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Hi there, I am hoping for a little insight. I don't have many LVN friends so I need to vent somewhere.

Let me preface this by saying that I know what I did was wrong, and it may sound as though I am making excuses but I am only explaining what happened. I can't say that I am a new nurse, because after I passed the boards in 2009, I worked at an outpatient clinic and a few months in home care. I am in California. I decided to be a stay at home mom for a couple of years before I was hired last month at an Assisted Living facility. I felt confident in my new job, it was almost like riding a bike. Last weekend, I worked on a floor I had only worked twice before. I was trained to pre-pour, because a lot of the medication needs to be given on time to 25 patients. I was told prepouring is not allowed but the nurses do it anyway. There are photos of the residents on the MAR, but many of them are outdated so they look different now. There are no other ways of identifying them, other than asking the veteran CNAs. I realize that once one gets to know the residents, there would not be any issues with identifying them. I wanted to give meds to three residents at a table where a CNA was feeding them, so I prepared them; labeled, crushed and mixed with applesauce. The way the facility refers to the residents is by their room number. I asked the CNA who was at the table, and I cannot tell where the miscommunication took place, somewhere between her telling me 120, 121A and 121B or 122 were at the table, I gave one of the another's medication. I was rushed, sweating, and stressed. The CNA looked down at the other meds and told me I gave the wrong med. My blood pressure dropped. She was right. I took her vitals soon after, and remained at her baseline for the next 4 hours until bedtime. I called the other two nurses who were working, and they both asked if anyone saw me. Otherwise, I should not say a word. I told them who saw me, and they said I would have to call the DON because if I didn't, that particular person is not trusted and would probably say something; in turn, making me look bad which could result in my termination. I did get a call back, got the lecture of my life about the rules of med administration, etc, etc. He did not tell me to do anything, but did tell another nurse to fill out a variance report, and call the resident's doctor and family. I finished my shift, and was called the day I was supposed to go back in and was told I was suspended until further notice. Three days later, I go in to speak with the DON and the executive director "to discuss the incident" but was terminated instead. The resident was fine, she was accidentally given Depakote instead of Gabapentin but had no adverse effects. They must have told me about five times how much my honesty was appreciated, but they had to do what they had to do. They actually looked quite sad; I envisioned our meeting being different. I was ready to defend myself. I told them they needed to update the resident's photos, and I hoped that the nurses would come forward when they make a mistake without fear of retribution. I was given my last check, and signed a form. That was that.

My question is, is this normal protocol for Assisted Living? I thought I would get counceling, maybe a longer suspension but was not expecting to be fired. Of course I would not use them as a reference for future jobs, but is it mandatory for them to report this to the board of nursing? Worried about my license. Anyone know what will or might happen? Wondering if there is anything I should do on my end...thanks for reading.

Lilmglvn, I don't believe the board gets envolved. They may have let you go because of a family member. May a daughter/son, etc, threatened to move the resident to a different facility if you weren't let go. Money talks, and unfortunately, nurses are a dime a dozen. They may have really like you, but they like the resident's money more. I wouldn't worry about it. Everyone makes mistakes, and if they say they haven't they are lying or don't realize they made the mistake. Learn from it! If you plan in staying at those type of facilities, let the mediates give the meds. I know you want to learn and help, but that's their job. Don't be to hard on yourself either. Working in LTC, is hard! You have a lot of people and responsibilities to handle. You did the right thing. They should have written you up, typically you get three chances, and educated you, and you could have given examples of how to make it better which it sounds like you were prepared to do. Also, you should be able to use them as a reference. Give a name of a supervisor who really liked you and they can't say what you did, all they can say is you worked from this date to this date. I believe legally they can't give out the error that you made. Hope that helps.

Thank you so much.

I am an attorney and rn in Ohio.... what you did would not constitute a violation of the nurse practice act because you revognized the error and followed up with vs and admitting error to the employer. As for the pt and their family they have no cause of action to sure because no harm resulted. As for using them as a reference do not do so. If a reference only gives dates and does not provide positive feedback it is implied you were terminated therefore causing more harm then good. Also they can say negative things! This just opens them up to a defamation suit from you...and truth is always a defense and you signed a paper most likely admitting to the error therefore giving them proof. Bottom line...license is pretty safe and dont put them on your resume.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Hi there, I am hoping for a little insight. I don't have many LVN friends so I need to vent somewhere.

Let me preface this by saying that I know what I did was wrong, and it may sound as though I am making excuses but I am only explaining what happened. I can't say that I am a new nurse, because after I passed the boards in 2009, I worked at an outpatient clinic and a few months in home care. I am in California. I decided to be a stay at home mom for a couple of years before I was hired last month at an Assisted Living facility. I felt confident in my new job, it was almost like riding a bike. Last weekend, I worked on a floor I had only worked twice before. I was trained to pre-pour, because a lot of the medication needs to be given on time to 25 patients. I was told prepouring is not allowed but the nurses do it anyway. There are photos of the residents on the MAR, but many of them are outdated so they look different now. There are no other ways of identifying them, other than asking the veteran CNAs. I realize that once one gets to know the residents, there would not be any issues with identifying them. I wanted to give meds to three residents at a table where a CNA was feeding them, so I prepared them; labeled, crushed and mixed with applesauce. The way the facility refers to the residents is by their room number. I asked the CNA who was at the table, and I cannot tell where the miscommunication took place, somewhere between her telling me 120, 121A and 121B or 122 were at the table, I gave one of the another's medication. I was rushed, sweating, and stressed. The CNA looked down at the other meds and told me I gave the wrong med. My blood pressure dropped. She was right. I took her vitals soon after, and remained at her baseline for the next 4 hours until bedtime. I called the other two nurses who were working, and they both asked if anyone saw me. Otherwise, I should not say a word. I told them who saw me, and they said I would have to call the DON because if I didn't, that particular person is not trusted and would probably say something; in turn, making me look bad which could result in my termination. I did get a call back, got the lecture of my life about the rules of med administration, etc, etc. He did not tell me to do anything, but did tell another nurse to fill out a variance report, and call the resident's doctor and family. I finished my shift, and was called the day I was supposed to go back in and was told I was suspended until further notice. Three days later, I go in to speak with the DON and the executive director "to discuss the incident" but was terminated instead. The resident was fine, she was accidentally given Depakote instead of Gabapentin but had no adverse effects. They must have told me about five times how much my honesty was appreciated, but they had to do what they had to do. They actually looked quite sad; I envisioned our meeting being different. I was ready to defend myself. I told them they needed to update the resident's photos, and I hoped that the nurses would come forward when they make a mistake without fear of retribution. I was given my last check, and signed a form. That was that.

My question is, is this normal protocol for Assisted Living? I thought I would get counceling, maybe a longer suspension but was not expecting to be fired. Of course I would not use them as a reference for future jobs, but is it mandatory for them to report this to the board of nursing? Worried about my license. Anyone know what will or might happen? Wondering if there is anything I should do on my end...thanks for reading.

Paragraphs, please. It's very easy -- just hit the "RETURN" key twice.

Pre-pouring is a bad idea. I've never worked in Assisted Living, but I can say that I never saw a nurse pre-pour the meds given to my mother, who lived in one. Decades ago, when I was a brand new nurse and we pre-poured, it was still a bad idea. But we labelled the little cups with the patient's name. I'm wondering if you did that.

You've made a medication error, then rather than immediately own up to it and attempt to mitigate potential harm to the patient, you consulted with two other nurses who advised you to try to cover it up. In fact, it seems that the only reason you ever admitted the mistake was that this particular CNA witnessed it and would have turned you in. That shows such a basic lack of integrity that I'm flabbergasted! A nurse who would even consider attempting to cover up a medication error like that isn't a nurse I'd trust to work with me, nor would I want to be in her care. Everyone makes mistakes. But covering them up is not the next step.

If I were your manager, I would have terminated you for not immediately admitting and reporting your mistake, calling the doctor and seeing to it that potential harm to the patient was minimized.

Ready to defend yourself? Otherwise known as being defensive . . .

The correct stance to take would have been, "I've made a terrible error and I'm so sorry. I'm so worried about what might have happened to my patient. I know how serious it could have been and I'm so happy that she's fine now. Believe me, this will NEVER happen again. In the future, I will not pre-pour medications and I will make CERTAIN that I follow the five rights." There really IS no defense for giving meds to the wrong patient. Your telling them they needed to update the photos sounds defensive, which sounds like an attitude problem. That, together with your med error and your lack of integrity probably made them think you were too much of a risk to keep on board.

Here's a link to what you should have done:

https://allnurses.com/general-nursing-discussion/what-to-do-531457.html

Specializes in HH, Peds, Rehab, Clinical.

Paragraphs!!! Please, for the love of all that's Holy, use some paragraphs!!!

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