When you hear a story about a nurse administering a drug via the wrong route...?

Question

for example IM instead of IV, was it because she did not see it on the MAR? Will it always be listed on the MAR (and then we double check by looking up the drug if we are unsure) or is it sometimes not listed and we have to find out for ourselves.

(I read the Jane Seymore (Dr. medicine woman) had bronchitis years back and the nurse gave her the antibiotic IV instead of IM and then saved her life by injecting adrenalin and cortisone to revive her...I wouldn't have known to do that to reverse the effects.)

(I'm a nursing student and have always seen in listed the route on the patients meds. sheet so I'm curious because that scares me.)

Answer 1

All nurses checking and administering drugs should know them 5 r's

Right medicine

Right Dose

Right Route

Right Time

Right Patient

If confused about any of the above then speak with a colleague as nurses should help each other out rather than making a possible fatal error.

One thing I got told in my training is that there are two types of nurses - those who have made a drug error and those who are going to make a drug error.

If there is no written route of administration on a drug chart then contact the doctor to write the drug properly and DO NOT give the drug until then.

Don't panic as when you qualify you may feel that you are all alone but i can bet you that there will be other nursing staff looking out for you and never feel to scared to ask questions as there is always new things to learn in this career.

All the best and hope you do well.

Answer 2

I am a retired RN of near 40 years.  when I gave a medication, I either knew the medication and the acceptable dosages and routes, or looked them up before administering them.  I knew if there was something that didn't jive, and withheld administering any drug until I was absolutely sure.  In the example of the prior poster, the dosage of an IV versus and IM route would alert you to the actual route intended, provided you knew your drugs as you should.  I am accountable for my actions, and no printed instructions would be reliable enough for me to blindly follow.  My suggestion to all students of nursing is to take this aspect of your responsibilities very seriously...it is probably the most frequent source of nursing errors.  This is a good question.  When you reveal that you would not know how to reverse the effects of the administered drug, you realize just how much you need to know about drugs when you practice nursing.  I used to study new drug information on a daily basis...it was as essential as brushing my teeth.  Know your drugs inside and out....it still won't guarantee that you'll never make an error..but it will make it far less likely.

Answer 3

We're talking about human-made systems and human frailties here. If there's some way, no matter how obscure, to s***w up, somebody will find it. A faded downslash in the M of IM, for instance, can give the appearance of a V. And people tend to see what they expect to see. If you have three patients getting IV ceftriaxone and one getting it IM, you may look at the latter but see the former. You'll want to look up the "swiss cheese" model of error theory.