Am I in the Wrong??

klone, MSN, RN · Mar 9, 2015

How do you know you are the only one who was reported?

Also, if the medication was supposed to be given immediately post-op, it would make sense that only the nurse who was taking care of the patient immediately post-op got disciplined for not giving it.

TheCommuter, BSN, RN · Mar 9, 2015

How do you know you are the only one who was reported?

This is a salient point that I'd like to elucidate further.

As someone in lower management, I can tell you that other employees' disciplinary actions are not routinely discussed out in the open. Therefore, if other nurses were reported, management probably will not be notifying you. The other nurses with whom you work might have been reported, but you just do not know it.

regerterb · Mar 9, 2015

I have no idea if it was supposed to be given Post-Op, nothing was written on the piece of paper, nor times, nor signed, nor was anything handed over from theatre. I am at a facility where the Dr's don't even chart the times on the med chart. I haven't been there long enough to even know if it is a once off thing or if its a prophylactic type dose-I would say post-op it would be prophylactic though?. Each Dr has their own set of instructions post-op, I am still trying to find where things are on the ward let alone know what each of the Dr's wants and specific needs are yet. My preceptor specifically said, you were the nurse reported for this. I mean I am not the only one that missed it. Why does it come on my back when the Dr hasn't even charted it to begin with? I just feel like quitting I am so humiliated.

regerterb · Mar 9, 2015

It was prophylactic. So over several days.

xoemmylouox, ASN, RN · Mar 9, 2015

It is just one of those lessoned learned experiences. You need to always clarify medication orders. If the MD does not write a time a medication should be given, they need to asked what time. If everyone bugs them enough for unclear orders, they will start writing better orders. I wouldn't quit over it, we all make mistakes. You say that you were reported.. Do you mean you were written up or reported to your Nursing Authority?

regerterb · Mar 9, 2015

Sorry I dont know if I mentioned that there was NO order, nothing on the med chart whatsoever. It was simply scribbled on a piece of post-op paper (with the theatre notes at the back of the patients file)-like it just hadâ€¦pt antibx x8, icepack, etc then aspirin with a tick next to it. I am not entirely sureâ€¦I think an incident report was put in.

xoemmylouox, ASN, RN · Mar 9, 2015

Well my advice is again to always clarify. The more often everyone presses the issue, the more likely the MD will write orders as they should. Being reported here means being reports to the Licensing authority which can lead to a lot of issues. Again I would just learn form this and never let an order go like this again.

vanilla bean · Mar 9, 2015

Truly, from how you describe the situation, it sounds like the doctor dropped the ball by not clearly ordering the aspirin and only making note of it elsewhere in the chart. That said, I'm going to echo what PPs have said and suggest that you just take it as a learning lesson and move on. What I think you should "do against it" is swallow your pride and simply state that you were unaware that you should be looking elsewhere in the chart and then clarifying orders with the physician, but now that you know that, it won't happen again (and from now on skim those other notes too). Sometimes we have to take accountability for things we did not necessarily do wrong. It is the rare facility that will reprimand the physician or hold them accountable for things like this falling through the cracks.

I'd also like to share with you that part of your schooling and orientation to being a nurse do not necessarily explicitly teach you how to adapt to your new role in terms of the dynamics of personalities you'll have to deal with and the culture of the facility and ward. These are also lessons you'll need to learn to adapt to your new environment and find your place. Dealing with difficult patients and coworkers, dealing with gossip and rudeness, navigating the "politics" involved in your new job - these are all lessons you need to learn too, in addition to the more formal policies and procedures about how things are done there. If you feel humiliated and want to quit every time you are criticized or corrected you are going to have a long, miserable adjustment period. If you can learn to develop a thicker skin and not take things personally or internalize them when you are criticized or corrected (whether justified or not), it will be a much smoother transition into your new role.

SBGangelJC · Mar 10, 2015

Thank goodness for electronic charting this would not happen. Too bad this happened to you. You were in your 3rd week orientation? I would say your preceptor should keep track of you and what you are doing to a certain point. Nurses have to look out for one another especially when you are new. Next time double check everything and make a note. You shouldn't give medications that have not been clarified, but you should seek clarification. If the doctor does not respond then write in your progress notes. No one can ding you for that.

regerterb · Mar 10, 2015

Thank you for all your replies! I have asked a few of the other nurses who all seem to agree that it was just a flow on effect and not one person is to blame. They said it is just unfortunate I was singled out this time. I found out from another nurse that each physician has his own set of post op orders which are listed in a folder which I was not told about at all even when I asked my preceptor...lucky I asked someone else... So have copied it and it now sits in my folder. Hoping this never happens again.

Nibbles1 · Mar 10, 2015

Brush yourself off. You are going to be fine. I missed so much "critical" things during orientation that my preceptor didn't go over. I made some mistakes and let me tell you, those mistakes stick in my brain so I'll be prepared next time. You are doing great! Hang in there!