I'm just looking for a bit of exercienced nurses opinions on this one...
I had an elderly patientwith a joint fracture that had presented the day before with pain and hx of dementia. He was receiving 1mg of Ativan and 4mg of Morphine IV to keep his pain under control and help with his agitation. When I came on shift at 1900, he had not recieved anything for pain or anxiety since 0630 that morning. Now I had a new grad working with me, soon to be off orientation in a few days, and had assigned her this patient. Pt was restless, c/o pain, trying to pull out IV and Foley. She went ahead and gave the 1mg Ativan and 4mg Morphine, pt was soon snoring and appeared to be resting quietly. I was not present when she gave the medication, as I had witnessed her give IV pain meds before and (like I said before) she was on her last night of orientation. I did witness a waste of Ativan 1mg for her as our Ativan comes in 2mg vials. Now the problem being is about 3 hours later, this patient crashed and could not maintain his own airway and was intubated and on a vent. ...
now, here comes the problem. Our Morphine is stored in 2mg and 4mg Carujets in the med room, it is counted together and stored together so I'm now wondering if she accidently gave 8mg instead of 4mg, however, I had brought up this possibility and she stated she had taken the 2mg dosage and 2 of them to equal the 4mg dosage.
We were quick to respond to the pt's needs and he's stabilized and is now off the vent and breathing on his own. However, what if she did give the 8mg? Am I now responsible as well for the med error as she was still on orientation?
HELP, I'm just frightened as I've only been a nurse at this facility for 3 months and was never told I was going to orient anyone... it just showed up on our board one night. Also, in our facility we use the team approach and I'm often charge over 12-14 beds with 2 LPNs or another RN to help.
Sorry for the long post and thanks for any advice.