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I have a floor nurse that administered medication to a patient after the order was dc'd, he failed to draw stat labs, and this patient ended up at the hospital with renal failure and anemia. That same nurse also initialed that he gave a procrit injection as a one time order, but the pharmacy never sent out the medication because it requires admin approval. These 2 instances where written up and given to the DON and the administrator. The MD was very upset and the administrator said this employee would be fired however he is still working and the write ups havent been issued to him. These write ups would have been his dismissal becuase he has already had so many and was given his final last week. I am torn. I feel like since our admininstration isnt doing anything about the unsafe care this nurse has a history of that I should report it to our local nursing board. I know everyone makes mistakes, however this is his trend and it puts our patients at risk. Please give me your thoughts.
EAP may also be an alternative, he maybe going through some personal issues and he may need help. Reporting him is not the answer, he needs to be confronted with love, patience, encouragement, and concern. Start a conversation with him, stating that your are concerned that he seems to appear angry and offer your help.
He doesn't sound angry to me; he sounds dangerously incompetent. Falsifying medication records isn't something that's best dealt with through encouragement and concern - it's a potentially life threatening action that at the very least indicated a worrying and repeated (from the OP's opening post) lack of understanding of the most basic elements of professional nursing conduct. And that is a Board issue.
He doesn't sound angry to me; he sounds dangerously incompetent. Falsifying medication records isn't something that's best dealt with through encouragement and concern - it's a potentially life threatening action that at the very least indicated a worrying and repeated (from the OP's opening post) lack of understanding of the most basic elements of professional nursing conduct. And that is a Board issue.
The first thing that ran through my mind when I read that the nurse documented but did not give the stated med was, "Wow, no wonder this pt was tx to the hospital needing several transfusions." Then I thought, "Holy cow. That stuff is expensive. I hope the pt wasn't charged for it."
I hope this gets handled properly by administration.
basically this nurse noted orders and did not carry thru with them. The medication that he kept giving was a blood thinner, this patient was bleeding. He gave 6 more doses after the medication was dc'd because this nurse didn't carry thru with the orders...... this is bad, but it could have been a lot worse.
What type of setting are you working in? Home Health, LTC? I can sure see a problem if this person is practicing in an independent setting. If this occured in a facility, the question will be asked, who else should have picked this up. The person who audits the charts, the charge nurse who should have realized the lab hadn't called with a result. Was this a situation of a cascade of error, or a system process? Also search your soul, do you or others have a personal dislike of this person that goes beyond wanting to do the right thing. Juding by the title of this thread, you are not reacting in a knee jerk fashion. Be careful also because the administration may be afraid of getting a law suit, throwing someone else under the bus along with the problem employee would help them solve the problem with an "action plan." Best wishes.
My bad,maybe I misread, I thought in the original post the writer said that he was throwing things. Don,t be so sanctimonious, we have all falsified records, either by omission or comission, thankfully no one has been injured. If every nurse reported her errors and received punitive sanctions for it, our profession would dwindle in numbers quite rapidly. I still say ask for a random urine test if they really want to get this guy some help. Also as nurse managers, we have to keep a succint paper trail and we have to document the plans that were put into place to assist the incompetent nurse.
Don,t be so sanctimonious, we have all falsified records, either by omission or comission, thankfully no one has been injured. If every nurse reported her errors and received punitive sanctions for it, our profession would dwindle in numbers quite rapidly.
Um, what? I most certainly have not falsified records or signed for drugs I didn't give, and I sincerely hope I speak for the overwhelming majority of nurses, here and in my workplace.
I've certainly made mistakes, and I've reported them - that's part of being an accountable professional. If I gave a patient six doses of a discontinued anticoagulant or signed for a medication I could not possibly have administered I have no problem with management and the Board being involved - I would clearly have lost insight into my own practice.
Also as nurse managers, we have to keep a succint paper trail and we have to document the plans that were put into place to assist the incompetent nurse.
I sincerely hope I'm misconstruing this - it sounds like you're speaking as a manager. And that makes me even more concerned about this post.
Oh. My. God. SIX more doses?!?! What in the heck is going on there?!?!?My mind is spinning right now. There are SO many things wrong with this that I can't even articulate my next sentence. Wow. Just wow.
I can give you the most likely scenario. It was still on the MAR, it was still in the cart, and he was pulling meds for 40 patients probably on evenings. And tired, because he'd been asked to pick up a lot of extra. Six doses in a row if it was, say, Coumadin means six days in a row.
I don't know what to tell you. We did discover a similar problem with Coumadin and a patient and did a root cause analysis and changed the procedure for changing those orders and stocking the cart. It took a bunch of us screwing up for it to trickle through that many shifts without being discovered.
passingthru
6 Posts
I agree, what is all that about "snitches get stitches", we are a profession that stands by a code of ethics. We are the advocate for the patient, incompentencies can further compromise the health of our clients.