Please help, need advice... (Long post)

jillyk*rn · Apr 6, 2006

hi,

i don't have any advice for you. i had no idea about cutting an unscored tablet either. never thought about it.

i do wish i had some wonderful advice, but i am sure that someone will.

hugs to you!!

mtnmom · Apr 6, 2006

I dont have any advice to give you, but given your efforts to fix the situation first (do you have those documented?) you did the best you could under the circumstances. Only thing I might have done differently was let your manage, charge nurse or whatever know first the difficulty that you were having.

Also you said the pill wasnt scored but did you just have to slice it in half? Or did you have to estimate (i.e. 3/4 of a tablet). With a pill slicer it seems as if it would be easier to accurately half a pill even if not scored than to cut off a 1.4, 1/3 or something else. Just my thoughts....

Editorial Team / Admin · Apr 6, 2006

i was terminated from my job as an lpn at an alf. i made a mistake... i had a resident who got his meds through mail order from the va, they sent the wrong dose of seroquel, a larger dose that he was on previously... after repeatedly calling the va and his md and getting nowhere, i ran out of the correct dose and out of fear for him not getting the medication and suffering a reaction, since it is a med you should not stop abruptly, i cut the unscored pill as carefully as i could with a pill cutter, and i gave him the medication. i told the nursing director what i had done, and how frustrated i was with the va for not sending the correct dose and all the times i contacted them. she told me i should not have done this, that it was illegal. i told her i would never do it again and that i did not know it was illegal, although i know you should not cut an unscored pill, i was more frightened that the resident would get ill from not having this med. the director also said it was illegal even for a pharmacist to cut unscored pills, but the pharmacy that is used by the facility does it all the time...
this happened on a monday, and when i went back on thursday, i worked the whole day and at the end of my shift, i was called into the ed's office and was told i was terminated. i asked her if i could just be written up or suspended but she told me it was a terminable offense. i have never ever even been written up before and am totally devastated.
i applied for unemployment and as of yet have not been approved, i told them the truth about my termination.
now, my lpn license needs to be renewed... i got the form before i was fired and was just going to send it out today and noticed that one of the questions on the back asks if i have been terminated from a licensed facility for professional misconduct, unprofessional conduct etc. is cutting an unscored pill considered one of these? is it illegal to do so? like i said, i knew it was frowned upon, but i thought i was doing the right thing at the time, although i would never do it again... i looked up my state board of nursing (ny), but i just couldn't find the answer to my question.
can i lose my license over this? i worked so hard for it and i am terrified...
i know if i answer yes to that question for my license they probably won't renew it. also if i apply for a job, what do i do, do i tell them i was terminated and why? i applied for a couple of jobs, but did not tell them i was fired...
please give me some advice if you are able, it would be greatly appreciated.

hello, maisyvb and welcome to allnurses.com

i am sorry things are not going well for you.

to answer your question, you must be honest and answer, 'yes', to that question. you were terminated for "professional misconduct". it is best to be honest. should you answer, 'no', you might lose your license all together.

good luck.

**canoehead, BSN, RN** · Apr 6, 2006

I would have done the same thing you did IF I couldn't get hold of the MD and get the dose changed, or an order to cut the pill. I really don't think cutting an unscored pill is illegal- otherwise we'd have thousands in jail, including me.

maisyvb · Apr 6, 2006

The pill was 100mg, and the dose was 25, I 1st cut it in 1/2, then I cut it in half again... the pieces were as equal as I could get them... This resident had been on Seroquel long term and I really was afraid to just stop it abruptly.

**canoehead, BSN, RN** · Apr 6, 2006

Hey, I just remembered- in OB we used to cut up pills all the time into quarters. The pharmacist would send us up a whole pill with the knowledge that we were cutting it. The doc knew, and actually once asked me is she could see the quarters so she could choose her "favorite"

I don't see how it could be illegal. But if your boss is lying to you it is maybe better to find somehwere else to work.

a21chdchic · Jul 28, 2007

Always be honest and up front about your actions. I don't believe what you did is illegal or even unethical, maybe not the best choice, but you are not the first or the last to have done the same.

Personally, I would wonder if the employer was just looking for a reason to terminate you? It sounds a bit anal to me. Nursing is about improvising.

But in the future, if you have questions or issues that you aren't getting anywhere with on your own--Managers get paid to problem solve, it's part of being a supervisor. Take the issue to them, tell them what you have already tried, and ask for suggestions for problem solving.

Good luck!