Dispute termination

22 hours ago, FloridaLpn2015 said:

Hello all. I was fired from my job for a medication error. I gave a PT. An extra 8 mg of Suboxone. The system that the facility has is ancient. They keep the Suboxone films in a small basket, when the PT comes to the window for medication you pull them up in the computer, verify who they are and dose. After that you count out how much they get and give the meds. Now I complained twice that we were overworked, down one nurse on the weekend and also distracted ( some of the nurses joke and laugh as well as playing music in the nurses station). I complained I felt it was too noisy, nothing was said or done. I made the error on Sunday. I did not realize I made the error until the end of the day and it was time to reconcile the meds. They supervisor asked what happened, I explained that it was so busy, literally dosing people nonstop from 6am to 10 am that I really can't recall what happened. Everything happened fast, I was working hard to get people in and out. We do verify after dispensing in the computer the doses that are remaining is accurate...but I literally cannot remember if I did or didn't...and I was being honest. I owned up and said...I must have given someone an extra dose somewhere but really can't recall. Anyway they terminated me. They said I made a previous error, which was not true...it was an error in the computer... I was so disgusted I just said they were incorrect and I gave them their keys and left. Do I have any recourse?

I'm not sure why you were giving medications to Physical Therapy in the first place. Surely that would get you fired! Did you mean patient? That would be "pt" and not "PT".

Medical errors can happen to any nurse -- I've made some whoppers. But one of the things that can help prevent them is close attention to detail. "PT" is different from "pt." Milligrams (mg.) is different from micrograms (mcg.). Why am I picking on your abbreviations? Because it's important. Is 0.25 mg the same dose as 250 mcg? You had best know for SURE.

You may have "felt" the nurse's station was too noisy, but you cannot really insist that everyone stop talking or laughing or even listening to music for four hours because you're giving medications. Management cannot insist that everyone "pipe down" in deference to you, either. You have to adapt.

I'm not a lawyer; I don't know if you have any recourse. I suggest, however, that when you mix up your abbreviations in a post on a nursing forum, it makes me wonder if you're correctly reading doses on your MAR or on your drug packet.

Also, getting disgusted and handing off your keys and leaving doesn't indicate that you were interested in retaining your job. So, I'm thinking you still need some time to reflect upon your part in the medication error and in your termination.

On 2/27/2019 at 3:36 PM, FloridaLpn2015 said:

We do verify after dispensing in the computer the doses that are remaining is accurate...but I literally cannot remember if I did or didn't...and I was being honest. I owned up and said...I must have given someone an extra dose somewhere but really can't recall.

This is a problem and it's very unfortunate that you walked out. I hate to point this out, but given your explanation of the discrepancy, you should hope it doesn't cross their mind that the missing Suboxone could have been diverted. If you are lucky they simply terminated you on the spot and that will be the end of it.

You don't have recourse regarding your employment. The question is, is it best to lay low and go on about your life, or consult with an attorney familiar with nursing/licensing issues to see if there is a way to mitigate the potentials here. I don't personally know the answer to that question.

On 3/1/2019 at 6:14 PM, TriciaJ said:

When asked in an interview why you left your last job: "I pride myself on accurate medication administration and had a difficult time in that environment. When I finally did make an error I realized I needed to find a different job."

OP, Tricia is one of the wisest of us all. This is beautifully written.

The problem is that we are not every able to practice for a situation where we make an error. Unlike CPR, where the muscle memory of training kicks in, when you make an error there's no practicing for it so you're reacting in the moment. Learn from this moment. Best of luck to you.

Thank you for your comments. I appreciate the correction about the abbreviation, yes I did mean pt. Autocorrect. I just want to clarify. The facility is a methadone clinic. We had 2 previous med errors. I do suffer from ADHD. The 2 weeks prior I reported to my supervisor and asked her to please address the noise volume in the pharmacy. There are 4 windows we sit at. 2 phones and a chart room. We pretty much have a line all day. One particular day one nurse played R&B music on her cell phone, I asked her to move it to the other side of her, away from me as I had a hard time getting hearing the pt.s through the narrow window. That same day another nurse behind us began to play classical music on her cell phone. I felt like my head was going to explode. Phones were ringing and people in and out which obviously we can't avoid, but we don't need 2 people playing 2 different kinds of music at once. Throughout the morning 2 of the younger nurses would get up from their chairs and goof off, dance and sing behind us other nurses dosing. Pt.s would often remark that we were having a party everyday. Some days were quieter than others depending on who was working. Anyway, this was the situation I brought to the attention of my supervisor, I asked her to go back to the cameras and look and see if it was appropriate behavior or not. I have worked in healthcare for 20 years, I know when things are appropriate and not. She said she would but she also said she was not a babysitter. I said to her that I have asked them to tone it down but it makes no difference. I requested her to do something twice. After that I asked her if I could do more charting and less dosing as the distractions were a problem for me, she stated ok. 4 days later I made the med error. It was on a Sunday. On Wednesday they called me to the office, it wasn't my usual supervisor, they said I made 2 errors when I know I made only one. There is only one incident report for one med error. If in the span of 5 months 3 nurses make med errors and only one is fired for it what is the difference? My error was wrong dose, pt. Not injured, the other nurse was wrong pt. wrong dose pt. Not injured and the other was wrong dose but right pt. So I'm left to feel like I was let go because I made waves. I complained, I was the outcast, the complainer, I wanted a more serious environment. I wanted the supervisor to supervisor and on many occasions she said she was not a babysitter.

Again, your recourse is to leave, which you did.

You are not going to force the types of changes you desired in that situation because entry-level workers are ultimately not in charge of everyone else.

So the right thing to do was leave and arguably it should have been done sooner. If things are bad enough that you feel an error is imminent or very possible because you cannot work safely in a situation, it is beyond talking to someone and asking them to do something - unless in some rare case they agree and make an immediate and effective change.

On 2/28/2019 at 2:11 PM, Wuzzie said:

Well, not if you walked out during your shift.

At my job we cant even leave until the whole hospital count is clear. By her doing that i wouldnt be surprised if later on she gets something in the mail from BON of an accusation of diversion. ?

On 3/1/2019 at 7:14 PM, TriciaJ said:

If you believe the environment was not conducive to accurate medication administration, then you're better off without that job. Might as well start looking for a new one.

If you have professional liability insurance, it would be a good idea to give them a heads up and let them advise you further.

When asked in an interview why you left your last job: "I pride myself on accurate medication administration and had a difficult time in that environment. When I finally did make an error I realized I needed to find a different job."

BONs are notoriously slow. If your old job does report you, hopefully you'll have a several months' clean record at your new job to negate any accusations.

Yaaaaas ms.tricia yes!

Just to clarify. I did not walk out on my shift, they said they were letting me go and so I left. I disagreed with their statement that I made 2 med errors and the assistant supervisor argued with me, we went back and forth 3 times until I said "fine, if you want to believe that but there is only one incident report so I don't know how that's possible." And I placed the keys on the desk and walked out of the office. Assistant supervisor let me into the pharmacy to get my bag and I left.

I was looking elsewhere for a job. And against my better judgement I was too relaxed about it. Hindsight is 20/20. My guard is up now. I write everything down, keep a paper trail and of course I will be more vigilant when giving medications. Sometimes we forget the main reason we are there which is to provide for the pt.s and keep them safe. I still don't forgive myself for letting my guard down and making that medication error. I took all my mental strength to go back to work the next day. I really just wanted to stay in bed with the covers pulled up over my head.