This reflection is on an incident that happened while I was doing medication administration. I prepared medication for bed one under supervision and I went to give it to the patient.  I looked at the name and date of birth of the patient on iclip however, I had forgotten by the time I made it to the patient. I then went to give the medication without supervision. When the patient double checked with me if the medication was correct I assured them that it was. But I had forgotten the layout of the bay. I made the mistake of forgetting that side rooms always count as beds. And in this case I forgot that side room was bed one. Hence why I administered the medication to the wrong patient. 

When I was first informed by the other student that I had administered the wrong medication I was shocked. I was in utter disbelief. I was quite confused as I thought I had administered the right medication to the right patient, until it dawned on me that the sideroom is bed one. My practice assor and I immediately let the patient know, who was quite understanding that errors can occur sometimes. I felt quite embarrassed and shaken. I work in healthcare and I have never made such a medication error before. I’m very careful and I always double check. I remember being tired and the pressure of doing medication administration with my practice assessor and another student making me feel stressed. Luckily the patient was fine and had been discharged the following day.

After this when administering medication I made sure to have my practice supervisor present and I took the computer with me, so that I can make sure I have the right person by asking them for their name, date of birth and if they had any allergies. I double checked it on the computer and made sure this was correct. I even counter checked it with my supervisor. I made sure that my supervisor was present when I was preparing simple medication like paracetamol and ibuprofen as I wasn’t allowed to prepare other medications. I then, with my supervisor present, gave the right medication to the right person. I have made sure to follow the 5 RIGHTS since I made the medication administration mistake.

The nmc states that a nurse should “take measures to reduce as far as possible, the likelihood of mistakes, near misses, harm and the effect of harm if it takes place” (NMC,2018) I plan to ensure that I uphold this statement from the NMC as I want to prevent any harm that could affect a patient in my care (within my ability). The NMC proficiencies for student nurses require us to “demonstrate appropriate listening skill” and “seek clarification where appropriate” which I didn’t do (Brown, 2018). I will ensure I listen to patients as they know more about their medications than we do. If they say the medication doesn’t seem right then I will double check with the nurse I’m with.

I have learnt a lot from this unfortunate experience. I know that I must always double check the name, date of birth, any known allergies and make sure it cooperates with the right bed.. I understand how serious this type of error can be with other potent medication. I could have seriously harmed someone. I will make sure to always use the 5 R’s before giving medication and prevent this type of error. Which are the right medication, right patient, right time, right dose and right route (Grissinger, 2010). Furthermore, I will ensure that if I’m ever hesitant about giving medication or feel as if I’m under pressure, then I will speak up because this prevents errors from happening. 

Brown, A. (2018). New standards of proficiency for registered nurses. British Journal of Community Nursing, [online] 22(Sup12), pp.S5–S5. doi:10.12968/bjcn.2017.22.sup12.s5

Grissinger, M. (2010). The Five Rights: A Destination Without a Map. Pharmacy and Therapeutics, [online] 35(10), p.542. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2957754/ [Accessed 18 Oct. 2022].

NMC (2018). The Code: Professional Standards of Practice and Behaviour for nurses, Midwives and Nursing Associates. [online] Nmc.org.uk. Available at: https://www.nmc.org.uk/standards/code/ [Accessed 18 Oct. 2022].

Reflecting on my second year placement at a hyper acute stroke unit HASU as a student. At HASU I was able to observe how the stroke pathway was conducting. The main focus of my reflection is caring for a palliative patient who sadly passed away. 

This patient was admitted 1 weeks ago with a suspected TIA however he was discharged as he was able to pass his swallow assessment and could mobilise with his frame well, he was medically fit to go home.This was good news for him and his family who were eager to have him home. A few days later he was admitted back into HASU after having a stroke with left side weakness. Although I wasn’t able to interact with him before he was discharged, I was happy for him and his family and wished them well. Seeing that he had deteriorated a lot since his last visit made me more compassionate towards him.

At first he was in the ward with all the other patients, but after his NEWS score was continuously 9+ and due to the nature of his stroke medical intervention was of no use, it was decided by the doctor that the patient would be on palliative care and be moved into the sideroom for a dignified death. This was something that was,understandably, strongly disagreed by the family who wanted there to be medical intervention for their father no matter what. Although the doctors had already explained why that wasn’t possible, me and my supervisor were tasked with reiterating the fact that the patient sadly could not have any more medical intervention other than keeping him pain free and allowing him to have a peaceful and dignified death. For the family’s sake we slowly stopped monitoring the patient NEWS score although the family insisted. For me this was really hard as the nurse asked me to remove his monitoring as it wasnt not needed any more. Although I was able to take his ECG leads off, I was met with disapproval and questions. I kept my composure and with compassion I explained to the family that we had to remove the monitoring as the patient was declining. However, they negotiated with us to keep the SpO2 probe on and I left it on.

The Patient passed away the following few hours with his family present. I felt really sad for the family who were in tears, we gave the family some space and let them grieve. After this I was able to start the bereavement process, I got the death certificate and asked the doctor to sign it. I also got the bereavement pack for the family. me and my supervisor were able to  do the patient’s last offices and wash him. I made sure to maintain dignity and show compassion towards him. After doing all our checks we were able to wrap him in the white sheets which were requested by his family and placed him into the body bag. I found this really hard as this was the first time i had done the last office, i was emotional.

Throughout this experience I learnt that compassion isn’t hyper focused only on the patient, but it extends toward the family as well. In a way we have to vigalinat about their feelings and be mindful/aware of what we say and how we say it. I also learnt that it is important to still speak to the patient when they pass away as if they were alive and treat them with dignity, respect and compassion. I now make sure to be compassionate and respectful towards any patient’s family member regardless of the situation. This adheres to prioritising people in the NMC code. Not only did we treat the patient with kindness, respect, compassion and dignity, we listened to the family and responded to their preferences.