I Need Advice. May Lose Rn License!!

[Shell5]

I am a RN who works in a LTC facility. A while back I let a guy who works at the facility, as I overlooked, give some insulin, 1 in and out cath, and do about 5 chemsticks. I was under the impression that this was allowed as long as we watched him. He graduated from LVN school, was working as a CNA. He did not pass the LVN board the first time around but was waiting to take it again. One of the other CNA's that didn't like him called the state and the state is in the building today. The state called me at home and I admitted that I did allow it. She said she was referring it to the board of nurse examiners. Now, I am afraid to loose my license. She said this was unprofessional. I know the board has different penalties. I guess I'm wondering if anyone out there knows if they will give the most severe penalty, revokation, for this offense. Please help me out. Thank you.

Texas RN.

[pricklypear]

Heck, unlicensed family members draw up and give insulin at home, unsupervised. I hardly think you drawing up the dose and supervising your NA is a crime.

But it's a totally different situation when family members do it for family members at home. The rules are different with hospitals and other institutions.

[barefootlady, ADN, RN]

Been away for days. Heard anything? Anything happening? Good luck.

[mcorrao77]

You have to relax.

Any board process is going to be measured in months.

And I think you're ok. Everything but the insulin falls under the BNE's delegation protocol which basically says you can delegate anything you are comfortable delegating, but you maintain responsibility.

Of course, med passes are different. But, the CNA was a GVN (grad voc nurse) until he failed. Just present it as a misunderstanding of what his change of status meant, as you could have delegated the insulin stick to a GVN.

Do you see what I mean: you knew you could delegate this at one point, but his status changed when he failed the exam and it was just momentarily lost on you what the implications of that change meant in terms of delegating this task.

From what you've said, this is the truth.

4 things:

1. You will not lost your license. At worst, you'll get a reprimand. You should see some of the stuff the board has to deal with. In a hospital, the board wouldn't even have been notified as this would be more appropriately handled in a 'peer-review'.

2. If you have nursing insurance, call them and tell them you will need an attorney to represent you to the board. Your malpractice insurance is supposed to cover that. If you don't, lesson learned - buy insurance. at 80 bucks a year, what kind of peace of mind would that be buying you now.

3. TPAPN is considered 'expunged' once completed. Do they have a record you took it - of course. But it's not supposed to be used against you. This shouldn't be an issue.

4. Don't contact the board again until you've been contacted and have a file/case number. Don't send any rebuttals or call for advice until you hear from them. It's possible that they will consider the report so low priority as to no follow up on it. Don't give them pause to say -- ah, this is the complaint that girl keeps bugging us about.

It's not the end of the world, it's not the end of your career. I wouldnt' be surprised if the BNE just dismissed it with a 'don't do it again'.

Breathe. You might not hear anything about this for months. You have to be able to function in the meantime.

~faith,

Timothy.

However, the CNA was hired as a CNA, not a GPN or GVN. This is different. The nurse should know what she can delegate and what she can't. Bottom line.

[mcorrao77]

I want to lend you my support too, but I have to say something after reading your reaction to this investigation. I'm sorry you're in this situation, but I think you do deserve some type of disciplinary action against your license -- not for the glucose checks or even the cath, but for allowing an unlicensed person to give insulin.

CNAs (at least in Oklahoma) aren't allowed to give injections. Until this guy passes his LPN/LVN boards, he's a CNA, and he's unlicensed. There's no way in the world I would allow an assistant to deliver any type of medication, no matter how well I knew that assistant or how close he/she was to passing the boards for the next step. I'm shuddering just thinking about it.

I know you were trying to help the guy, and while that's admirable, you went about it all wrong. Demonstrating to him would have been okay. Showing him how to do a correct assessment, the five Rs of med administration, correct technique -- all good. But you crossed the line when you allowed him to actually administer the insulin. And you did it more than once, if I read you correctly -- you say:

The last time? You allowed him to draw up the insulin, too? How many times did you allow an unlicensed person to draw up and adminster insulin on one (or more) of your patients?

I know you must be frightened, and I'm sorry for that. The most the board can do is take away your license; they can't put you in jail, so don't worry about that kind of stuff. There will be a hearing, and you'll be allowed to present your side of the story. I think a nurse attorney would help you make an effective case for yourself in front of the board, because if you tell the board what you're telling us, the board won't be happy. While you see this as a 'friggin mistake', what you actually did was allow battery on your patient. It could have been a 'heinous crime,' and I think you're minimizing its importance and your unprofessional behavior.

I really don't mean to come down on you like a ton of bricks, despite the tone of this post. I'm not a mean old nurse or a hard-ass. I just don't know any other way to say it. All of us have made mistakes, and we've all learned from them. I hope you learn from this one and grow to understand why these actions are illegal and unethical and unprofessional. Good luck.

Well Said!

[Shell5]

Thank you. I came back and reread this. It helped me again.

[SFCardiacRN]

I think you'll be OK. Sounds like a reprimand to me. Zasha's advice is right on.

[rnmom3153]

GOSH, this just reminds me of the many dumb things I have done without thinking it thru in my 30 year career. I probably could have lost my license once or twice but by the grace of God I'm still around.

I agree totally with Zasha {Timothy}. Gosh, he hit it right on the head! I'm thinking of you and you're in my prayers. I'm sure you are aware of how important it is to avoid projection and to "Let go and Let God" OMG...I can' believe I just quoted a slogan:imbar

Please keep us posted and surround yourself with as much positive support as possible! Above all DO NOT:banghead: :deadhorse :selfbonk: :smackingf

Sorry, words don't come easily to me these days {fighting a severe depression} so I let the smilies do the talking!:)

[Mayprosper]

I give you my 100% support, I know how you feel. I too am enrolled in the TPAPN program, just recently, but am afraid about the State BNE receving info about a drug screen and my termination! So far, the TPAPN program, has been of no help, I am unable to find work, I had, in the past a felony conviction on my record, and now TPAPN, I feel I'm fighting a hopeless battle with TPAPN. I think under your circumstances you were doing the right thing, the CNA was practicing under your license, wasn't he? That could be where the arguement could go. I think your wise about seeking advice from an attorney, and if you find one, I'd love to get advice from one too! I understand in this TPAPN program, we are supposed to be drug free, but after 30 years of nusring, I suffer from chronic pain, and do live, and function on Hydrocodone. Why do nurses look so bad if they are functioning fine with this med, but it would be ok, for a receptionist, bank teller to function daily on these meds, and he or she may never be reprimanded. I just thought of something, if the BNE does sanction you, I think it could possibly be Remedial education. Good luck to you, I share in your pain, and worry!