JULIE Lord was stressed, nervous and on just her second day on the job when she mistakenly injected a nursing home palliative care patient with 10 times the required amount of morphine, a court heard yesterday.
Five hours later the patient, Stanley Valentine Whiley, 67, was found dead at Tamar Park nursing home at Legana.
The inquest into Mr Whiley's death in March 2010 began yesterday in the Launceston Magistrates Court.
Mr Whiley had heart disease and a week before his death had suffered a major stroke.
State forensic pathologist Chris Lawrence described those events as two ``perfect explanations'' for his death but could not discount that morphine played a part.
Dr Lawrence said the dose, which was at the lower end of the fatal range for morphine, was ``like the last straw that broke the camel's back''.
Mrs Lord graduated with a nursing degree in February 2010.
Two weeks later she was on her second shift as a registered nurse and in charge of 38 nursing home residents. That was the day of Mr Whiley's death.
She had already done some work at Tamar Park as a carer.
She told the inquest her medicine management training at the nursing home was limited to watching the facility manager Sandra Renshaw do two or three drug rounds.
Tim Cox, counsel for Tamar Park owner Aged Care Services, highlighted Mrs Lord's university training in administering drugs, which required students to gain a perfect score in competency.
Mrs Lord said that on her second shift things quickly got beyond her as she attended to a dementia patient with a body rash.
She fell behind in her rounds and at one stage she was trying to fix a fax machine.
Other residents began asking for their meals so they could take their medication.
``I was feeling very stressed and very late in my rounds as well, I was way out of my depth,'' Mrs Lord said yesterday.
It was in this context that she started to prepare morphine for Mr Whiley, she said.
This included taking carer Gaylene Buller into the drug room to observe the process.
Mrs Lord said she followed the proper procedures but misread the vial containing the morphine.
This resulted in her injecting Mr Whiley with 25 milligrams of the opiate rather than 2.5 milligrams.
She did not check again on Mr Whiley but had other staff observe him and report back to her.
Mrs Lord realised her mistake when she began drawing another dose for Mr Whiley five hours later. She then went to check on him with a carer, but he was dead.
She said support and staffing levels were inadequate and enrolled nurses had recently stopped working alongside registered ones.
Mrs Lord said Mrs Renshaw's evidence that she'd been buddied for a week when she first started was incorrect.
Mr Cox suggested she had been offered counselling after the event, but Mrs Lord said that was not true and she had to organise her own. She also said she could not remember being given the number of another registered nurse to call if she needed help.
Earlier, Mrs Buller gave evidence that she was not trained in administering dangerous drugs and had only observed nurses do it fewer than 10 times.
She said bullying occurred at the facility and she ``was scared of the way the place was being run''.
She said enrolled nurses had recently been made redundant.
The inquest in front of coroner Rod Chandler continues today.