Fired for a medication error

  1. 3 I accidentally gave Phenergan IV instead of IM. No harm came to the patient. I told the ordering PA and my lead nurse, and filled out an incident report. Because of our computer system, there is no way to chart the change in route without charting an error. (House policy states IV route is not permitted due to risk of occurance unless it is in a larger vein than the hand or wrist. I gave it in the AC.) I was fired the next day without risk management's involvement, my manager citing safety issues and disorderly conduct.
    Am I correct in assuming this might be wrongful termination? I thought incident reports were used as a quality control tool to discover and prevent errors?
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  3. Visit  stiches} profile page

    About stiches

    Joined Feb '12; Posts: 7; Likes: 12.

    43 Comments so far...

  4. Visit  psu_213} profile page
    0
    I tend to think it is a bit unfair to be fired over a "simple" med error; however, this is just personal opinion and the facility can do what they choose. It is true that the incident report is a QA tool, but it sounds like several people knew about this error other than just what was on the report.

    Sorry this happened to you...
  5. Visit  Ruby Vee} profile page
    22
    wrongful termination? i doubt it. i don't know where you're located nor do i know the laws of your area. if you're a relatively new employee and still on probation, you can be fired any time for any (or no) reason. but reading through your post, i find myself wondering if there weren't a good reason for your termination. no where in your post do you express knowledge that you could have injured a patient, that you made an enormous mistake and that you take responsibility for making that mistake and for ensuring that it never happens again. instead, you seem to believe that because you went through the correct motions afterward, it's ok. no harm, no foul.

    if i were your manager and you gave phenergan iv instead of im, i'd look for some evidence that you're aware of what an enormous mistake you made, the potential harm to the patient, and that you're horrified that you made the mistake. someone who takes a "no harm, no foul" attitude to a medication error may not be super-vigilent to prevent it from happening again. unless you demonstrated a lot more awareness to your manager than you did in this post, i think the termination was a good call. probably not what you wanted to hear, but hopefully it will help you to re-examine your mistake and re-evaluate your priorities.
  6. Visit  GrnTea} profile page
    3
    what disorderly conduct? something else you didn't mention?

    i agree it doesn't sound too good otherwise. this was a serious error, and while nobody expects you to don sackcloth and ashes, some sorrow and regret would have been appropriate.

    yes, occurrence forms (also known as incident reports, or by other names) are supposed to be aimed at quality improvement. they are also to let the risk manager know that something has happened before s/he gets the subpoena for documents from an attorney, or for other reasons. submitting is absolutely the right thing to do, but your having done so does not give you a free pass for appropriate consequences.

    we have so many students and new grads here shaking in their boots worrying that they'll be fired if they make any error at all; it's not true, unless it was really egregious or repeated. some places might have put a written warning in your file and perhaps put you on some sort of supervised probation for a first occurrence. i'm not sure why they brought out the big guns if this was a first error...was it? perhaps not.

    good luck in your next job. be careful out there.
    Last edit by GrnTea on Feb 29, '12
    JEN077, not.done.yet, and Meriwhen like this.
  7. Visit  subee} profile page
    8
    Stitches: I wouldn't have fired you because you did the right thing and reported the error. We have no clue to where you are in your career. If HR didn't forbid it, I would suspended you (without pay, of course) - assuming that you are young and clueless but capable of appreciating that this could have been a career killer and deserve a second chance. Someone gave me a second chance 30 years ago because they realized that I was exhausted and anxious about being in a new, stressful situation. After that I because uber aware of how a small lapse in attention could cause an error.
    Scooby's mom, Mazee, elprup, and 5 others like this.
  8. Visit  Merlyn} profile page
    5
    Quote from stiches
    I accidentally gave Phenergan IV instead of IM. No harm came to the patient. I told the ordering PA and my lead nurse, and filled out an incident report. Because of our computer system, there is no way to chart the change in route without charting an error. (House policy states IV route is not permitted due to risk of occurance unless it is in a larger vein than the hand or wrist. I gave it in the AC.) I was fired the next day without risk management's involvement, my manager citing safety issues and disorderly conduct.
    Am I correct in assuming this might be wrongful termination? I thought incident reports were used as a quality control tool to discover and prevent errors?
    wrongful termination? I doubt it. Hospitals now days have an abundance of nurses to pick from. It's heartless and cruel but it is the way of things. It's much cheaper for a hospital to fire than it is to start a full scale investigation. It's happen to me. The best advise that I cam give you is to move on.
  9. Visit  Meriwhen} profile page
    0
    Wrongful? No.

    Fair? Don't know because it seems like there's some key information missing. It seems like a drastic knee-jerk reaction to fire you for one medication error that you did report and take responsibility for. So you either left out that key info that could help solve this puzzle, or this incident happened to catch your manager in the wrong place at the wrong time. With all due respect, I think it's the former...especially since you're the one mentioning "disorderly conduct."

    Best of luck as you move forward from this.
  10. Visit  LynnLRN} profile page
    11
    Wow, if every nurse where I worked got fired for making 1 medication error I'm pretty sure none of us would be working, ha! Human error is going to happen whether we like it or not. The important thing is you realized what you did and then talked to the PA. Shows you have integrity. I worry more for the people who try to cover it up, leave and the harm happens on the next shift and nobody knows what happened. Or worse people who don't even realize they made a mistake. Firing every nurse who makes a mistake is not going to prevent future mistakes. So I have a hard time believing a nurse would be fired for 1 mistake that was not a sentinel event or completely negligent.

    If you got fired for 1 medication error its either you're newly hired or you have been written up for other things and this is a repeated offense.
  11. Visit  simmdd} profile page
    4
    I think we all forget that we are human and we make mistakes. I have worked around the best nurses and doctors and watched them make tons of mistakes. Yes we have other people lives in our hands but things will happen and we do the best job to correct it but sometimes things happen. Is it ok? NO but we are nurses and we are going to make mistakes. Can we learn from them? Yes but I do not think making comments to make a person feel worst then they already feel is helpful. I say talk to some people to see what you can do if anything. If there is nothing you can do about just pick yourself up and move on and learn from it. You will do better next time. Good luck to you.
  12. Visit  stiches} profile page
    5
    FYI. As a matter of course, I should mention that the medication error was a single event. I did not mention my follow-up which included checking on the patient because I was concerned about their welfare. Thank you, simmdd for not assuming the worst about the entire situation. Perhaps knowing the fact that my manager is new in his position might help. In addition, there was absolutely NO investigation into the event before my termination. While I do have concerns about my unemployment, those of you who think I was entirely at fault should know that my lawyer thanks differently. There are times when seeking the advice of legal council does make a difference.
    yowi, Merlyn, Scooby's mom, and 2 others like this.
  13. Visit  zorabanks} profile page
    5
    Sorry this happened to you. We are human and are going to make mistakes at times. So glad that the pt. was not harmed. In my opinion if any nurse tells you that they have NEVER made a medicaiton error of any kind, then they are not telling you the truth! Good Luck!
    Merlyn, hope3456, silverbat, and 2 others like this.
  14. Visit  SoldierNurse22} profile page
    8
    Wow, seems like an overreaction based on the info provided. IM vs IV Phenergan? Pshh! Just a few months ago, we were pushing IV Phenergan on my ward every other day. The pharmacy instituted a policy change because it's a vesicant and all of us on the Oncology ward looked around at each other, shrugged and said "OK", as if we don't give plenty of chemo vesicants on a daily basis. We diluted the holy hell out of it when we gave it, but I dunno. Perhaps I'm just used to it, but given in a diluted form over a couple minutes and then followed up with a nice flush--that was standard practice back in late 2011. Yeah, what happened with the OP was a med error, but for goodness' sake, they owned up to it. No need to slap around the 2nd victim in a error now, eh?
    v8grrl, JEN077, Borntobenurse?, and 5 others like this.
  15. Visit  Need4Speed305} profile page
    2
    OK, I know nothing about you and I'm sure you (and your legal team) will figure this all out in due time. I also have no opinion as to if this was/was not a wrongful termination, not my call. The one question I do have, however, is why were they ordering Phenergan IM in the first place if the patient already had an IV? From my standpoint I would have just asked "can we do it IV since X-patient already has a line?" What is the purpose of the IV if you weren't supposed to use it? Just my thoughts, hopefully this all sorts itself out for all parties involved.
    BlueEyezRN and TokeRn like this.


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