Is this a Med Error? I have been kicked from clinical. Help

  1. I' am in my last quarter of nursing and I was recently failed for my clinical portion 2 days from graduation. I looked into a MAR to see if a client could have a narcotic. Turns out the client had 10 min befor she could get it. The ten minutes passes and I go into the narc drawer and again double check the last time she had the medication and it was indeed time for her to get it. I signed the narc book and being a student needed a cosigner asked my instructor to cosign. She asked me where the MAR was and I told her it was in the MAR book. She said "so you want me to sign a med without having the order from the MAR? Its not safe!" and sent me home to fail the clinical portion and therefor have to repeat the theory and clinical portion next quarter. I'm fighting it but I wanted to know, has anyone else ever had a nurse/teacher co-sign a narc without the teach/nurse seeing the MAR first? As I thought the narc book only verifies the count I would always just have them cosign and then do my 3checks of the seven rights and administer the medication. Is/was this wrong or have any of you done the same thing? Thanks for your help
  2. Poll: Have you done this before? Or as a Nurse signed for a narc without MAR open

    • Yes, I dont think it's wrong. It just verifys the count.

      19.23% 5
    • No, I havent and I dont know where you are coming from.

      80.77% 21
    26 Votes / Multiple Choice
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    Joined: Dec '12; Posts: 7; Likes: 1


  4. by   Meriwhen
    We used Pyxis during most of my clinicals and the times we didn't, the instructor obtained the narc for us. So I can't say I have similar experience, sorry.

    Personally, I don't think it was a med error because you'd still (better!) be checking the med using all the rights before you gave it to the patient.

    However, if you violated the facility's P&P which required that the MAR be present when signing out narcs, or you ignored initial instructions from your CI that she wanted you had to bring the MAR when getting narcs, then you indeed do wrong.

    I know that the word of the CI is law in clinicals...even so, to dismiss you from clinical for this one incident seems kind of harsh to me.

    Best of luck with challenging it.
  5. by   HeartsOpenWide
    This is not a med error. You may have been breaking policy however, was this a rule you were trying to side step in an interest to get the patient their med sooner? I do think failing you is a bit extreme; your instructor should have used this as a learning experience, have you do a research paper on med errors caused by not double checking/ consigning high alert meds, 5 rights, ect
  6. by   Esme12
    I'm not sure what the policy is.......but you have to follow all procedures according to the policy....but I think failing you is a little harsh......I thinking an in service about med errors and how to prevent them is more appropriate......I would set up a meeting with your dean to discuss this matter. I think your CI is a bit extreme.
  7. by   Overland1
    This should not be, in itself, sufficiently extreme to be failed out for. If there is absolutely nothing more to this story, then it should have been used as a learning experience, maybe with a short research paper as "penance" (maybe do a few laps around the beads, too ).

    When you return next semester to repeat that clinical rotation, the school makes some money; at least they gain something from it (don't mention this to them as the problem will only worsen for you).
  8. by   Bouncyball
    I don't think that is a medication error. You should not have been failed. Have they been picking on you all semester and waiting for you you make a mistake, or did that come out of nowhere?

    My instructor requires us to show him the mar for our current shift, and the previous shift to verify the last time the prn was given before getting it from the Pyxis.
  9. by   nursing?s
    yes, at the begenning of my very first quarter I reported to the Dean of Nursing that one of the nursing instructors cheated in order to raise other students grades. I have had a target on my back ever since, because this is a very small school and all the instructors stick together. I have not given them one reason to do anything, and as I stated above I had been doing narcs this way since the beginning of school. I have met with the dean and she has a week to decide and I have also written to the VP of accidemic affairs in hopes I can get this taken care of within the next couple of weeks.
  10. by   Bouncyball
    I'm sorry your going through this. I hope you are able to get this sorted out.
  11. by   Katie71275
    No not a med error and shouldn't result in failing as you did not harm the patient. We do have to have the MAR with us when we are pulling meds and our teacher looks at the meds/mar to make sure it is correct before we pass meds.
  12. by   KJM-RN
    I'm kind of confused... So meds just have to be verified with your prof before you go pass them by yourself? In my state, meds must be passed only with the prof standing by our side, not even allowed to give a pt. meds with a nurse, must be the prof. Of course we can follow a nurse while they do their med pass, but we can't be the one to hand the meds to the pt.
  13. by   Racer15
    The way my program did it, we would get the MAR, gather our meds, then hand the professor the MAR and show them what we had so she could compare it to what the MAR said. Then we went off on our merry way. We never drew up narcotics though, someone had to get those for us. I don't feel what you did was fail worthy though.

    And kjm84, by my third semester, we were allowed to administer most meds by ourselves. We had to let our instructor double check that we had the right meds and dosages, but once they confirmed we had what we were supposed to, we could give them with no supervision. The only exceptions were things like insulin injections. Although I remember my ER clinical, I was giving IV push meds by myself with no one watching. Also did a lot of things with no supervision during my practicum. Guess every state is different!
  14. by   grpman
    Why turn in an instructor? This almost never works out for the student's good over time. I try to stay off their radar, do good with grades, and do good in clinicals. Then I stay quiet and worry only about my own problems which are many.

    If you are reading this as a new student in nursing school, don't turn in your instructors for anything unless it will legally come back on you or cause God to strike you dead on the spot. All else is trivial and may bring reciprocity.
  15. by   Pepper The Cat
    Were you getting the med from the MAR or just from the Narcotic Book?
    If you were using just the Narcotic book than I see the instructor's concern. What if the med had changed since the last dosing?
    What if the previous nurse gave the wrong med?