Oxycodone Mistake

[Angelasc]

I'm a heart surgery nurse. Yesterday a very serious thing happened while I was working with a colleague who has just finished her internship.  I trust her very much. But for the last couple of days she still has to be accompanied with meds. One patient was in a lot of pain, and my colleague took oxycontin 5mg extended release.  She administered it, I just didn't check if he had already received it, because I thought she already checked.  But in fact, he already took it at 12:00 and we gave her another one at 19:30. In the evening he developed a psychosis and wanted to go to another hospital.  I didn't give the medicine but I signed with my colleague.  Obviously the responsibility is mine because my colleague is not yet officially autonomous.  I feel deeply guilty for not checking and I can't forgive myself.  I don't know what to do, I can't do this profession anymore, I'm not attentive and intelligent enough.  But I really need support and I can't talk without crying

[Tegridy]

3 hours ago, Angelasc said:

Sorry if I didn't answer, I didn't want to think about it anymore. I still feel very guilty en down. I'm trying to be more careful, I can't take another mistake like this again.  Thanks everyone for the replies, they helped me a lot.

Everyone makes med errors and I doubt an extra 5 of oxy will make any difference

[mmc51264, BSN, MSN, RN]

On 11/20/2022 at 7:29 PM, LovingLife123 said:

What was the frequency of dosing?  Usually oxy is given 4-6 hours.  7.5 hours later of 5mg is not going to induce psychosis.  

She said Oxycontin ER, not oxycodone (short-acting) 

[JBMmom, MSN, NP]

On 12/4/2022 at 1:01 PM, Angelasc said:

I can't take another mistake like this again. 

Highly doubtful that you will make this exact error again, however, you need to remember that mistakes happen. I'm not supporting careless nursing care, but your mental health is too important to put something like you can never make a mistake again on yourself. Be kind to yourself. You are clearly conscientious and work to act in the best interests of your patients, so keep your high standards for yourself and others. But not at the cost of your own health and well being.  

[Lust4life, BSN]

LovingLife123 said:

What was the frequency of dosing?  Usually oxy is given 4-6 hours.  7.5 hours later of 5mg is not going to induce psychosis.  

The hospital environment itself is going to cause psychosis in some people.  Going days on end with little sleep causes psychosis especially in the elderly.

You are way overthinking this and being too hard on yourself.

It was extended release though. Which makes me wonder why he isn't ordered a PRN for breakthrough pain. But that's another thing. 

[Lust4life, BSN]

Was he ordered that ATC at like 8a and 8p since it's extended release, and also ordered a PRN for IR secondary to breakthrough pain? 

Didn't know they had 5mg oxy in ER. But anyway, even if it were ER, seems like the time given apart wasn't very close and I'd think that he probably would've gotten confused regardless. 

Don't beat yourself up. Mistakes happen and everyone survived. I bet it was probably only a matter of getting the pill a little bit early.