First med error - crushed a SR tablet

[mistyda]

I had my first med error the other day and I feel so crappy; mostly because I think it was handled wrong.

I am in week three of orientation on a med/surg unit. I graduated in May.

My patient was an 80 yo with a fx pelvis after a fall. She was ordered an 180 mg verapamil. I went to give it and she said she was unable to swallow any pills. I told my preceptor and she said to just crush it. I thought to myself, hopefully it's not a sustained release, but didn't check because I assumed my preceptor would have picked up on it if it was.

I realized it was a few hours later when I looked it up and was so upset. It was nagging me and that should have been my first clue to not do it!

Pt. had no adverse effects that I saw and preceptor said it's no big deal. It was the end of the shift and I left upset about what happened. Dr. was never notified as far as I know. That was Friday and I go back tomorrow. I've spent all weekend so upset. I wish I had just called the Dr. to tell him. Now I've spent all weekend worrying and am scared to go back to work tomorrow. I know it was not handled correctly and I'm not sure what to do three days later! Any advice?

[deyo321]

If the patient told you she couldn't swallow it whole then you should look into getting the order changed to the non-extended release. I would imagine that other nurses are making this mistake as well since she can "never" swallow it, if that makes you feel any better. The important thing is to learn from your mistake and correct it so it doesn't happen to anyone else.

[PerrieRN]

I know the feeling. My first med error was at a Nursing home, I gave a resident a whole hydrocodone instead of the half one! (She had orders for a whole one at night 1/2 one in am and lunch) I just looked at the MAR and saw hydrocodone and pulled it out of the card. (they had bubble packed cards in a Narc drawer)I cried like a freakin baby! It was taken care of correctly. I called the Doctor and he just said it probably will help her more than hurt and I just might become the resident favorite nurse! My director talked to me to calm me down but I was devastated that I might have hurt the resident. Lesson was learned look closely at mars and medications, that has remained with me through my eight years of nursing. It happen like the first month of being out of orientation. What was your outcome, did you just leave it alone or say something, I have been ordered to crush a pill that was SR just because there was no other option.

[morte, LPN, LVN]

That's what my preceptor at the time said pretty much; crushing it and giving it is better than not giving it at all.

it depends, are you trying to help them on to the next realm? then maybe it is a good idea....are you going to crush oxycontin, mscontin? blood pressure meds can kill, also, you know.....how about fosomax? give some patient a nice case of erosive esophagitis?.....dilantin caps-pH is about 9, again esophagitis or worse.....they are DO NOT CRUSH for a reason....some other dosage, route, or even total chnge onf med is required!!!

[mistyda]

morte, i didn't agree with that reasoning either hence this post....