When an Error Happens
Tell the truth right away. Don't make an error worse by trying to cover it up or sweep it under the rug. If you have done your best to follow patient safety rules and to avoid mistakes, chances are that it is a minimal mistake, but you must report it. Discuss it privately with your supervisor. Then notify the M.D. and anyone else your supervisor says must be notified.
Remember the three types of errors: where you do something incorrectly; when you omit something; or when you do the wrong thing. Any one of them constitutes a reportable error. The damage done will tell you how dangerous it was, but other factors can be involved as well. These can include such things as whether you were preoccupied at the time, trying to do too many things at once, partied all night and didn't sleep well, or tried to do something by yourself and should have asked for help.
What should I do if I'm late passing the medications?
Perhaps you forgot to pass your medications before you took your break, so you're a few minutes late in getting to them. This is a situation that you need to contend with yourself so that it doesn't happen again, but it does not require notifying the world.
If you forgot to change an IV bag and now it has run dry and blood has backed up and the line is clotted, well, that's another story. At the very least, you need to pray that the patient has good veins and you can get the IV restarted easily. You will need to apologize to the patient and notify your supervisor.
Hopefully, your errors will be small and cause no real harm to the patient. However, if you have made a significant error, you need to own up to it and notify the M.D. as soon as possible to begin to rectify the error. For instance, you were busy and gave the wrong patient a set of medications. You didn't take the time to double check the name band. The medications were for a patient who was away from his bed when you were passing these meds and you got confused. This was all the more reason to double check, but you were sure you had the right patient because you have spent some additional time talking with him and his family.
In patients with his condition, one of the meds is contraindicated. You notify your supervisor and then call the M.D. The M.D. is not happy, but says the patient has taken this medication before and had no ill effects from it. His orders are to keep a watchful eye on the patient, re-check his vitals in an hour, and call the M.D. if the patient's blood pressure or heart rate changes. He further advises you not to tell the patient what happened because he'll worry needlessly at this point.
You will also most likely have to fill out an incident report that will be filed with the quality improvement office or with the DOPCS. This is a statement of the facts, who was notified, and any untoward effects noted. It's kept on file in case the situation is investigated or any litigation proceedings are brought on by an incident. Incident reports should not be copied and placed in your personnel file and there should be no further mention of it unless something more serious develops.