easybreezy, if that's the biggest mistake that's been made in your facility, then COUNT YOUR BLESSINGS. Here's a brief list of the errors that have I have seen in some of the acute care facilities in my area:
Administering Potassium instead of Saline to flush a heparin lock. The patient died.
Taking a pregnant patient on a Magnesium drip to the bathroom, and while doing so, removing the tubing from the pump, failing to make sure that the tubing was clamped, resulting in the patient receiving a 500 cc bolus of Mag. The patient died, although her unborn babies were successfully delivered by C-section and survived.
Removing Epinephrine instead of Ephedrine from the Pyxis machine, resulting in a pregnant patient receiving an IV overdose of Epinephrine. The patient spent several days in the Cardiac ICU.
A resident wrote an order for 500 mg of IV Benadryl, and the nurse administered it without questioning the order. The patient spent several days in the ICU.
Seeing a nurse fail to properly dilute IV penicillen for a newborn, resulting in the baby receiving several thousand times the normal dose for a newborn. The baby suffered no ill effects.
Having a nurse practitioner write an order for IV antibiotics for a newborn that was incorrect. The pharmacist failed to catch the mistake and filled the prescription. The nurse administered the drug. The baby died. Everyone involved was charged with manslaughter, but eventually cleared. The nurse who administered the drug spent several years under probationary status, and ended up in therapy.
Maxine, if you spend very much time in this business, you will find that people make mistakes (no one is perfect), but if you examine each one of these errors closely, and question why
these errors occurred, you'll discover that they didn't occur as the result of one bad nurse. Sometimes it's sloppy practice by the hospital; sometimes, it's the result of several people failing in their duties; sometimes, it's the result of poor staffing.
Hopefully, if you are blessed, you will work in a system that encourages you to admit your mistakes, because the results of errors can't be fixed unless those around you know about them.