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indefinite suspension because of med error

Geriatric   (8,044 Views | 32 Replies)
by bunbao bunbao, BSN (New) New

bunbao has 4 years experience as a BSN and specializes in CVA.

908 Profile Views; 9 Posts

Hi,

I'm not sure if this is the right place to post this, so I'm sorry if it's not and please move it to the right forum if possible for me, thank you.

I have a friend who is a new grad, been working at a skilled nursing facility for about 3 months. She was oriented and trained for only 4 days. Yes, it is bad that she took the job when the training was so short, but what had been done already been done :(. Her usual schedule is AM shift, but on the day that she made a mistake, she was on pm shift covering for someone else. So this was like her 1st time working on the PM shift, on a Saturday with no supervisor. She is an RN, but working on a med cart as a charge nurse. The nurse/patient ratio at this facility is 1:26 with 2 CNAs in the pm.

The shift got really busy right at the start with a new admission, and a hard stick resident whose IV for hydration came out (she's on g/j tube too). Then about 2 hours in, she got another admission. She was just overwhelmed overall.

This is when the event happened...She made a med error by giving a resident metformin when the resident blood sugar was at 75. The resident didn't eat his dinner, so later he was found unresponsive. His blood sugar was at 28 when they checked. Glucagon and 911 was called. The resident was transferred to the E.R. The next day, we called the hospital to check the resident's status. His blood sugar was up to 96, more alert and responsive, and will stay at the hospital for a few days for monitoring.

My friend is really devastated and knows that she made a huge mistake. She apologized to the family, the DON, and everyone else who's involved. She can't sleep, cry, and all that. The DON took my friend off the schedule and suspended her indefinitely (my friend also signed this form).

Well, now the questions are...

1. Would this status "indefinite suspension" going to hurt my friend's future employment?

2. Would it stay in her record if there is back ground check done?

3. What can she do now?

4. What does indefinite suspension mean? Does it mean that she is suspended until the facility decided on what to do with her?

5. What if my friend decided to not come back to work even if the facility takes her back?

6. How can she keep her status clean?

I'm sorry, my friend and I are both new to the world of nursing and would like to hear any advices. Please focus on what she can do now, instead of what she should have/have not done. Thank you all very much, we both really appreciate it.

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amoLucia specializes in LTC.

5,459 Posts; 46,603 Profile Views

Please be honest - is this about you or 'a friend'? Regardless ...

Personally, I think it's a rather harsh action to suspend the nurse unless there have been OTHER disciplinary occurrences. Or other episodes when questionable actions have occurred and the facility is pondering the nurse's future. If there is more to the story's background/history, it sounds if discharge is possible.

And your positing seems to lean toward that possibility or to one of voluntary resignation. Right now, her position is still up in the air and it's a 'wait & see' situation. Until a decision is made, one can only wait. Polish up the resume and begin looking out for employment opportunities out there if just to start the process until a decision is made.

Was something missed re a BS of 75 with the expectation that the pt will soon be eating his dinner? I don't see this as anything terrible, which is why I question is there more to the story. There's too many 'iffy's' outstanding here for me.

Hope all works out well.

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Nurse Leigh specializes in Telemetry.

1,149 Posts; 32,152 Profile Views

Perhaps she should have made sure that the patient ate something to help keep his BS from dropping further, but IIRC metformin is not normally held due to low BS. (Correct me if I am mistaken -it's been awhile since I dealt with this). . . I really hate these facilities and hospitals that give subpar training then when someone inevitably makes an error, goes overboard with disciplining the staff member instead of using it as an opportunity to educate the staff AND find out if there is a root cause (understaffing and too little training ) *sigh*

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bunbao has 4 years experience as a BSN and specializes in CVA.

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The dinner tray was on his table and he was alert when it was delivered. The medication then was given, but I guess he slept instead of eating it. When we found him unresponsive his tray was still full, untouched. He also did take a few bites of the snacks before dinner, but not much.

There have been no other disciplinary occurrences that I know of. The surveyor is coming soon and a mock survey has been done, so there has been a lot of strict rules being enforced at the facility. Could this be it? The facility was also recently bought by the current company (a few months back), so most of the upper management are new (administrator, DON, ADON, etc).

Is it too late to turn in a resignation letter (to avoid the indefinite suspension staying on record) when the indefinite suspension form already signed?

Edited by bunbao

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663 Posts; 9,606 Profile Views

Metformin does not drop blood sugar. It decreases absorption of carbohydrates. There must have been some other med or insulin the patient got? A blood sugar of 75 is normal. It's not really your fault he didn't eat if he was AOX3 but it probably would've been good for him to have a snack at HS anyway. Trust me, this is really minor compared to some things. I gave the wrong insulin to the wrong patient sending her to the ER and did not get suspension. We aren't perfect and will make mistakes. You really did do anything wrong to me. Maybe could have been more proactive, but stuff happens.

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5 Followers; 37,448 Posts; 100,583 Profile Views

With an indefinite suspension, I doubt the employer will be bringing her back to work. Best for her to submit a letter of resignation and start job hunting.

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63 Posts; 1,554 Profile Views

With a blood sugar of 75 some other intervention should most likely have been done. In most facilties that I am aware of a blood sugar less than 80 requires some kind of intervention and a follow up blood sugar check. Metformin is a long acting medication, yes it should be taken with food but does not affect blood sugar like insulins do. It is possible for episodes of hypoglycemia to occur which is what I would call this episode and proper interventions should have been attempted. Suspension is a bit harsh at this point especially if there are no protocols for what to do in the situation of a blood sugar of 75.

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OrganizedChaos has 10 years experience as a LVN and specializes in M/S, LTC, Corrections, PDN & drug rehab.

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You mean YOU, not 'a friend', right?

Was there insulin given? When you saw that his bs was so low you should've done something at that point.

But it sounds like you lost your job. Shake it off & apply for other jobs.

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1 Follower; 6,986 Posts; 32,927 Profile Views

You mean YOU, not 'a friend', right?

Was there insulin given? When you saw that his bs was so low you should've done something at that point.

But it sounds like you lost your job. Shake it off & apply for other jobs.

75 isn't low, and as prev stated metformin does not have this effect. something else was going on here.

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OrganizedChaos has 10 years experience as a LVN and specializes in M/S, LTC, Corrections, PDN & drug rehab.

1 Follower; 1 Article; 6,883 Posts; 64,978 Profile Views

75 isn't low, and as prev stated metformin does not have this effect. something else was going on here.

Did you read my post? That's why I asked if insulin was given to make the bs drop plus we don't know what normals are for him. I am aware metformin does not have that affect.

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663 Posts; 9,606 Profile Views

75 isn't low, and as prev stated metformin does not have this effect. something else was going on here.

Agree. At my hospital, below 70 requires intervention unless symptomatic under 8o. Definitely something else going on, that was my first thought too.

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LadyFree28 has 10 years experience as a BSN, RN and specializes in Pediatrics, Rehab, Trauma.

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With an indefinite suspension, I doubt the employer will be bringing her back to work. Best for her to submit a letter of resignation and start job hunting.

This.

At this point it is time to look for jobs and move on from the situation.

I am still puzzled as to why there was a penalty for using Metformin; although, because the pt didn't eat, the possibility of calling the physician to notify them that the pt didn't eat before giving and diabetic med is a policy, then I could see why a suspension was warranted, but this doesn't make a lot of sense. :no:

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