I am RED HOT over this one.............

[thegreenmile]

as we all know or better learn , psych is a very litagous nursing specialty. i am ancc certified since 1995 with 11 years of service, a huge pt. and staff advocate, have an excellent work history, always pick up ot to avoid manadation for my coworkers, and have never had an open complaint on my license.

recently, i was 1 of 3 rn's that was involved in a prn med error during an urgent intervention, a dr. was involved as well. i was not the nurse that administered the wrong med but was the only one of the 3 who got unreasonable punishment (note: i'm the union president & steward). the employer gave the other rn's a written warning but suspended me and turned me into the state board of nursing, "***"?? and you know the dr. got nothing. i am fuming with anger but realize the board will look at the employer as an idiot for wasting their time if they have to investigate. the issue is, now i have to suffer through the "process". i'm about to leap off a tall cliff , per say, and exit stage left on my own accord. i feel like i'm in an abusive relationship with this employer and simply wont tolerate it any longer. anybody been there? done that? please help!

[Smitty08]

HI

It really doesn't make sense that you got turned over the BON - unless you were the supervisor, and even then thats not a clear shot. Sounds like they have a bone to pick with you (Union!) and the state board should be able to see through this. A humble attitude would probably play best there, if it even goes that far. Its going to be tough to keep working in such a place, wow! Don't give up, sounds like you are in the right!

[Jolie, BSN]

Please don't assume that the BON will view your employer as idiotic for wasting their time on an investigation.

If you have not already done so, please notify your malpractice carrier and/or retain legal counsel.

Goodluck.

[Mr Ian]

Have you asked the employer to explain why they have treated you differently?

Even if they don't respond to the question - the different perceived treatment will be in writing. But get legal/union advice first.

[thegreenmile]

Most certainly, Mr. Ian, I have inquired with the employer over and over what makes my situations different than anyone elses and they deny the disparagement when it is so transparent that everyone sees what is going on. Thanks all for your responses, I truly need your input right now.

[Mr Ian]

You were all involved (3 nurses; 1 doc) in the incident.

They have been reprimanded or exonerated and continue to work.

You have been suspended and reported to the BON.

That's a significant difference.

I guess they're holding you specifically responsible for some causative factor in the incident.

Have they shown you the findings of their internal investigation that led them to this decision?

I went thru similar - but different - when a patient went AWOL from a home visit. I was sat on the ward at the time 2 hours away and the social worker and aide who took him were not held to account.

The management stated - it was my decision to allow the pt to leave the ward.

My decision at the time had actually been to tell the social worker - "He's not been too settled over the weekend, but he was fine yesterday. You're a clinician; if you think it's ok to take him, then you take him. If not, then don't. I will back you which ever decision you make".

She took him - and lost him - and wrote a 3 page damning report about how I'd said he was fine etc etc....

I actually didn't care about the place so it was no biggie and walked out of the job.

[aloevera]

just curious, what part did you play in the incident??? were you charge nurse or supervisor?

[thegreenmile]

None of the above, I was the staff RN w/multi pts going off. I simply set up a PRN med combo, got interrupted and pulled away to deal with another incident before I was finished with labeling the med in the locked med room, the charge RN took the cup, handed it off to another staff RN (temporarily pulled to adult unit to assist) with a verbal directive to administer to pt "B", which he did do. I had later, when things calmed down, initialed the prn because the 3rd RN who passed the med had returned to the adolescent unit, (wrong move I know). But I did make a late entry to correct that documentation and the company was resistant to me doing so. But they suspended me and turned me into the board. The other RN's got written warnings.

[Mr Ian]

So what are they pulling you up for? Some medication adminstration error? And reporting it to the BON?

From that scenario it sounds as if you made a lesser mistake than charge RN.

Tho it is wrong to make up and leave meds (they should go pot to patient without interruption) - it does sometimes happen. Labelling meds is a complete no-no - but in this instance you state you didn't have opportunity to breach that practice anyhow (I know it's a common time saver and have done it myself in the past).

However, the charge RN who took the unlabelled med and passed it to the next nurse with instruction to adminster must have been satisfied that the med in the cup was the right one.

The adminstering nurse should be the dispensing nurse - but in necessary times things have to adapt.

If this is the total scenario - and you relay this in your synopsis to the BON - they are likely to ask many questions about the practices at your employment in order to gain an overview of the general workplace scenario.

Has your employer given written notice about their reason for suspending?

And a copy of what they sent to the BON?

[thegreenmile]

Yes on the written notice for suspension and No on the copy of the complaint to the BON. They verbally say "violation of general duty without abuse or neglect". I just cant even believe I'm in this situation and quite disturbed by it all.

[Mr Ian]

I understand your frustrations - I was in a similar position 3 years ago - and one prob 5-6 years before that about clinical judgment. It is not pleasant and management tend to target scapegoats with emotional venom rather than attempting to resolve the problem(s).

I'm a bit slow piecing things together - but I get the impression that the medication you made up was for pt A - but was given to pt B instead - or something?

And that the medication was recorded erroneously which you later went to amend when you realised/were told about the mistake?

Administering meds is like the 'chain of evidence' used in criminal law - there must be no room for 'mistakes' in handling or the evidence becomes tainted. In medication, it is similar because what is meant to happen is not always what does happen if the 'chain' is broken - as is so in this apparent case.

And have they identified in the 'violation' what exactly it is you are culpable for? It sounds as if they are making you responsible for the medication being made up - and then taken to the wrong patient and administered - based on the fact that if you hadn't made up the medication and left it in the room then it wouldn't have been wrongly administered.

If there is a policy about that - then I'm sure it equally effects the senior RN who took the unlabelled medication and instructed another RN to administer to pt B.

What is also important is what steps were taken after the error was identified to rectify or remedy the matter.

Have you retained any official representation yet on the matter? I would have hoped so and don't wish to impede their counsel.

My only advice would be to accept you are now in 'due process' and to focus only on the resolution of your predicament.

Once that's done - perhaps you can do as I did - I raised complaint against all 8 people maliciously involved in the process - which was trimmed down by the decision-maker to just one culpable person - and so I dropped the complaint, before sanctions were made against him, with a "higher moral ground" letter stating they were being as unjust and unfair to one person as they had been to me. But anyhow - that's for later.

Something to remember - the managers who have underwritten this complaint - still have managers above them (unless this is a one-off stand alone hospital and the administrator has determined/approved this course of action) - and their managers will not be impressed to see erronenous management tactics - especially if they come back and bite them in the preverbial. Don't regard the actions as being the 'whole' of management or your employer - they are simply one or two wanky bosses who think they can do this to people.

The BON - If they can be bothered to make a case of this - I believe they will identify your small part in the error and look for evidence that you recognise where you had a part to play; express regret and remorse and have sought to improve your practice.

The employers - who cares what they think. Don't resign. That's playing right into their game. Do start looking for another job to fill in with - there's no reason you can't be employed elsewhere on a casual level (PRN); if you're suspended on full-pay, do some voluntary work - and let the employer know you've got other employment so they can't stiff you on that one too.

Personally, once I'm in the clear, I'd stay with them - just to annoy them. :angryfire

(That's what I'm doing now - and have been for the last 3 years.... )

[aloevera]

I am still confused.....was the med you prepared given to the wrong pt???

if you did not tell the other nurse to do this, how are you to blame? Did you instruct her to give it? If not, then I don't see how it is your fault..

also, if you did not give that med to the pt, then you definately should not have signed it off...so what did the pt. get that that med was prepared for?

excuse me, I am slow tonight....(am just finished with my 5 day straignt)