Are Nurses the Last Fail-Safe?

How does your facility handle medication errors? Most of the facilities in which I’ve worked attempt to treat med errors as problems with the “system” and not with the nurse.

Thankfully, I’ve had no serious med errors in my career, but I’ve always been suspicious of the “tell us your or someone else’s errors so we can fix the ‘system’” approach. Yes, facility systems do need to improve. And I believe that healthcare processes have improved to become more fail-safe.


Nurses are the ones likely to draw up, pop out, dispense, spike, or otherwise administer medications directly to the patient. In most cases, the Five Rights (listed below) come down to US. With very rare exception, the five rights ARE our fail-safe against making medication errors. (One exception: when a pharmacist or pharm tech mixes up a wrong med or dose, but puts a right label on the bag or syringe. A nurse often cannot tell if a premixed clear solution actually contains what the label states.)

I would like to emphasize the importance of accuracy again…this time in the context of medications. Med errors are serious. The time taken by nurses to ensure medications are administered by the Five Rights will be redeemed multiple times over, by preventing the time and cost to correct or mitigate harm to our patients.

So I say: don’t be quick to blame the system. Let’s claim our responsibility, and never EVER become less vigilant about accuracy, especially with medications.

The Five Rights:

  • Right Patient
  • Right Medication
  • Right Dose
  • Right Route
  • Right Time

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Byron Webb Romero, RN, MSN

Finished BSN at Lyceum of the Philippines University, and Master of Science in Nursing Major in Adult Health Nursing at the University of the East Ramon Magsaysay Memorial Medical Center. Currently working at Manila Doctors College of Nursing as a Team Leader for Level I and II, Lecturer for Professional Nursing Subjects, and also a Clinical Instructor.

What Do You Think?