Too often I have seen the true patient advocate punished for the same thing that would be ignored in a less outspoken nurse. Sometimes the nurse is the last in a chain of errors starting with poor handwriting, through complicated systems, ending with an error. This nurse becomes a scapegoat.
Once an LVN on a telemetry unit was terminated when the patient removed the leads, coded, and was revived with brain damage. She went into the room when she heard the tech say, "Mr. so & so is off the monitor." She started CPR and called the team. Why was she fired?
Probably to have something to tell the family.
The JCAHO has a policy on Sentinel Events that a "Root Cause Analysis" be done focusing on the system, not the individual.
Management needs to learn this!
Only the abusive, unsafe, or incompetent should be fired (and lose their license).
One mistake by a competent caring nurse should be documented and that's all because the nurse is more disturbed than anyone else.
Punishment serves no purpose.
If the problem is lack of training about a type of medication or treatment the education should be provided.
PS the www.florenceproject.org
Assignment despite objection form is good. I suggest filling one out any time unsafe staffing or floating make mistakes likely.
[This message has been edited by spacenurse (edited November 15, 2000).]