Fired for a medication error

[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?

[psu_213, BSN, RN]

If you are so worried about getting fired then no one would admit the mistake. The OP didn't have to tell anyone about the mistake. Think about it, IV vs IM? With no witnesses? She didn't have to admit it, but she thought the process would protect her and it didn't. Shame on them.

I agree that it is total bull manure to fire a nurse over a 'simple' med error where no pt harm occured. However, it sounds as if the facility was within their rights to let the OP go. Perhaps since she new in the job, the NM saw this as an attempt to demonstrate her authority to the rest of the staff.

I almost hate to bring this up...what was the 'disorderly conduct' mentioned in the first post? Just wondering if this had something to with the NM's decision.

[Chaya, ASN, RN]

In L&D we used IV phenergan all the time, good patent vein, highest port over 2 min.

In Kaiser it would take a whole lot more than a documented, reported, followed up medication error. We can't even be written up for med errors unless it is obvious neglect or intent. A reporting form is done that does not have your name on it and you may be given a QA questionairre to fill out (why did it happen, how could you prevent it in the future, etc.) They did this to get nurse to admit the mistake so we could fix it.

If you are so worried about getting fired then no one would admit the mistake. The OP didn't have to tell anyone about the mistake. Think about it, IV vs IM? With no witnesses? She didn't have to admit it, but she thought the process would protect her and it didn't. Shame on them.

Exactly.A few years back hospitals began to take a less punative approach to med errors and to encourage voluntary disclosure in order to discover where and how in the process errors occur and educate staff to prevent them from recurring. Let's face it; if staff members see that the consequence for voluntary disclosure of a med error is threatened loss of livlihood, you do the math. Not to take med errors lightly but this has got to be a step backwards!

[Ruby Vee, BSN]

i almost hate to bring this up...what was the 'disorderly conduct' mentioned in the first post? just wondering if this had something to with the nm's decision.

​i've been wondering about that, too. i wish the op would explain what is meant by "disorderly conduct".

[cindyloowho]

Just culture will only work if we support its virtues. I don't think you should have been fired because it sounds like you followed up with appropriate actions. Why so harsh, other posters? Have you all never make an error?

[Ruby Vee, BSN]

just culture will only work if we support its virtues. i don't think you should have been fired because it sounds like you followed up with appropriate actions. why so harsh, other posters? have you all never make an error?

yes, i've made errors. med errors, even. one of them was quite serious. anyone who tells you they've never made an error is either lying or too stupid to realize they've made one. the issue that i have -- and perhaps others will agree -- is that the op seems to take an attitude of "no harm, no foul" rather than being miserable about the possibility that he may have harmed a patient. if his manager saw him as being caviler about the med error, that may have been the reason for the termination.

the "disorderly conduct" concerns me, too.

[RNsRWe, ASN, RN]

Our policy is different at my facility. My original comment still stands, I would have questioned the order. Again, best of luck to the OP.

Huh. Well, I admit I'm kinda surprised in that I really didn't think any facility was still using this med IV, considering the insane adverse effects. Even before the hospital I worked for at the time banned it from IV use, *I* got each and every order that I came across changed from IV to IM. I didn't want it on my plate if someone got seriously injured from it---and I'm happy to report the three or four times this came up (before the ban), every doctor changed that order once I told him/her why I wanted it changed. Just made good sense.

[Merlyn]

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!

But according to some administrations we are not human. We have to be perfect every time that we pass meds. The higher ups have erasers, we don't. Too some Supervisors it's easier to firer a nurse then to get up to find out what went wrong and how do we fix it.

[wooh, BSN, RN]

Should a nurse be fired over a med error? In general, I would say no. Was OP fired ONLY over this med error? From what the OP has said, I don't think so.

[stiches]

The disorderly conduct was not what some people assume. (I didn't go screaming down the halls and start fist fights or anything) The disorderly conduct stems from not following policy and procedure.

[Merlyn]

Should a nurse be fired over a med error? In general, I would say no. Was OP fired ONLY over this med error? From what the OP has said, I don't think so.

A nurse should not be firer for one mistake, but the bean counters in the administration can always say "We have rid our institution of inability and again we will go forth with only a com pendent staff of professionals. There will never be another mistake made on our holy ground( until the next one )

[Blue_Elder]

Come on you guys. Just string her up already. This field is hard enough as it is without your peers making you feel like crap. I agree about being more concerned with the nurses who don't report it. Or who are bff's with the boss and nothing ever happens to them because they "had a rough shift". Comments like these and treating our nurses like this is why most nurses are taking anxiety meds or antidepressants, and wanting out of the profession.

[stiches]

There are 22 right to work states in our country. Part of the total legislation in this package made it legal for any employer to fire any employee at any time even if there is no reason. While I will never discount the seriousness of my error, I think the consequences of it are a summation of having a new manager and being paid at a higher rate than those in the same department. In addition, I know of several nurses who have confessed to hiding an error rather than confessing to it due to fear of losing their jobs. I stand by my original decision to own up to my mistake even if it cost me employment. I refuse to sacrifice my integrity for dishonesty.