I work in a pediatric oncology unit and, most days, I love it. Recently, however, I made a medication error resulting in my giving a child a dose of morphine that was too small to be effective. When I discovered my mistake, my nurse-manager helped me resolve it. The little girl's pain is now under control and her parents still want me to care for her, but the incident has shaken my confidence. I'm terrified that I'll make another error and seriously injure one of my tiny patients. Do you think I should reconsider my commitment to pediatric oncology? -F. W., TEX.
I think that if most nurses were perfectly honest, they'd admit to having made at least one medication error at some point in their career. Mine occurred when I was a new graduate working in a urology unit. My patient was a young man with intractable diarrhea who'd contracted a parasitic infection while traveling in South America. In those days, medications were "poured" at the nurses' station amid the din of ringing telephones, patient call bells, and multiple conversations. In the confusion, I administered an overdose of the ordered opioid.
I discovered my error while charting. Rushing to my patient's room, I found him in a state of euphoria. I called his physician, treated and monitored my patient as ordered, and reported the error.
My patient recovered quickly with no lasting harm. But I was devastated by my error and considered leaving the profession. It took a good "Dutch uncle" talk from a wise nurse to remind me that to err is human-but we can learn from our errors and become better nurses. And she was right.
That's the same talk I'll give you. Your remorse tells me the kind of nurse you are. Oncology is a tough specialty, but if you love it, stick with it. Turn this unfortunate incident into a learning experience. If you need more training or education about pediatric dosages or pain management, seek it out. You'll be a better nurse for this experience, and your patients need you.