[jo272wv]

Need some advice: I was supose to administer a nitro patch to the right foot of a pt for blood clot prevention. I was called into the office two days later and told I put it on the left foot and would recieve a write up. I tried to explain to the nurse manager who I respect very much, but all she would say is the family compained and I had indeed put it on the wrong foot. The patch had my initials on it so I agreed it could have happened. When I got home I thought it thru and came to the conclusion that this situation is wrong because:

1. I have never applied nitro to the foot so I double checked the order.
2. I am very anal so I placed all the supplies on the right side of the pt.
3. I took down only one sock which was the right one.
4. I commented that the nurse before me liked to use a lot of tape for all four sides were taped.
5. I removed the old patch and washed the foot and applied the new one.
6. I pulled up the right sock and pulled down the sheet.

I am 95% sure I did the right foot and know that if I did not it would still be my fault even if the previous patch was applied wrong because I should have caught that. But I know I did the right foot not the left.

My question: what would you do next? rebuttle the write up or just let it go and rebuttle it if it comes up later. No harm came to the pt and the patch was only on two hours before the family said they found it.

I am the type that will admit if I know I am in the wrong and accept the punishment so I am not just trying to get out of this.

Thanks all

[TazziRN]

I'm surprised you were written up for this. It warrants a med error report, but I don't think it warrants being written up. There's no way you can prove you put it on the correct foot, so a rebuttal would really do you no good. If there is no disciplinary action attached, just let it go and move on.

[allele]

It could be different where you work, but where I work we just call all occurence reports "write ups" (i.e. falls, med errors, etc). Anyway, where I work these occurence reports are used specifically for system errors and trying to find how the error could have been avoided. We are not spoken to individually (for example, if I give the wrong med to a patient, I won't be told I did it....it will come up at the next staff meeting with no names used and we try to hash out how the error could have been avoided). I don't know what happens if there's a sentinel event, though. I'm sure I'd hear about that! But, if they wrote up the med error and it's to be used to find how the error could have been avoided...let it go. The above poster is correct, I'm not sure how you can prove you put it on the correct foot. I supposed anything could have happned, it could have fallen off and maybe another staff member replaced it, a family member, the patient, etc. There are too many variables. If you are being formerly written up, I think I'd try to argue my side, though. Good luck!

[Mulan]

If you are given something to sign, just put down that to the best of your knowledge the patch was placed on the correct foot at the time you placed it. Or make out an incident report of your own that says the same thing. Anything could have happened to it after you placed it.