Help - Suspended

Published

I am a new nurse. I worked for a couple of months in the ER but then I transferred to a Med/Surg unit. I administered insulin coverage for a high sugar before a procedure. He was NPO. The next day, our Nurse Clinical Instructor said that she would have given the coverage also because the sugar was so high. I know that you don't normally give coverage when a pt. is NPO. He went & returned from his procedure & was sleepy but arousable & he even took some PO meds & talked. He actually yelled at one of my co-workers. About 1 1/2 hours later (approx. 6 1/2 hrs after receiving the coverage), I checked his sugar, & it was 9. I know that seems unreal, but it was. I initiated hypoglycemic protocol Stat & he went to ICU for a day but then returned to our floor & is talking & eating. I did everything that I was taught. I asked my Preceptor & she said that I didn't do anything wrong. He's doing great. I have been suspended since Wed. without pay. This happened on Tuesday. They just told me to go home Wed. afternoon. I never would have known that I was suspended if I didn't call HR & ask them my status. I received notice from my manager that they will call me on Monday to set up a meeting & that she is meeting with HR on Monday to investigate further. I asked them to send me somthing in writing that I am suspended & the basis for it, but they haven't. I saved the man's life. They mentioned that I should have called a code, but I ran for the D50 & yelled out that I needed a blood draw stat. They didn't call a code when they went into the room either. They also want me to make some late entries in the chart, but how could I? I'm suspended without pay so therefore, I can't & I shouldn't do any work.

It's not looking good. I feel they are looking to fire me & I can't understand why they are doing this to me. I just got my 90 day evaluation on 2/14 & I met expectations on everything, including pt. safety. I can't believe that this is happening.

Can I lose my license for this? I didn't do anything wrong, that I know of. If they fire me, does that affect my license? Do they make a complaint with the Board of Nursing? Does anyone have any advice for me? Please help me. Thank you.

Does anyone have any advice?

Up Vote Up Vote ×
Specializes in Labor & Delivery.

WAITING IS THE HARDEST. No, you won't your license, you didn't commit a crime, cause a death, intentually cause harm. Yes, they could report you to the Board of Nursing, but it's doubtful. But you must have had a tip-off that something was happening, for you to contact HR. Check you hospital policy book about notification and suspension. And for them to suspend you, somebody else had to make a big stink over it. My question is were there specific orders for pre-op insulin and if not did you contact the dr. Just because it's high, doesn't mean you cover. Remember he's NPO for quite a while. And just because your preceptor agrees with you, doesn't make it right. Take a word of advise, keep your facts straight, don't add to, take away from, minimize, maximize. You shouldn't be terminated, but then I know of nurses who were terminated for less. The most important thing is to learn from your mistakes. Don't let this get you down - every nurse has been reprimanded for something, and if they haven't, it's bcause they won't admit it or haven't gotten caught. Remember if you stay in this profession for very long, this won't be the last time you get blasted. I hope your charted well, remember, especially in an adverse situation, CYA - cause ain't nobody else going to do it for you. By the way, it would be a very wise thing not to discuss your situation with anybody else - friends or enemies, you can never be sure of when it comes to sticky situations.

s

Up Vote Up Vote ×

wow. i'm sorry this happened to you.

i'm not sure if i would have given the insulin; i probably would have called the doctor to get orders.

but being what it is w/the bs of 9, i would have started the d50 and then called a code. i would have also notified the doctor and nm to cover my butt. i think you were suspended because someone is covering themself. nurses are subjected to a host of various liabilities. it's always wise to maintain your nsg insurance ea yr. i really hope this situation works out for you.

leslie

Up Vote Up Vote ×

OK, heres the diabetes CNS in me speaking. First, If the sugar was high, coverage is appropriate even if the patient is NPO. Hyperglycemia in hospitalized patients is a serious problems that increases their risk of complications such as infections. Depending on whether it was regular insulin or humalog, the insulin would have peaked by 6.5 hours. Pts need more frequent blood glucose monitoring if they are NPO however, every 2 to 4 hours routinely is appropriate.

However, something you said makes me suspicious of hypoglycemia long before you checked his sugar..... the fact that you state he yelled at one of your co workers. Unexpected or inappropriate anger is a symptom of hypoglycemia.

Having said all that, I think you acted appropriately when you realized the pt was hypoglycemic, if just would have been better if you had discovered it earlier. I don't know the type of institution you work for but I can't imagine they would have suspended you for this incident. Sounds like you are inexperienced and need a little more education but certainly I would not consider this a reckless act, just the type of error that occurs when a nurse is not well experienced.

Up Vote Up Vote ×

Leslie

As I was running to the pyxis to pull the D50, I yelled a couple of times that I needed a blood draw stat & I told the charge nurse what the sugar was. I also called the doctors when when one of my co-workers was pushing the d50. I followed hospital protocal exactly the way it had been taught to. I can't believe that this is happening to me. They told me that they will call me tomorrow to arrange a meeting with me. This is just horrible. I don't even know my rights.

Up Vote Up Vote ×
Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

Annette ket us know how things come out. A couple of years back I had a patient with a glucose of one. Frankly I see no errors on your part. The doc knew he was going for the procedure as he obviously did by ordering it.

It should have been clarified whether to cover or give half or what ever. I hope this doesn't dampen your love of nursing. Sometimes nurses become "it" in a power struggle with employers and docs.

Up Vote Up Vote ×

I'm sorry but I don't quite understand (I'm a new grad).... what exactly does insulin 'coverage' mean? Is it different than the usual administration of insulin? What are they saying she did wrong? I dont really understand her situation... If someone could explain I'd appreciate it :)

Jessica

Up Vote Up Vote ×
Specializes in LDRP.
I'm sorry but I don't quite understand (I'm a new grad).... what exactly does insulin 'coverage' mean? Is it different than the usual administration of insulin? What are they saying she did wrong? I dont really understand her situation... If someone could explain I'd appreciate it

Coverage means administration of sliding scale insulin, dose based on Accucheck results.

Up Vote Up Vote ×

Why call a code for this? If it was being handled correctly by the poster and her co-workers and the docs were called? I think that she did her best in this situation. It was an emergency yes, but a code? I would love an explanation. Yes I know that seizures could occur etc, but they had not at the time had they?

Up Vote Up Vote ×
Why call a code for this? If it was being handled correctly by the poster and her co-workers and the docs were called? I think that she did her best in this situation. It was an emergency yes, but a code? I would love an explanation. Yes I know that seizures could occur etc, but they had not at the time had they?

I am with sharann. I really dont understand why you would get in trouble for just doing what the sliding scale says. ... Also I thought a code was only for cardiac/respiratory arrest... if the patient was not symptomatic with the low BS then why call a code? Or would a patient ALWAYS be symptomatic with this low of a BS?

Up Vote Up Vote ×

it's safer to call a code, imo. it was an emergent situation.

Up Vote Up Vote ×
Specializes in LDRP.

What I would have done:

Would have depended on several things, such as, how high was the blood sugar, how long was going to be npo,e tc. I most likely would not have treated it. It's easier to give insulin than to give d50.

Up Vote Up Vote ×
+ Join the Discussion