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Med error..... Could I lose my license?

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RN66 RN66 (New) New Nurse

Has 1 years experience.

Hi. I have a serious question to ask. OK so. A pt had an order for dilaudid q6. I thought it was q4, because his oxy was q4. I gave it ONE time four hours apart. Realized my mistake at the end of the shift. Didn’t tell anyone. Pt is a-OK, still alive. This happened 2 weeks ago and it’s been eating me alive bc IDK what to do. It’s in the chart that I gave it four hours apart and the order was q6.

Can I lose my license??

I want to tell my manager. But I’m scared. But it’s already done so I’m either gonna lose my license or not at this point. But can someone with experience please shed some light and perspective on this situation????

Thank you so much in advance. 

You aren't going to lose your license. Tell your manager or it will look like you are trying to hide something. Follow the rights of medication administration every.single.time. Move on and do better.😁

Don't wait for an audit to discover this discrepancy.  Go to your manager now.  At this point she will be more concerned with your failure to report your mistake than the actual mistake.  Don't make things worse by delaying any longer.

RN66

Has 1 years experience.

4 minutes ago, caliotter3 said:

Don't wait for an audit to discover this discrepancy.  Go to your manager now.  At this point she will be more concerned with your failure to report your mistake than the actual mistake.  Don't make things worse by delaying any longer.

Thanks so much for responding. My hospital has an online reporting method, that I did try to fill out the day after the incident, however the website wasn’t working. I did just turn in the report. But can I lose my license or do you agree with Wuzzy?? 

One med error is not going to affect your license, especially if your employer does not make a report to the Board.  Take the energy you are using to worry about that and use it to be more careful in your daily med administration. 

RN66

Has 1 years experience.

5 minutes ago, caliotter3 said:

One med error is not going to affect your license, especially if your employer does not make a report to the Board.  Take the energy you are using to worry about that and use it to be more careful in your daily med administration. 

Again, thank you for the information. I don’t think there’s anything wrong with using energy to be both concerned with the possibility of losing my license AND being more careful with medication administration. But to each their own. 😊

Rose_Queen, BSN, MSN, RN

Specializes in OR, education. Has 15 years experience.

If you want to see what nurses lose their licenses for, go to your state's BON website. You'll find that the vast majority have zero to do with med errors and a lot to do with criminal issues, drugs, or alcohol. A medication given early (and not necessarily a full 2 hours because your facility likely has a protocol in place for meds having a window of time to give) is not a reason to lose a license. If it was, we would have a very very limited nursing workforce.

Sour Lemon

Has 9 years experience.

1 hour ago, RN66 said:

Hi. I have a serious question to ask. OK so. A pt had an order for dilaudid q6. I thought it was q4, because his oxy was q4. I gave it ONE time four hours apart. Realized my mistake at the end of the shift. Didn’t tell anyone. Pt is a-OK, still alive. This happened 2 weeks ago and it’s been eating me alive bc IDK what to do. It’s in the chart that I gave it four hours apart and the order was q6. Can I lose my license?? I want to tell my manager. But I’m scared. But it’s already done so I’m either gonna lose my license or not at this point. But can someone with experience please shed some light and perspective on this situation???? Thank you so much in advance. 

No, you will not lose your license. And I'm going to be the "unethical" one here and suggest that you leave well enough alone. No harm came to the patient, the amounts pulled and administered match, and the patient's chart is documented correctly.

Informing a manager two weeks after the fact seems like a bad idea under these circumstances. And when you drag a third person into a situation like this one, you may obligate them to take action whether they want to or not.

5 minutes ago, Sour Lemon said:

No, you will not lose your license. And I'm going to be the "unethical" one here and suggest that you leave well enough alone. No harm came to the patient, the amounts pulled and administered match, and the patient's chart is documented correctly.

Informing a manager two weeks after the fact seems like a bad idea under these circumstances. And when you drag a third person into a situation like this one, you may obligate them to take action whether they want to or not.

This is the better option.  Over time you will see just how much passes by the wayside when one allows the sleeping dog to continue to sleep undisturbed.

Been there,done that, ASN, RN

Has 33 years experience.

You must get past the losing your license mindset. Your patient is on a BOATLOAD of narcs. The patient has  developed a tolerance. 

NO harm.. you learned from this. Keep your lip zipped.

kaylee.

Specializes in Stepdown . Telemetry. Has 7 years experience.

4 hours ago, Been there,done that said:

You must get past the losing your license mindset. Your patient is on a BOATLOAD of narcs. The patient has  developed a tolerance. 

NO harm.. you learned from this. Keep your lip zipped.

I Agree with this. At this point that patient is long gone and its over and he was fine. Going to the manager now will be worse because it seems like you were trying to cover it up. As sour lemon admitted, I will also be the “unethical” one and say that if this DID ever resurface say you did not realize it was q6. Odds of that happening are slim, but saying you knew would be bad. 
 

As long as you have taken stock and learned something, you can be OK with moving on.

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

This sort of error isn't going to lose you your license, they won't really care to be honest.

Ideally, reporting this to your employer wouldn't come back on you, what should be addressed is the nonsensical orders for q4 hr oxycodone and q 6hr dilaudid.  (q 4hr oxycodone makes sense, that's how long oxycodone lasts, q 6hr hydromorphone only makes sense if the patient is only expected to have increased pain for 4 of every 6 hours).  If it was deemed necessary to allow for an increase in opiates based on assessment, then the range of the oxycodone should have been increased, not add nonsensical dilaudid).  

cynical-RN, BSN

Specializes in ICU. Has 10 years experience.

Learn from it, but say nothing. It is inconsequential to bring it up now. Nonetheless, I must question the education or pharmacology knowledge you retained from school if you truly thought such an error would kill your patient, granted I don't know the dosage, but I can estimate the typical dosage of such order.

I also agree with whoever said that you should abandon that "my license is on the line" mentality. I hear it frequently and it just sounds silly. I rarely hear other professions operate from such an inferior complexity. 

Edited by cynical-RN

Serhilda, ADN, RN

Specializes in Cardiac Telemetry, ICU.

Just move on. I know some Florence Nightingales will roll in to encourage you to snitch on yourself but literally nothing good will come of it. It'll only make you look suspicious that you waited 2 weeks to come forward. 

The Seasoned Nurse, BSN, RN

Specializes in Trauma ICU. Has 6 years experience.

On 11/19/2020 at 4:29 PM, Sour Lemon said:

No, you will not lose your license. And I'm going to be the "unethical" one here and suggest that you leave well enough alone. No harm came to the patient, the amounts pulled and administered match, and the patient's chart is documented correctly.

Informing a manager two weeks after the fact seems like a bad idea under these circumstances. And when you drag a third person into a situation like this one, you may obligate them to take action whether they want to or not.

I 100% agree. You will not lose your license and bringing this up will just make you look bad. I think the most likely worst case scenario is an audit discovers the error, your manager is notified, and you have a little chat about the five rights. The manager can document that you were “counseled” and everyone moves on with their lives. As long as it doesn’t happen over and over, you will be fine.

I think most of us can say "Been there, done that" re: medication errors.   I have nipped the anxiety your having by owning it & reporting it immediately.  Realize it's a learning opportunity for you.   Your not the first & unfortunately won't be the last.  I gave an oxycodone 5mg instead of a Dilaudid 2mg years ago, my first shift as a traveler but still no excuse, I felt like a failure, like a criminal, etc.  I called the doctor & she ended up calming me down, "He's not going to die, he's OK, just monitor him"   I then felt it was only fair to tell the patient, he was an attorney of all things!!  He was so understanding.  Owning it when it happens will make you feel better no matter the outcome & your management & co-workers will appreciate your honesty.

cynical-RN, BSN

Specializes in ICU. Has 10 years experience.

2 minutes ago, JJ1023 said:

I think most of us can say "Been there, done that" re: medication errors.   I have nipped the anxiety your having by owning it & reporting it immediately.  Realize it's a learning opportunity for you.   Your not the first & unfortunately won't be the last.  I gave an oxycodone 5mg instead of a Dilaudid 2mg years ago, my first shift as a traveler but still no excuse, I felt like a failure, like a criminal, etc.  I called the doctor & she ended up calming me down, "He's not going to die, he's OK, just monitor him"   I then felt it was only fair to tell the patient, he was an attorney of all things!!  He was so understanding.  Owning it when it happens will make you feel better no matter the outcome & your management & co-workers will appreciate your honesty.

LOL. I would've been more concerned about not attenuating his pain with 5mg of oxycodone rather than him dying if he was supposed to get 2 mg of hydromorphone. I think some nurses have misplaced priorities from worrying too much. I don't know if nursing school fosters the inferiority complex or nursing as a specialty inherently propagates paranoia.