Marnae, I too am sorry for your situation. It can be quite devestating when a med error is made. It's too bad the facility you work for feels that a punitive reaction is the solution. I have been a nurse for 23yrs. and believe me no one gets by without a med error in their nursing career. We've all been there. No one makes an error on purpose and instead of laying blame, which is not only damaging to the self esteem of the person involved in the error, but to other nurses in the facility as well. Doubt, suspicion, anxiety, anger are just some of the emotions that are the fallout of such action. Instead, along with your input, they should be trying to find out what the circumstances were that contributed to this error and how can things be changed to lessen the chances of it happening again. I've read a few articles on this and they are all stating that we should start with the premise that errors will be made, not with the nurse will never make an error and if he/she does they will punished. We are all human and the fact is errors will be made. Punishing someone does not take away the fact the someone else can and probably will make the same error if the system isn't changed. There are a few things I am confused about. First, were all three jobs you mentioned in the same facility or the same organizaton? Second, why did you get a "final performance improvement counseling"? Was this your first time being disciplined for a med error or any other type of performance problem? And third, why the fitness for duty eval. by a psychiatrist? It is a pretty serious allegation to make that someone is not fit for duty for whatever the reason (intoxication,substance abuse, behavioral problems). It seems to me that if that were the case they should be involved in trying to get you help with your particular situation. I understand your feelings regarding other nurses who made med errors and their handling of it. But I wouldn't say too much about that. People have a way of relating what happened to them inaccurately. Either because they don't see the whole picture, aren't willing to admit what role they played, have difficulty accepting any criticism, or enjoy the "drama" of the story telling and administration bashing. Find out your institutions policy on med errors and bring that with you. Check out the policies on fit for duty and final performance improvement counseling. Be prepared. I find that if I rehearse in my head the points that I would like to make and how I want to say them, it helps to remember to get everything in. Also, don't sound whiney. Be as professional as you can be. "Yes I made the error and since then I've thought about how and why it happened. I have some possible solutions that may prevent it from happening in the future", some thing like that. Whenever anyone starts raising their voices or getting whiney, those that are listening start to shut off. Think of yourself in the position of the listener. Haven't you found yourself doing that? That's some of what I've learned through my nursing career in dealing with anyone. Also I believe you have the right to bring someone of your choice with you as your "witness" so to speak. It shouldn't just be you and "them". Maybe you would want some legal advice on this and a visit to your facilities employee assistance program might be helpful for you. If you have a union go to them for info. and assitance. Don't be afraid to state how you feel or how you see things, but be professional about it. I wish you luck Marnae. Let us know how things go.