I made a med error; got fired and my job is reporting me to BON. What do I do?

[Nurse Beth, MSN]

I'm sorry you're going through this, and it must be incredibly stressful. First, take a deep breath. We've all made errors. A medication error does not define you. Here's a step-by-step approach to handling the situation:

• Verify with the Board of Nursing (BON). You may want to contact your state's BON directly to clarify whether they have received a report about you. Most BONs will confirm whether they have had any official filings or reports about a nurse. If the BON hasn't received anything, you may not have to worry, but it's good to verify.
• Review the situation. If you haven't already, document everything you remember about the incident, including the circumstances that led to the error. Med errors are seldom made in a vacuum. Was it a one-time mistake? Were there any contributing factors like staffing issues, unclear instructions, or distractions? This will help you when you explain the situation later.
•  The BON may open an investigation to determine the severity of the situation. Depending on the nature of the error, it may result in a variety of outcomes, ranging from no action to a warning to disciplinary action. The majority of nurses are disciplined for substance abuse or criminal offense, and not medication errors. The investigation will likely consider any history of errors or issues on your record.
• Consider legal counsel. You may want to consult with an attorney who specializes in nursing licensure issues. They can guide you through the process with the BON and help protect your rights. They may also help you craft a response that reflects your accountability but also highlights any mitigating circumstances.
• Remediation or education. In many cases, demonstrating that you are taking steps to prevent it in the future, such as completing additional training or education, may result in the BON showing leniency. You may be required to complete a medication administration course or other relevant training to demonstrate your commitment to improving your practice.
• Be honest and reflect. Think about what you would do differently if you could. Typically, overlooking one of the rights of medication administration is the culprit. If this was a first-time error, be sure to communicate this, along with your commitment to learning from the mistake and ensuring it doesn't happen again.
• Stay professional. Throughout this process, maintain professionalism, communicate respectfully, and follow all directions from the BON.  Respond promptly to any communication. Being proactive, honest, and cooperative will work in your favor.

Take it one step at a time and remember that this is an opportunity for growth. 

Best wishes,

Nurse Beth

[Edie Brous]

I would disagree with a few things.  Speak with an attorney BEFORE you do anything.  DO NOT call the nursing board directly.  It can take months from the time a complaint is made until you hear from them.  Calling them can just move things along faster which gives you less time to prepare.  Logs, journals, diaries, etc. can be discoverable so DO NOT write down everything in as much detail as possible UNTIL you have spoken with counsel and can write it as a private memo to your lawyer to protect it.  Start taking medication administration safety courses now so you can collect CME certificates of completion BEFORE you receive any notification that you are being investigated.  Nurses ARE disciplined for medication errors.  If you are currently in practice it can be easy to make another error just because you are anxious.  See a lawyer sooner, rather than later so you have an actual context & can get the support you need.

[FullGlass, BSN, MSN, NP]

To OP: you have received good advice so far.  I have a minor disagreement w/JPHeeler.  Write down what happened for your private use only.  This type of journaling can help you reconstruct what happened and is good for self-reflection.

Every RN, NP, and MD has made medication errors.  I certainly have.  Please don't panic.  

Also, many RNs, NPs, and MDs, get reported to their respective boards and are still practicing.  I know NPs that are still practicing that were reported and disciplined for, among other things:

- drunk driving

- shoplifting and substance abuse (same person)

- opioid pain med abuse

They had to take remedial actions to the satisfaction of the nursing board, but they completed those and are still practicing.

Please consult with an attorney that helps nurses.

Best wishes

[JPHeeler]

I agree with Edie. Also, think (don't write)  about why the error happened and how to prevent it in the future. Take classes based on your self reflection. It may not be all about medication error. Time management? Pharmacology? ADHD? Dyslexic? Critical thinking? If you are questioned, answer only the question and don't fill in uncomforable silences. I'm assuming you don't have to worry about any patient law suit? What is the statute of limitations where it happened? Just because you get an attorney doesnt mean you don't have to do your own research and stay diligent. But your license is worth it, and the faster, the better, the attorney may be able to stop it from ever reaching the BON. If you get an option to get your job back, take it, even for a short time until you can quit on your own terms, it most likely will look better for you.