Just Terminated

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Hi there, I am hoping for a little insight. I don't have many LVN friends so I need to vent somewhere.

Let me preface this by saying that I know what I did was wrong, and it may sound as though I am making excuses but I am only explaining what happened. I can't say that I am a new nurse, because after I passed the boards in 2009, I worked at an outpatient clinic and a few months in home care. I am in California. I decided to be a stay at home mom for a couple of years before I was hired last month at an Assisted Living facility. I felt confident in my new job, it was almost like riding a bike. Last weekend, I worked on a floor I had only worked twice before. I was trained to pre-pour, because a lot of the medication needs to be given on time to 25 patients. I was told prepouring is not allowed but the nurses do it anyway. There are photos of the residents on the MAR, but many of them are outdated so they look different now. There are no other ways of identifying them, other than asking the veteran CNAs. I realize that once one gets to know the residents, there would not be any issues with identifying them. I wanted to give meds to three residents at a table where a CNA was feeding them, so I prepared them; labeled, crushed and mixed with applesauce. The way the facility refers to the residents is by their room number. I asked the CNA who was at the table, and I cannot tell where the miscommunication took place, somewhere between her telling me 120, 121A and 121B or 122 were at the table, I gave one of the another's medication. I was rushed, sweating, and stressed. The CNA looked down at the other meds and told me I gave the wrong med. My blood pressure dropped. She was right. I took her vitals soon after, and remained at her baseline for the next 4 hours until bedtime. I called the other two nurses who were working, and they both asked if anyone saw me. Otherwise, I should not say a word. I told them who saw me, and they said I would have to call the DON because if I didn't, that particular person is not trusted and would probably say something; in turn, making me look bad which could result in my termination. I did get a call back, got the lecture of my life about the rules of med administration, etc, etc. He did not tell me to do anything, but did tell another nurse to fill out a variance report, and call the resident's doctor and family. I finished my shift, and was called the day I was supposed to go back in and was told I was suspended until further notice. Three days later, I go in to speak with the DON and the executive director "to discuss the incident" but was terminated instead. The resident was fine, she was accidentally given Depakote instead of Gabapentin but had no adverse effects. They must have told me about five times how much my honesty was appreciated, but they had to do what they had to do. They actually looked quite sad; I envisioned our meeting being different. I was ready to defend myself. I told them they needed to update the resident's photos, and I hoped that the nurses would come forward when they make a mistake without fear of retribution. I was given my last check, and signed a form. That was that.

My question is, is this normal protocol for Assisted Living? I thought I would get counceling, maybe a longer suspension but was not expecting to be fired. Of course I would not use them as a reference for future jobs, but is it mandatory for them to report this to the board of nursing? Worried about my license. Anyone know what will or might happen? Wondering if there is anything I should do on my end...thanks for reading.

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Have you looked under your BON website and pulled up your license to see if any "complaints" or "disciplinary " reports have been added? I saw on another forum someone posted that the BON is required to notify you if disciplinary action is to take place...

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

I never pre-poured any where I worked. I worked a lot of nursing homes & 25 residents is not that many. I know even though there is a time frame, you can start one hour before if it takes you awhile because you don't know the residents.

So it begs the question, if you knew pre-pouring was wrong, why did you do it?

When I would first start at a nursing home it would take me forever because I would have double the amount you had. Since I didn't know the residents I would have the ask other nurses or the CNAs. But it's always better to be safe than sorry.

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I am going to check daily, last update was on the 7th, nothing yet,,..

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You are absolutely correct. I should have just done things my way, but even with prepouring it took me forever, and I was already given a hard time for it. I am thinking maybe I am not cut out for assisted living.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
You are absolutely correct. I should have just done things my way, but even with prepouring it took me forever, and I was already given a hard time for it. I am thinking maybe I am not cut out for assisted living.

Just because the other nurses did things their way & didn't get in trouble, didn't mean it was right.

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I didn't say it was. I know I was in the wrong.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

Oh & it's not that your not cut out for assisted living, the nurse(s) who oriented you just showed you the wrong way of doing things. Pre-pouring isn't any faster than pouring a cup at a time. You were new on the floor & didn't know the residents. It always takes awhile to get into a groove.

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I think termination was a little harsh in this instance, but you were completely wrong and they were in the right to terminate you. However, I think it should be a law that people in a facility that don't take care of their own meds should have to wear an ID band.

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Well I have worked in long term care and assisted living and 25 is a lot for assisted living. You develop your own routine that works for you. We all are entitled to our opinions. Here is mine about your situation I think for being rushed you did what was best at the time, I have been in the exact same situation more than once where administration didn't seem to care if pictures where updated or not an I was required to rely on the CNAs to assist me an 9/10 times they are extremely busy to help an if they do not like you or your just as needed staff they will not help you at all :( which is horrible for those residence. If this was me I would wash my hands with it an walk away I highly doubt your license is in jeopardy ( word of warning for the future) cyob with documenting if you give the wrong med to wrong patient document, who you notified, vital signs, family called, reaction of the patient every so often, called DoN, administration; Md all of that and what exactly MD states bc this will be used in court :) don't fret! As far as pre setting meds I would say over half of LTC nurses do it. Don't let others fool you they will pretend like they are better than you!

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Unfortunately, I'm from Indiana and in LTC or assisted living I've mentioned this numerous times they won't make them wear ID bands because this is their homes an they shouldn't have to is what I have been told. That is why they have room numbers, or names outside of the doors.

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That is PROBLEM!! THE FACILITY SHOULDN'T DISMISS ANY NURSE DUE TO A VERY EASY MIX UP!!

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