Published Apr 14, 2016
xanderfan
36 Posts
Hi everyone. I made a med error and I feel horrible about it and it was only the day after that I caught myself. I told my supervisors and they told me to fill out a med error form, I informed the MD and the patient had no adverse effects. I accidentally gave a patient oxycodone when they were due to have oxycontin. My issue now is that I was told I needed to inform the patient, I'm not sure that's a good idea, the meds are the same and it's just the releasing that's different. They had no adverse effects, no complaints of pain, no constipation, nothing. Thanking God for that. Plus the MD is aware and said it was fine. I feel like telling the patient will only make them lose trust in me and make the situation worse. I told my supervisor my position on that and they said they will review the facility policies. But I wanted to know what other nurses have experienced or done in that situation. Have you told the patient what happened?
Anonymous865
483 Posts
I am speaking from the position of the patient.
I have had a physician tell me they made a mistake. Apologize for the mistake. Explain how the mistake occurred and what they were doing to prevent similar errors in the future. Their honesty and transparency made me trust them more.
Another time with a different dr I had an invasive procedure. The next day I developed a temp of 103.5 and excruciating pain right where the physician did the invasive procedure. One week later I was hospitalized and had exploratory surgery to remove the massive infection. I asked why I got the infection. He suggested several things that weren't consistent with my medical history. Then he said sometimes there is no known cause. Mine was no known cause. I asked if the invasive procedure could have caused the infection. He said there was nothing in the literature to suggest that infection is a possible complication of that procedure.
He even had his minions (aka residents) singing the same song.
It made no sense to me, so I went to NIH.GOV and looked up the procedure I had and what potential complications were. The National Institutes of Health says in their literatue "there is strong evidence that potential complications include but are not limited to " the very infection I had.
Clearly the attending and his toadies were lying to me, so I got a copy of my medical record and there in the admitting notes were that I was admitted for infecion probably related to the procedure done here on x date.
I trusted nothing those drs told me after that. I tell everyone I know to avoid these physicians because they are deceitful. Since it was a teaching hospital and they had the residents lying to me, I will never trust a resident that trained there. The attending apparently was training residents to lie to patients
The infection almost killed me. I was off work for 3 months. The thing that made me angry was not that I got the infection. (I wasn't happy about it, but understood the low risk of the test vs. the significant risk of missing a diagnose made it an appropriate test to do.)
What made me furious was the lies and cover up.
All they would have had to do was tell me honestly what happened, what they did to minimize the infection risk, and apologize for the complication.
The medical community needs to learn from politics. It is always the coverup that brings down a politician. Politicians who admit to what they did and apologize almost always survive.
That was a round about way to say lies, deceit, coverup always damages relationship. Honesty and transparency build relationships.
Be honest with your patient. Tell the patient what happened, what you do to prevent mistakes like this, and what break down allowed this to happen.. Explain what impact the mistake had on patient. Apologize.
Your patient will probably trust you more because of you honesty.
neuron
554 Posts
Not a nurse, but I didn't tell the pt. But told my supervisors and thankfully they didn't tell the pt. Telling a pt. can make it worse. No adverse reactions/no side effects, learn from the error. The pt can turn it on you when you made an honest mistake.
I disagree with not telling a patient about a mistake.
What do you think the patient would think/do if they discover the mistake rather than you telling them about the mistake? Possible reactions could include:
1) This nurse/this hospital are really stupid. They gave me the wrong med and no one even noticed. I can't trust them.
2) This nurse/this hospital made a mistake and covered it up. What other mistakes have they made and covered up? What other lies have they told me?
Lies and coverups create distrust.
I disagree with not telling a patient about a mistake.What do you think the patient would think/do if they discover the mistake rather than you telling them about the mistake? Possible reactions could include:1) This nurse/this hospital are really stupid. They gave me the wrong med and no one even noticed. I can't trust them.2) This nurse/this hospital made a mistake and covered it up. What other mistakes have they made and covered up? What other lies have they told me?Lies and coverups create distrust.
So this poster, after discovering her error a day 'later', should tell the patient that he received 'Oxycodone' instead of 'Oxycontin', when there were no adverse reactions or side effects (which she stated)? I suppose as they have different effects.
cayenne06, MSN, CNM
1,394 Posts
In this case, the best thing would have been to tell the patient as soon as you identified and reported the incident. If handled correctly, i doubt the patient would be unduly distressed by the revelation, or have any reason to lose trust in you. I honestly don't know if I would worry about notifying the patient at this point, so far after the fact. But ideally, they should know.
I agree with Anonymous865- acknowledging our mistakes can build trust, if you do it in the right way. It's good for patients to know that you are a human being. If you are ever involved in a mistake that causes harm, your biggest defense against being sued is going to be the relationship you have with your patient.
Regardless, it really is the patient's right to know what happens to them. That's the bottom line.
I do agree that it's important that the patient trust the nurses and the best way to create that rapport is transparency. My supervisor, DON and everyone knows about it, the MD is aware. At this point I'm waiting to see what the decision is. I still feel terrible about the whole thing. Everyone says that errors occur and I'm bound to make more in the future but this feeling of horror and guilt just won't leave me. I really don't like making mistakes.