Do most med error incident reports result in a write-up?
First post, new grad, NOC charge nurse.
Had a crazy night the other day...We were short -had 4 CNAs for 100+ residents, as well as three 9pm admits; I come on at 10p and have to get admit paperwork, observations, and my own full-body assesment b/c i don't "trust" the PM/admit nurse's assessment, plus TBs done ...I spent a lot of time helping CNAs with morning get-ups (hoyers) and completing several time-consuming day/PM TXs due to our wound nurse resigning..plus toileting/changing/turning residents during my midnight and morning med pass; more-so than usual d/t being short. Busted my butt and did a great job that night. Written up the next day for not giving a resident scheduled morphine cream - however this resident was, IMO, "snowed" from the previous shift. She was responsive/easily arousable but denied having any pain and had been given her PRNS -moprhine, ativan, haldol, tylenol - at every available time d/t her family being in the facility during the PM shift and requesting her be medicated even when not warranted. (This resident can be sound asleep and her family will request her Ativan/Haldol/morpine be given all at once).
I'm worried about this med error/incident and kind of find it ridiculous that I might get written up for this. Comments/suggestions? I understand I was technically at fault for not giving a scheduled pain med, however this person was sound asleep and when I gave the AM meds she denied having pain. It's silly to me because there are long-term residents there that are non-verbal/non-mobile and probaly in pain but don't even have PRN tylenol?!? Despite e faxing MDs and asking the day nurse to f/u it never gets done. I DO understand pain management and when signing out my morning Narcs (I offer pain meds to my resident's in the morning b/c they go to PT early before breakfast and I don't want them to be hurting) I find that I'm usualy the only nurse they've gotten pain meds from that 24hrs....
Should I even make my case in opposition to this write-up or just take it as a lessoned learned? Meeting with the DON this week. Thanks.