ __ ] with what he does and it's detrimental at times to certain things but >> probably can be stressful >> but it's not a life >> right I mean these are like human lives >> right and I think also the amount like people in the emergency room I can only speak from the emergency room in this that people threaten lawsuits all the time >> all the time >> all the And I mean a lot of the time it's like >> okay >> okay like it's not legitimate but there is times where like it is scary. It is scary because we are out there we are working hard. We have a lot of years experience. We're making judgment calls.

[00:31:00]Like we are working under a physician you know like their orders.

[00:31:04]>> But it's also scary because there's a lot of like lawsuit happy people and that scares me. I know this this is why I love watching the legal MP.

[00:31:18]>> Shout out to her. If you guys don't follow her, you need to because she drops the best bits of tea that even as a nurse for 12 plus years, >> she will post something sometimes and I'm like, "Oh shit." If you are a nurse, you need to be following her because I've learned so much from her content.

[00:31:38]And this is what we were talking about like in nursing school >> they teach you how to like speak like how to chart like you're in >> you know whatever >> what do they teach you like how to chart you're in >> it's like foundation third person yeah it's your it's your tiny first little assessments but they're not they're not real >> it doesn't teach you how to paint a picture cover yourself legally like >> all of that and I think that that's something I wish I would have learned in nursing school >> I think it should be taught It's actually like insane to me that it's not taught.

[00:32:12]>> But I will say the one place that still does kind of freak me out as a nurse working in the ER, this is like ER specific is triage. And that is the place where I feel like because you're afraid you're going to miss something.

[00:32:29]It's not only that, but I feel like in our hospital specifically, and there are many like this, but like you know, our lobby can be inundated. Like you could be the Insane.

[00:32:39]>> Yeah. You're the triage nurse looking out into a sea, a literal sea of people to the point that there is only standing room. I can no longer see any of the patients that I've triaged because we're 60 deep out there and there's not space for 60.

[00:32:55]>> Oh, yeah. So when you think about that and then think about the lawsuits that we have heard about like online and stuff like that, a lot of them do come from the waiting room because people die out there.

[00:33:05]>> I know. I Yeah, I've seen it.

[00:33:07]>> I know. Same. And it's scary.

[00:33:10]>> It is scary. Speaking of triage, >> I have a would you rather?

[00:33:15]>> Ooh, I'm ready. Let's go.

[00:33:17]>> Would you rather >> Mhm.

[00:33:20]>> be in triage by yourself for a full 12-hour shift >> by myself? like meaning you're the only nurse out there.

[00:33:26]>> Oh, >> with 60 plus people in the waiting room for the whole 12 hours.

[00:33:33]>> Okay.

[00:33:34]>> Or would you rather >> I don't know if I'm ready.

[00:33:38]>> be the IT nurse or charge nurse answering all the ambulance traffic, rooming everybody, >> the whole thing. Hell on earth.

[00:33:49]>> On a Friday the 13th full moon.

[00:33:52]>> Oh my god. With every bed taken in the department for 12 hours.

[00:33:57]>> With every bed taken.

[00:33:59]>> Mhm. And no movement.

[00:34:00]>> And ambies are still I'm sure just on wall time.

[00:34:03]>> Yeah. On wall time all day.

[00:34:11]>> This one sucks.

[00:34:12]>> They're both terrible.

[00:34:13]>> This is both like equally as terrible.

[00:34:16]>> I would choose triage.

[00:34:17]>> You would?

[00:34:18]>> I don't know. I don't know. I don't I think 60 plus people in the department.

[00:34:23]So after put into perspective you get screamed at all day long.

[00:34:27]>> All day long but I think after a while I would just like be numb where you can't just >> Nothing can hurt you anymore.

[00:34:33]>> Nothing can hurt your soul anymore. But when you're at it like you got to stay.

[00:34:38]>> You got to stay sharp and I mean you do in triage too. I don't know. It's different though. It's different.

[00:34:43]>> I think that you're right. You're not doing like department movement and like >> so with it in charge, you are literally the eyes and ears of the entire department. Like I'm constantly coming up with like a plan B and C and it's constantly changing by the end of it.

[00:34:57]>> I drive home and I like literally I have no thoughts. There's there's nothing left in my brain at all. Okay, I do agree with you. I think I'd put I'd pick triage, but the thought of that >> makes your heart race.

[00:35:11]>> It literally makes me want to quit. My armpits are sweating >> thinking about it.

[00:35:15]>> I love reading med errors. They're my favorite. These episodes are going to be my favorite for these and the cringiest moments. And I really like the haunted.

[00:35:23]>> So you guys have to tell us.

[00:35:25]>> You have to tell us if you like those ones, too, cuz we really like reading them, but we want to make sure you guys are liking them, too.

[00:35:30]>> Yeah.

[00:35:31]>> But on that note, mom life calls. I'm going to go pick up the kids from school. Thanks for tuning in.

[00:35:37]>> We'll see you next week. Bye, guys.