Med error,I'm suspended,I need advice,please!

barefootlady, ADN, RN · Aug 27, 2005

I am so sorry this incident happened and has caused so much distress to you. You were right to accept the responsibility for your part in this mistake. The RN has, no doubt, accepted her error as well. I hope the end results are fair, equitable to you both, and that a warning is given to this LTC facility. NO more having the RN supervisor handle meds, patients, and cover the building. Good luck and keep us posted on the final results. Please, reconsider leaving nursing, this episode will make you a far safer nurse and a more caring one too. In todays facilities of any type, those are the kinds of nurses we need. You are in my prayers.

barefootlady, ADN, RN · Aug 27, 2005

I am just wondering, have you attempted to apply for employment benefits? I do not know if you are eligible to receive them but I would find out. Why you ask? It just seems to me as if this facility and its administration is trying to put their lack of staffing, poor safety practices, and probably lack of following state guide lines on the RN's and your shoulders. If benefits are called for and they protest, it is just another way to draw attention to the facility and its lack of following safe nursing practice. Has anyone reported the poor staffing practices to the state? It will probably get a lot dirtier before this case is ended. I hope the union backs you in everyway it can.

jalo123 · Aug 27, 2005

gosh, we are all human...i'd say the only problem u had was that u didnt document your attempts to answer the reason why the narc count was off.....My facility has a "no blame med error reporting form." No one on the form is identified as far as the name goes... we've all made mistakes,,,the important thing is to learn from them,,,and go on, and make for sure it's reported to the MD..

HuggyPuglet · Aug 27, 2005

A mistake was made by both nurses & unfortunately you were the only one held accountable. Your management did not handle the situation fairly or professionally at all, not to mention the idiot security guard & his big mouth. We all make errors, I know I have, but you learn from them & move on. It sounds like you learned from this so now it's time for you to move on...to another facility. Good luck!

I agree! I have a question, although maybe I missed it in skimming over the postings on this. Seems there were alot of unusual circumstances in this whole thing. Did the other nurse step up to her part of the responsibility in all this?

I hope everything works out for you.

BETSRN · Aug 27, 2005

Here's a little rundown of what happen.40 bed unit,we were short a nurse so the RN that was covering the house had to take one cart.9pm at nite she was called to another floor for an incident that had taken place.I was at the station trying to catch up on a pile of charting and numerous other things.ONe of her pts. foleys came out and she asked me to look for one,I did that and when I came back she had poured pills for a pt but couldn't give them because he was in the shower.She left them on top of the cart and asked me to give a pain pill to another one of her pts.She left for the other floor,I went to give the pt the narcotic and notice that the count was 5 off.I didn't give him anything until I could find out why the count was off.The gentlemen then finished his shower and was asking for his pills that were prepoured by the RN.I called the RN and asked if she wanted me to give them to him,she said yes and I did(BIG MISTAKE)So happens when she came back and I told her about the narc not being right,she said,Oh my God I put five Oxycodone instead of 5 phenobarbs in the cup.I immediately sprang into action,Assessed the pt.called the DR.CAlled 9ll.Looked for narcan in the crash cart.The pt at this point was fine.He left the building in 10 minutes and was admitted for observation.He returned the next day with no harm done.I was treated like an absolute criminal,I was not allowed to enter the front doors without being escorted and was told by the security(very loudly,not to cross the line.I am sick.

The #1 rule you learn (or you should have learned) in nursing school is that you never give meds prepared by another nurse no matter what . The fact that the other nurse pulled out 5 narcs instead of something else is just as bad. Glad nothing happened. Just let this be a hard lesson!!

Mama2-3 · Aug 28, 2005

I am so sorry this incident happened and has caused so much distress to you. You were right to accept the responsibility for your part in this mistake. The RN has, no doubt, accepted her error as well. I hope the end results are fair, equitable to you both, and that a warning is given to this LTC facility. NO more having the RN supervisor handle meds, patients, and cover the building. Good luck and keep us posted on the final results. Please, reconsider leaving nursing, this episode will make you a far safer nurse and a more caring one too. In todays facilities of any type, those are the kinds of nurses we need. You are in my prayers.

I just wanted to thank each and one of you wonderful nurses for your support as I go thru this mess.The RN that was involved in this with me has told me that they are reporting her to the state board of nrsg.If she is being reported,so am I.Oh well,I told the truth,pt. is fine,that's all that matters right now.The facility will let me know on Monday.I will keep in touch and keep praying."IT is better to be punished for doing right,than to be punished for doing wrong."take care and God Bless. :

DutchgirlRN, ASN, RN · Aug 28, 2005

Nursing 101.....NEVER EVER administer a med to a patient that you yourself have not pulled! With that said.....I agree, find another job. The management is obviously over reacting. Good Luck.

ClaireMacl · Aug 29, 2005

Hi,

I'm sorry for what happened to you, it sounds like the treatment for trusting another nurse is totally uncalled for. Sure, as everyone has said, never administer something you've not seen dispensed or drawn up by someone else, but still!

I said this on another thread somewhere, but a few weeks ago, one of our newly qualified nurses was supposed to be administering 75mg of morphine IM to a Sickle Cell patient (yes, they do get that much here!!!), she not only walked into the wrong room, but also didn't check patient details etc before administration and gave the drug to the wrong patient. Ironically, despite the clear consequences of such a lethal dose of morphine, the patient suffered no ill side effects and even had the audacity to say an hour later that he was still in pain! That nurse was not sent off duty, not disciplined, nothing, jus reprimanded. Ironically, she is going on the IV drug admin course next week - needless to say, anything she asks me to countersign, I'll be going with her to the patient to check that I'm not going to be held liable if she makes another mistake!!!

I made a mistake as a newly qualified RN a few years back, I was to give insulin to a patient, on that ward, we were to double check all IM's and IV's, so I checked with a very senior nurse. I don't think she paid attention and signed anyhow. I realised as I walked away from the patient that I had picked up actrapid instead of insulin. I immediately informed the nurse in charge, monitored the patient, called the doctor and for me... I had four months of intensive monitoring of my every move. The DON actually had weekly meetings with me, on every shift I had to have the NIC sign off on how I performed. I felt so demoralised, so trust me, I know how you feel! I had told the nurses when I started that ward that I had little drug admin experience and needed supervision (recognising limitations - a good thing I thought), but they took no heed and I ended up suffering for it. Of course, after the four months, the DON said she didn't understand what the problem was in the first place and I was clearly a safe nurse, but every shift, I had the humiliating experience of asking the NIC if they would comment on my performance. I left that ward and never looked back!!!!!!

I hope you don't leave nursing! I think your clarity on the situation shows what a good nurse you are. Ok, so administering other peoples drugs is a no no, but we all trust too much from time to time. I hope you reconcider, though I agree leaving the trust you are at is probably a good idea.... but, if they put something on your permanent record, it may be advisable to work the time off till that warning comes off, otherwise other hospitals may be wary since you have to declare all incidents and warnings on interview.

Best of luck and sorry you've had such a bad time.

Claire xxx

kevagonia · Aug 29, 2005

You don't want to work there anyway. Get this situation taken care of, and then move on. These people will not be supportive-especially if you have another med error in the near future.

This is amateur night. Get it cleared up and move on.

Daytonite, BSN, RN · Aug 29, 2005

It really irks me that so many of you jump forward to justify a serious mistake made with narcotics. I feel badly for this nurse as well and I'm glad there was no harm to the patient, but there could have been. We are all taught to only give medications that we, ourself, prepared. We were also taught that once we have a medication out of it's container not to let it out of our sight.

If some of you are doing the same things as the original poster of this thread, you need to re-think and correct the way you practice and handle medications. With the advent of DRGs, MDSs, and APCs the Center for Medicare and Medicaid Services is compiling a lot of data about the effects of drugs on the elderly. There is a group currently compiling and studing the trends of medication errors in healthcare settings. Medication administration is not something to take casually. It is so easy to do that, however, when a good deal of your work shift involves medication administration. Adverse drug reactions, whether from taking or receiving a right or wrong medication account for a good chunk of the money Medicare and Medicaid pay out to healthcare providers. They have the data to back up this claim. Medicare is going to continue looking at this data and researchers are going to attempt to find ways to prevent medication errors from being made. That will mean more rules for all of us to follow. That's the way Medicare has been leading the changes in the way healthcare is practiced in this country for some years now. With all this computer data they have compiled and because they are footing a big part of the bill, they have clout to back up their claims.

Do what you were taught in school. Follow the 5 R's, right patient, right drug, right dose, right route and right time. There is a 6th R, right attitude. Check and double check labels on bottles and never, never give a medication you didn't yourself take out of a labeled package or container and didn't keep within your sight. Don't forget to stand by and watch as each patient takes their medications. If you make an error and it gets reported to a disciplinary board, they will accept no excuses from you for not following these very simple rules.

Mama2-3 was very courageous to share her experience with us all.

dorrybnursing · Aug 29, 2005

I don't think anyone was trying to justify mama2-3's mistake, we all know that giving meds we did not draw up is an absolute no-no. We were commenting on the fact that the punishment did not seem to fit the situation.

It really irks me that so many of you jump forward to justify a serious mistake made with narcotics. I feel badly for this nurse as well and I'm glad there was no harm to the patient, but there could have been. We are all taught to only give medications that we, ourself, prepared. We were also taught that once we have a medication out of it's container not to let it out of our sight.

Ms.RN · Aug 29, 2005

do what you were taught in school. follow the 5 r's, right patient, right drug, right dose, right route and right time. there is a 6th r, right attitude.

right attitude? :eek: or did you mean right to refuse? :roll