Another nurse got fired because of me.

roser13, ASN, RN · Aug 7, 2009

personally i would have called the nurse before taking the situation any further, i know we are nurses; which means we don't make mistakes but lets be realistic we are only human.

I don't understand - what would calling the nurse accomplish? She can't undo her signature....

**NickiLaughs, ADN, BSN, RN** · Aug 7, 2009

You did the right thing, no need to feel guilty. I wish the LTC facility that I had worked at had cared more. This one nurse's sole duty on day shift was to do wound care. And she would sign it as done, but never actually did it. The wound treatments that I would do on evenings would be signed and dated with my signature, a week later I would come in with the same dressings still on. I was angry, frustrated and brought it to the DON's attention.

She did nothing to this nurse. As far as I know, this horrible nurse is still out there working somewhere. Her phone calls more important than doing wound care.

Honestly, I couldn't wait to quit this job.

SurvivorRN · Aug 7, 2009

I would have notified the supervisor and filled an incident report. Then leave it to management to do what they need to do. I personally would not have called the family member myself..but that is just me..

DoGoodThenGo · Aug 7, 2009

I discovered a pretty serious medication error last week, (Signed, but not given. Involving blood pressure.) and had to file an incident report. I called the resident's family per protocol. The resident's daughter told me something like, "Well, I'll take care of it. I can guarantee you this won't happen again!" Apparently she did, because I got to work today, and found out that the nurse had been fired. It's a tough economy, and I hate to see anyone lose their job right now. I know I had to do what I did, but I feel bad for this nurse. Anyone can forget to do something sometimes. How am I supposed to feel about this?

While your feelings of remorse do you credit, remember you did not get this nurse fired, she got herself fired.

What is drummed into every student's head during the first few weeks of nursing school? COA! Chart, chart, chart and cover your hinney.

As other posters have stated, you do not know what was or is in the fired nurse's employment file, and it may be that this error was the last straw. It could also be that the patient or the family member you contacted are well connected enough to have pull and that did the nurse in.

Whatever the reason you did what was right and decent, so let your soul be at rest. Think of it this way, horrible as you feel about this nurse being fired, you would feel allot worse if something went down and BOTH of you were let go.

shoegazer · Aug 7, 2009

I can't believe someone got fired for this one thing. I hope that this individual has a long history of careless mistakes. We all make mistakes. I would prefer to work in an environment that encourages people to be open about their errors so the system can be improved, rather than punish individuals.

Ruby Vee, BSN · Aug 7, 2009

i know i'll probably get excoriated for admitting this, but i have signed for meds i didn't give. it's not a good practice, but i remember once going into a room fully intending to give all the meds in my hand. gave the po meds and the nitroglycerine paste, but just as i was getting ready to give the heparin injection, the patient in the next bed had a run of vt. forgot all about the heparin as i went to shock the patient. later, when i went back to the mar to sign off my meds, i remembered drawing up the heparin, so i signed that off too. it was only the next day, when i saw that syringe still lying on the nurse server that i remembered i hadn't given it.

i've put medication patches on a patient with yesterday's date, too, because i'm so brain dead i've forgotten what date it is. (if any one of you reading this claims you've never done such a thing, i'm sure you will one day.)

although i would never advocate dishonesty, there may be a very good reason why that catapres patch got signed off but not given.

DolceVita, ADN, BSN, RN · Aug 7, 2009

You did what you were supposed to do. That can often be very hard.

What I want to know is why they have you call the family. Have you been given special training on how to present this information to family members? You are not the DON. It sounds like a poor way to manage risk.

I know nurses present information to people all the time but this sounds like a job for the people in charge (that is why they get the big bucks).

Still the mistake belongs to the other nurse not you.

Larry77, RN · Aug 7, 2009

Hmm...what was the outcome with the patient...were they so hypertensive that they had a CVA d/t not getting a new patch? Seems like you could have circled the error signature, signed yourself, replaced the patch, and let the DON know...This sounds like a simple mistake, you sign for it go to grab the patch and get pulled away d/t someone falling or whatever then forget to grab the patch...if this was the worst thing this nurse has done I would feel bad as well, if the nurse had made other mistakes than this was probably the last straw as others have alluded to and they needed to go.

buttercup99 · Aug 7, 2009

I don't think it is classed as falsifying records, that suggests a deliberate act. Call me naive but i think the chances are that she signed it, intending to give it and got side tracked. Yes, this is not good. But it is something that happens. It is very easy to get sidetracked.

I am a final semester student (Bachelor of Nursing) and I sometimes do something and forget to document it (I always remember during the shift though, usually when I go to write the nursing note.) Anyway, so I started documenting on the way to doing the task instead. Like if I was going to give a jug of water, I would write it in the FBC on my way past the nurse station so I wouldn't forget. You know what happens once you walk in the patients' rooms, you never get out because they all want something. Anyway, that is probably a bad habit and I am sure once I have more experience, I will be better at remembering to document immediately AFTER the task.

If it were me, I would change the patch and report it through the anonymous no blame system we have (a phone call.) However, if it were more than a once off, i would report it also to the Nurse manager. Your system is obviously different. I would be well within my rights to anonymously report it but you obviously are required to report it to the management and it would be easy to prove that you knew about it if you didn't report it.

Therefore, you did the right thing. You have to protect your own license. I agree that there must have been something else going on as one med error should not cause a nurse to lose her job.

I have witnessed the shift co ordinator finding out that the FBC chart was incorrectly filled out and this was in an important situation - an abdominal paracentesis patient who must have an albumin infusion per each litre of fluid drained. So she rang the nurse at home and clarified the documentation. Then the nurse was required to fix it the next day. It wasn't reported. It was more important to find out exactly how much fluid was drained than to cane someone for an innocent mistake.

The same thing has happened when meds have been given and not signed for. The nurse is rung and asked did you give this, and asked to sign the next day.

rn/writer, RN · Aug 7, 2009

Forgive me, but technically, I see no difference. The consequence of giving the medication and not signing for it and signing for it but not giving it are equally serious.

I agree that they are both errors. And, yes, not signing for a med has the potential for the med to be given a second time. That could be serious, except that in the case of a patch, the nurse would see the new one with the current date and know that the change had already taken place. Worst case, the new patch would be removed and an even newer one would replace it. I'm certainly not advocating this, but at least with a patch there is some proof of what happened.

The reason that signing for a med but not giving it is more serious goes beyond the medical realm into the area of reimbursement. Medicare and insurance companies do not care if the nurse was tired or her feet hurt or she had too many patients. They are like sharks after blood if they can point a finger and make an accusation of fraud. I'm not sure how they get wind of these things, but they seem to have their ways. Facilities have been subjected to microscopic audits, denied payment and fined hefty sums when suspicions of fraud have been brought up. This might seem like an overreaction, but real fraud is out there. LTC facilities do not want even a hint of this kind of problem for fear of the repercussions it can bring down on their heads. So, while a single mistake might not get you booted out the door, a pattern of errors might.

Dorito, ASN, RN · Aug 7, 2009

Was there a poor outcome with this patient? It seems unusual that the family had to be notified about the situation. IMO it seems that this practice would discourage nurses from filling out incident reports rather than encouraging them to report a mistake in good faith. I'm assuming you applied the patch when you realized that it hadn't been put on?

miss81, BSN, RN · Aug 7, 2009

I would have approached the nurse first. Maybe if she called the family herself and explained the situation herself it wouldn't have blown up like this. I doubt she as trying to falsify records, some of you guys are so harsh. one of the PP stated, "That's what she gets for screwing up"? Geesh, maybe it was a mistake. I would have at least given her the courtesy call. I know one time I was giving a patient his meds and the patient in the other bed started choking. When I got home that night I realized that I had the pt's nitropatch in my pocket. I called the unit and the nurse working that night called the doc and got new orders. It was an honest mistake.

Maybe there were other compounding incidents that led up to the nurse getting fired. But, I wouldn't doubt that the way managers cater to families these days that the nurse may have gotten fired to please the family. I'm not saying we should cover stuff up, but we need to have each others backs when reporting stuff! We all can't be Supernurse!