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What to do if you make a medication error

Written by: Mandy Day-Calder
Published on: 8 Jan 2020

Picture the scene: it’s 1pm, you are tired and hungry. You have been on your feet since you walked onto the ward at 7.30am, yet you are barely halfway through your shift.

Medication errors
Picture: iStock

Once you complete the lunchtime medication round, you are hoping to grab a quick break. But then, just as you thought you were almost there, a sickening feeling washes over you.

You realise you have just given your patient the wrong medication. What you have been dreading since you entered nursing has happened – you have made a drug error.

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Irrational thoughts are normal

When you first notice that you have made a mistake, it’s natural to feel a sense of panic as adrenaline surges through your system.

Often this is followed by ‘guilty’ thoughts such as ‘did anyone see me?’. In the shock of the moment, you may even be tempted to cover up what you have done.

This instant reaction, as your mind tries to avoid the reality of the situation, is perfectly normal.

Regardless of the irrational thoughts that initially flood your brain, you know you must act responsibly and professionally. That means admitting your error in an open and honest way – not only to your manager but to your patient and/or their relatives.

Maintain professionalism

In conjunction with the General Medical Council, the Nursing and Midwifery Council has published guidance on the professional duty of candour, along with a series of case studies to help nurses and midwives understand how to meet the duty of candour in a range of scenarios.

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As you work through the necessary steps of the process – such as assessing your patient for any adverse reactions, alerting medical staff, explaining what’s happened, apologising and writing a statement – it’s likely you will experience a range of emotions. These could include guilt, shame, embarrassment and fear, all of which can make staying calm and professional particularly challenging.

Here are some tips to help you manage the situation:
•    Focus. Patient safety is paramount, so your immediate priority is to check if the patient has been harmed. You will likely need help to do this.

•    Breathe. Getting defensive won’t help anyone, so take a moment to gather your thoughts.

•    Stick to the facts.  Now is not the time to get emotional or blame anyone or anything else.

•    It’s not about you.  Maintain professional boundaries when talking to your patient.

•    Make notes. Document what has happened while the incident is still fresh in your mind.

•    Stay in the moment. Even though you may be worried about your patient’s well-being, as well as any potential implications for you, try to avoid catastrophising.

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It’s important to take the time to reflect on the incident, on your own and with a senior member of staff. This gives you the chance to learn from what happened and make changes to your practice. It can also help to rebuild your confidence.

Coming to terms with making a professional mistake can take time, so be patient with yourself. And as well as saying sorry to others, don’t forget to look after yourself.

Mandy Day-Calder is a life/health coach with a nursing background, and runs a healthcare training company.

This is an abridged version of the article What to do if you make a medication error which was first published in Nursing Standard.

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