Covered Up a Narcotic Med Error

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It is unfortunate that in your facility as well as in so many others there is such a culture of foreboding when there are quality issues. We all can learn from them and hopefully not repeat them. One thing to remember is that there will be an "investigation", your QI department will be involved. They will be looking at trends and in your specific case, they will look for the root causes for the medication error. You may not be the only one who recently has had a medication error at your facility. There may be problems within the system that they are currently investigating. It is always best to report errors. The cover up is going to be another issue but I imagine the facility will not want to press the issue with the MD who was part of the cover up. Fortunately there was no harm to the patient. I can only hope anyone reading about your situation will learn from it and will not be so fearful to report errors in the future.

We've all made errors. What is unforgivable is covering it up. Trust and nursing ethics have been compromised. I am surprised that Nurse Beth says "It seems the husband who made the complaint is reacting out of proportion". His wife was given the wrong medication and it was covered up. He should be furious. This could have had serious, even deadly consequences, so I don't think he was over reacting. This is obviously part of the culture on this unit if the senior nurse is telling her colleague who made a narcotic error, not to report it.

As a nurse educator, this makes me wonder how nurses are being trained. One of the things we try to instill in students is the "nursing conscience". Ethics and critical thinking should be so ingrained that nurses have the guts to admit and face up to mistakes. We are nurses for one reason - that is the patient. I understand panicking, but even in panic we cannot betray the trust our patients have placed in us.

If this nurse was afraid of a law suit, there is more likely to be one now than there would have been if the mistake was reported in the first place. I have seen nurses make errors and the patient or family did not sue because the nurse was honest about it.

Specializes in Surgical ICU, PACU, Educator.
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However, my senior nurse friend advised me to not tell the DON and I listened. I didn't fill out a report. And I charted that pt requested this med.

This statement is what concerns me. You should face the consequences of covering up the error. At the same time there needs to be a root cause analysis since the "senior nurse" advised not to complete the occurrence report.

The findings when looking at all nurses in your unit may indicate training of not only you is needed. The Occurrence report should not be looked at as a negative finding pointing directly at the nurse involved to punish an unintended error.

You did not go to work that day with the intent to give the wrong medication. The error needs to be used as a learning opportunity to see what steps of medication administration methods need review or revision to prevent the same occurrence again.

Specializes in Critical Care; Cardiac; Professional Development.

There were actually three errors in this scenario. One is the actual medication error. The other is false charting. The final is failure to follow policy regarding the reporting of an error. All three of these are disciplinary offenses. The severity of discipline will probably be worse than if you had charted truthfully and followed company policy. A friend/coworker who advises you not to follow your facility policy is no friend, I'm afraid. I think it likely you will be terminated over this and am curious how it all has turned out.

We have all made med errors. Doing the right thing is hard, but the difficulty of it doesn't excuse failing to do it. I hope you learned from this and that you carry it with you across the remainder of your nursing career.

I really am sorry that you had this experience, as another poster stated, "That was no friend" for telling you not to report. Depending on the facility dynamics among staff, this could be a great learning experience. Always do what you KNOW to be right. If this does get to you BON, you must be honest, explain that this error was your responsibility to report and that, due to your 'friend', you did not write an incident report. As harsh as reporting yourself feels you most like would have gotten your hand slapped, some monitoring at work, and training. Now your 'friend' here is NOT off the hook. Her statement indicates the lack of communication and trust at your facility and perhaps suggests that there could be MANY other events that were also not reported. This is most definitely not a good thing and a HUGE red flag. Let the BON know that you will happily comply with any re-training, monitoring etc. This event will definitely wake you up but you will have a great opportunity to reflect on the incident, and most importantly, ask yourself the big question, 'Why did I do as my senior nurse friend suggested?' If you find that this action was an inner feeling of inadequacy, lack of knowledge or feeling overwhelmed you can take the opportunity to address these issues and come out the other side feeling stronger. Good luck to you, and please keep us updated. We are all here to help and support you.

The fact that she followed the senior nurses direction should have an impact. She should state that to any authority. The MD put in a one time order. That is part of this error, but they were trying to help. There was no harm to the patient (no allergies noted, I'm assuming), not saying it was right.

Specializes in General.

Mistake covered up (with mistake). It brings us deeper into ethical problem, even law. It cost a lot, even the job. It's a serious problem especially in JCI accredited health services (IPSG and QPS).

It happened, luckily it did not run into sentinel event, and it was good you gained an insight and learned it hard way. The point is you try to be a good nurse at the end.

Good luck.

Specializes in Tele, ICU, Staff Development.
Though we only hear one side of this, I don't think the husband is "reacting out of proportion." A patient was given an incorrect medication and it was covered up. That does not foster trust! If I were this patient's spouse, I would start to wonder what else might have been covered up or if all staff ethics were so flexible. I am sure the OP has learned a heavy lesson from this occurrence, and it may be at the cost of his/her job. As with all things, the way out is through. Good luck.

I hear you. If he's reacting to the cover-up, I agree. If he's livid because a mistake was made, he could be vengeful. Not sure if he knew there was a cover-up or not.

Specializes in Med Surg Tele.

How was she worse because she received a 10 mg roxi? I don't think they have any grounds to sue you but I'm not a lawyer. What damages would they claim? Ohh my wife was knocked out and a little loopy for 4 hours? I wouldn't worry about getting sued.

A potential opportunity for gain would make many "livid."

Specializes in Dialysis.
On 2/1/2018 at 12:31 PM, Alex_RN said:

I know this sounds terrible but we really did provide the best care we could, compassionately, while overworked and chronically understaffed.

For those of us who have worked LTC, no matter how bad it sounds, its a truth that exists in many facilities, no matter how nice the facility

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