help

[lovemydogs]

I'm looking for some help/advice from experienced nurses &/or managers. I am new to nursing, BSN earned in may, but have been in a hospital setting for 13 years both as a master's level rehab staff and as a risk manager, so I'm a more familiar w/ nursing processes & requirements than the typical new grad. I work in a community hospital 12 bed ICU and am a little more than 1/2 way through orientation. A mistake I made was brought to my attention from last week that let me preface by saying I understand the seriousness of it and am not taking it lightly. I've switched preceptors halfway through my orientation b/c my first one went on medical leave. The 2 preceptors are VASTLY different, but both excellent nurses in their own right. My new preceptor & I had a little run in last week b/c I, unfortuantely, had it in my mind that didn't need her help as much as she wanted to give it. Since this interaction, I've had a total mind shift, and expressed that to her yesterday morning (the first day I've seen her). About midmorning, my managers came to me with an issue. Apparently last week (which it happened on a particulary crazy day full of admits, d/c & really sick pts) I documented that I gave a medication and took a blood sugar, when in fact I had not. I remember making the documentation because I HONESTLY thought I had done them. Obviously the labs/pyxis showed something different. Neither instance resulted in patient harm (THANK GOD) but now I am suspended & may lose my job. I was as honest & forthright as I could be, and expressed my remorse and my enlightened mindset, but am terrified that so early on into my career no one will hire me if I am terminated. I totally understand the manager's standpoint, but I see so many things go on the unit that are as bad or worse (IMHO) that go untouched.

Has anyone had experience in a situation like this and if so, what has the outcome been. I'm a strong believer in the culture of pt safety & that mistakes should be taken as learning experiences. This IS NOT a pattern of behavior for me, in fact last week I had an excellent 90 day review. I know I'm in orientation, but with the nursing shortages, esp at my facility, I would hope they would take it to be an opportunity for re-education - but am I being unrealistic?

Thanks in advance

[tryingtohaveitall]

Unfortunately, they may be skeptical that you made an honest mistake and may instead interpret this as falsifying documents, which is pretty seriously. Honestly, I have to admit I would be very leery of a nurse if this happened. A mistake is one thing, but being dishonest is quite another.

NEVER sign off a med til it's actually been given, and then do it as soon as it's given so you don't forget.

I wish you the best and hope things work out well with a 2nd chance.

BTW, I believe you because you have nothing to gain by telling us a lie, I assume. I'm just telling you how it would look to me.

[lovemydogs]

I feel so horrible about it because the last thing I was trying to be was dishonest. Much like people who sign off their MARs before giving meds, I don't think they do it because they MEAN to be dishonest, but rather trying to be efficient. Wrong none the less. I can honestly say that the day this happened was the worst day I've had while working as a nurse, even before this was brough to my attention. I know how it is perceived and really no one can "beat me up" any more than I do myself, but I still don't believe one mistake should cost you your career if you have an otherwise stellar history. In patient safety circles, there's alot of talk about looking at the situation then looking at trends of a particular employee when determining if disciplinary action is necessary. Unfortunately I think my manager has a zero tolerance state of mind.

[richard1980]

Hopefully they'll give you a 2nd chance, just don't get into bad habits like that b/c they'll stick with you and someday a patient could die because of it.