I had a patient who was prescribed IV dilaudid for pain and the parameters that the medication was not to be given if the systolic blood pressure was less than 110. I took her blood pressure three times and it was never above 95 systolic. However, I didn't chart the blood pressures and the patient complained to hospital customer service and I was fired because I could not prove my claims.
I know it was wrong not chart the vitals. However, I don't have a record of not charting on my patients. I also don't have a reputation for being mean to patients. I know that I did the responsible thing by taking her blood pressure and not giving her the medication. I think that people make mistakes and of all the mistakes you can make, I didn't hurt anyone.
It was not the first time I had been in trouble. I had lost a morphine sulfate tablet. I reported to the pharmacy and my unit manager. I was drug tested and the results came back negative. After that experience, I changed the way I passed my medications. It didn't matter because after that patient complained about me, I was fired.
I am not defending poor performance but can't you learn from your mistakes and do better next time? I mean apparently not.
What I am asking nurses who have experience is if on ONE OCCASION you did not chart vitals and you are a new nurse getting the feel of the floor. Should you be fired?
Do people really lose pills and what happens when you do? Is this really what happens?
I am not going to defend what I did. Or argue with you. No one is perfect.
Specializes in Acute Care Cardiac, Education, Prof Practice.
Tasha I am sorry for your situation. I do believe people can learn, and I think this is a great opportunity to rally yourself, look hard and long at the situation and see what you can improve on. Talk to people know you personally, professionally and advisory.
When it comes to that next interview you want to be well prepared to explain your previous situation, how you would have handled it differently and what you learned from the experience.
Tait
PS. And as a reminder to other members, let us please keep this thread on track.
Tasha, I'm not trying to argue with you. I think you might have a hard time proving your point about the charting, but chalk it up as a lesson learned. I hope everything works out for you.
Thank you OP for this thread, it is a good reminder (or eye opener) of what is out there. It would be nice if people were allowed to learn from their mistakes, but don't expect that in 99 out of 100 workplaces. We are all disposable. Your replacement on the job will be disposable also, should they be complained about.
I'm confused about you never charting the vitals. Even if you had basic vitals that you did with your assessment that should give you some back up for withholding the med. what is your floor's policy? Q4? Q8? Did you fill out the rest of your nursing assessment? I find it hard to believe that you never charted any vitals throughout a 8 or 12 hour shift/ never addressed pain level/ rationale for holding the Dialudid in your charting. And if you didn't do any of that, I think that's more than a "learning curve" mistake. Do you have a flow sheet/ computerized charting that would make the omission obvious to you?
Good luck in the future, hopefully you will be able to learn from this experience and move on.
They take vitals q 8h. Because this pt's bp had been low the night before, I took her blood pressure again and it was sys 95. I took the blood pressure three times because she wanted the pain med. It was not in the range. I would have given her the medicine if it had been safe do so. It wasn't. I also charted on some other problems with this patient. I had the patient for two nights and her blood pressure was not high enough to give the med. Her medication was higher in the day time and she would get it then. I took the pressure. She slept most of the night too.
If it was a rtc pain med. I would have had to chart on why I didn't give it. It was a prn. I charted my assessment. I took the women's blood pressure three times. She slept through most of the night.
Ah, ok. Makes a little more sense now, but then again, it's early for me here so my brain isn't working yet (just put munchkin on the bus). Really sorry about what happened- I know I've had days where my charting wasn't as complete as it should have been and I've held my breath for a few days. Again, good luck in the future! :heartbeat
Coffee Nurse, BSN, RN
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