Investigated?

[whatisgonnabemyname]

I am under investigation

So just received an email from my manager as she is investigating I need to enter my response. Pt complained I didn't give him pain medication. Well provider complained. I gave PRN oxy at 8pm. At 9 he took all the meds except for scheduled oxy and tylenol. I returned tylenol to pyxis. Never pulled out oxy bc I wanted to space it as much as I could and anticipated he would refuse. He refused thlenol and I mentioned scheduled extended release oxy but he refused that too. Pt told the resident he never refuses meds, and it was escalated. 

Quitting is not easy because they pay for my program. Also is by any remote chance my license threatened by this?

It really bothers me that whoever emailed my manager implies that I wasn't comfortable giving another oxy so close and therefore charted it as refused. This is an assumption (inaccurate) and that is not very professional. They should stick to the facts they have. 

This is the same manager who called me on my first day of in-class orientation. I answered the phone and she asked "what time did you get to orientation?” I said 0630 (orientation scheduled for 7am). She said well I got a call you were there at noon. My jaw dropped. I said don't know what to tell you, but I was the first person to show up here. So she kept insisting I was late. Turned out, there was a person with a similar first name, but her name starts with T and mine with S. Just proves she didn't verify last name before accusing me and then insisting I was late while I was claiming I wasn't. 

[JKL33]

You have a lot of extraneous information in your post. For instance, a mistake your manager made on your first day of orientation is irrelevant. Your manager is now simply investigating a complaint that was made to them, as is part of their role. They must do it.

Your reply to your manager should be as few words as possible in order to accurately explain your actions. Something like:

"The patient declined the medication as noted in the EMR."

If you are further asked why you never pulled the med say something like "did not want to have to remove and return controlled substance if the pt declined, so decided to ask patient before pulling med. Pt declined the med."

Out of curiosity, are these both long-acting and short-acting oxy that were involved here? Why would you worry about spacing out medication that the patient is allowed to have?

 

[whatisgonnabemyname]

JKL33 said:

You have a lot of extraneous information in your post. For instance, a mistake your manager made on your first day of orientation is irrelevant. Your manager is now simply investigating a complaint that was made to them, as is part of their role. They must do it.

Your reply to your manager should be as few words as possible in order to accurately explain your actions. Something like:

"The patient declined the medication as noted in the EMR."

If you are further asked why you never pulled the med say something like "did not want to have to remove and return controlled substance if the pt declined, so decided to ask patient before pulling med. Pt declined the med."

Out of curiosity, are these both long-acting and short-acting oxy that were involved here? Why would you worry about spacing out medication that the patient is allowed to have?

 

So, I got to work and during report pt complained of pain but said I don't like to take pain meds. I explained it is better to take it than chase the pain. He agreed and I pulled immediate release oxy at 0747. At 9pm, I pulled all the meds except oxy extended release. I also pilled typenol. I didn't pull oxy bc I wanted to confirm with the pr bc he was hesitant to take it in the first place. Also, even though it is scheduled, one hour is pretty close for a fragile, older patient. I wanted to talk to pharmacy or provider first. So, I go to give meds and he pushes tylenol away. I said "well I have another pain med coming oxy.” And he said no to that as well. So I returned tylenol and documented both as reefused. 

[JKL33]

"Pt was hesitant to take pain medications and only took the oxy IR after discussion of rationale for treating pain. He then declined both of his regularly scheduled pain medications when offered at 2100 as noted in the EMR."

[whatisgonnabemyname]

 

JKL33 said:

"Pt was hesitant to take pain medications and only took the oxy IR after discussion of rationale for treating pain. He then declined both of his regularly scheduled pain medications when offered at 2100 as noted in the EMR."

I did respond with something similar. I wish I gave myself some time to calm down before responding and not let my emotions overtake. So I added unnecessary details but overall, that is what I said.