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In most hospitals, new nurses must take written tests to establish their overall competence. But, sometimes, an inexperienced nurse isn't carefully screened before she's put on the job. Then, her lack of knowledge could lead to dangerous medication errors.
In one case, amazing as it sounds, anew ly hired nurse administering lactulose didn't understand basic information about this drug, which is used in hepatic coma. One evening, when she went into the patient's room and found him unconscious, she returned the drug to the patient's bin rather than administer it through his tube. The reason she noted on the medication administration record was that he was sleeping!
Apparently, the nurse hadn't read any information about the drug even though she wasn't familiar with it.
Of course, the nurse should have at least gone to another nurse or pharmacist for clarification before she administered the dose. But a nurse who makes such a basic mistake usually doesn't know she's in error. So, new employees must be carefully screened and tested by the in service coordinator or head nurse.