Am I in the Wrong??

[regerterb]

I had an incident that I was reported for at work. I am a new grad, 3rd week in and was left to my own devices last week with 4-5 patients on a post-op ward-my preceptor nowhere to be seen. So a patient came up from theatre, I checked his med chart, gave all required meds for the day and went home. Today (4 days later) I got called in for a discussion about how I have been reported (only me) for failure to give Aspirin. It was NOT charted when he came up, however was listed in a post-op info sheet that goes in the patients folder. It did not say when to give it/times etc. I understand I SHOULD have seen this and questioned it as to why it was not on the med chart…however it also means at least 5-6 nurses have also missed it that were looking after him during this time. Why am I the only one being reported?? Or am I missing something…should I do anything against it? I am just confused.

Thanks for your help!

[regerterb]

Thank you! í ½í¸Š

[Ruby Vee, BSN]

Thank goodness for electronic charting this would not happen. Too bad this happened to you. You were in your 3rd week orientation?

No, this can happen in electronic charting as well. Can, has and does. If the physician doesn't write a time on the order, it goes to the top line of the MAR -- a line that isn't visible unless you make a habit of "pulling" on the top line of the box to drag it down and check to see if there is anything up there. Even if you do that, it appears as a "conditional" order, which you wouldn't realize had to be given on your shift unless you saw the order and investigated further. We've had several shifts of nurses miss important post-op orders because that's a brand new glitch in our system.

[PMFB-RN, RN]

This:

I am a new grad, 3rd week in and was left to my own devices last week with 4-5 patients on a post-op ward-my preceptor nowhere to be seen.

& This:

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 had…pt antibx x8, icepack, etc then aspirin with a tick next to it. I am not entirely sure…I think an incident report was put in.

Both of these indicate that you work in an incompetently managed dump. They are making you their scape goat for their own incompetence with two shining examples above of management incompetence. Start your job search NOW.

[jadelpn, LPN, EMT-B]

Be sure that you obtain your own malpractice insurance if you do not already have it.

Secondly--here's the lesson in this. You now know that each MD had their own order set. If it is not included in the packet you get post op, then you just need to know where to find them should this occur again.

Also, critically thinking, there are more than one surgery that would require some sort of anti-coagulation therapy post-op. So if you are not seeing an order for it, question it.

[regerterb]

Thanks everyone for the input. There is a communication book on the ward that had stated from the nursing manager for everyone to please check dr so and so's orders on return to the ward as the anaesthetist had not charted it and that it is everyone's responsibility to check that medications have been given. Should I ask her as to why it was purely me being reported?

[PMFB-RN, RN]

Thanks everyone for the input. There is a communication book on the ward that had stated from the nursing manager for everyone to please check dr so and so's orders on return to the ward as the anaesthetist had not charted it and that it is everyone's responsibility to check that medications have been given. Should I ask her as to why it was purely me being reported?

They left a new grad in her third week of orientation all alone. Why would you want to work there?

[Nurse SMS, MSN, RN]

I am going to be honest here and say that it does not sound like you were "reported" as much as pulled aside for educative purposes to ensure you know that you need to read the MD notes and clarify anything that doesn't jive with the orders. This wasn't you "getting in trouble" from where I sit. It was you, as a new grad, being watched closely (a good thing), being let know what you did wrong (another good thing), being told what you should do from here forward (ANOTHER good thing) and sent back out with faith you will adjust your practice accordingly (and yet again, ANOTHER good thing).

However.....I too find it alarming that you are only three weeks in an have been on your own since two weeks. That is just plain dangerous, both for you and for the patients. Crazy.

You learned. I am betting you check every chart from here on out.

[Nurse SMS, MSN, RN]

Should I ask her as to why it was purely me being reported?

No, you shouldn't. You should take what you learned from it, shake off your hurt feelings and move on. There is nothing to be gained by whining "Why was I the only one to get in troubbbllllee?? SHE did it TOOOooooooo!" except to be seen as a whiner and someone who can't take criticism well.

It was likely you because YOU are the one being watched as a nurse who is barely out of training wheels. Chances are it would not have even been caught if it had not been your patient. That is a BAD thing, not a good one as far as patient care goes. Shake it off, big girl panties up and onward. You will be a better nurse for this having happened. What does or doesn't happen to others has nothing to do with you.

[TexMex22]

I just feel like quitting I am so humiliated.

If you quit every time you make a mistake, you will remain unemployed forever.

Everyone makes mistakes. What's important learning from them and improving.

[regerterb]

Thanks everyone. Have actually photocopied each specific Dr's orders now so I know for next time! :)

[regerterb]

Check, and check and re-check and ask for others to check and check again!

[Nurse SMS, MSN, RN]

Good :) Very good.