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Discussion

Bully! Help! I need to write a rebuttal!

I got a reprimand and for what! Am experienced ICU nurse. Took job on telemetry floor, but floated to ICU. This ICU is like no other. Two nurses, one teletech and maybe one patient if they are lucky. The ICU doesn't like to take patients. M.I.s are admitted to floor (telemetry). Since the ICU had three patient, I was scheduled to float there. Took care of my patient who was on cardizem drip. The calculations on the pump were wrong. The pharmacy mixed the bag wrong. When I told the Head nurse about the wrong calculation, she became furious and said we go by what pharmacy says and that is the police. I said I can't go by that. I need to go by the insert, i.e. 125 mg/125 cc. That is the way I mixed the drip. The head nurse was trying to calculate the drip based on 125 mg/100 cc. It simply would not come out a l:l She called the house supervisor who came to ICU and explained that my calculations were correct and any other calculations would be a med error. The supervisor also informed pharmacy of the error they had made.

The next day the Head Nurse called the Nurse Manager. I have the worst reprimand written against me that there is. I was supposedly rude. I was not rude. I did not listen to this nurse and that is why she called the supervisor. What this nurse was telling me was wrong and to run the drip her way would have been a med error.

This manager said, "This was just about the last straw! She had had it with me!" So, I said, "Well mayble I should resign and look for a job somewhere else. This manager says, "Oh, we don't want you to quit. We want you to correct your whatever!" There were also two other allegations regarding communication with patients. The two patients had given all the nurses trouble but I was reported as not getting along with two patients. The one didn't get restoril. They lady didn't have an order for restoril. She had an order for hydrocodone. I tried to appeas her by giving her something for her aches and pains as she claimed she had aches and pains too. The previous nurse had given Restoril but had not gotten an order. I was new at the time and I wanted to say strictly by the policy. Also, unfortunately, her physican does not want to be called after 8 p.m. because he comes in at 5 a.m. (unless it is an absolute emergency) Don't get me wrong. Her physician is one fine doctor. So now I have been bitten and I have two black eyes. And yes we have some very mean bullies on this floor. So, what do I do? How do I write a rebuttal. The Hospital stated this is a right to work state and the hospital can fire you at any time. This was told in our orientation. The nurse manager seem to have no feeling for anyone, just blatantly stating "You are awful, etc etc etc. What does one do. I have always been noted as giving my patients the best care possible.

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Remember this statement??

I said, "Well mayble I should resign and look for a job somewhere else.
Do it, before these people have you in a bigger mess! JMO:)!

I too, think I would resign if it were me. This kind of craziness can only get worse.

Yes, I'd get the heck out of there.

If you want to write a rebuttal how about an incident report, it was a potential medication error, write up the pharmacy and the charge nurse stating what she told you.

Write a rebuttal...then leave!

Don't miss the opportunity to do your part for new employees on this floor! Write your rebuttal, just as you wrote to us here. Just be objective. "Aligation: did not give Restoril. Rebuttal: there was no order for Restoril, despite the fact that it was given the prior evening. Offered Hydrocodone for comfort, as patient c/o aches and pains". From your post, it sounds like you were absolutely justified in all your actions, and are more fit to work in that ICU than the ICU staff!

Again, stand by your principles! What good are they if you don't? But don't just leave without addressing each issue that has contributed to your decision.:kiss

Hi Bitten,

Just wanted to say I work in ICU and we mix our Cardizem gtt in a 1:1 ratio also. Continue to do what you KNOW is right. I would think twice about working in an establishment such as this. The heirachy needs a scapegoat. The bottom line is, what ever you do in your capacity as a nurse, you and only you will be held accountable.

Bitten -- Sorry to hear what's going on down there.

Seems to me each of these little run-ons with the folk you're dealing with will only serve to further aggravate them and make them even more wanting of seeing you get nailed. Don't provide them that opportunity. At some point they might just be tempted to set you up for the big get-even.

Write the rebuttal and immediately start your job search.

All the best!

Apparently you don't have a union to help protect you in situations like this. Something to think about when you look for another job, which, I suggest might well be immediately after (as suggested above)

"how about an incident report, it was a potential medication error, write up the pharmacy and the charge nurse stating what she told you."

Remember this. You are never, never, never wrong if it is for the patient's benefit. If there is no order then do not give the restoril. If the drug calculations are wrong change them. I would definitely want you to take care of me in the hospital. Take comfort in that when you are doing the right thing it seems like you are alone. You are not!!!!! Keep doing the right thing and when you look back you can hold your head up high and also face yourself in the morning. Good Luck

So were there 5 bottles of cardizem in 100ml of NS? 1:1 ratio. If this is the case! Incredible,crazy and outrageous. I had a great friend with an MSN who was the clinical manager of an ER. He was there on a contract. They refused to extend his contract because he wanted to have the policy changed on Tridil> The policy suggested it was to be administered based on micrograms/KG/min. Never ever have I incorporated the patients weight into a Nitro dosage!! Robert

I doubt that you'll find any nursing unions in a right to work state.

What's up with giving a Restoril without an order? How can they condone that?

Sounds like a pretty sloppy, lax place to work and that they want you to conform to their standards, or lack of. LOL

  • Author

The vials we had were Cardizem 50 mg/10 cc. So, I added two and l/2 vials and the amount came to 125 mg/125 ccs. I have also used the five vials on my previous job. The 5 vials equals the extra 25 cc. And 10 cc + 10 cc + 5 equals the 25 cc which is added to the 100 cc bag. It may be harder for me to get a job because I am 61 years old. I will write a rebuttal to this and go job hunting. I will be eligible for early retirement in August. This is enough to make anyone leave the field. I love nursing, don't get me wrong, especially ICU/CCU and I really enjoy working with the the night time supervisor and employees. The new night supervisor understood exactly where I was coming from. Math has never been my problem. I have never used Nitro or Tridil on a kg bases. Where I worked previously, we used the standard premix and we don't use the kilograms. I agreed to float to ICU and I wanted to keep up my skills but I am sure that is obviously out. I hope to get back to ICU/CCU full time........somewhere.

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