Treatment "error"= med error???!!!

[kwagner_51]

Ok we just went through State Survey and FAILED!! I tried to tell them tht they needed to mop the pt floors, but they didn't listen. We got dinged on environment issues, 'floors' and according to rumor, below standard care of pts.

I had a note attached to my time card to see the DON before I left this AM. I waited until 7:45 and then left. I have to be back @ 3PM for a mandatory meeting and then go back again @ 7PM!!:angryfire

That was the brief history to what I am being written up for.

According to the nurse I follow, the Wound Dr came in about 3 weeks ago and threw a FIT because a pt had spenco boots on. He said he didn't want to see those pieces of sh*t on any of the patients again.

We didn't get the order d/c'ed and had been signing that they were on. The nurse that trained me told the DON, ADON, the Administator and anyone else she could think of that we couldn't find the boots. She sent them to laundry and never got them back. She went to Laundry and looked. When I came on shift, I also looked the the d*mned boots and couldn't find them.

In trying to protect our pt's feet/hips [she's severelly contractured, where her feet touch her hips and rub, causing decubes.] we wrapped her feet with bed pads and put one between her hips and her feet. we improvised.

Last night I worked another unit and EVERY ONE of the pt's had the spenco boots on!!

The mandatory meeting today is about wound care and the wound Dr. will be there.

According to the NM for this unit, the DON wants to see me to write me up for this "med error". I am going to refuse to sign it and put in the reasons why in the comments section.

Have any of you heard of being written up for trying to do the best you can with what you have?

I am so ANGRY I'm ready to walk.

The dr. is going to answer many questions from me.

I'm really confused because the wound dr is the ONLY dr for all the pts. If he doesn't want them on one pt. doesn't it stand to reason that he doesn't want them on ANY pt?

Thanks!!

_______________________________________

In His Grace,

Karen

Failure is NOT an option!!

[CoffeeRTC, BSN, RN]

I see your point and feel your pain. What was ordered and what did you sign for? If a treatment or positioning device was ordered and you don't have the proper supply or equiptment, you need to circle it and make sure you get it ASAP. That might mean calling pharmacy or letting PT/OT know about it and documenting everything you did. Yep.....missing a treatment is considered an error and can be written up for. How long did you guy improvise....3 weeks?

A lot of times PT/OT will order a device that we don't have or maybe it isn't working for the resident. What we will do will remove the spint if say its rubbing or causing blisters and try to put the body part in the proper position with pillows, etc. and let PT/OT know about it ASAP.

Sounds like someone dropped the ball.

[GingerSue]

According to the nurse I follow, the Wound Dr came in about 3 weeks ago and threw a FIT because a pt had spenco boots on. He said he didn't want to see those pieces of sh*t on any of the patients again.

We didn't get the order d/c'ed and had been signing that they were on. The nurse that trained me told the DON, ADON, the Administator and anyone else she could think of that we couldn't find the boots. She sent them to laundry and never got them back. She went to Laundry and looked. When I came on shift, I also looked the the d*mned boots and couldn't find them.

In trying to protect our pt's feet/hips [she's severelly contractured, where her feet touch her hips and rub, causing decubes.] we wrapped her feet with bed pads and put one between her hips and her feet. we improvised.

Last night I worked another unit and EVERY ONE of the pt's had the spenco boots on!!

I'm really confused because the wound dr is the ONLY dr for all the pts. If he doesn't want them on one pt. doesn't it stand to reason that he doesn't want them on ANY pt?

just wasn't sure - are you saying that you were signing for the boots being on, even though the boots couldn't be found?

sounds like the dr doesn't want the boots on any patients - but even if the dr doesn't want them on one patient then that decision doesn't necessarily apply to all patients (individualize the treatment - according to the needs of each individual patient)

yes, it does sound confusing when the dr has said that the boots aren't to be used, yet on another unit all patients have them.

[Jolie, BSN]

We didn't get the order d/c'ed and had been signing that they were on. The nurse that trained me told the DON, ADON, the Administator and anyone else she could think of that we couldn't find the boots.

I'm really confused because the wound dr is the ONLY dr for all the pts. If he doesn't want them on one pt. doesn't it stand to reason that he doesn't want them on ANY pt?

Thanks!!

_______________________________________

In His Grace,

Karen

Failure is NOT an option!!

I'm sorry for your continued troubles. I don't quite understand the events in your post, but 2 things concern me:

1. The order was not DC'd, and the staff continued to sign as though the boots were being applied. That is falsification of a medical record. Reason enough to fail a state survey, and reason enough to land oneself in front of the BON.

2. A request a doctor makes for one patient in his care goes for that patient only. It is not reasonable to assume that the same request applies any of his/her other patients. All are individuals with specific needs that may or may not be similar to those of other patients. Any questionable orders MUST be verified with the physician. It is the nurses' duty to do so.

Again, I'm sorry for your troubles, but I believe there have lapses in professional judgement here.