Isn't there such a thing as a learning curve?

[tasha1722]

I had a patient who was prescribed IV dilaudid for pain and the parameters that the medication was not to be given if the systolic blood pressure was less than 110. I took her blood pressure three times and it was never above 95 systolic. However, I didn't chart the blood pressures and the patient complained to hospital customer service and I was fired because I could not prove my claims.

I know it was wrong not chart the vitals. However, I don't have a record of not charting on my patients. I also don't have a reputation for being mean to patients. I know that I did the responsible thing by taking her blood pressure and not giving her the medication. I think that people make mistakes and of all the mistakes you can make, I didn't hurt anyone.

It was not the first time I had been in trouble. I had lost a morphine sulfate tablet. I reported to the pharmacy and my unit manager. I was drug tested and the results came back negative. After that experience, I changed the way I passed my medications. It didn't matter because after that patient complained about me, I was fired.

I am not defending poor performance but can't you learn from your mistakes and do better next time? I mean apparently not.

[50caliber]

It all boils down to solid documentation/charting. Treat it as your best friend because its the only thing you are going to have by your side if management turns on you or you get sued. If you went out of your way to take the pt. BP X3 to verify pain admn parameters, I think it would have been only logical for you to chart that down cause it was obviously of some significance or you wouldn't have checked the BP x3. Perhaps, you were busy and forgot. If you didn't chart it, it was never done. Its a hard lesson to learn and unfortunately, you got fired for it. Whats done is done, learn from it and move on.

[tasha1722]

I will never get hired at another hospital again. So it's kind of hard to move on.

[Coffee Nurse, BSN, RN]

I will never get hired at another hospital again. So it's kind of hard to move on.

What makes you say that?

I agree, the hard-learned lesson here is to CYA and always, always document, especially when narcotics are involved. And, technically speaking, you did hurt that patient, by withholding her pain med. It was a sound decision on your part, but unfortunately your charting doesn't back you up on that.

Try not to be too bleak about your prospects. There are many, many, many nurses who've been fired and then hired somewhere else before.

[tasha1722]

If I had a pattern of not charting. I would understand the termination better. I agree I should have charted though.

[Coffee Nurse, BSN, RN]

I think it was probably less a pattern of not charting, and more a pattern (at least in management's eyes) of losing one narc, withholding another without sufficient documentation of your rationale, and a direct patient complaint on top of that. Also, unfortunately, it's difficult if not impossible to prove that you don't have a pattern of not charting, since you'd be trying to prove a negative.

[nursel56]

What was her complaint? Did she tell Customer Service that you never took her blood pressure, or that the parameters were too narrow? Because I am assuming when you took her blood pressure you told her it was too low for you to give the med? I guess she should have been p/ssed at the doctor, not you.

Don't those electronic BPs store information? You were fired based on the complaint of a possibly un-truth-telling person who either lied about tasha taking her BP or should properly have talked to her doctor to change the parameters of her IV Dilaudid. Excuse me while I puke.

I would say Tasha those mistakes don't seem to rise to the level of fire-able offenses, but I'm learning more and more about the harsh realities for nurses these days. Best of luck, I know it looks bleak, right now. (((tasha)))

[Coffee Nurse, BSN, RN]

You were fired based on the complaint of a lying druggie.

Uh...where do you get this from?

[tasha1722]

In report, I was told this patient could not get her narcs due to a low BP.

I don't think it's an issue of proving a negative. If you look at my charting on the patients, it was consistent. I have never had it brought up as an issue before. People make mistakes.

[tasha1722]

Our blood pressure machines don't store the information. I did take her blood pressure three times and explained the situation to her. But I did not CYA.

[nursel56]

Uh...where do you get this from?

Uhh. . .intuition ? . No, wait. It's because I'm mean. Also I lack compassion. Nice catch!

[Coffee Nurse, BSN, RN]

In report, I was told this patient could not get her narcs due to a low BP.

I don't think it's an issue of proving a negative. If you look at my charting on the patients, it was consistent. I have never had it brought up as an issue before. People make mistakes.

But your proof would be -- since you have entered A, B, and C for charting, then it is complete, and since X, Y, and Z are not charted, then they never existed in the first place. They've already found a spot in your charting where the latter proposition is false, so that pokes a hole in the entire thing.