Very upset and depressed...almost got fired

[mondkmondk]

I can't give too much info just in case someone I work with comes here and of course, I surely don't want to violate anyone's privacy. Anyway, I worked this past weekend and wasn't aware of a policy in place at this new facility I've worked in for only a few months. They do not allow admissions on weekends and I admitted someone on the weekend. The reason for no admits being this place does not have access to a 24 hour pharmacy to obtain ordered meds. The DON was very angry with me (rightfully so) and really let me have it. She didn't write me up or fire me but I'm on a thin line now and I'm very upset with myself for not calling her before accepting the admit. I have been a licensed nurse for 17 years and I've never made such an important mistake. My confidence is gone; I don't know how to get it back. There are a few nurses there that I just know are probably happy that I got reamed esp. this one who never lifted a finger to help me out with anything when we worked together even though I don't think I've ever done or said anything mean to her.

How can I pull through this? I know it is a learning experience etc. but I mean it, I'm really depressed now (it doesn't help that I already suffer from a similar mental illness which predisposes me to extreme depression). I'm not suicidal or anything, but if I end up being wrote up or fired, I probably will be. I just really pride myself on being a good nurse and it is like I've been whacked at with an ax.

Thanks for listening...

Blessings, M.

[catlvr]

My first thought was the same as everyone else's: why didn't the other staff clue you in to this policy? If that is the mentality of the facility, I think that I'd be looking for a new position, and take it as a learning experience.

One of the hardest things to learn is how to pick youself back up after falling; but since chances are good that we're going to continue to make mistakes, it is a really valuable lesson. Forgive yourself for this, study that P&P manual while you consider if you want to stay at the facility, and resolve to do better.

Good luck!

e

[arelle68]

They failed to inform you. Their fault. Forgive yourself, forgive them, and go back to focusing on the needs of your residents.

[mel82]

How can you not have access to a pharmacy on the weekend?

[wooh, BSN, RN]

If that's the worst you've done (getting them an extra couple days of payment for a new patient), then you're doing good.

[CapeCodMermaid, RN]

WOW....

First off to the poster who said the hospitals HAVE to speak to the admissions person before sending someone...NOT around here. We've gotten patients sent to us with no warning at all. The hospital does NOT care about our insurance issues -they care about getting the patient out of the hospital.

At my last facility, before I got there, they didn't take weekend admissions because the nurses told everyone it was too much work..yikes...how do you all think your salaries get paid?

Do you have an ekit...a first dose kit to take meds from if the pharmacy can't deliver? I, too, am surprised that you don't have access to meds 24/7. What happens if there is an order for a new antibiotic on a Saturday? Does the patient wait till Monday?

Finally..one thing we do which keeps everyone informed...we have a note book at the nurses' station. Any new policy is put in the book and all the staff must sign that they've read it. We also use it for patient specific things like "Mrs Jones does not want to get out of bed before 10 am"...everyone knows the latest and if they say they were never told, I give them a copy with their signature on it.

[mondkmondk]

Thanks everyone; I am not as depressed today and can't help but think if they wanted my resignation or planned to fire me, which they haven't, then they must think I'm a decent nurse who just made a mistake. In the med room, there is a tiny piece of paper that has a name and phone number on it; it is an on-call pharmacist but the note also says to never call him, so maybe that is why they are passing surveys? They probably take the paper that says to never call him down for the surveyors.

The DON called me off my supper break when she reamed me and now all my aides are coming up to me and asking what I got in trouble for. I can't believe how nosy people are. Of course, this facility probably has more aides than anything so naturally they can get gossipy. 2 other nurses that all of a sudden quit were the main CNA topic this weekend. I told them to go gossip on their own time too. I know I would hate to be gossiped about, which I know I am being gossiped about now since I didn't tell anyone what I got in trouble for, although I know the licensed nurses know and have probably by now already told the aides. ARGH!

Anyway, thanks for letting me vent and for all those who allowed that they've made mistakes too....

Blessings, M.

[Michigan]

Sorry, sounds like you were dumped on.

Very confused. How can hospital d/c to a facility without talking with someone at the facility. How are papers signed for admission? Who calls report?

Another warning sign- no 24 hour pharmacy? What happens with new admission meds? We have an e-box, but it is just that- emergency (a med change, prn, etc) not to fill for admission. Who is double checking these meds?

We also use a communication book for MINOR policy changes, something like that would be a big annoucement, posted way prior to the change taking place.

Also, agree with previous post about weekend admissions. Yes it is time consuming, but I want a paycheck. Someone for admissions is on call after normal business hours, holidays and weekends where I work.

[barefootlady, ADN, RN]

I am glad you are not so depressed. I am concerned regarding future incidents. It would weight on my mind that no fellow co-worker informed me of such an important policy issue. I really hope nothing else comes up to cause you problems but I would not bet a hour's wage that it will not happen. Sounds like this facility has some issues that need to be addressed. Good luck to you.

[evilolive, BSN, RN]

I'm glad you're not so depressed either. It's amazing what facilities don't tell you though, when you're a supervisor or charge. I'm a fairly new grad, one year of exp. at my facility and I'm a supervisor. I've had to check my P+P soooo many times, and often times I don't find what I'm looking for.

I've been reamed so many times (often times for not finishing other nurses' work), and after awhile your skin becomes a bit thicker. For example, when my boss gives me "the look" now, I just stare right back at her... eventually she backs off and finds someone else to pick on.

Best of luck, and like another poster said, if this is one of the only "mistakes" you've made, you're on a good run!

[makes needs known]

Since the patient survived this "illegal" admission and you did too, I bet your facility will make arrangements to start taking new admissions on weekends. An empty bed makes no money.

[morte, LPN, LVN]

Since the patient survived this "illegal" admission and you did too, I bet your facility will make arrangements to start taking new admissions on weekends. An empty bed makes no money.

ah yup.....

[LesMonsterRN, ADN, RN]

How strange not to have pharmacy services on the weekend.

As an aside, I'd love to not have admissions on the weekends. We can get meds, but sometimes it's a challenge to make sure we've got the equipment that a new resident will need.