In Trouble With The Bon!!! Please Advise Me...

78BugRN · Mar 2, 2005

I'm hoping for you that they handle this internally. If they reassign you and send you to some classes, it will also remove you from the other problems in this unit (the competitiveness, overwhelming situation, finicky MD's, etc). I'm surprised that you didn't apply for transfer when you realized you were in over your head. Talk to a lawyer but give some serious thought to what you really want out of this.

Claver · Mar 3, 2005

Many years ago as a stressed out staff nurse on a medical unit I gave a patient a triple dose of NPH insulin - for his evening medication. I had misread the order. Lucky for me the MD was right on the unit so when I told him what had happened he gave glucose via the IV and we checked the blood sugars until they were within normal range. I was very disturb by it all - so I can imagine what you are going through. Both of my daughters are lawyers- and they have advised that you consult a lawyer IMMEDIATELY- a few of the other posters have recommended this. Next, just try to calm yourself - review what has happened in your mind and try to develop a plan on how you could avoid making these mistakes again. You need to get away from ICU - if you feel overwhelmed it is not good for your emotional or physical health - and there are other areas that are just as satisfying- finally, if you are a praying person just pray to God for strength to get through this period. Good luck.

I'm hoping for you that they handle this internally. If they reassign you and send you to some classes, it will also remove you from the other problems in this unit (the competitiveness, overwhelming situation, finicky MD's, etc). I'm surprised that you didn't apply for transfer when you realized you were in over your head. Talk to a lawyer but give some serious thought to what you really want out of this.

allnurses Guide · Mar 3, 2005

Wow... that's all I can say.

I disagree with the poster who advised you not to leave your job voluntarily. I'd definately leave it if I were you. You've made WAY too many med errors, dangerous errors; you are, as you said, definately way in over your head. Is there an area of nursing that you may like better, that may be a bit slower paced, less stressful?

Actually, yes, before you leave the hospital that you are working at, I would make sure that the situation has been resolved. Hopefully the matter can be resolved internally, and then once you've "done your time" (served a suspension or whatever), perhaps you yourself can suggest a reassignment. Work in a different area of the hospital, try to redeem yourself, before you try to move on to a different facility.

sleepless in norman · Mar 3, 2005

First off, these folks are not going to believe you are not diverting, now you are a liability, they have proof of a norcotic discrepancy, the reason for not drug screening you?, they have proof enough, if you came up engative it would hurt their case, your having a urine drug screen on your own accord proves nothing, if you are addicted admit it and go on, their will be more legal ramifications if you fight them and lose, if not, find another employer and conatct an attorney in healthlaw, preferably one who is also an RN, make sure you maintain a current mailing address with your BON, should they report you. But long before you accept the advice of anyone, contact a Heatlhlaw Attorney. Good Luck.

LadyBugLass · May 10, 2005

Sorry, I have not checked back with site in nearly 3 months! For some reason, about half the original post is missing. :rolleyes: But the bulk of the issue is what everyone read!

Update: I did quit voluntarily. And I felt like about a thousand tons was lifted off of my soul. My boss was very nice, but told me that she was still filling out papers for the BON. So okay. That was on March 1.

I called the BON myself and spoke to an investigator. She told me to "turn myself in" ! I was also told to get an independent evaluation from a counselor in addiction issues. I didn't have anything to hide, so I did that right away.

I had to take an MMPI and about 10 other tests (took nearly 4 hours to complete them all.) Then I met with a counselor for about 2 hours. She was really wonderful! She figured about 10 minutes into the process that I was NOT an addict/alcoholic. But we did discuss other problems, like stress management and depression. All said it cost me about $250, but it was not wasted time or money. My written tests were interpreted by a third party. It showed a "low level of deception and a high level of validity", "a very low possibilty of addiction issues", and "a very high level of anger" (angry at myself? YOU BET!:chuckle ) The recommendation, IF requested by the BON, was for education in documentation.

Here's the deal...I STILL have not heard anything from the BON!! I did NOT turn myself in; I have nothing to hide, but I don't want to give anyone the rope to hang me with. Right now, I am doing PRN home health case management, and have not had one problem.

Opinions, anyone? Did my old boss really turn in those forms? Does it take the BON awhile to do things? What? I am starting to get more comfortable looking in the mailbox. I had been told that I would hear from them in "a couple of weeks" and it has been nearly 3 months. What to make of this?

By the way, I did tell my boss when I quit that I had a negative drug screen. I also had been doing some things with narcotics (using a 10mg syringe of morphine, 2mg at a time, over a 12 hour shift) that ALL of the staff did (that is where I "learned" how to do this). Do you think that maybe she decided not to start an investigation that would reflect poorly on the whole unit? This was a floor that was VERY big into looking good.

**SKM-NURSIEPOOH, BSN, RN** · May 11, 2005

well for one thing, i'm glad you were able to resign your post voluntarily, reducing any further negative *attention* onto yourself & possibly others.

that being said...you've mention several things that raised red flags for me though. one being the bon recognizes is your sloppy (at best...divertive at worse) documentation technique/problem before you did! the other thing is the amount of errors made that you *remembered* enough to post here. my only fear is that there were many more. luckily for you...those didn't have immediate/adverse reactions. however...i was concerned with the way in which you seemed to blow-off your *mistakes* simply because "no harm" was done. i also know how catty many nsgs are with each other....let alone with new to practice nsgs. i also understand how one can get caught-up in the nuances of each medical/surgical service preferences. however....no matter how others behaved or tried to bully you...you're ultimately responsible for the care of your patients & that absolutely means being diligent over medication administration, proper handling/disposing of narcs, & proper documentation! those things are basic in nursing...period. how did you manage to get through nsg school if you didn't master that? why would you take-on (more importantly...keep) such an intense position when you *knew* you were in over your head? and yet you'd stayed :angryfire!!!! that's what sooooo troubling for me :uhoh21:!!!

what could've happened to you to either make your ego so huge or deflated that you weren't strong enough to go to your nsg educator for refreshers in medication errors/documentation. why didn't *you* approach your nm instead of letting things go as long as they did? didn't you think that *someone* was looking at those slips of papers & that a record was being kept somewhere? these things indicate an unsafe practioner in any clinical area...not just critical care!!! the mistakes you've described here could've very easily have been committed on a med/surg unit....make no mistakes about that!!! if someone was either injured or worse, died from your negligence....you bet your bottom dollar that not only would the hospital been sued...but you would be held accountable too. criminal as well as civil charges could've been placed & you wouldn't have had a leg to stand on because in the court of law...nurse experts would testify what a prudent nsg should/would & shouldn't/wouldn't know within their scope of practice...even if said nsg is a novice one!!! if i'm sounding a bit strong or harsh...its only because i *do* care & *am* concern for you!!!

now...i'm not holding you totally responsible for what happened on your unit in terms of how you were taught to sign out 10mg of morphine to use 2mg at a time & save the rest until it's gone (or *other* bad habits). whoever taught you this should be held accountable for that & if this is how your colleagues practice signing out narcs...then it's definitely a system wide error that must be addressed!

that said....i still sense a lack of responsibility on your part...especially where the bon is concerned. please correct me if i'm wrong but...if the bon told you to *turn yourself in* & you've not done so as of yet....why not? especially if you have nothing to hide!!! you've gone out of your way to take drug screenings without hesitation and gone through a battery of tests which seem to prove that you don't have an abusive or co-dependency habit with drugs/etoh. however...i'll be the devil advocate here because i don't quite understand what the bon means by *turn yourself in*...unless they're saying for you to voluntarily surrender your license. now if that's the case...then absolutely not!!! did you seek legal counsel yet? and if not...why not?

quitting this job removes you from the road of more/potential med errors & was the right thing to do for not only yourself...but for that of the patient's & your other colleagues. however...i'm still concerned it took your nm to approach you regarding this problem. you mustn't make the mistake of thinking that this matter is going to *go away* just because you've left & haven't heard anything from the bon. trust me when i tell you...if your nm told you this was going to be reported to the bon...it was!!! she has to cover the hospital for state/jcaho investigations. sooooo...if you value your license & nsg career...then take the time, money, & effort to seek legal help! but you must first take full responsibility & recognition for your actions resulting in your current position (all the personality bs crap on the unit aside). you didn't properly go through the five rights of medication administration...you didn't properly/effectively document what you've given(& my bet is that you've not done so with *other* meds/procedures as well...not just with narcs)...& that you could've injured or killed someone over it!!!

i implore that you digest all of this....then you'll be able to go on from there.

good luck to you & do pray ~

regards,

moe

TCASII, ADN · May 11, 2005

As a pre-nursing student only, yet having plenty of hosptial experience, what do you mean they told you to turn yourself in? To who? Confused as to what that means since you already spoke to the BON?

Your errors were very careless and common sense would have told most people to get help or transfer, but never stay in an environment where the pace and chaos is too much for a new grad. Surprised you didn't.

Reserving my comments on the addiction counseling.........

lil'nurse · May 11, 2005

One of my co-workers (RN) got a letter a few weeks ago about an incident that happened over 3 YEARS!!! ago. She was an LPN at the time working in LTC. The BON is investigating her documentation. I don't think I would consider myself in the clear just yet.

SmilingBluEyes · May 11, 2005

I wish you the best and I am sorry it all came to this. Harsh lessons to learn for any nurse.

Moe covered it all very well, so I have nothing smart or helpful to add. Good luck to you.

CHATSDALE · May 11, 2005

maybe you need to step back and reevaluate yourself..some professions you just cannot get into sloppy work habits..no one was hurt*THIS TIME* but unless you learn to work with precise rules in mind someone definitely will

a] i think that this is possibly the wrong type of floor for you...some people work more efficiently when they are not pushed the max

b] if you get out of this with your skin & license intact. sit down with yourself and decide that working anywhere is not deciding who y ou can shave off the needed work to make someone else think you are doing y our job...nurses must work independently and while the head nurse may need to checkup from time to time bassically you need to be trusted to do your job

c] t here are many jobs in which your nursing training would be invalable ie working in a attorney's office as forensic nurse advisor, school nurse etc

i certainly don't want the rest of your life tainted by this bad choices can erase all the work you put into your schooling

good luck

GrnHonu99, RN · May 11, 2005

Hi!

Im just a nursing student so I cant offer much advice but to say good luck!! I have one question though, do all errors get reported to the BON? Im so scared that I will accidently give the wrong medication and hurt someone...did anyone else feel like this in nursing school? What do you do on a daily basis to be aware/avoid this problem?

krob0729 · May 11, 2005

Hi!
Im just a nursing student so I cant offer much advice but to say good luck!! I have one question though, do all errors get reported to the BON? Im so scared that I will accidently give the wrong medication and hurt someone...did anyone else feel like this in nursing school? What do you do on a daily basis to be aware/avoid this problem?

as a new grad, i can tell you that you MUST ALWAYS remember the 5 rights to med admin. read the order, look at the dose, reread the order, recheck the med, re-read the order and re-recheck. if you still have questions...ASK FOR HELP!!!!! the only stupid questions are the ones not asked. Yes, med errors happen in school, but not if you check and recheck yourself, and ask your instructors for help. Never think you know what you're doing. Always know that there is that possiblity of something going wrong. I have my 5 rights taped to the front of my med book and i carry my med book everywhere with me when handing out meds. I probably always will. Too scared not to. My instructor taught me to never get 'comfortable' with my job. That that is when most mistakes happen. Hope this advice helps. Good luck in school. And by the way, you're not 'just a nursing student'. you're a nursing student and you are just as important as a licensed nurse. Students give care and help the injured and ill also. :)