Med error could cost my job? Need help!

Nurses General Nursing

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Hi everyone! I really need to get this off my chest and get some responses back on your opinion of the problem.

I was off work for 3 1/2 months for some personal problems. When I returned to work, I am not allowed to work nights or be mandated. Soo, the hospital I work at said this is a disability. So I had my MD fill out the paper work which included a detailed summary of my problem. I just got back into the swing of things, and now I have a major problem.

I was working evening shift, and it was really busy on my med-surg unit. Patient A asked for a pain pill, and so did patient B. I knew it wasn't time for patient B's pain pill, but I went into the med room to get patient A a pill. I got into Pyxis, our computer system for medication distribution, scrolled down to my patient and selected Vicodin ES. When the drawer opened, I removed one pill, opened it, and placed it in the cup, but the cup tipped and the pill was ont he floor. SInce the drawer was still open, I accidently hit cancel all meds, which cancels my action and makes the machine still think that theres the original number of pills in there. In my case, there were four, I took one but it fell, so now theres three, but since I hit cancel all meds, the machine thought it had four still. My nurses aide came into the room and told me that pt C was climbing out of bed again, and pt D was coughing so hard she was throwing up. I was now in a hurry to go help her out, so i put the dropped pill in my pocket until I could call pharmacy and figure out how to fix the problem in the pyxis machine. I created a discrepancy because I still had to remove a pill and the true number was different from the machines number.

The night just got worse from that point. I spent a good part of my night on the phone, with every ones family members, three different doctors on different patients, attempting to keep my Houdini in bed, etc etc etc you all know how it goes. I totally forgot about that pill!!!

The next day, I go to work, and I get called to HR. I'm instantly placed into a state of panic, what did I do wrong, did I get a serious complaint against me (I had a pt not happy with me the week before), was I being sued, I mean a million things were going thru my mind. I practically ran to the other side of the building to get to HR. When I got there, I was out of breath and scared to death to hear what was going on. When they told me it was over this discrepancy, my mind went totally blank. I didn't remember what I did with the pill, and I didn't have it on my person. Since I didn't know exactly what happened to the pill, and I didn't have it to prove that I didn't take it, They placed me on administrative leave of absence, unpaid. They told me that I could get either probation or I could be let go. I got hysterical. I had to call my mom to come get me, I was so upset that I couldn't function. My manager had to stay with me as long as I was in the building, which was embarrasing. I took an extra nerve pill while waiting for my mom to come get me. I just sat there and cried, telling her over and over that I didn't take it, I would rather die than risk my job. I love my job, and I've been with the company for six years now.

When my mom got me home, I took my managers advice and checked my uniform from the day before. My mom was a witness. We checked all the pockets. I had a shirt that has double slit patch pockets on the front. I always use the pockets closest to my body, never the ones further out. We found the pill in the front pocket. I was so happy that I cried. My anxiety medicine had kicked in,and I remembered the entire incident from the night before. I immediately called the hospital, requesting to talk to the head lady in HR. I explained to her what had happened, and she told me that its fishy since just an hour and half ago, I didn't know what happened to it. But its the truth. I'll swear on a Bible, I'll give hair sample for drug testing, whatever they want. I'm not a drug abuser, never have been. And the thought that they are suspicous of that makes me upset, but I can see where they are coming from. Its been over a week since this happened. Its been more than five days. I still haven't heard anything yet. The waiting is killing me. Just the thought that I could lose my job is driving me insane. Has anyone else dealt with anything like this before, what came of it, or does anyone have any suggestions for me? I could really use all the support I can get at this point. Thanks

My manager had to stay with me as long as I was in the building, which was embarrasing. I took an extra nerve pill while waiting for my mom to come get me. I just sat there and cried, telling her over and over that I didn't take it, I would rather die than risk my job.

I can certainly understand how anybody could have made this mistake.

But it sounds like you took a "nerve pill" while the manager was with you waiting for your mom to pick you up?

It seems like taking any medication at the hospital, especially during this inquiry where you were under observation by management, would make the situation worse.

It might have, in their eyes, confirmed their suspicions.

:typing

I am sorry for your trouble. I believe you but like other posters, the facility feels like it has a duty to keep drugs strictly accounted for and rightly so. Seek legal advice, do everything possible to clear up this situation. I do feel like the facility is taking a hard stance with you because you are under work restrictions, after all, they never like it when a nurse is not at their beck and call. Good luck and let us know how it turns out.

Specializes in critical care; community health; psych.

This is a more common occurrence than many care to admit. It's so easy to happen. I've seen it dealt with by wasting the next day with a buddy who won't make waves. We kept a written log for discrepancies. No, it's not the proper way to handle it but that's the reality. It helps to be part of a clique.

There were two problems here. One with the pyxis and the other by walking out of the building with a narc. It's a combination of errors that make for a fishy looking recipe for trouble. I do believe you because the exact same thing happened to me. However it was handled in a much less dramatic manner by my manager. I had to fill out a med error report and that was the end of it.

Is it possible that management wants to move you on for other reasons? Maybe this is just the mechanism to make it happen??? I'd start cleaning up my resume. The unfortunate circumstance is that even though you did not take the drug, the narcotic was taken off the premises which in and of itself is a mishandling of narcotics and perhaps grounds for termination if someone wants to see you gone. I'm really sorry this is happening to you. We work so hard and sometimes things get chaotic and out of control.

Specializes in OB, M/S, HH, Medical Imaging RN.
I, too, believe you but I also understand if others do not want to believe you because this sounds like an "unreal" story. No matter how bad things get you should never put a narc in your pocket.

I used to put narc's in my pocket. Deep pants pocket not scrub top pocket. 3 patients all wanting their pain meds. I would pull them at the same time and put them in my pocket whether they be pills or injectables. I would also leave wastes in my pocket until I had time to return to the med room and have someone watch me waste.

The story is not at all "unreal" the key here is that she still had the pill. If she was after the narc she would have taken it and not have been able to return it the following day. Sounds to me like they are unfairly judging her because she had just returned to work after having personal problems. I commend her for going back to such a stressful job.

Specializes in ER, ICU, Psych.

:eek:

hi this is a really ugly situation. i had something much more serious happen to me, and it turned out ok.

i was working in a nuring home as a unit manager for a temp agency.

the drug delivery arrived as i had an aide come to me with the info that a patient was experiencing extreme pain. i asked the aide to stay with the drugs while i went to the patient. when i came back and went to log in the drugs there was a whole card of vicodin missing. i had already signed for everything.

the facility did an investigation reported it to the board as they had to. i had no prior incidents of any medication errors or missing narcs so they found me not at fault as far as the missing drugs but reminded me to use protacall re accepting drugs. they later found out that the person who delivered the drugs had not even delivered them, but because i had signed without finishing the cross check i was in violation of protocal.

it may be hospital policy to put persons on administrative leave when this sort of thing happens at that facility.

you should ask, if you have had no previous problems this should work out.

by the way i hope you have good . if you don't let me know and i can help you. keep me posted. if you have worked at this facility for 6 years you should have many people that can vouch for you.

dawn

They should have requested a drug test immediately and didn't so they have no proof to back up any accusations. And if you haven't been in trouble before, they can't use your record against you. Keeping you on staff for 6 years is also in your favor. I use to work in a place that had a pyxsis and we often had discrepencies...pharmacy would just come up and make the necessary adjustment. And many times it had to do with hitting the wrong key just like you did. And sometimes the anwer was, "I don't know what happened." If they're jumping all over you, I wonder if they have a problem they haven't mentioned to staff yet.

It does seem wrong to keep you in the dark about this. I think I'd go to HR and tell them to get on with it, (very nicely), or I'd find someone outside to help me, even if it means getting a lawyer. Mind you, I don't mean to threaten them...just do it quietly and get some solid advice. First consultations are often free. Not asking for a drug test makes me suspicious of their actions, especially since they can do it on a whim.

I believe you're innocent...these things happen to us all the time. I lost a vicodin one time because that patient had meds in a bottle from an outside pharmacy and when pouring her med, one fell into the drawer and I didn't see it. The count was wrong that night, even though it had been right in the morning and I was counting with the same nurse. No one made a fuss and the next day, I decided to clean the med cart. I was very happy to find that vicodin and be able to explain, even though no one questioned me.

Plenty of nurses and doctors have done worse things than this and kept their jobs and licenses, so buck up...you'll be okay. And in the future remember, nursing is no longer about caring for sick or elderly...it's covering your back. That's what we're all so frustrated about. Good luck.

Specializes in Orthopedics, Med/surg.

I have been wondering if this could be discrimination. When I went back to work, I had some restrictions on me, such as I can't work nights or be mandated due to my psyche problems. When I went in to hand in the necessary paperwork for this, no one was available to hand it to other than the secretary. When I went back 1/2 hour later to make sure it was delivered to someone, it was laying on her desk, my name side up, and she was not in the office. Anyone could have read that, and it was filled out by my MD with all my diagnoses on there. My direct manager is supporting me, fighting for me, but it seems like everyone else is against me. Hopefully tomorrow (monday) we will get some sort of answer.

Specializes in ER, TRAUMA, MED-SURG.

Hey dmwRNpa -- I wanted to respond when I read your post. That is kind of what happened to me this past summer, and I am still fuming about it!! I did give them a drug screen, and it came back clean, and I knew it would. When they couldn't pop me for positive drug screen, the powers that be terminated me for one charting mistake I made on a very busy day. And it was not false documenting, not narcotic disc. It was an incorrect number given on a 0 to 10 pain scale!! If you ask me, it was total BS. I'll be thinking about you and your situation. Keep me posted, and pm me if you would like.

Anne

This is really scary for those of us who are wanting to become nurses. It makes it seem like any type of human error can cause you to lose your entire career.

It just proves that if they want to get rid of you anything goes. Pain scale is not exactly scientific data. There is a lot of guessing.

Hey dmwRNpa -- I wanted to respond when I read your post. That is kind of what happened to me this past summer, and I am still fuming about it!! I did give them a drug screen, and it came back clean, and I knew it would. When they couldn't pop me for positive drug screen, the powers that be terminated me for one charting mistake I made on a very busy day. And it was not false documenting, not narcotic disc. It was an incorrect number given on a 0 to 10 pain scale!! If you ask me, it was total BS. I'll be thinking about you and your situation. Keep me posted, and pm me if you would like.

Anne

Specializes in Tele, ICU, ER.

Sure sounds like the facility is going overboard here. Where I've worked, the pharmacy "keeps an eye" on trends for users. If discrepencies keep popping up on the same person, they investigate. But one pill? Come on!

That said - you've learned a valuable lesson, regardless of whether you're terminated from this job or not. If you MUST carry around something you need to waste, or a narc you need to give that you can't give this minute, put it somewhere that you canNOT forget it. Some folks tape the little vial of 2mg ativan (where they only gave 1mg and need to remember to waste it) right on their shirt, with tape. Me, I do'nt like having that as a decoration and prefer to tape it to my car keys in my pocket, or my pack of smokes. Something I KNOW I'm gonna see before I go home. If it's taped to my car key, you can bet I will not be driving home with it.

We nurses have to get creative simply because we work SO hard and are SO busy that we can't always ideally waste something right at that moment because we can't find another nurse right then to waste with us. It happens often!

I'm sorry you're going through this. While your facility might use this, for whatever reason, to get rid of you, I think you'll be ok in the end. Brush up your resume, and if you think they have ANY chance of reporting you to the board (which I doubt would go anywhere if you have no prior problems, but would be a pain in the orifice) then consult an attorney.

Good luck!

For those demanding a drug test, you're missing the point; it really won't do any good. If the hospital wants to paint a picture that she's diverting drugs, they can do so without saying that she's taking the drugs. Not all diverters will divert for their own taking. Right or wrong, the hospital in this case could easily say, "We have a protocol we follow when accessing and administering narcotics. When it's not followed then we are mandated to make inquiries. In doing so, we found a narcotic medication to be missing. It was only after confronted that this employee fessed up and found the medication on her person at home. This is in violation of hospital policy and having a narcotic at home that is not prescribed is against the law. For these reasons we have no other recourse but to suspend/terminate/review, etc., this employee..." It's a harsh reality, but may be what they try to do.

Let's face it, we've all made mistakes. A lot of them. Some more serious than others. Anyone of us at any time could be the target of an inquiry for whatever reason. And, if an inquiry is done, it's likely they'll find some mistakes because we are all human. Just don't make any of your mistakes serious enough or close enough together time-wise that gives them a reason to look. Something tells me that they are trying to get rid of this employee and are using this as their excuse. It's unfair.

To the O.P., you don't have to answer this publicly, but is there any reason they might want to try and get rid of you? Be honest with yourself and evaluate things from the hospital's perspective, only for the purpose of trying to stay ahead of them. If so, and you have union representation, get them involved ASAP as well as an attorney. This could get worse before it gets better.

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