Medication Route Error

[OneRN50]

I am a seasoned Nurse and feel so stupid for this issue...I worked a midnight recently and was to dose a patient with his Suboxone prior to transfer to another facility. I checked and double checked the dose ....I crushed the sublingual tab which is our practice. For some unknown reason I dissolved it in water prior to giving it to him . I know better...we dissolve our gabapentin in water prior to administration but never a SL Suboxone...oh I'm so upset! And I feel so dumb. I made my NA and the doctor aware. Now I'm extremely worried about the consequences.  I have extreme anxiety and can't stop going over and over it in my head

[JBMmom, MSN, NP]

Everyone has made a mistake. Everyone. You are not going to lose your job. You acknowledged the mistake, you'll definitely never make that one again, and you will move on. The patient is fine, just maybe didn't get the full dose that time, give yourself a break. 

[OneRN50]

Thank you so much to all who have given me kind words of encouragement...I am so grateful for all of them and you ..I love when Nurses encourage other nurses...and I treasure my title and profession 

[subee, MSN, CRNA]

OneRN50 said:

I hope it passes soon I hate this inner turmoil...I feel like I've done what I should by reporting to my supervisors and if they take it further I guess I'll have to go through it 

Think about this:  why are you punishing yourself with anxiety for a minor, minor, minor error in administration?  If you reach this level of anxiety easily, maybe you should do something about it.  This is a mole hill of which you are making a mountain:)

[OneRN50]

I'm a conscientious person and treasure my license and I think it's kind of rude of you to say that..you don't know me...and if you must know I do something about it everyday.  I suffer from generalized anxiety disorder and I take medication and I see a counselor when I need to but thanks for your concern 

[subee, MSN, CRNA]

OneRN50 said:

I'm a conscientious person and treasure my license and I think it's kind of rude of you to say that..you don't know me...and if you must know I do something about it everyday.  I suffer from generalized anxiety disorder and I take medication and I see a counselor when I need to but thanks for your concern 

I was just guessing but I guess I was right.  It's not rude to point out that you might have an anxiety disorder.  After 9/11, I developed a case myself.   I don't know you but I do know that you are literally in a crisis over a nothingburger.  You came here for support.  Perhaps you should get in touch with your counselor because I don't believe there's any reason for you be actually suffering from this trifle of an error.  

[OneRN50]

You do not work where I work and can't speak for every situation....please do not comment on my post anymore 

[chare]

OneRN50 said:

You do not work where I work and can't speak for every situation....please do not comment on my post anymore 

Based on your initial post, you seemed to be overreacting to a very minor medication error; and continued to do so even after members responded that this was a minor error.  

When @subee wrote that you "should do something about" this, I don't think she did so out of spite, and tended to agree.  After you informed us you suffered from generalized anxiety disorder, I still doubt @subee responded out of spite when she suggested seeing your counselor.

Best wishes, and please take care of yourself.

[OneRN50]

Call it what you want and if you look back I thanked everyone for their kind words and they made me feel better but that person acted like it was a crime to feel bad and judged me saying maybe I should do something about...why do that. I wasnt looking to be judged... I was OK with the words of encouragement... I would not do that to anyone on here 

[hppygr8ful, ASN, RN, EMT-I]

OneRN50 said:

Call it what you want and if you look back I thanked everyone for their kind words and they made me feel better but that person acted like it was a crime to feel bad and judged me saying maybe I should do something about...why do that. I wasnt looking to be judged... I was OK with the words of encouragement... I would not do that to anyone on here 

It doesn't matter if you were not looking to be judged. The fact of the matter is we are judged every day several times a day. While I don't know @Subee personally I have always found  her responses to be compassionate and well meaning, It was in no way inappropriate or unsupportive.  When I reread her answer to you it did in fact appear to be very supportive. People being supportive doesn't mean telling you only what you wanted to hear but also offering coping skills to help you manage better in the future. There is a huge difference between being conscientious and having anxiety in the face of a non event and having an almost pathological level of anxiety.

I mean this with every kindness because like you I suffered from general anxiety which was Caused by ACE's that I had to unpack over several years after a failed suicide attempt. Because I learned that most criticism is actually motivated by a desire to help. I was able to fire my therapist and get off all psych meds and be a pretty happy person today.

[OneRN50]

I didn't intend on getting a mental health evaluation by posting my dilemma. I'll be deleting my post now. Thank you to those who gave me encouragement 

[klone, MSN, RN]

Are you going to do anything about the fact that it is ordered to be crushed and swallowed, which is NOT how a SL med is supposed to be given?
 

SL suboxone taken orally risks ineffective absorption and withdrawal symptoms. Maybe a lit review presented to the ordering physician is in order. 
 

As nurses, it is our duty to use evidence to guide our practice. Blindly following physician's orders that our incorrect is not prudent nursing practice, and could result in disciplinary action or loss of license if it results in patient harm. 

[klone, MSN, RN]

https://www.bicyclehealth.com/suboxone-faq/swallow-suboxone#