advice needed

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Im an RN and work at an LTC/Skilled rehab facility. Ive been working at this facility for 8 months and have never had any write ups or anything management has had to reprimand me for. I go into work today, and the DON asks to see me in her office. she and the administrator were both there. the DON hands me a copy of the MAR. it was for a lidocaine patch to the lower back that was to be put on by the day shift nurse at 0800 and taken off by myself, the evening shift nurse, at 2000. I circled the past two nights and wrote on the back of the MAR that the patch was not available - as i could not find the patch anywhere on his back. I even had an STNA double check for me to make sure I wasnt blind. He could not find the patch on his lower back either. The DON told me that the STNA found the patch on his lower back both of the following mornings and said I never took it off of him. I attempted to plead my case, telling them I did indeed check for patch placement, as did an STNA, however they put me on suspension. Can I get fired over this?

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Is this the same STNA? ( student NA)? Why are the DON and administrator using the observations of an STNA, did they talk to the patient?

How big is this patient's back and is he alert and oriented? Why didn't he ask for the patch to be applied?

I've seen those patches stuck everywhere in the bedding.

Honestly, I smell a set up.

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no its a different STNA. the pt is A&O x 1-2 at best. intermittent confusion but always pleasant. average sized guy (maybe 170 lbs, 5'8"ish) so normal sized back. And i told the DON and administrator that sometimes the patches fall off and maybe when he was putting his pajamas on the patch came off? i honestly dont know. but the patch wasnt there..and they are looking at me like im a complete liar and making this stuff up. they want me to write a statement right now and bring it in as part of their investigation. but i dont know what to write because i already told them everything

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Specializes in nurseline,med surg, PD.

Yes they can fire you. However it would be a really stupid thing to be fired for such a minor situation. Your being an RN costs the facility a lot of money. They may want to replace you with an LPN. So they look for a reason to fire you. There is no loyalty in nursing. Let us know what happens. I'll be thinking of you.

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I know they aren't trying to replace me with an lpn because company policy states only RNs are allowed to work on the skilled nursing unit. All of our lpns work on the long term care unit. I'm just so confused :( I don't know how to make a good argument for it or try to save my job or if it's even worth saving :(

thank you guys for your support and I'll keep you updated

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This could be a learning opportunity. Have the RN reporting off SHOW YOU THE patch during report. With all I've heard recently about nurses diverting, it's the prudent thing to do for this very reason.

This does sound sketchy to me.

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This could be a learning opportunity. Have the RN reporting off SHOW YOU THE patch during report. With all I've heard recently about nurses diverting, it's the prudent thing to do for this very reason.

This does sound sketchy to me.

Good plan if OP gets another chance. Lidocaine patches are not a scheduled medication, but any patches would need verification of placement / location before during shift change.

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no its a different STNA. the pt is A&O x 1-2 at best. intermittent confusion but always pleasant. average sized guy (maybe 170 lbs, 5'8"ish) so normal sized back. And i told the DON and administrator that sometimes the patches fall off and maybe when he was putting his pajamas on the patch came off? i honestly dont know. but the patch wasnt there..and they are looking at me like im a complete liar and making this stuff up. they want me to write a statement right now and bring it in as part of their investigation. but i dont know what to write because i already told them everything

Do NOT put anything in writing without counsel or your malpractice carriers advice.

Have they discussed this with the nurse that "supposedly" placed the patch? That should be the focus of their witch hunt. Did the patient complain of , or exhibit back pain during these shifts?

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Good plan if OP gets another chance. Lidocaine patches are not a scheduled medication, but any patches would need verification of placement / location before during shift change.

How weird. I actually read the OP as "fentanyl patch." Lol, big difference.

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Yeah it was not a fentanyl patch. Just a lidoderm. I spoke with a fellow nurse who told me she thinks that the day shift nurse was trying to set me up. That maybe she put the lidoderm in a different spot (not the lower back how it was ordered) and that's why I couldn't find it. This is just an assumption of course. But as far as I can tell that's the only explanation that makes sense

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i have insurance (nso). how exactly would they be able to help me? im sorry, im new at this. i thought they were only helpful if you were in trouble with the bon?

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
i have insurance (nso). how exactly would they be able to help me? im sorry, im new at this. i thought they were only helpful if you were in trouble with the bon?

Excellent for you that you have this insurance. Yes, do contact them. If they can't help you with this situation, nothing lost. But it does smell like a set-up. Do bring them on board. Hopefully they can at least advise you how to proceed further, let you know what options you have and even recommend an attorney if you want to go that route. You pay premiums for a reason. Call them.

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