Need Advice Please!!!

[nurselala33]

Hi, I am actually posting this for my sister who is also an LPN..She needs some solid advice about an incident that happened in her first weeks of working as an LPN.

She was asked to give a vaccine to an infant. All the vaccines are kept in the same Refrigerator. They are not separated in any way. She had only been working there a little while and was a new nurse. She took out what she believed to be the infants vaccine but was still unsure. She did what she was taught in school. When in doubt ask. She took the vaccine to the doctor on call and asked him if it was correct. He said Yes. She was the only nurse on duty and expected to give 4 shots to the infant so the medical assistant gave 2 of the shots which is not allowed in our state but the doctor had knowledge of it and allowed it.

After she went to the computer to add the information she noticed the lot numbers were not matching up. She brought it immediately to the doctors attention. A report was filed and the parents of the infant alerted. It was written in the report that "inexperienced nurse made med error"...No mention that she had brought it to the doctor on duty was made. No mention of the medical assistant giving 2 of the shots.. It gets worse now...

Here it is 6 months later and today the family of the infant comes in. They refuse to let my sister near the baby and it turns out that someone in her office told their biller of the family practice what had happened, leaving out the part of the doctors role and the part about the medical assistant give 2 of the shots and in turn she told the grandmother of the infant who she worked with that my sister was the one that gave the shot. She gives her my sisters name and tells her she was the one that gave the shot even though it could have been the medical assistant. Now my sisters name and reputation are being dragged through the mud. The family was never told that my sister asked the doctor first. My sister wanted to call the family and explain what had happened but she knows she would lose her job.

My sister does not know what to do. The doctors told her its no big deal, its over and to let it go. But my sister wonders if its going to follow her now. Will it go on her record as a nurse? Why is she taking the whole fall for this...What should she do? Any advice would be greatly appreciated.

Jean

[DutchgirlRN, ASN, RN]

# 1 it sounds like alot of he said/she said...

#2 if she asked the doctor and he said it was the right vaccine...how does that mean she

gave the wrong vaccine just because the batch numbers didn't match?

#3 there an awful lot of hippa violations going on in that office

#4 seriously doubt something like that would go on her record. she did nothing wrong

if i'm understanding it correctly

#5 if an ma is not legally allowed to give the vaccine (which i doubt) and the doctor

allowed it, she (your sister) should find another job.

[nurselala33]

# 1. i came here because i told my sister give great advice..not trying to be he said..she said..

#2. it was the wrong vaccine.

#3 what hippa violations are being broken?

#4 you are understanding it correctly.

#5 ma are not legally allowed to give the vaccine in our state, none of the other doctors allow it, its only the one and my sister is going to look for a new job in the fall after she has her 1 yr in. she is just worried it will follow her to her next job.

[pagandeva2000, LPN]

Is this a private office? If so, then, I would think that if the doctor said it was okay, and safe to administer, and is not making a big deal, this means that at least it was not reported to the state (although I cannot say for certain that the family will not actually do anything about this independently). Did the doctor say that he was going to fire your sister? Did he speak to this family?

Maybe, in hindsight, I would have charted what vaccines the medical assistant administered and what vaccines I actually gave myself. Also, I usually tactfully mention who I spoke to for clarity...eg "Consulted with Dr. Feelgood, instructions are that order is valid and safe to administer...So and So, Medical Assistant administered flu and pneumococcal, varicella and dT administered by writer". Also, for the future, if there is an insert in the container for the vaccine, I would take it out and read it.

What is unfortunate, is that ultimately, the nurse takes the ride, so to speak when the aide, medical assistant, or whomever else makes the mistake. It is interesting how soon some Medical Assistants will suddenly cry "The NURSE did this or said that" but there are quite a few MAs that call themselves nurses until the trouble comes in. However, the MA works under the license of the doctor, she has no independent license, so, actually, the doctor can delegate her to give a shot if he wishes. He takes the ride if she made an error. That's why I say I would document who did what.

What I am also curious about is what numbers did not add up? Was it the lot numbers or expiration dates? As long as they are not expired, that should not have been an issue. Also, many times, doctors and hospitals use more than one company for the same vaccines. For example, I have seen flu shots by Sanofi as well as Merck, or GlaxoSmithKline, and they have varying lot numbers.

Sometimes, even with the best intent, flame wars happen with families. If your sister is uncomfortable, maybe she should consider leaving. Sorry to hear she is experiencing such a hard time right now.

[jean333]

I need to make clear she gave an adult vaccine and it it should have been a child's. That was the mistake. The doctor did not talk to the family the only thing that was said was that it was an inexperinced nurse gave an adult does of pneumonia and it should have been a childs does. My sister read the report and it was never documented that it was brought to the doctor first to make sure it was the correct vaccine. It is a small private practice. How can she find out if it was reported to the state?

Jean

[DutchgirlRN, ASN, RN]

# 1. i came here because i told my sister give great advice..not trying to be he said..she said..

#2. it was the wrong vaccine.

#3 what hippa violations are being broken?

#4 you are understanding it correctly.

#5 ma are not legally allowed to give the vaccine in our state, none of the other doctors allow it, its only the one and my sister is going to look for a new job in the fall after she has her 1 yr in. she is just worried it will follow her to her next job.

#1 he said/she said was referring to what the family members and office staff members were telling each other it had nothing to do with what you said.

#2 your sister is responsible no matter what the doctor said. it is her responsibility to know which is the correct vaccine. doctors are fallible like anyone else. if a doctor orders demerol and i give hydromorphine thinking it was the generic equivalent and showed it to the doctor before administering it and he said "yes that's it" it is still my mistake.

#3 someone in her office told their biller of the family practice what happened and told the grandmother of the infant who she worked with that your sister was the one who gave the shot. major hippa violations there. no one should be discussing the matter other than those directly involved.

#5 if it was reported to the state she will know. i doubt that it was. i imagine an soe was filled out to cover the doctors butt, not your sisters. why wait until fall? if this doctor is allowing ma's to give vaccines that they are not legally allowed to give and she knows about it then she is also copable.

we do give good advice here and sometimes bad advice, however sometimes people just don't like the advice because it's not what they want to hear. i'm speaking legalities here not anything personal. respectfully, i admire you for trying to help your sister, however i think although she didn't give the wrong vaccine intentionally the fault still lies with her. i've made med errors. everyone does. to me that's not the issue. it's that ma's are illegally giving vaccines.

[tnbutterfly - Mary, BSN]

i can understand your concern regarding your sister's situation.

however, these are questions that the members of allnurses.com cannot answer. the only reliable source of information is your state board of nursing. you may also want to address your concerns to an attorney as we connot offer legal advice.

best wishes to your sister.