Another nurse got fired because of me.

Nurses General Nursing

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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?

Specializes in CTICU.
you don't sound so much like a "goody two-shoes" as you do like someone who doesn't have much actual experience at the bedside. you're commenting about what you learned in nursing school, not your experience. therefore, i'm expecting that you don't have any -- or much. so whether or not you disagree with me is irrelevant.

convenient to assume that someone who disagrees with you has no experience to base their opinion on - but actually i have around 15 yrs experience, mostly in critical care. what you learn in nursing school is not always different to what you do in real life. we all choose what kind of nurse to be, and what we want to let slide. medication administration is not one place i choose to slack off (possibly because in my grad year i was involved in a massive medication error which led to a patient death). if that offends someone's sensibilities, oh well - it helps me sleep at night.

ps: i totally agree that you could call your coworker and check what happened - but if they truly signed it as given and did not give, for no good reason... i might have to record that.

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Specializes in Rehab, Infection, LTC.
I dont understand why the family was notified and not the patient themselves. It should have been up the the patient if they wanted to formally lodge a complaint?

this is a weird policy that your hospital has...

our facility used to have the same policy. the nurses never called the family tho..the supervisor's always did.

one day i was working and received a call from a dialysis center about a pt discharged 1 week prior. they were questioning why a med had been started on this pt. it was a bp med. i also recieved a call from his sister right after that questioning the same thing. told them both "let me look into it and i'll call you back".

got the chart from medical records and the doc (who just happend to be there on rounds) and I start looking thru it. she realizes that the med had actually never been ordered for the patient in the first place. it had been a transcription error on the dischaging nurse. she said "some IDIOT transcribed this wrong!", so i say "omg, who was the idiot??" she looks, starts laffing and says "um...it was you!"

we actually ended up changing TWO policies from this error. at the time, the doc would sign the discharge med list (used as prescription) and the d/c'ing nurse would write all the meds in. believe it or not, we all thought this process worked, lol.

as a result, the nurse now fills out the d/c meds and THEN the doc signs it.

at the time, the policy was to call the family also. i was also the supervisor so i called the dialysis clinic and the sister and told them both it had been a transcription error that i had made myself. luckily no actualy harm came to the patient but it sure could have. the med had made him hypotensive and extremely dizzy. that was why the dialysis nurse was looking into the med change after he was discharged from us because she was trying to figure out why he was dizzy.

his sister was livid with me as one might think. i apologized and moved on. technically, the error was the fault of myself AND the doctor. at no time did i EVER blame her. not even when i was meeting with our lawyers over it. as you might expect, his sister tried to sue us over the error but since there had been no harm, her case was dismissed.

as a result, we changed not only our discharge policy but the med error policy too. i had been following policy and notifying the doc, the family and in this case, the dialysis center so they could stop the med. being the supervisor, i called the family.

now only the DON or administrator calls the family AFTER an error has been investigated. no matter what the error is...only those two notify the family, ever.

we realized after looking into our policy at the possible liability that notifying a family before the investigation is made could cause.

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Specializes in L&D/Maternity nursing.

Southernbeegirl, I guess what I am not understanding is why notify the family over the patient themselves? I'd understand it if there was some cognitive impairment on the patient's end and/or a family member is their guardian or POA. But especially if it was an incident where there was no harm, and the patient was fully functional both physically and mentally, then why not inform them of the error? What does the family really have anything to do with it?

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Specializes in Mental and Behavioral Health.

southernbeegirl,

You asked me what my coworkers think. This seems to be the general consensus: They are relieved not to have to be covering up this nurse's mistakes all the time anymore, and say that I did the right thing. This error was just the last straw. They say that I didn't get her fired, that she got herself fired for a multitude of reasons.

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Specializes in Mental and Behavioral Health.
Southernbeegirl, I guess what I am not understanding is why notify the family over the patient themselves? I'd understand it if there was some cognitive impairment on the patient's end and/or a family member is their guardian or POA. But especially if it was an incident where there was no harm, and the patient was fully functional both physically and mentally, then why not inform them of the error? What does the family really have anything to do with it?

End-stage Alzheimer's unit. Cognitive impairment of a catastrophic proportion.

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Specializes in L&D/Maternity nursing.
End-stage Alzheimer's unit. Cognitive impairment of a catastrophic proportion.

ahh thank you for the clarification! This now makes sense to me.

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Specializes in L&D/Maternity nursing.

I am sorry arelle68 that you have this weighing on you. It must be really tough.

But I do thank you for sharing. I've learned a lot from this thread that I can take with me once I am licensed and out there working.

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Specializes in Mental and Behavioral Health.
Sometimes TPTB can take a situation that you have presented to them and use it as ammunition against someone that is under the gun to begin with and you know nothing about this vendetta. You get caught up in it whether you want to be or not. That is one reason why things should always be discussed with people first. We all have our own views about what should cause a termination or some other punishment. Most people don't want to be involved with "that final straw" if they can help it.

This situation was the final straw for the fired nurse. Not the only straw. One straw of very, very many.

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Specializes in Mental and Behavioral Health.
even if you disagree with what the op did, please express your dissent in a professional manner. it isn't necessary to scold or shame or lay a terrible guilt-trip on her. keep in mind that she is new to the field and doesn't have years of experience to fall back on. in lieu of that, she relied on the facility policy and the advice of her direct superior. had she done otherwise and come here to vent that she got in trouble, i'll bet a great many responses would be scolding her for not understanding her place as a newbie and following the protocol.

keep in mind also, that if a nurse doesn't report a med error, she can find herself in jeopardy if there is evidence that she knew or should have known about it. the professional courtesy of calling the other nurse and/or giving her time to correct the situation can backfire. most of the time it probably wouldn't, but any time you step outside the p&p or established protocol, you do take the chance that you, too, will end up in the line of fire. every nurse has to count the cost in her own economy and decide what she is willing--or not willing--to do.

i do find it ironic that a few who have taken this young nurse to task for not showing her coworker compassion and professional courtesy have done so without extending those same qualities in her direction. even if you think she was dead wrong, you can express your views kindly and help her to understand your point of view. there doesn't appear to be any malice in what she did. if anything, the facility's policy is the villain here and the nurses who stand to be harmed by it should, perhaps, suggest a revision.

in the mean time, those who are saying incident reports ought to be educational rather than shaming or punitive have it right. a good place to start incorporating that philosophy is with the posts in this thread.

a lot of this flack i'm catching is because everyone is paranoid and freaked out at the thought of losing their jobs right now. they've found a safe way to express that...picking on me on a website thread where everyone is protected by faceless anonymity and pseudonyms. it is really ok with me. i know that what i did was right, and that my residents are safer because i was honest about it. i would do it again.... now, back to your nursing news:

medical mistakes will kill 200k this year: report!

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A lot of this flack I'm catching is because everyone is paranoid and freaked out at the thought of losing their jobs right now. They've found a safe way to express that...picking on me on a website thread where everyone is protected by faceless anonymity and pseudonyms. It is really OK with me. I know that what I did was right, and that my residents are safer because I was honest about it. I would do it again.

Thank you for such a great response.

Your message demonstrates admirable wisdom, maturity and compassion. That you can see past the slings and arrows to underlying issues shows remarkable poise and a willingness to connect on a deeper level.

Your patients and your coworkers are lucky to have you.

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After reading all these posts, I can't say that I'm suprised that the nurse in question got fired for what turned out to be one more in a long line of mistakes. One mistake seemed over the top to fire someone over.

I'm just wondering though-can one be absolutely sure the patch in question was never placed? I mean, after 5 days, it would be easy enough for it to come off somehow--if the pt is sweaty a lot, or got it really wet during a bath, or maybe even picked it off herself, as dementia pts are known to do..

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Specializes in Mental and Behavioral Health.
After reading all these posts, I can't say that I'm suprised that the nurse in question got fired for what turned out to be one more in a long line of mistakes. One mistake seemed over the top to fire someone over.

I'm just wondering though-can one be absolutely sure the patch in question was never placed? I mean, after 5 days, it would be easy enough for it to come off somehow--if the pt is sweaty a lot, or got it really wet during a bath, or maybe even picked it off herself, as dementia pts are known to do..

This is why we place it near the center of her back, and low enough that she can't reach it. That is where we found the patch that was dated with a date some 10 days prior. The patch was to be change q 7 days. The fired nurse had signed that she had changed that patch 3 days before, which she obviously had not.

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