Scandal...I may have my license revoked? help

Nurses General Nursing

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Okay hypothetically,

I am a nurse of 2+years at a hospital. I relieved a nurse who told me that a pt needed dressing changes frequently and the day shift nurse previous had given her a similar report. 0800 I assessed the pt to have a dry and intact dressing-documented. (when questioned on this later, I told my director the pt may have had bleeding underneath circumfrential wound, but I didn't see any. I told the pt I would do a better assessment upon dressing change later that same morning) 1045-1100 physical therapy notified me that the dressing was bloody underneath. 1045-1100 dressing was changed by me. The dressing was bloody and soaked through to the pillow directly underneath, clots were formed on the kerlix, and when the dressing was removed the wound dripped blood. 1100 I immediately notified the surgeon, who was upset that lovenox had been given that morning, by night shift, and that it took so long for the nursing staff to report the condition of the incision. I reported to him the information I had been given in report and the condition of the pt and he told me that he wanted the incident written up. I arrive @ work, start care of 6 pts, and get called out for a peer review.

Specializes in Med/Surg.

I'm not seeing where you are getting the "I may lose my license" thought, either....IMO, your actions were the most RIGHT amongst all of the nursing staff involved. It seems you were the FIRST one to report the bleeding to the MD (since it was passed on in report for at least 3 shifts that the dressing needed frequent changing). The nurse BEFORE you gave the Lovenox, so that wasn't your fault, either. You were the one that the buck stopped with, but I don't see that YOU made any kind of error, as the dressing was dry and intact when you assessed it and you documented as such. Perhaps almost 3 hours later was a bit too long in between checking it (since you were told it needed frequent changing), but that's subjective. Not that big of a deal.

Obviously, as someone else said, there are a WHOLE lot of details we don't have, so it's hard to form an opinion completely, but based on what you've said, that's how I feel.

Lastly, as others also have said, the nurse that gave the Lovenox should NOT be on the peer review committee. That nurse perhaps made the biggest error in the chain of events, and any nurse on the peer review should be a completely uninvolved/disinterested party. That nurse will NO doubt have an agenda. PLEASE speak up about that. That's just wrong on so many levels.

I would say, calm down and try not to sweat it. I don't think it's an issue to worry about your license by any stretch of the imagination.

Ok I went back and read your post again, now I think I might have an idea of what's going on. You got report that the dressing needed frequent changes not scheduled changes but changes due to saturation of blood, it was the third report at least that contained this information, and the patient was on Lovenox. Nobody put two and two together until you found that the patient was actively bleeding not just oozing from the incision. You reported this finding to the surgeon (who apparently had not done a post-op assessment of his patient's wound). So once again, I completely fail to see where YOU are in the wrong. I see several people before you that may have an issue, and only IF the patient had a negative outcome. The surgeon who didn't assess his post-op patient, the MD who ordered the orignal lovenox or who failed to suspend all blood thinners post surgery (if that's standard for this surgery), the nurses each before you who were continually changing saturated dressings and not reporting this to the surgeon and finally the nurse who gave lovenox. Many links failed in the chain of care but I don't see where you failed at all. They should not in the least be making you feel like you might lose your license.

Specializes in med-surg/pedi, tele, er, rehab.

the problem is that the only person the director is willing to sacrifice is me, there are also other things in play that may not have been mentioned in my post to protect identity. One med was given late and one order was entered late.

Specializes in Cardiac care/Ortho/LTC/Education/Psych.

As I said before , as soon this drama is over and you pick up pieces of your dreams in your hand ..RUUUUNNNNNNN......... They can not do anything to you except to fire you . Firing would be blessing if you work in a such environment and you know that you are doing right. Bow and say: Thank you , you saved me misery!!!

But also fight!! If you see that it is a set up ( and it looks like one) then do not settle until you pull a few heads with you down to earth. Call agencies that oversee work ask them what to do, call your attorney , (I hope you have your personal insurance) ,

Small person can do many things.."Look up at the sky. Ask yourselves: is it yes or no? Has the sheep eaten the flower? And you will see how everything changes . . . " Little prince :)))

Good luck to you. There is soo many nice places to work and nice people to share responsibilities with . Too bad we have to deal with this on routine.

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