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?

[Borntobenurse?]

Not necessarily. My concern would be was it diluted ("to holy hell" as said above, hehe!)? Straight phenergan into a vein, especially a peripheral vein? You can take someone's arm off with that.

You know I would say come on who would do that, but then I remember a GN giving lipids through a peripheral line, and not even piggybacked on anything. He got fired too, but he works in rehab now so it doesn't always work out bad. Thats a lot worse than just giving phenergan IV (when it is made for that).

As far as dosing I have given it both way. IV/IM phenergan is interchangable and there is no need for different doses. Yes phenergan is bad for the veins, but that's why you dilute it and push it slow, or with a pump preferably. Phenergan is one of my favorite drugs for its diversity, although I don't get to use it that much anymore (day shift now, and I generally want my pts up walking, not sleeping).

[Lab Scientist]

excellent reply. i know of someone who was killed from receiving lidocaine iv rather than im. different drug, i know, but just goes to show that wrong route can be devastating.

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.

[Nurse SMS, MSN, RN]

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

yup. this is the part that got my attention. sounds like a loss of temper or composure of some kind.

[HolyPeas]

not enough information to say for sure but I kind of get the feeling OP is disassociating herself/himself from what actually went down. I dont see how the institution would benifit from having to go through the hiring process again vs just reprimanding you unless theres something more to this.

[Merlyn]

not enough information to say for sure but I kind of get the feeling OP is disassociating herself/himself from what actually went down. I dont see how the institution would benifit from having to go through the hiring process again vs just reprimanding you unless theres something more to this.

Do you work for a stat facility? They don't care about the expense. They have all the money they want. Their sugar daddy is call the tax payers. They one, I don't know now, had a no tolerances policy for med errors one error and you were firer. the result no one reported any patients be damn I need my job.

[HolyPeas]

I dont know about a stat facility but I do work in a state facility.

I can assure you, they dont have endless budget ;o)

So many typing errors I can barely make out what you are trying to say.

[Merlyn]

I dont know about a stat facility but I do work in a state facility.

I can assure you, they dont have endless budget ;o)

So many typing errors I can barely make out what you are trying to say.

I was on my way out the door when it wrote the above. I had no time to proof read it. I was trying to say that the facility that I worked for seemed to have an over abundance of money to waste. For painting walls that had been painted 3 weeks before, for refreshing parking lots that had been done the week before. You see they were given a huge amount of money each year by the state and if they didn't use all of it , the next year they were given less. So they just used it up. and with the no tolerance policy, I you reported that you made an medication error you would be firer period. union or no union. So, suddenly there were no more errors. Errors were made but not reported. Fear of losing your job won over patient safety all of the time. State facilities became the safest places to be if you were sick. This kept the politicians happy. and that's was what the big wigs wanted.

[evathediva]

My worst fear as a new nurse is passing a med and not being told in report that this patient takes their med crushed and the patient aspirates. Or the patient takes their pill with a thickener and you forget! I hope that I can over come all these fears as a new nurse and work with full confidence .