Disciplinary action - medication error

[spenbobb1]

Received a disciplinary action for a med error. During work I wasn't feeling well, and another nurse took over for me. I was in the middle of a med pass, and after giving her a report I told her the med pass wasn't finished. Few hours later I get a call at home asking if I had given a scheduled dose of narc to a resident, and I replied no I hadn't gave that resident meds. Come to find out that nurse that took over for me went to a going away potluck for another nurse, and didn't finish the med pass.I was held accountable for that resident missing a scheduled dose of narc because by the time nurse started the med pass it was time for the next dose. I was told it should be first priority to give narc's first. My answer with most residents on the hall with scheduled narc's everyone can't be first. Wondering if others feel I should have received disciplinary action for this.

[Here.I.Stand, BSN, RN]

No, you shouldn't have; the other nurse assumed responsibility when she took report. Also think of it this way--a med error is a med error. It would be an error if the pt didn't get his/her meds--regardless if narcs were involved or not. You reported to her that the med pass was not finished, but she chose not to finish it. Therefore, she made the error by not giving the meds. I'm sorry this happened! Do you have a Liability Insurance carrier you can talk to, see if you can get this off your record?

[BuckyBadgerRN, ASN, RN]

Did the other nurse accept the keys to the cart/med room? She took report, to me that means she was accepting all responsibility associated with it. Was she penalized as well?

[TheCommuter, BSN, RN]

Received a disciplinary action for a med error.

These types of instances are the reason why so many nurses are so fearful to disclose medication errors via self-reporting.

Medication errors should be scrutinized to formulate techniques that will improve the overall system. Unless a nurse exhibits a pattern of recklessness, or unless a patient was harmed or dead, medication errors should not be the basis of witch-hunt style disciplinary action.

[jadelpn, LPN, EMT-B]

And this also screams to the fact that nurses go into work sick, as to not get "spoken to" about feeling lousy they take their EARNED sick time!

Once you give report and hand off to another nurse, they take responsibility to look at the information on the patients, and continue to medicate accordingly. That the other nurse chose to go off on a potluck is not your issue.

"I was unwell, but chose to come into work as to assist in part of the med pass until you could get a replacement for me. I clearly reported off as to where I was in the passing of medication. When I left was well within the time period that patient PDQ would get their scheduled dose of narcotic. That is was not given is a practice issue that pertains to the oncoming nurse, and not me. If there is policy that scheduled narcotics are the priority, I was unaware of this, as my goal is to get everyone medicated within the correct time frame. I was also unaware that once I report off to another nurse that I was still continuing to be responsible for the actions and/or inactions of the nurse in question. So going forward, I am understanding that your policy is that all patients who have scheduled narcotics are to be medicated first? So I further assume that the MD is going to tweak the times of the scheduled narcotics as it is unlikely that the 20 patients who have scheduled narcotics can not be medicated the same time?"

If this is some sort of policy or rule, going forward the only thing you can do is to just medicate with narcotics first, then go back and do the regular med pass of all of the patients. Which can really put one behind on the med pass. So be sure there's some written policy about this. Or next you will be called in due to meds being late.

Sounds to me like a passive/aggressive "you should never be sick" issue.....

[firstinfamily, RN]

When you give report you are relieved period. If tasks were not completed, once you give report it is the responsibility of the person relieving you to have finished the med pass. Did you do a narcotic count with the nurse who you gave report to? If you are being written up I would be adamet about the nurse you gave report to be written up also. It was her responsibility to complete the med run and if she gave report to someone else and didn't tell them about the med pass not being completed that is her problem not yours. Also what time did you clock out? Does that time correlate with the med time the narcotics should have been given? This sounds like managements reaction to an unjustified absence. You should not report to work if you are sick period. Do not abuse your sick time, use it for when you are sick. Do not feel guilty about calling in when you are sick. They will try to make you feel guilty, but staffing issues are their problem and they have to have enough staff. Even if it means they have to work on the floor!!(ha, ha) Put your brave face on and face them. I would also be looking for another employer. Good luck!!!

[RNsRWe, ASN, RN]

OP, please come back and let us know the resolution of this mess. I, too, take the stance that you reported off, the nurse relieving you took the responsibility from THAT MOMENT on, and what she did or didn't do is not your problem. It's the facility's, and the relief nurse's responsibility.

Put it in writing to HR, copy the union (if you have) the nurse manager, and your liability carrier. Sometimes, seeing a bunch of "cc's" on a notification letter like this is enough to stop a problem COLD, and get a retraction. Don't settle for less.

[kbrn2002, ADN, RN]

I am thinking that if you got a write up for not giving a med after you had already reported off to your replacement any possible error should have been on that replacement, after all you were already off the floor. So wrong for you to held at all responsible, and if there is any way to fight this I would. If there is no way to fight the write up I would be looking for another job.

[caliotter3]

Unless there was an error you committed prior to turning over the keys to the other nurse, responsibility moved to her once she accepted the med pass. She is the one that should have been disciplined.

[Caffeine_IV]

I believe that the relief nurse should get the disciplinary action instead. They came in to take over and instead of passing meds went to a potluck. A lot of residents would have received their meds late due to this.

That really makes no sense and seems more like an action against you for going home ill.

[SubSippi]

These types of instances are the reason why so many nurses are so fearful to disclose medication errors via self-reporting.

Medication errors should be scrutinized to formulate techniques that will improve the overall system. Unless a nurse exhibits a pattern of recklessness, or unless a patient was harmed or dead, medication errors should not be the basis of witch-hunt style disciplinary action.

If I screw something up, I'll talk to the doctor about it. But I don't plan on ever filling out one of those forms!!

[kbrn2002, ADN, RN]

If I screw something up, I'll talk to the doctor about it. But I don't plan on ever filling out one of those forms!!

Yeah, another big reason why med errors go unreported. I have discovered med errors committed by other nurses, one was a wrong dose of a narcotic administered multiple times. The first nurse committed the initial error and then every nurse after that committed the exact same error. I didn't commit the error, but since I found it I was the one that had to do the paperwork and it took about 20 minutes.

Seems to me like I was the one being punished with the extra work for discovering somebody elses mistake. Won't do that again any time soon.

Sorry for the slightly off topic...now back to your regularly scheduled programming!