Ok, here's the story. I just need a different set of eyes and point of views regarding this issue.
I work nights and I am a new grad. I am in a new grad residency program and in orientation in the SICU. I was assigned two pts, one of the pts I had the previous night.
This particular pt is something else. First off, she has a hx of IV drug use and was in the ICU d/t a kidney biospy. She was a transfer from the floor. She argued with my preceptor and I most of the night over the "pain management". According to notes from the floor, she will go to the bathroom for about "30 minutes" and then come out with a small bag full of syringes that was not given at the hospital. This pt also has several bruising and needle marks on her lower legs bilaterally that she claims another facility caused by attempting IV starts.
Well, this night I got the pt, I got report from the day nurse who said an order was entered to change her Percocet to 15 mgs PRN q 6 h. He gave her the 15 mg of Percocet at approximately 1600. She was also SCHEDULED for Oxycontin 80 mg at 2100. Well, it was about 2030, and I was getting ready to get her scheduled oxycontin out of the pysis. We have an hour before and after schedule med is due to give the med. I wanted to be somewhat ahead of schedule just in case something happened (ie other pt crashing).
I go to the med room to get the oxycontin. There was another nurse in there at the time. I pulled up my pt's name and her med profile and her oxycontin was grayed out. I asked the other nurse what that meant and she said I would have to go to another pysis to get the oxycontin. I said ok and exited out. As I was on my way to the other pysis, my other patient started crashing. I ran into the room and my preceptor was already there. The other nurse asked me if I wanted her to get the oxycontin for my other patient, I said yes as I'm trying to get oxygen on my crashing patient.
Fastforward to an hour later, I go into my other pt's room and she asked me for her 15 mg of Percocet. I look at the MAR and the nurse who gave her the 80 mg of Oxycontin charted that she also gave her the 15 mg of Percocet AT THE SAME TIME! I advised the patient of this. The pt stated "I never seen that nurse before in my life and she came in her and gave me my 80 mg of Oxycontin, the green pill. She never gave me the 15 mg of Percocet, which are white pills and it would have been 3 of them. She only gave me one pill".
So, I told my preceptor what happened. We checked the pysis and sure enough, the Percocet and Oxycontin were pulled out at the same time under my co-worker's ID. The patient states she knew she couldnt have her Percocet until after 2100, and she would have asked for it. The pt also states the nurse did not have a med cup, she opened the 80 mg of Oxycontin and gave it to her in her hand. My first reaction was to check the trash for open wrappers, but the housekeeping lady had already dumped the trash.
My preceptor went to the other nurse and asked her what happened. It was a totally different story. The other nurse said that she gave all 4 pills to the patient and asked for her pain score which the pt replied it was a 9/10. The preceptor had no choice but to go to the nurse manager because the pt started throwing a fit about the Percocet not being given. The nurse manager interviewed the pt, who told her the same thing she told me.
We had to call the pt's doctor and advise him of what happened, and then override the Percocet and give it to the pt. I gave it and then keep the wrappers for myself. I charted that I gave them and made sure my preceptor was in the room at the time.
I was also interviewed by the nurse manager and I had to send something in writing about this whole incident. So did my preceptor. The nurse involved also had to take a drug test. I don't know who to believe. I feel so bad because it was my patient. What do you all think? I'm only hoping the patient was proven to be a liar. Is that wrong?
