Getting nicked(trouble) in the OR

Double-Helix, BSN, RN · Apr 20, 2017

This constant fear of losing licenses is a fallacy that many new nurses get caught up in. In truth, there are very few things that you will lose your license for, and they almost exclusively involve gross negligence (such as coming to work impaired, stealing, drug diversion, violent crimes, willfully breaking policy in a way that knowingly compromises patient safety).

Obtaining informed consent (and verifying that consents were obtained) are not your responsibility as a nurse. Making a mistake like not noting an implant, incorrectly counting surgical items, placing a foley incorrectly, running an antibiotic at the wrong rate... those things aren't going to jeopardize your license. They may get you yelled at by a surgeon, even written up if it's a repeat offense, but the BON isn't going to seek to pull your license for that. Now, if your patient sues because they develop a pressure injury because you never reposition them, but you document that you checked and repositioned throughout the case, you could certainly be held liable for that. See the difference? A mistake vs willful lying.

Sour Lemon · Apr 20, 2017

Hello. I am a new nurse straight out of school working in the OR. I thought it would be helpful to myself and others if we could gather everyone's tips and experiences about where you can get nicked (trouble) in the OR when it comes to my license. Such as .... not noting an implant during foley insertion, consents not signed, etc.
any tips and stories would be greatly appreciated

Look on your state's BON site. Most have a section where you can read about disciplinary actions that have been taken against licensed nurses along with why.

Editorial Team / Admin · Apr 21, 2017

Where you can get in trouble with your license in the OR:

Forgetting you're on call, drinking, and showing up drunk when you're called in. Affidavit: Pennsylvania VA nurse drunk on call and likely during surgery

Acting outside of your scope of practice and running a c-arm when you're not an x-ray technician or surgeon with privileges to do so.

I worked with a nurse who took a patient into the OR before the surgeon on call assessed the patient and got consent (the case was booked by the off-going call surgeon; the surgeon doing the procedure needed to get consent). She lost her job, but that was it. There were no repercussions to her license.

I've made med errors. Fortunately they were small and the patient was not harmed. I still have my job and license and didn't even receive a write up for them. A coworker made a major med error that resulted in a teenager now being on a cardiac transplant list. She was not fired for that, but did eventually get fired for attendance issues. No BON involvement.

Seriously, this fear of losing a license is far more than it should be. Know your nurse practice act, know your scope of practice, practice as a prudent nurse should, avoid illegal activities or showing up to work when impaired, and your license will be fine.